Medication Non-Adherence, (a serious pharmacy issue)

If you polled the nations pharmacists about one of the biggest issues they face in pharmacy, I think most would agree that medication non-adherence is near the top of the list.

Non-adherence is also called non-compliance, and basically means that the patient does not take the medication or treatment as prescribed.  When a patient does this they are considered to be non-compliant.  There are many barriers to patient compliance in pharmacy and we will address some of the most common reasons a little further down in this blog.

The National Community Pharmacists Association (NCPA), estimates that non-adherence adds to the healthcare costs of this country by as much as $300 Billion each year (other researchers have estimated the amount at closer to $100 billion a year, but either number is still significant).  This cost comes about because non-adherence leads to patients with more hospital admissions, more office visits, and more changes to therapy due to their refusal to take medications correctly.  The most common method to treat many of the most common disease states is to use medication.  Diseases that are included in these statistics include diabetes, hypertension, high cholesterol, antibiotic treatments, anti-coagulation therapy, and other chronic disease states.

A study from Temple University in “The Journal of Applied Research” By A. Wertheimer PhD, and T. Santella B.S. found these significant statistics:

-Approximately 125,000 people with treatable ailments die each year in the U.S. because they do not take their medications properly.

-14-21% of patients never refill their original prescription.

-60% of patients CANNOT identify their own medications (!!)

-30-50% of patients ignore or otherwise compromise instructions concerning their medication

-Approximately 1/4th of all nursing home admissions are related to improper self-administration of medication

-12-20% of patients take OTHER people’s medications.

-Hospital costs due to noncompliance are estimated at $8.5billion annually.

-Non-compliance occurs in 50 to 75% of patients.  This rate is even higher in patients with chronic illnesses.

-Children are also less likely to comply with medication regimens because of their dependence on adult caregivers to administer their medication.

I can sit here all day and throw statistics out, dollar values (costs), and life threatening ailments that could have been prevented by proper medication compliance.  I could get on my pharmacist soapbox and preach to the choir about how important it is to take your medication correctly.  But ultimately the decision to take a medication the correct way still falls squarely on the shoulders of the patient or their caregiver.

Do you want to treat your disease state?  Do you want to feel better?  Do you want to optimize your chances to improve your life when medication is the only option left?  Do you want the chance to minimize side effects?  WE CAN MAKE YOUR LIFE EASIER.

So let’s talk about solutions, what can we the pharmacists at Spartan Pharmacy offer you the patient to help you achieve your health care goals?  What can we do to help you remember to take your medications correctly and how can you help us to determine your barriers to compliance?  We can’t be there in your kitchen doling out your medication each morning and we definitely can’t be there forcing you to take your prescriptions.  But, we can come up with solutions to help you understand your treatments, plan your doses so it doesn’t affect your day, and also lower your costs when applicable.

Let’s talk about barriers to medication compliance and some of the solutions available to you in our stores.

1.  You take a large volume of medications due to multiple chronic disease states.  You can’t seem to remember if your took your pills, or when you are supposed to take them.  You frequently double up a dose or forget doses because you are feeling overwhelmed or otherwise confused.

Let me tell you that you are not alone, this is one of the most common problems we see in our stores because we have many patients who have multiple chronic disease states and who take a large volume of medications a day to treat their conditions.  We need to talk to you and figure our first if there are ways for us to decrease your medication load, or switch you to some of the new combination therapies available to patients.

Once your regimen is straightened out then we can discuss MyPak with you.  MyPak is Spartan Pharmacy’s solution for patients who take multiple medications a day and who need help managing their prescriptions.  By utilizing strip packaging we are able to create daily “MyPaks” for our patients in a convenient easy to use system.  You tear off the strip for your morning/afternoon/or evening dose, each pak is labeled with the medications and time of day you should take them.  We review your medications and determine which time of day is best for each medication and then create the ideal MyPak based on our review.

If this is something you think could help you or a loved one please contact us at any of our locations.

2. Is the cost of your medication the barrier to your treatment?  If so, again, we need to talk.  There are many medications that are available generically that were not previously available.  Let’s have a frank discussion with your physician about what they are prescribing you.  There are alternatives for most treatments that are equivalent or of equal benefit at a lower cost to you.  Of course not all medications can be switched to a generic alternative and but we have the ability to search out rebate/discount cards that can help as well.  We are your greatest advocate and your greatest asset.  Let us do the leg work so that your physician can treat you more effectively.  You will end up with better results and will feel better thus improving your medication therapy compliance.

3.  You have trouble remembering to order your prescriptions or have trouble getting to the pharmacy to pick them up.  In this case you are probably most like me, (yes even we are non-compliant at times) I forget to reorder meds or don’t have time to pick them up.  We offer a simple and convenient solution for this.  Auto fill and free delivery from our stores.  We can set up your regular medications to be filled automatically each month.  When we get your order ready we will call you, and then if need be we can arrange for delivery to your home.  Along with that we also will know when you run out of refills and can automatically fax/call/e-script your physician for additional refills.  All that is required of you is payment for the item and making sure you take your medication as prescribed.

