September is National Cholesterol Education Month, with World Heart Day on September 29. It’s a perfect time to think about heart health and revisit how cholesterol plays a critical role.

Even if you do not have high cholesterol (hyperlipidemia), everyone must lead a heart-healthy lifestyle!

Cholesterol: Broken Down

• HDL (High-Density Lipoprotein)- Also known as ‘good’ cholesterol, HDL absorbs cholesterol in the blood and carries it to the liver to be flushed out of the body. High levels of HDL can lower your risk of heart disease and stroke.
• LDL (Low-Density Lipoprotein)- Also known as ‘bad’ cholesterol, LDL makes up most of your body’s cholesterol. However, high levels of LDL can result in a fatty build-up (plaque) that raises your risk of heart disease and stroke.
• Triglycerides – Triglycerides are the most common fat in your body, storing excess energy from your diet. High triglyceride levels, in combination with high LDL and/or low HDL levels, can result in heart disease and stroke.

Cholesterol Tests: Everyone gets them!

A cholesterol screening is a simple blood test. Prior to the test, you may be asked to fast (not eat or drink) 8 to 12 hours beforehand. However, always check with your doctor for their recommendations.

• Most healthy adults should get their cholesterol checked every 4 to 6 years.
  • However, those with heart disease, diabetes, or a family history of high cholesterol may need to get their cholesterol checked more frequently (~once a year).
• Children and adolescents should get their cholesterol checked once between the ages of 9 to 11 and once again between the ages of 17 to 21.
  • However, children with obesity or diabetes may need to get their cholesterol checked more frequently (~once a year).

Your Next Steps

Checking in with your doctor annually ensures you get the care you need! But here are some things you can do to protect your heart health.

Leading a heart-healthy lifestyle involves:

• knowing your risk,
• making healthy choices
• taking steps to reduce your risk for heart disease

Take some time this month to try these preventative measures which can ultimately help your overall health and well-being.

References:

AHA (2020). HDL (Good), LDL (Bad) Cholesterol and Triglycerides. American Heart Association. https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides

CDC (2023). LDL and HDL Cholesterol and Triglycerides. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. https://www.cdc.gov/cholesterol/ldl_hdl.htm

CDC (2023). Get a Cholesterol Test. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. https://www.cdc.gov/cholesterol/cholesterol_screening.htm

Images:

1. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/the-ten-ways-to-improve-your-heart-health

In the upcoming weeks, Narcan (naloxone 4 mg) nasal spray will hit the shelves of many grocery stores, pharmacies, and gas stations for purchase directly over-the-counter without needing a prescription.

To help you understand this rescue drug better, we’ve compiled some frequently asked questions and their answers.

What is Narcan? Is it different from naloxone?

Narcan is a brand name for a nasal spray that contains naloxone as its active ingredient. It is a lifesaving medication used to reverse the effects of an opioid overdose. It is an opioid antagonist, which means it binds to the same receptors opioids bind to in the brain, blocking the opioids and reversing their effects. It can rapidly restore consciousness in someone who has overdosed on an opioid.

Currently, Narcan is the only version of the naloxone nasal spray that is over-the-counter. However, the Food and Drug Administration (FDA) has recently approved a second over-the-counter naloxone nasal spray called ReVive. People can expect this alternative to be more broadly available at a lower cost in 2024.

Why should I carry Narcan?

Opioid overdoses can happen anywhere, anytime, and to anyone. Keeping Narcan in your emergency kit or carrying it on the go can save lives. 

Can Narcan be used for all types of opioids?

Yes! Narcan is effective for reversing prescription painkillers prescribed for chronic pain, injuries, and surgeries, as well as opioids commonly found in illicit or street drug use.

Common opioids include:

• morphine
• codeine
• OxyContin (oxycodone)
• Vicodin (hydrocodone)
• tramadol
• buprenorphine
• heroin
• fentanyl

Who can be given Narcan?

Narcan is safe to be administered to anyone of all ages, from infants to teens to older adults. This can be especially useful for children and teens who unintentionally ingest a prescription opioid.

What are the signs and symptoms of an overdose?

Here are the signs and symptoms to look out for: 

Act fast! If someone displays symptoms or you suspect an overdose, use Narcan.

How do I use Narcan? What do I do after?

If you suspect an overdose, act quickly. Look for signs like difficulty breathing or unresponsiveness. If the person does not respond to gentle shaking, follow the steps: LAY – SPRAY – STAY.

