Beware of Non-Prescription Medications

Beware of Non-Prescription Medications

Non-prescription medications are not necessarily as innocuous as many people think.  Newer antihistamines claim to be non-drowsy, however they would be better termed “reduced drowsiness!”  Children can have unpredictable reactions to drugs and these new antihistamines have been associated with effects such as behavioural changes, headache and skin eruptions in kids.  Convulsions have even occurred!  Always weigh the pros & cons in consultation with your pharmacist.

 

It’s important for both health care providers and patients to be vigilant for adverse effects with their medications to ensure problems are managed quickly.  An article in the Journal of the American Medical Association has pointed to a link between sildenafil (Viagra®), used for erectile dysfunction, and an increased risk of melanoma – a form of skin cancer.  The overall numbers were still low but suggest the need to investigate further.

Sun Exposure is Good For Health!

With all the news about sun protection and skin cancer, it’s worth knowing that some sun exposure is actually good for your health!  A 20-year Swedish study of over 30,000 women found that sun avoidance led to a life expectancy equivalent to smokers – that is, getting NO sun is as bad for you as smoking!  While they didn’t identify an effective “dose” of sunshine, benefits increased with increased exposure – as did skin cancer, but also with a better prognosis.

 

Although some sun exposure can be considered healthy, too much can lead to uncomfortable burns, aging of the skin and increased risk of skin cancer.  Sunscreens help to offset these risks, but only if they are used properly.  Choose an SPF of 30-45 and make sure it is a broad spectrum product to block both UVB and UBA rays.  Apply liberally, about 1 oz (2 tablespoonsful) before going out and re-apply every 2 hours – more often with water exposure or perspiration.

Talk To Pharmacist About Sunscreens

There is a dizzying array of sunscreens on the market and some are better than others.  Also, one size does not fit all, so talk to our pharmacists about which product is the best one for your skin and activities.

Hot Drinks Cause Cancer?

Hot Drinks Cause Cancer?

Well, here’s a new one for you – drinking very hot drinks increases your risk of cancer; specifically, esophageal cancer!  The International Agency for Research on Cancer has determined that the temperature of your drinks is likely much more important than what you’re drinking.  “Very hot,” defined as 70o Celsius or 160o Fahrenheit, (temperatures commonly enjoyed in places like China, Turkey, Iran and South America) is now considered carcinogenic to humans.

 

The National Health Service (NHS) in the UK is bracing for a surge in cancer rates they believe will be fueled by an epidemic of obesity.  Going hand-in-hand with this will be increases in type 2 diabetes and coronary heart disease – all costing the system an additional £2.5 billion annually by the year 2035.  The NHS is recommending drastic changes to stem the problem, including marketing restrictions, a sugar tax, and steps to increase physical activity.

Marriage Reduces Cancer?

You may have already heard that marriage benefits your health, but a California study has quantified the benefit – at least in terms of cancer.  Married men enjoy a 29% lower risk of death from cancer than their unmarried counterparts and married women have a 17% lower risk.  However, they aren’t sure why; there are 2 schools of thought:  economic benefits of marriage or social benefits.  The same study found minimal economic impact, pointing to social advantages.

Guilt With Cancer?

When it comes to cancer, many patients experience significant guilt – believing something in their lifestyle is responsible for their illness.  Researchers at the National Cancer Institute are trying to sort out how much cancer risk is attributable to environmental factors (i.e. lifestyle) or just “bad luck,” such as random gene mutations.  The bottom line is that both contribute to cancer risk, but environmental factors are probably responsible for up to 90% of cancers.

 

Knowing that YOU can influence your health and it isn’t all beyond your control is very empowering.  Our pharmacists are ready to help you make positive changes in your lifestyle – whether it’s smoking, sleep, diet or activity.

Lifestyle Factors

Lifestyle Factors

Australian researchers looked at various lifestyle factors to try to rank which ones, individually or in combination, posed the greater risks to health.  Not surprisingly, smoking was the highest hazard, with high alcohol consumption and physical inactivity close behind.  Interesting factors that had significant impact were prolonged sitting time, short sleep duration and long sleep duration!  Obviously, combining two or more of these lifestyle factors upped the risks.

Nutrition Labels

Nutrition labels on foods help us to make better choices for our health but, when dining out, we generally don’t know how good or bad the menu items really are.  Recently, the New York City Board of Health unanimously voted to have chain restaurants and some concessions post salt warnings on their menus.  Any item containing more than 2300mcg of salt is labelled with the image of a salt shaker on a black triangle.  This may be the start of a great trend!

White Coats!