4.  Medication side effects (adverse effects) which decrease your desire to take the medication because it interferes with your day to day life.  Many medications cause side effects, some are less desirable than others.  Some medications affect individuals more than others.  If you are dealing with undesirable side effects from your medication you need to tell your pharmacist or your physician.  There are usually options or methods available that we can recommend to help alleviate those symptoms or we can recommend a medication change to your physician.  Remember we don’t know you are having an issue with a medication unless you tell us.

Are there other reasons why you are not taking your medication as directed?  If so please bring them to our attention.  Maybe the problem you are having is more common and easy to address than you think.  As pharmacists we are trained to be experts in regards to medications, this is what we went to school for. Make sure you speak up.  Ask questions when you don’t understand something.  We are here to help you because we care about your health.  The last thing we want is for our patients to be a statistic.  We take pride in our ability to serve our customers better than any of our competitors.  One of the best gifts we can offer you is a medication regimen that you are comfortable with, that meets your health care goals, and ultimately improves your life.

 

Happy Father’s Day

First things first, to any fathers out there reading, Happy Father’s Day! Hopefully you get to spend the day with your children or enjoying your favorite dad hobby whether it’s fishing, golfing, or just relaxing.

 I became a father on August 17th, 2011. It was a very happy and momentous day. There is a lot of emotion that comes with being a first time father and it’s also a very overwhelming time because your life rapidly gets thrown into a tail spin.

 Flashback to December 2010, my wife approached me with a big smile on her face and pregnancy test in hand. After the initial joy of pregnancy we settled back into our routine preparing and getting ready to bring the little one home in 9 months. I had a moment of self reflection one day (in the mirror) and realized that I was no longer the fit, svelte, young man I used to be. I looked at my waistband in my jeans and saw a number over 40”. I looked at my closet and saw a lot of XL clothes and even some XXL’s. I climbed on the scale and saw that my once lean frame was now carrying close to 235lbs! I am only 5’11” tall, so that put my BMI (body mass index) at a whopping 32.8, that qualified me as OBESE, something I never imagined ever being. My joints hurt, my feet hurt, and sometimes it even hurt to bend over and pull on socks. I made the decision at that point to get back in shape and be a good role model for our child. I signed up for Weight Watchers for men in January of 2011, and begin walking on a treadmill hoping to work my way up to running again soon.

 On the day of Noah’s birth I had lost 35lbs and was able to run 5 or more miles at a nice clip. I was slowly getting back into form. Flash forward to today and I am currently at 185lbs and a much healthier (but not perfect) BMI of 25.8. I recently ran the marathon relay with a few of my coworkers here and plan on running the Half Marathon again next year. I am also biking and training to do a sprint triathlon this year as well. I only have a few more pounds to go until my goal weight of 175lbs. My joints don’t ache anymore and my feet don’t hurt even after a 12 hour day at work. My clothes are getting too baggy now, and pretty soon I am going to need to go shopping to update my wardrobe.

 Adam asked me to share my story with all the fathers (and mothers) out there because it doesn’t take a special person to do this. I am not special, I am just a normal guy who decided he needed to take his life back from the grasp of obesity. Your kids look up to you everyday and they emulate and imitate their parents because they don’t know any better. Setting a good example for your children is the best gift you can give them.

 Healthy changes in your diet are as easy as putting down the chips and having an apple, substituting broccoli for fries, or skipping the second helping. I don’t profess to be an expert or a dietician, but simple changes in how we eat can go a long way. Cutting your portions down can save you precious calories and exercising for 30 minutes a day 4 or 5 days a week can help speed your metabolism and help you lose those pounds.

 Are you interested in losing weight? Do you struggle with making the right food choices? There are plenty of resources available to you, just ask your Doctor. Get a physical to make sure you are healthy enough to exercise. Join a program like Weight Watchers or Jenny Craig, or download a calorie counting app for your smart phone. There is no magic pill that will make you healthier and there is no prescription that we can provide for you to lose weight without the will and motivation to do it yourself. Sure, there are prescription options available but unless you change your diet for good there is no pill that will ever totally fix the problem.

 My father always set a good example for me growing up, he worked incredibly hard (now retired), he came home grumpy sometimes and as a kid I didn’t understand why. But he didn’t take out his frustration on us he took it out with weights and cardio. He religiously exercised after work for an hour to vent his frustration. He would spend hours outside in the yard chasing us kids around, playing run down, catching football, playing frisbee, or competing in obstacle course races that we created. I didn’t have a lot growing up, my family was large and all our money went to food, clothes, and savings. What we did have was a lot of love, two parents that cared more for us than we could ever begin to imagine, and we had each other. We didn’t have cable so my brothers, sister, and I spent a lot of our time outside playing until the streetlights came on. I want to be able to give that gift to my child too, I want him to grow up in a responsible family, and I want to teach him to make healthy choices. I won’t be able to force him to do anything once he gets old enough to think for himself but I do hope that I can show him the mistakes I made so that he isn’t destined to repeat them.