You cannot overdose on Narcan, so it is safe to continue administering new doses every 2-3 minutes until emergency services arrive.

Can I give myself Narcan?

You cannot administer Narcan to yourself. This is why your friends and family must know that you carry Narcan, where you store it, and how to use it.

Can I use Narcan if I’m unsure someone is experiencing an overdose?

Narcan has no effect if opioids are absent in a person’s body. If it is given to someone who is not overdosing on an opioid, it will not harm them.

Are there any side effects or risks associated with Narcan?

After using Narcan, some people may experience side effects such as shaking, sweating, nausea, or irritability. This is commonly referred to as acute withdrawal syndrome.

Where can I buy Narcan?

The current retail price of Narcan is approximately $44.99. The manufacturer of Narcan currently has a search tool to find Narcan online or at a store near you: https://narcan.com/buy 

Can I get Narcan for free or at a reduced cost?

NaloxoneOhio is an initiative to provide Ohioans with a database of providers and sites that offer free Narcan. Access that here: https://naloxone.ohio.gov/get-naloxone/individual

For More Information, Visit:

CDC. (2020). Save a Life from Prescription Opioid Overdose. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. https://www.cdc.gov/rxawareness/prevent/index.html

References:

Bennett, A. S., Freeman, R., Des Jarlais, D. C., & Aronson, I. D. (2020). Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study. JMIR formative research, 4(12), e22411.https://doi.org/10.2196/22411

Carpenter, J., Murray, B. P., Atti, S., Moran, T. P., Yancey, A., & Morgan, B. (2020). Naloxone Dosing After Opioid Overdose in the Era of Illicitly Manufactured Fentanyl. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 16(1), 41–48. https://doi.org/10.1007/s13181-019-00735-w

Images:

1. https://narcan.com/
2. https://narcan.com/opioid-education
3. https://narcan.com/resources

This month, we are joined at Plain City Druggist by Jadelyn Cheng a fourth-year pharmacy student from The Ohio State University’s College of Pharmacy.

Jadelyn will graduate in May 2024 with her PharmD degree and will then take the test to become a registered pharmacist. Jadelyn will be with Tayler and the gang here in Plain City throughout September, so please stop by and meet her while she is here.

Here is what Jadelyn tells us about herself:

Hello there! I’m Jadelyn Cheng, and I’m thrilled to be joining Plain City Druggist this month. I’m currently a fourth-year student pharmacist at The Ohio State University’s College of Pharmacy, where I have served as class president for all four years.

Math and science have always been my forte. I attended a STEM high school and a bioscience technologies program, honing my skills in engineering and research. Initially, I had aspirations of pursuing drug discovery and development. However, I soon realized that my passion for medications was more patient-centered and decided early on in high school to pursue pharmacy school instead.

I completed my BS in Pharmaceutical Sciences from Ohio State in 2020 and started pharmacy school that same year. I have diverse interests in pharmacy, but all stem from my love for pharmacy education. My experience primarily lies in community pharmacy, having worked for Kroger Pharmacy for six years. I enjoy building relationships with patients and earning their trust to provide recommendations.

Furthermore, I’m passionate about academia. I’ve taught undergrad and first-year pharmacy students and would love to continue teaching the next generation of pharmacy students. My immediate plans involve applying for industry fellowships to utilize marketing, research, and informatics to create information accessible to all.

Outside of the pharmacy world, I’m an avid reader and am currently on book 97 out of 100 for my 2023 reading goal. I also enjoy creative writing and love music and live concerts. I was fortunate to catch my favorite band in nine different cities last year!

I look forward to our month together!

Imagine your body as a complex puzzle, and each piece of that puzzle is a gene. These genes hold instructions for how your body works, including how it processes medications. Sometimes, people have slight differences in their genes that can affect how they respond to certain medications.

That’s where pharmacogenomics comes in. It’s like a special guide that helps doctors and pharmacists choose the right medication and dose for you based on your unique genetic makeup. It’s all about making sure the medication you take is the best fit for your body.