In this era of more casual dressing, a study has found patients prefer their physicians to wear a white coat – at least if s/he is a dermatologist!  Apparently, professional attire – in particular, a white labcoat – forms part of the impression the physician makes on the patient; patients believe the physician to be more knowledgeable & skillful.  Such impressions have been shown to affect patient outcomes, not just in dermatology, but other medical specialties as well.

 

Statistics are showing that one of the most dangerous times for patients is the time period after discharge from hospital.  Often, this transition involves medication changes, diverse care providers, uncertainty about procedures, and delays in documentation for both patients and care providers – and sometimes combinations of these issues.  It behoves all involved – caregivers AND patients with their families – to be extra vigilant and ask questions during this risky time.

 

Our pharmacists want to ensure you, or your family members, understand your therapy.  Take the time to listen to the counseling and don’t be afraid to ask questions.  Isn’t your health worth the time investment?

Pay Attention To Pregnancy

Pay Attention To Pregnancy

Pay attention to what your body is trying to tell you – especially when you’re pregnant.  For example, most headaches are simply due to tension or eye strain, but a headache that is atypical for you may be a sign of something more serious.  A severe headache (or any headache, if you don’t normally suffer from them) may be an early warning sign for pre-eclampsia – a dangerous condition.  Other warning signs:  increased blood pressure, fever & seizures.  Seek help!

Loss of Bone Density

Pregnancy often causes women to lose some bone density as the body sacrifices important minerals to meet the demands of the growing fetus, however levels to return to normal about a year after breastfeeding ends.  Studies looking at vitamin D supplements to mitigate this bone loss have conflicting results.  Bottom line:  high doses are not recommended.  Stick to the usual guidelines, 600 iu daily (from all sources), preferably from diet, not supplements.

 

Many misconceptions persist about alcohol consumption during pregnancy.  1 in 10 women continue to drink while pregnant and many others think it’s only an issue in the first trimester or that a little sip now-and-then won’t hurt.  The American Academy of Pediatrics has issued a report that NO level is safe at any time during pregnancy.  Alcohol in pregnancy can lead to birth defects as well as neurodevelopmental, intellectual and/or behavioural disabilities.

Monitor Drugs and Alcohol

You not only need to monitor what you consume during pregnancy, but also when you’re trying to become pregnant!  NSAIDs are a group of drugs, including ibuprofen, ASA & naproxen, commonly used for pain relief and available without prescription.  They have been shown to block ovulation by preventing the follicle from rupturing to release the egg.  They also reduce progesterone levels, furthering decreasing ovulation and preventing implantation of a fertilized egg.

 

Pregnancy is a critical time for managing your health and weighing the pros & cons of the treatments you seek.  Many drugs that are generally considered safe may have a significant impact on a developing fetus.  Ask our pharmacist first!

Regular Sleep Important

Regular Sleep Important

Many studies have pointed to the importance of sleep in a variety of health conditions.  There are several tips for getting optimal sleep:  maintain a regular sleep schedule, create an environment conducive to sleep, avoid stimulants (caffeine, nicotine) & sedatives (alcohol, sleeping pills), get regular exercise, and keep napping to a minimum.  There is evidence that “screen time” affects sleep patterns as well, so limit television and computer use an hour or two before bedtime.

Sleep Hygiene

Many people prefer to skip good “sleep hygiene” to manage insomnia and, instead, turn to drugs for “immediate” relief.  However, these medications don’t produce a good “restorative” sleep and come with their share of side effects, including dry mouth, blurred vision, constipation, and hang-over effects.  They also cause confusion and can increase the risk of falls – especially in the elderly.  At best, they are a band-aid and you’re best to address any underlying causes.

 

If you suffer from more than occasional insomnia, bypass medications and look to one of the following techniques to re-set your sleep cycle.  1) Sleep Restriction: do not allow yourself to nap to make up sleep shortfalls and, if awake in bed, get up and do something relaxing until the urge to sleep returns.  2) Reserve the bed only for sleep (and sex!) – no TV, paperwork, etc.  3) Learn relaxation techniques.  4) Look into CBT – cognitive behavioural therapy.

Jet Lag

Jet lag can occur any time our travels take us more than a couple of time zones away – and seems to be particularly bad when travelling east.  There are steps you can take to minimize jet lag.  Gradually start moving bedtime and mealtimes towards those of your destination, starting about a week beforehand.  Once there, go directly to the new schedule (avoid naps and snacks) and get as much daytime sunlight exposure as you can, to reset your circadian rhythm.

 

Whether you’re considering a sleeping pill or something “natural,” such as melatonin, to help re-set your sleep cycle, our pharmacists can help steer you in the appropriate directions to improve the quality of your sleep.