 This father’s day I would like to ask all the dad’s out there that struggle with their weight or their fitness to take some time for yourself. Improve your life, take the steps necessary to make sure that you are healthy enough to be a good role model for your children, and someday your grandchildren. Getting up every day and exercising before work or finding time to squeeze in a walk instead of watching TV for an hour every night isn’t glamorous, but the benefits it provides far outweigh the risk of doing nothing. I struggle sometimes to find the motivation to workout just like everyone else. But I also tell myself  that I will never regret a workout when it’s completed…but I always regret the workout I skip.  Do you need some added motivation? Join me for a run sometime or if you mountain bike or cycle on the road stop by and visit me at the store maybe we can meet up in South Park. If I have time I would be happy to join anyone out there who is looking to improve their fitness. As a pharmacist I interact with the general public everyday, and I see the way being unhealthy and overweight is killing our society. If I can give back to help you out I would be happy to, just stop in and chat sometime with me. I would love to help motivate you to get out and change the path you are on.

 “Be the change you wish to see in the world.” -Mahatma Ghandi

 If you are interested in following me on my personal blog you can follow me at www.fitdadorfatdad.blogspot.com

 Happy Father’s Day,

 Ron Obringer

Father, pharmacist, and reforming fat guy.

Summer and Sunscreens!

Summer is rapidly approaching, the signs are all around us. The weather is warming up, kids are graduating from school for the summer, and Pittsburgh staples like Kennywood and Sandcastle are opening their doors for the season!

If you are anything like me you look forward to getting out of the house and spending time outside. Whether it is a walk around the block, a run in South Park, or a week at the beach on vacation. We are all finding ways to get out of the house and enjoy the weather before the snow rears its ugly head back in the ‘burgh.

Along with all this summer fun comes an essential tool for protecting ourselves from the stealthy killer known as skin cancer. We now know that sunscreen and sunblock are essential for protecting our skin from cancer, premature skin aging, and even protecting our immune systems.

Sunscreen

There is a lot of changing research into which methods are best and a great deal of confusion among the general public as to what SPF, Sunscreen, and Sunblock are. We also get many questions in regards to waterproof or water resistant and what that means.

Popular Water Resistant Sunscreens

There are two types of sun rays that affect our skin, UVA (long wave) and UVB (short wave) rays. UVA light rays are the most prevalent and the least intense of the two, UVA light can also penetrate through clouds and glass. UVA light penetrates the skin deeply and is the main culprit in premature skin aging and wrinkling. It was originally believed that UVA (also known as the tanning rays) had little effect on skin cancer risk, but after nearly 2 decades of research scientists can now point to UVA rays as potential cancer initiators. Tanning beds primarily emit UVA light at a concentration of 12 times what you get from the same amount of exposure to the sun. Modern research now shows that tanning beds can drastically increase your risk of melanoma, this is especially true in the younger skin of teenagers.

UVB light is less prevalent in the environment, but is the primary cause of skin reddening and sunburn. UVB also plays a significant role in skin aging, wrinkling, and increased cancer risk. UVB light is most prevalent between 10am and 4pm, it is essential during this time of day to seek shade or protect your skin with clothing or sunblock/sunscreen. UVB light does not penetrate glass well, but is easily reflected onto your skin from surrounding light colored surfaces, snow, or water.

There are a great deal of myths surrounding sun exposure, if you would like a quick informative read, I would recommend this link (Click here)

The most important way you can protect yourself and your skin from UVA and UVB rays is to avoid long spells of direct unprotected sun exposure during the hours of 10am to 4pm. This can be accomplished by seeking shade, spending time indoors, and by protecting your skin with a physical barrier like a zinc sunscreen or clothing, or a chemical barrier like sunblock.

Many clothing items, especially sports related clothing now also provide a UPF rating which can tell you how well the article will block the sun. The higher the UPF rating for your clothing, the less UV light will pass through the garment to your skin. Loosely woven fabrics (ie, clothes you can see through) are going to block a lot less UV light than tightly woven fabrics that are harder to see through.

Sensitive skin, and Kids Sunscreens

So you are all set to head outside and take in the summer weather, you have your tightly knit fabrics, your wide brimmed hats, and of course your sunglasses (which prevent cataracts!). You then need to decide which sunscreen or sunblock is best for you and your skin type.

Sunscreen and sunblock “strength” is determined by SPF (sun protection factor). SPF is not actually an amount of protection, but an indication of how long it will take UVB rays to redden skin with the sunscreen/sunblock as opposed to without the protection. An SPF of 15 would protect the user’s skin from redness 15 times longer than no protection at all. A sunscreen with SPF of 15 will screen out 93% of the suns UVB rays, an SPF of 30 would screen out 97% of the suns UVB rays, and and SPF of 50 would screen out 98% of the suns UVB rays. All sunscreens block the majority of the redness causing UVB rays that reach your skin, the higher number just determines how much longer you can stay in the sun before you risk burning. Most cancer and physician organizations recommend a minimum of SPF 15.

When choosing a sunscreen you want to pick a product that will protect you from both UVA and UVB rays. Make sure the label reads “BROAD SPECTRUM,” UVA/UVB Protection, or “MULTI-SPECTRUM.” Those terms are usually indicative of a sunscreen that will protect from both UVA and UVB light rays.