Here’s how it works:

• Your Genes Matter: Just like you might have inherited your eye color or hair type from your parents, you also inherit certain genes that influence how your body handles medications.
• Personalized Treatment: Pharmacogenomics helps healthcare providers understand how your genes might affect your response to medications. This helps them prescribe the best medicine and dose for you. It will also help providers avoid medications that will not be effective on your body, saving you the hassle of going through ineffective medication and spending money on expensive medication that won’t be fully effective for you.
• Avoiding Side Effects: Some people might experience side effects from certain medications because of their genes. By knowing about these gene differences, your doctor can choose a medication that is less likely to cause problems for you.
• Effective Treatment: Sometimes, a medication that works well for one person might not work as well for another. With pharmacogenomics, your doctor can select a medication that is more likely to be effective for you.
• Safer Choices: Pharmacogenomics can also help prevent bad reactions between different medications you might be taking. It helps your healthcare team choose medications that won’t interfere with each other based on your genetic profile.

Pharmacogenomics is all about giving you the safest and most effective treatment possible. It’s like having a personalized medication plan that’s designed just for you and your genes! So, if your doctor ever asks you about your family’s medical history or suggests a genetic test, it’s all part of making sure you get the best care. Also, since your genes will never change, this will be one time test and it will be accurate for the rest of your life

References:

Genetics – National Institute of General Medical Sciences. Available at: https://nigms.nih.gov/education/fact-sheets/Documents/fact-sheet-genetics.pdf (Accessed: 21 August 2023).

What is pharmacogenomics? (no date) NHS choices. Available at: https://www.genomicseducation.hee.nhs.uk/blog/what-is-pharmacogenomics/ (Accessed: 21 August 2023).

During these warm summer months, when we get a chance to avoid the Ohio rain, who doesn’t love an afternoon at the pool? However, a refreshing swim is a nice summer treat that can quickly be made miserable with a case of swimmer’s ear, so let’s talk about what swimmer’s ear is, how to prevent it from happening, and how it is treated.

Swimmer’s ear, also known as otitis externa in the setting of excess moisture, is inflammation in the outside ear canal, typically due to a bacterial infection caused by the presence of water in the ears.

The moist environment helps bacteria grow, so it is important to make sure to dry your ears after getting them wet, whether by swimming, bathing, showering, etc.

Luckily, this is an infection that is not considered contagious. Swimmer’s ear most commonly is diagnosed in adolescents (ages 7-14), but is prevalent in all age groups. There is also an increased risk in those who live in moist/humid environments, those who use cotton swabs to clean their ears or have a history of ear canal injury, and those who have a history of skin diseases like psoriasis or eczema in the ear.

Some common signs of swimmer’s ear include:

• ear pain
• itchiness
• a feeling of fullness in the ear
• redness
• possibly some slight drainage from the ear

The most effective way to prevent swimmer’s ear is to keep your ears dry! This can be done in multiple ways:

• Wearing earplugs while swimming.
• Wearing a shower cap while bathing.
• Tilting head to side to drain water from ears after getting them wet.
• Pulling on your earlobe may help to better remove water from ear canal.
• Using a hair dryer on ears at a low heat/cool setting.
• NEVER use cotton swabs to clean out or dry your ears! This can risk causing more damage to the ear canal and ear drum.
• Do not try to remove ear wax on your own! Ear wax helps to protect the ear canal from infections. If you are concerned about having earwax removed, talk to your doctor about having it done professionally.

Over-the-counter ear drops will not help to treat an infection, even if marketed as suitable for swimmer’s ear. These drops are used to help dry the ear canal, but will not help to manage the underlying infection. Talk with your doctor to determine if using over-the-counter drying ear drops is appropriate for you to use after swimming.

Moral of the story: keep your ears dry as best you can and talk with your doctor as soon as possible if you think you may have swimmer’s ear or any other ear infection.

Enjoy the rest of your summer and happy swimming!

Resources:

Medina-Blasini Y, Sharman T. Otitis Externa. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 12, 2023.https://www.ncbi.nlm.nih.gov/books/NBK556055/

Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical practice guideline: acute otitis externa [published correction appears in Otolaryngol Head Neck Surg. 2014 Mar;150(3):504] [published correction appears in Otolaryngol Head Neck Surg. 2014 Mar;150(3):504]. Otolaryngol Head Neck Surg. 2014;150(1 Suppl):S1-S24. doi:10.1177/0194599813517083

Ear Infections. Centers for Disease Control and Prevention, 2 Apr. 2022, www.cdc.gov/healthywater/swimming/swimmers/rwi/ear-infections.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthywater%2Fswimming%2Frwi%2Fillnesses%2Fswimmers-ear-prevention-guidelines.html.

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