CFS – Chronic Fatigue Syndrome

CFS – Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) has long been thought to have a basis in some type of infectious/immune process.  Now, American research appears to give credence to this theory.  They have found that patients who have recently developed CFS have a specific pattern of cytokines (signaling compounds secreted by immune cells); these could act as a method of diagnosing CFS but, potentially, also as a route to develop therapies to treat CFS.  Fingers crossed.

Associated with Fibromyalgia

Chronic Fatigue Syndrome has been associated with Fibromyalgia; the main difference seems to be an overwhelming intolerance of exertion with CFS, while FM’s dominant feature is pain.  Both are suspected to have their origins with the immune system but there is no cure and treatments only help modestly.  However, research is showing improvements in FM with exercise.  It seems moderate exercise activates the parts of the brain involved in pain modulationC

Gout is a condition where excessive uric acid in the bloodstream forms sharp crystals which deposit in joints (often, the big toe joint), damaging tissue, and leading to swelling & pain.  Treatments are aimed at reducing uric acid, both from dietary sources and using medications.  Now there is evidence that sleep apnea increases gout attacks by about 60%.  It is believed that the hypoxia from sleep apnea leads to an increase in uric acid too.  Treat the apnea to reduce gout risk!

 

Gout is classified as a form of arthritis (pain/inflammation in joints) and a mainstay of therapy is reducing purines in the diet which lead to the production of uric acid crystals.  Purines are found in abundance in red meats, organ meats, shellfish and beer.  Also recommended is staying well-hydrated to help keep the crystals dissolved.  New evidence now suggests eating a low GI (glycemic index) diet; it also lowers uric acid levels and may be a useful adjunct to treatment.

 

There is often much you can do to help reduce the risk of disease as well as manage chronic conditions.  Our pharmacists would be happy to discuss the lifestyle adjustments you can make to feel healthier and happier.

Medical Marijuana Not As Beneficial As Thought?

Medical Marijuana Not As Beneficial As Thought?

While anecdotal reports on the benefits of medical marijuana abound, scientific evidence is lacking.  There is some support for its use in managing some types of pain, multiple sclerosis and nausea related to chemotherapy, but very limited evidence for other uses – and, what studies do exist are of poor quality.  Another complication is the variance in marijuana products and “doses” of their active components.  Standardization is necessary to produce good evidence.

Side Effects Need To Be Weighed

Marijuana, as with all drugs, carries side effects that need to be weighed against the potential benefits of its use.  These side effects may be particularly important in youth, whose brains are still developing.  Marijuana can interfere with neural pruning, altering cognition, behaviour and mental health.  It has been linked to lack of motivation and there is some evidence that it can trigger psychosis or schizophrenia in susceptible individuals.  It’s not to be taken lightly!

 

Not unlike alcohol, the use of marijuana can be dangerous when it comes to driving or the workplace.  MRIs have shown that marijuana decreases psychomotor function and can significantly impair drivers – even at low THC (the active component) levels.  In the workplace, statistics have demonstrated that marijuana users have 85% more work-related injuries and a 55% higher chance of causing an industrial accident – not to mention 78% greater absenteeism!

Road Side Tests For Marijuana

Because marijuana is so often used recreationally, concerns about impaired driving are as justified as they are for alcohol use.  A convenient and accurate means of doing a roadside test for marijuana impairment would be a boon for traffic enforcement.  Saliva tests exist, however they can detect the drug for up to 48 hours – past the time of impairment.  A breath test is under development that can detect marijuana use in the last 30 minutes to 2.5 hours.

 

When there’s a lot of media excitement about a particular drug or therapy, important details may be overlooked or ignored.  As with any medication, the benefits need to outweigh the risks.  Our pharmacists can help fill in the blanks.

High Blood Pressure Leads To Several Problems

High Blood Pressure Leads To Several Problems

High blood pressure can lead to several serious problems, including stroke, heart disease, kidney damage and blindness.  Many things are known to increase blood pressure – smoking, salt intake, being overweight – and now you can add a new one to the list:  napping!  A review of 9 studies involving over 100,000 participants found that daytime napping led to a 19% increase in the risk of developing high blood pressure.  So, save your sleeping for bedtime.

Quiet Neighbourhoods Are Great

Quiet neighbourhoods may be more than just a nice place to live – they may be better for your health.  A study published in the Journal of the American Heart Association showed that living within 100 metres of a major roadway with heavy traffic increased the risk of high blood pressure by 22%.  And, being within 100-200 metres upped the risk by 13%.  Further studies may find what, specifically, leads to the problems but, for now, consider home location a factor.