There are numerous chemical compounds approved by the FDA for use as a sunscreen. They fall into two categories, chemical and physical. The majority of UV screening compounds are considered chemical. What that means is that they form a thin, protective film over the skin and absorb UV radiation before it penetrates the skin. Physical barriers reflect the UV radiation and are less desirable due to the physical appearance of the products. (Remember the lifeguards in the 80’s movies with the white zinc oxide covered noses and the wide brimmed hats? Not the most wonderful look, but they are an excellent form of protection from the suns rays).

Finally, what is the difference between a waterproof and a water resistant sunscreen? Some sunscreen manufacturers were forced to recall or change the labeling on their products due to misleading labeling regarding this last year.

The FDA determines that a sunscreen is water resistant if it will maintain its SPF factor after 40 minutes of water exposure. A product is considered waterproof if it can maintain its SPF factor after 80 minutes of water exposure. What does that mean for you? Well if a product does not list either waterproof or water resistant and you are swimming or exercising you need to reapply the product very often because the protection will just wash off. If you are using a waterproof or water resistant product you should reapply consistently after 40 to 80 minutes, or after towel drying yourself or after excessive perspiration. Just because its waterproof does not mean you can apply once and forget it.

Important facts we all need to remember:

-Stay in the shade when you are outside especially between 10am and 4pm.

-Avoid tanning beds.

-Cover up with UPF clothing, and DON’T forget the Sunglasses!

-Use a broad spectrum sunscreen, water resistant when possible (especially if you will be in contact with water, or sweating).

-Keep newborns (under 6 months of age) out of the sun entirely.

-Inspect your skin regularly for unusual marks, bumps, and freckles. (See this slideshow for details).

-Report any of these to your physician as soon as possible, don’t wait.

Many of us take for granted how dangerous over exposure to the suns rays can affect our lives. Skin cancer is a very real and very scary disease. It can kill you.

Food for thought from the Skin Cancer Foundation: Five or more sunburns (over the course of a lifetime, NOT a single summer) can DOUBLE your risk of melanoma, the most serious form of skin cancer.

Enjoy your Summer!! See you in the stores!

-Ron

Blog disclaimer:

Reasonable effort and care have been taken to prepare this blog, and the information provided is believed to be accurate at the time of posting. However, this information is not intended to constitute and “authoritative statement” under food and drug administration rules and regulations. When in doubt please make sure to contact your pharmacist or physician when making dietary changes, or regarding medical treatment and other related issues. This blog is meant to be informative, Spartan Pharmacy asks that you please use this information as a reference and not a replacement for proper medical treatment. Please, leave that to the professionals!

All Photos unless otherwise noted are copyright protected and owned by Ronald P Obringer, any unauthorized use without permission of the owner is strictly forbidden.©Ronald P. Obringer

Letter from the Owner.

A letter from the owner.

 

I want to take this opportunity to say Thank You to all of the customers that Spartan Pharmacy is privileged enough to serve. I thought that those folks interested enough to read this newsletter might be interested in learning about the challenges that an Independent Pharmacy faces each and every day, and why taking the time to write this message is a pleasure for me.

 

People would think that all of the big pharmacy chains are driving Independent pharmacy owners out of business, but that’s not the case. In all honesty, I don’t even think of them as our competitors. Sure, they share the same market place with us, but once someone learns about Spartan Pharmacy’s (and Independent Pharmacy in general) level of care and service, people rarely go back to a chain.

 

The biggest competitor to ALL retail pharmacy is the Pharmacy Benefit Manager, or PBM. You see their names emblazoned on your insurance card: Medco, ExpressScripts, CVS Caremark are some of the nation’s largest PBM’s. These companies are billing companies for insurance plans. All prescription claims that go through insurances get processed through a PBM. There are some up sides, but the negatives far outweigh the positives.

 

An example of how this works is as follows: Mrs. Smith has a Highmark insurance plan. That plan’s Rx benefits are all processed through Medco. It does not matter what pharmacy you go to, the pills in that prescription are all billed to the same place. The PBM, Medco in this case, then sets the reimbursement price and the copay. Non of this is controlled by the pharmacy. In effect, it levels the playing field, and allows people to go to any pharmacy that they want without having to worry about prices. Customers can pick and choose which pharmacy they want to go to based off of service and convenience… At least that’s how it used to be.

 

Now, the PBM’s have every prescription claim that has ever been filled for not only Mrs. Smith, but the entire Highmark network as well, and they now own their own pharmacies. It is commonplace now for Spartan Pharmacy customers to get letters and phone calls directly from the PBM’s trying to get our loyal customers to switch over to the PBM’s pharmacy, also known as “mail order”. Often times lower copays are promised, or “specialist hypertension or diabetes pharmacists” are claimed to be the ones filling your prescriptions, but in reality, the Rx is usually processed by a pharmacist or technician who is literally processing thousands of Rx’s a day in an assembly line. The trouble is that with all of this power, things have a tendency to become corrupt.

 

I have personally seen countless examples of PBM’s mailing medications without the customer requesting it, especially right before an expensive brand name medication goes generic, in an effort to clear out their inventory at the expense of the customer. Both of my own parents have been called by a certain PBM offering them better service and pricing, if they would only leave Spartan Pharmacy. The list that I could type could go on for pages, but that is not my intention.

 

If you are taking the time to read this article, then you are already our customer, and are interested in our business. Without customers like you, Spartan Pharmacy, and Independent Pharmacy as a whole could not survive. I want to say “Thank You”, for no matter what you have been told or offered, you have decided to share your business and your trust with our staff. All that I can ask is that you continue to give Spartan Pharmacy the opportunity to earn your business. Sometime we cannot compete with the PBM’s in the lop-sided fight in which they set all the rules. More often than not, we can. Please do not hesitate to just ask “can you help me with my prescription costs”. Our staff comes to work every day with that very intention in their hearts. Your decision to allow us to care for you and your family also enables Spartan Pharmacy to then take care of our staff’s families. Thank you for that gift.

 

Sincerely,

Adam Rice, Pharm D.

Owner, Spartan Pharmacy

DEA Drug Take Back Day (Saturday April 28th)

The DEA Drug Take Back Day is this weekend, Saturday April 28th from 10am-2pm.  Find a location close to you by clicking here.

Locations that are close to the communities we serve are below:

-BALDWIN BOROUGH POLICE DEPARTMENT

-PLEASANT HILLS POLICE DEPARTMENT

-PITTSBURGH BUREAU OF POLICE (Zone3 Station)

-CASTLE SHANNON POLICE DEPARTMENT

-MT. LEBANON POLICE DEPARTMENT

-SOUTH PARK TOWNSHIP POLICE

-BETHEL PARK POLICE DEPARTMENT

-PETERS TOWNSHIP POLICE DEPARTMENT

Many of these locations are being hosted by the Police departments listed, but are not at the police stations.  Make sure to check with the DEA website to find the location that is close to you.

This is from the press release on the DEA website describing the reasons for the events and why they host them:

April 28, 2012
10:00 AM – 2:00 PM

The Drug Enforcement Administration (DEA) has scheduled another National Prescription Drug Take-Back Day which will take place on Saturday, April 28, 2012, from 10:00 a.m. to 2:00 p.m.  This is a great opportunity for those who missed the previous events, or who have subsequently accumulated unwanted, unused prescription drugs, to safely dispose of those medications.

Americans that participated in the DEA’s third National Prescription Drug Take-Back Day on October 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take-back sites that were available in all 50 states and U.S. territories. When the results of the three prior Take-Back Days are combined, the DEA, and its state, local, and tribal law-enforcement and community partners have removed 995,185 pounds (498.5 tons) of medication from circulation in the past 13 months.

“The amount of prescription drugs turned in by the American public during the past three Take-Back Day events speaks volumes about the need to develop a convenient way to rid homes of unwanted or expired prescription drugs,” said DEA Administrator Michele M. Leonhart. “DEA remains hard at work to establish just such a drug disposal process, and will continue to offer take-back opportunities until the proper regulations are in place.”

“With the continued support and hard work of our more than 3,945 state, local, and tribal law enforcement and community partners, these three events have dramatically reduced the risk of prescription drug diversion and abuse, and increased awareness of this critical public health issue,” said Leonhart.

There is an App for that.

Refills for Spartan Pharmacy just got easier!  We recently started accepting refills from www.refillrx.com and the refillrx app.

The Spartan Pharmacy label has a fancy new enhancement, it is now equipped with a barcode! (I know, exciting right?)

This slideshow requires JavaScript.

With this beautiful new barcode you can use the APP on your Android or Apple phone to scan the barcode and request your refills instantly!

To get the APP please go to the APPstore for your particular device.

  • Download the RefillRX APP (created by Transaction Data Systems)
  • Once downloaded, click on the APP
  • Select Scan barcode
  • Align your Rx barcode inside the box – the app will automatically focus, and scan the barcode.  (Try to avoid glare on the label, for best effect)
  • Your refill will upload to the store it was filled from automatically, you can check the status of the prescription on the app or on www.refillrx.com.

You can also scan these to get the app:

Android

iPhone:

This slideshow requires JavaScript.

Don’t have a smartphone?  You can also use the service online at www.refillrx.com

  • Go to: www.refillrx.com
  • Click on register
  • Locate your pharmacy
  • Input your patient information
  • Create a username and password for future logins.
  • View/refill your prescriptions.

Just another way we are working to keep things simple for our customers to stay on top of their refills and speed the process of filling their prescriptions.

See you in the stores!

Blog disclaimer:

Reasonable effort and care have been taken to prepare this blog, and the information provided is believed to be accurate at the time of posting. However, this information is not intended to constitute and “authoritative statement” under food and drug administration rules and regulations. When in doubt please make sure to contact your pharmacist or physician when making dietary changes, or regarding medical treatment and other related issues. This blog is meant to be informative, Spartan Pharmacy asks that you please use this information as a reference and not a replacement for proper medical treatment. Please, leave that to the professionals!

All Photos unless otherwise noted are copyright protected and owned by Ronald P Obringer, any unauthorized use without permission of the owner is strictly forbidden.©Ronald P. Obringer

Allergy Season is HERE!