 

High blood pressure is often called the “silent killer” because it is generally without symptoms but can lead to some devastating outcomes such as stroke or blindness.  Unfortunately, while we know many things that make it worse (or better), we still don’t know what causes it.  What is also known is that up to 90% of us will eventually develop high blood pressure in our lifetimes, so take steps to reduce your risks and, hopefully, postpone it as long as possible!

Ideal Blood Pressure

“Ideal” blood pressure is considered to be below 120/80 but the goal of treating high blood pressure is to get it below 140/90 – as long as there aren’t other considerations, such as diabetes.  A recent analysis of 19 studies is suggesting this target is still too high and there are significant reductions in morbidity and mortality by tightening this up to closer to 120/80.  Such numbers may not be appropriate for everyone, however, such as those with diabetes or the very elderly.

 

Monitoring your blood pressure allows you to catch any changes early and act on them before much damage is done.  Our pharmacists can help you choose a good home meter or offer to take readings right in the pharmacy.

Sleep Is Essential To Our Health

Sleep Is Essential To Our Health

Sleep is essential to our health in a variety of ways, so sleep deprivation can have its consequences.  For example, after just one night of only 2 hours of sleep, there is a drop in levels of immune system mediators along with an increase in stress mediators.  The good news is that just two 30-minutes naps are able to restore these chemicals to their previous levels.  This could benefit those whose work odd shifts or in situations that create demands which interfere with sleep.

 

Many symptoms we see when suffering from an infection (viral or bacterial) are actually signs of a healthy, functioning immune system fighting that infection.  However, many people see them as an indication that antibiotics are required.  A recent survey found that, while there was understanding that antibiotics should not be overused, there still isn’t clarity on what symptoms suggest a need for antibiotics.  More education is needed to help the public learn the distinction.

Beware of Overusing Antibiotics

Overuse and inappropriate use of antibiotics continue to fuel dangerous antibiotic resistance, potentially leading to the development of untreatable superbugs.  It is estimated that up to 30% of all antibiotic prescriptions are unnecessary – and that number swells to about 50% for respiratory tract infections.  Much prescribing is in response to patient demands but “watchful waiting” most often proves the antibiotic unnecessary.  Learn to be a patient patient!

Reducing Prescribing Rate

Since close to half of all antibiotic prescriptions for upper respiratory tract infections – including the common cold, pharyngitis, rhinosinusitis and bronchitis – are unnecessary, there are renewed calls to reduce the prescribing rate.  Except in confirmed cases of bacterial infection or signs of pneumonia (x-ray, purulent mucous, high fever), watchful waiting should be employed.  Patients need to understand that recovery can take 10-20 days, but antibiotics won’t help!

 

Sometimes the best treatment is no medication!  Knowledge is the key to knowing when to treat – or when not to!  You can always talk to our pharmacists for information and reassurance.  They’ll steer you in the right direction.

Rising Incidences of Kidney Stones

Rising Incidences of Kidney Stones

Concerns are being voiced over rising rates in the incidence of kidney stones – particularly in women and adolescents.  Kidney stones are made of calcium oxalate and form from crystals in the kidneys.  They are usually small and pass out unnoticed, but they can grow as big as golf balls and cause considerable damage, pain & infection.  Their production has been associated with inadequate hydration but the thought is that these new cases are also due to increased salt intake.

 

Most people who have experienced painful kidney stones would be more than happy not to repeat the process!  Generally, increasing fluid intake to 8-10 cups per day is a good place to start – as long as you aren’t on fluid restrictions for another reason.  Also, reduce soft-drink consumption as well as foods rich in oxalates and meats.  And, watch your salt!  Finally, ensure you are getting adequate calcium – preferably from dietary sources.

Proton Pump Inhibitors

A potent class of drugs used to treat acid reflux & ulcers, proton pump inhibitors (PPIs), is being associated with increased kidney disease.  PPIs are intended to be used for short periods of time (2-8 weeks) to allow tissues to heal, but since symptoms often return, many patients take these drugs continuously.  Now available without a prescription, there are concerns about higher rates of side effects.  Don’t take for more than 2 weeks without consulting your physician.

Beware of Drugs Without Prescription

Just because a drug is available without prescription, does not mean it is completely safe to take; better to term them less unsafe!  Case in point:  overuse of loperamide (found in Imodium®), used to treat diarrhea, has been associated with cardiac death!  A distant cousin to opioids, some have attempted to use loperamide for a “high” or treat withdrawal symptoms – with disastrous consequences.  In fact, it’s not even always the best choice for managing acute diarrhea!

 

Taking over-the-counter drugs is not always well-advised; sometimes your symptoms are a sign of an underlying issue that needs to be addressed.  Always consult your pharmacist on the appropriateness & use of all medications.