Due to the unusually mild winter we have had, allergy season is rearing its ugly head a little earlier than normal this year!

The signs and symptoms of allergies are usually itchy, watery eyes, runny nose, sneezing, and in some cases congestion.  There are many options out there to treat your symptoms but no cures yet.

The most common treatment for allergies are the antihistamines, but there are also many other products that you can get over the counter or by prescription if your doctor feels they are necessary.  We will discuss the majority of those options in this blog as well.

Antihistamines:

When you are exposed to an allergen that your body is sensitized to, your immune system jumps in to save the day.  Cells in your body called mast cells release histamine.  Histamine will attach itself to receptors in your body that cause blood vessels to enlarge, it also causes redness, swelling, itching, changes in the bodies secretions, and sneezing.  Antihistamines block the receptors in your body where histamine binds, therefore decreasing or preventing your symptoms.

Antihistamines most common side effects include drowsiness, dry mouth, dry eyes, and decreased urination.

Who should not take antihistamines?  Anyone with a prostate problem, trouble urinating, thyroid disease, nursing mothers, infants, kidney disease, emphysema, glaucoma, and individuals taking sedatives, sleeping pills, and muscle relaxers.  If you are taking any other medications you should make sure to check with your physician or pharmacist before taking any additional products over the counter.

Examples of Over the counter antihistamines:

Less/non-drowsy:  Claritin (loratadine), Allegra (fexofenadine), and Zyrtec (cetirizine)

Drowsy:  Chlor-trimeton (chlorpheniramine), Benadryl (diphenhydramine)

Prescription antihistamines include Clarinex and Xyzal

Some OTC antihistamines

Decongestants:

The next product available to treat symptoms of seasonal allergies are the decongestants.  Decongestants relieve the congestion associated with seasonal allergies.  They are available as tablets, liquids, and nasal sprays.

Decongestants work by decreasing the swelling in the tissues of your nasal passages.  The swelling is what produces the abundance of fluid and mucous in your nasal passage. Decongestants shrink these tissues and blood vessels and relieve your symptoms.

Nasal spray decongestants should only be used for 3 days at a time.  Using those products for longer periods, or more often than directed on the package can actually cause your congestion to get worse, a condition called rebound congestion.  Oral tablets can be used for longer periods of time safely.

You should talk to your doctor before taking decongestants (oral or nasal spray versions) if you suffer from any of the following medical conditions.  High blood pressure, heart conditions, glaucoma, thyroid disease, diabetes, or prostate problems.

Over the counter products include Sudafed (pseudoephedrine), Sudafed PE (phenylephrine), Afrin, and Neo-Synephrine.  There are also many combination allergy products that contain both decongestants and antihistamines.  Talk to your pharmacist to determine which product is best suited for your needs.

Prescription decongestants include the same ingredients as the over the counter products, but are usually combined with another prescription only product like Clarinex-D.

OTC Decongestant products.

If your symptoms only include itchy watery eyes there are numerous eye drops available to treat your symptoms as well.  These include antihistamine, decongestant, and redness reducing drops.  There are a multitude of products available over the counter for itchy, watery eyes.  See your pharmacist to determine which product is best for you.

There are other options available to treat your allergy symptoms by prescription as well, these products would be used at the discretion of your physician if your symptoms are severe enough to warrant their use.

Prescription Options:

-Corticosteroids: These products are used to decrease inflammation associated with severe allergies.  They are most commonly used for severe allergic reactions and asthma.

-Nasal steroid:  these are a subclass of the corticosteroids, they are most commonly used for individuals who need something stronger than what they can get over the counter for their allergies.  Nasal Steroids are topical and have limited systemic side effects, your doctor can determine if these are right for your symptoms.

-Nasal Antihistamines:  these are topical antihistamines that have less of the drowsy side effects associated with many oral antihistamines, again your physician would determine if these are suitable for your symptoms.

-Mast Cell Stabilizers:  these are potent prescription drugs primarily used for asthma sufferers.  They are used to treat mild to moderate inflammation in the lung tissues, because of their effects on the mast cell these products also help to relieve some allergy symptoms.  Mast cell stabilizers are usually used in conjunction with a steroid or antihistamine because they take a few weeks to get to full effect.

For severe allergy sufferes we would recommend you see an Allergist about “allergy shots.”  Allergy shots are actually immunotherapy and are used for patients who suffer from allergies for more than 3 months a year.  They help to build up your immune systems tolerance to the allergens that affect you most.

Come see us if you have any questions about allergies!

Blog disclaimer:

Reasonable effort and care have been taken to prepare this blog, and the information provided is believed to be accurate at the time of posting. However, this information is not intended to constitute and “authoritative statement” under food and drug administration rules and regulations. When in doubt please make sure to contact your pharmacist or physician when making dietary changes, or regarding medical treatment and other related issues. This blog is meant to be informative, Spartan Pharmacy asks that you please use this information as a reference and not a replacement for proper medical treatment. Please, leave that to the professionals!

All Photos unless otherwise noted are copyright protected and owned by Ronald P Obringer, any unauthorized use without permission of the owner is strictly forbidden.©Ronald P. Obringer

Krill Oil

We have been getting an influx of calls and requests in our stores for an Omega-3 product called Krill Oil.  We figured this would be a good opportunity to share what we have learned about the product with our customers.

Krill are tiny shrimp like animals, they are abundant in the seas and are a primary food source for many large sea animals.  Mainly whales, mantas, and whale sharks.

Nature's Bounty Krill Oil Available in our Stores.

Krill oil is rich in the Omega-3 fatty acids DHA and EPA, very similar to other Omega products like fish oil or flaxseed oil.

Krill oil has many listed uses,  these include heart disease, high cholesterol, high blood pressure, stroke, cancer, osteoarthritis, and depression.

The benefits of krill oil are similar to fish oil.  Omega-3 fatty acids are believed to be beneficial fats that can help to lower cholesterol.  They also help make your blood cells slide past each other easier which makes dangerous clots less likely.  Omega-3 fatty acids have also been shown in some studies to help decrease inflammation.  Because of these effects the range of uses for Krill oil mirror that of fish oil or other Omega-oils.

Omega-3 products have been most heavily studied for use in patients with high cholesterol or high triglycerides.  Many studies point to the effect that omega-3 has on HDL (high density lipoprotein) the “good” cholesterol.  These studies also show that doses of 1000-1500mg of omega-3 fatty acids like Krill Oil help to lower LDL the “bad” cholesterol.  Higher doses of krill oil exceeding 2000mg a day have also shown promise for lowering triglycerides as well.

Use of omega-3 products for arthritis and swelling have gained in popularity in the past few years as well but there are no definitive studies that I can find that say whether these products definitively help.

The effects of krill oil on cancer, depression, and stroke prevention are also untested and unproven.

If you are considering a krill oil product these are the things  you should know.

1. Check with your Dr. or Pharmacist to make sure that an Omega-3 product is safe for you to take.  These products can interact with certain medications.

2. Krill Oil appears to be safe for use in adults, safety and efficacy have not been adequately studied.

3. The most common side effects you may see with Krill Oil.  Loose stools, bad breath, heartburn, a fishy taste or fishy burps, upset stomach and or nausea.  While most of these aren’t too bothersome it may discourage some from using the product.  If you get these side effects from a Krill oil product there is always the option of an enteric coated fish oil or flaxseed oil.

4.  Pregnant or breastfeeding women should avoid these products.  There is no definitive studies done on their safety.  When it comes to the safety of your child we always recommend you err on the safe side and avoid most medications unless medically necessary.

5.  Krill oil can increase the time it takes for your blood to clot.  If you are taking a krill oil, fish oil, or any other Omega-3 oil you should stop these products 1 to 2 weeks prior to any surgery.  Always make sure that your physician knows about any over the counter supplements you take well in advance of any scheduled surgeries or procedures.

6.  As with fish oils, if you have a seafood allergy it is best to avoid Krill Oil and to stick with plant based Omega-3’s like flaxseed oil.

7.  Krill oil can also interact with blood thinning agents like Coumadin (warfarin), plavix, pradaxa, and aspirin.  If you take any of these medications or other blood thinning products please contact your physician and pharmacist before starting on a krill oil supplement.

We hope this brief blog has helped you understand this product better.  Please contact us if you have additional questions about this or any other product that we carry!

Stay Healthy!

 

Blog disclaimer:

Reasonable effort and care have been taken to prepare this blog, and the information provided is believed to be accurate at the time of posting. However, this information is not intended to constitute and “authoritative statement” under food and drug administration rules and regulations. When in doubt please make sure to contact your pharmacist or physician when making dietary changes, or regarding medical treatment and other related issues. This blog is meant to be informative, Spartan Pharmacy asks that you please use this information as a reference and not a replacement for proper medical treatment. Please, leave that to the professionals!

All Photos unless otherwise noted are copyright protected and owned by Ronald P Obringer, any unauthorized use without permission of the owner is strictly forbidden.©Ronald P. Obringer

The Dreaded Ear Infection.

It’s that season again… for ear infections!

Holiday break is over… Parents are back to work, and kids are heading back to school and daycare.

Which can only mean one thing… chances are, your kid(s) will probably have an ear infection this winter/early spring.

Ear infections, also called AOM for Acute Otitis Media, are one of the most common reasons patients see a physician. Ear infections result in about 25 million office visits each year, and physicians write roughly 16 million prescriptions each year to treat AOM.

Around 90% of children will have had at least one episode of AOM by the time they turn 3 years old, with about 1/3 of those children experiencing 3 episodes by the time they turn 3. Additionally, the younger the child is when they experience their first ear infection, the more likely they are to experience more ear infections down the line.

Multiple factors can increase the risk of a child having an ear infection, including attending daycare, exposure to second-hand smoke, lack of breast-feeding as an infant, and abnormal eustachian tube function, resulting in fluid build-up in the inner ear.

Fortunately, there are many steps a parent can take to reduce the risk of their child having an ear infection. This includes breast-feeding the infant for at least 6 months after birth, and avoiding feeding the child in a position where the child is laying down and facing up. Perhaps most importantly, a child’s home should be SMOKE FREE. Also, a vaccine (called PREVNAR 13) is available once the child is 6 weeks old, and it is administered in 4 doses at ages 2, 4, 6, and 12 months. This vaccine will protect the child from the most common bacteria that cause ear infections. Side effects from this vaccine include redness and tenderness at the injection site and irritability. Side effects from the vaccine generally resolve after a short time.

So, how do you know if you or your child has an ear infection?

Signs and symptoms of ear infections include a fever (although it’s not always present), ear pain (which can present as a child tugging at the ear), impaired hearing, decreased appetite, and irritability. In addition to these symptoms, there can be a bulging and discoloration of the ear drum (called the tympanic membrane), resulting from fluid build-up in the inner ear. These signs and symptoms are necessary for the diagnosis of AOM.

The major decision that a physician must make is whether or not to prescribe an antibiotic to the patient because 1/3 of ear infections are caused by viruses, NOT BACTERIA, and 80% of bacterial ear infections spontaneously resolve within 2-3 days. This is important to note because patients taking an antibiotic will likely not experience any relief of their symptoms until 2 or 3 days of antibiotic use, but they will be at an increased risk for side effects like diarrhea when using the antibiotic. Antibiotics will NOT treat viral infections.

If the child is older than 2 years old, does not have a fever, and has mild symptoms, many physicians may choose to follow the “wait and see policy,” which involves monitoring the child’s symptoms until the infection goes away on its own, treating the symptoms (ibuprofen or Tylenol for pain) and making sure the child is adequately hydrated.

If the child is less than 2 years old, however, many physicians will prescribe an antibiotic in order to treat the infection and alleviate the symptoms.

The drug of choice for treating ear infections is amoxicillin (“the pink stuff”), usually given as a flavored liquid. Amoxicillin is usually given 2 to 3 times per day for 7-10 days. In order to prevent the infection from returning, it is very important to finish all of the medication exactly as prescribed.  Follow up with the pediatrician if the symptoms get worse.

If the patient is allergic to penicillin – DON’T WORRY. The physician will likely prescribe azithromycin, which is just as effective as amoxicillin.

If the patient’s symptoms get worse or do not improve at all after 2-3 days, the physician may prescribe Augmentin, a slightly stronger formulation of amoxicillin, or azithromycin.

Finally, if the above treatments fail to treat the ear infection, the physician may prescribe Levaquin or Zyvox, which are powerful antibiotics and the last resort for seriously resistant ear infections.  Most can be treated simply with Amoxicillin or Azithromycin.

Remember, help prevent the spread of infections by washing your hands regularly, keep your children’s environment smoke free, and avoid situations will seriously ill guests.

-Michael Galbraith Duquesne University PharmD Candidate.

About the author:  Michael is an intern with spartan pharmacy, he will be graduating from Duquesne University in 2013.  You will most often find him in our kings school road store.  Thank you for taking the time to read our blog.

 

Blog disclaimer:

Reasonable effort and care have been taken to prepare this blog, and the information provided is believed to be accurate at the time of posting. However, this information is not intended to constitute and “authoritative statement” under food and drug administration rules and regulations. When in doubt please make sure to contact your pharmacist or physician when making dietary changes, or regarding medical treatment and other related issues. This blog is meant to be informative, Spartan Pharmacy asks that you please use this information as a reference and not a replacement for proper medical treatment. Please, leave that to the professionals!

All Photos unless otherwise noted are copyright protected and owned by Ronald P Obringer, any unauthorized use without permission of the owner is strictly forbidden.©Ronald P. Obringer

Do you need a new Pharmacy?

As you may have already heard many large chain pharmacies will be dropping Express Scripts after January 1st, 2012.  In the Pittsburgh area this will affect UPMC health plan members and all other Express Scripts Members.  Spartan Pharmacy is not one of those pharmacies.

During this transition we want to make things as easy as possible for you to get your prescriptions transferred and filled.  You don’t need the hassle of long wait times or long lines in the grocery store pharmacies.  Give us a call at any of our locations and let us know that you would like to transfer your prescriptions to us.  We will call the pharmacy, transfer your medications and get you on your way.  We realize that you have better things to do with your time than spending it waiting in line.

If you are an existing customer or a new customer, thank you.  As an added incentive we would like to offer anyone who refers a new patient to us a $10 referral bonus which can be applied to your next purchase in the store.  Just have the person who you referred let us know that you recommended Spartan Pharmacy to them.

This is a big change for many people, the shock of having to pack up your prescriptions and move somewhere else is a daunting task.  You are comfortable with the staff and the pharmacists from your previous location and we can understand and sympathize with you.  Rest assured that our pharmacists and staff will take excellent care of you and your families.  Since we are a small local company your money will also stay in the local communities.  We are also equipped to handle compounded medications, if you are interested please inquire at any of our stores.

You can go to our website www.spartanpharmacy.com to get addresses, locations, and phone numbers.  You can also follow us on facebook and twitter (@spartanpharmacy).   From the website you can also fill out a webform that will help us transfer your medications as well.

We hope that you all have a safe, happy, and healthy New Year.  Looking forward to meeting and seeing all of you in the New Year!