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pharmacy

Prevention for shingles
by Tamara Dulin, R.Ph.
Prevention for shingles Maybe you had chickenpox as a child, or as a teenager. Maybe you had it later in life. However, if you did, you are now considered to have the number one risk factor for shingles.

Many of us don't think about chickenpox unless we are close to a child or relative who has recently had it. In that case, it was probably the topic of conversation (where or who they contracted it from, the extent of the blisters, the itching, and the overall general miserable feeling associated with it). However, people don't consider it a risk factor for another disease, shingles. In fact, the two primary risk factors for shingles are: 1) Having had the chickenpox virus, and 2) Age.
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Leaves of three...let it be!
by Tamara Dulin, R.Ph.
Leaves of three...let it be! The poison ivy plant is a bit elusive in that it may not always be recognizable. The one distinguishable characteristic, however, is that the leaves, almost always, grow in clusters of three. Remember (and follow) the old adage: "Leaves of three; Let it be!"

Like most people in the Midwest, I am looking forward to the warmer days and the anticipation of beautiful spring blooms. Like many others, I also look forward to "spring cleaning" my yard and weeding my flower beds to prepare for summer.
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Proper use of inhaler is a key step to better breathing
by Tamara Dulin, R.Ph.
Proper use of inhaler is a key step to better breathing Is he using the nebulizer correctly? Has anyone watched him use it? Also, is he following the proper procedure for the nebulizer?

In my role with Nightingale Home healthcare, I am often asked questions by our professionals in the field about a patient’s medications. I chose to share one of the recent questions here, with the hope that some of our readers may benefit.
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Teaming herbals with Rx prescriptions needs monitoring
by Tamara Dulin, R.Ph.
Teaming herbals with Rx prescriptions needs monitoring
In addition, there are potentially “undiscovered” interactions with these supplements.

I was recently contacted by a middle-aged woman who sought my advice about her medications.

Specifically, she was suffering from fatigue and bloating.
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A fungus among us...
no one is exempt from athlete’s foot

by Tamara Dulin, R.Ph.
A fungus among us. no one is exempt from athlete’s foot Last issue, I shared some information about the treatment of cracked heels. This time, I’m going to move to the other end of the foot—the toes. Tinea pedis is the term for a condition that is better known as athlete’s foot. Athlete’s foot is a fungal infection of the foot which typically starts between the toes. Early infection is commonly noticed in the area between the fourth and fifth toes. This may progress to include the bottom of the foot, the sides of the foot, and even to the toenails. The fungus that causes athlete’s foot can also cause fungal infections of other parts of the body such as the groin (referred to as “jock itch”) and also ringworm.
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Is your medication off the shelf?"
by Tamara Dulin, R.Ph.
Is your medication off the shelf? FDA withdraws propoxyphene

Propoxyphene has been withdrawn from the United States market. Propoxyphene is the narcotic opioid ingredient of the popular Darvocet® (in which it is in combination with acetaminophen), and it is the sole ingredient in Darvon®. Other products that contain propoxyphene are Wygesic®, Balacet®, Darvon Compound®, and many generic versions.
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Sore throat season is here
by Tamara Dulin, R.Ph.
Sore throat season is here Sore throats caused by common viruses typically need to run their course; however, there are supportive treatments that can help alleviate the bothersome symptoms.

While common viruses responsible for colds and flu cause most sore throats, there may be other causative reasons to consider as well. These include mouth breathing, post-nasal drip, fungus (“thrush”), bacteria, and even reflux. Because of these various causes, it is necessary to determine the reason of the sore throat in order to guarantee successful treatment.
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Laxative choice should fit the symptom
by Tamara Dulin, R.Ph.
Laxative choice should fit the symptom Prevention is the key because it is typically easier to prevent constipation than it is to treat it.

Nearly everyone has had a bout with constipation during his/her lifetime. The most common cause of constipation is poor diet. However, medication side effects, pregnancy, and lack of exercise can also contribute to the problem. Constipation can leave you feeling bloated, irritable, and in pain. In some severe cases, it can cause bowel obstruction, which could lead to a medical emergency. Prevention is the key because it is typically easier to prevent constipation than it is to treat it.
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There’s no x in Rx
by John Musico
There’s no x in Rx The story begins in Egypt 3,000 B.C. with a character named Horus described in the 'Egyptian Book of the Dead'.

The pharmacist’s predecessors were the alchemists and the pharmacists’ logo resembles a latter form of the alchemists’ logo. Both symbols look like an R with its leg crosshatched. Why do they look like that? Further, some people describe the pharmacists’ logo as an R with an overlapping x. Why?
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Another summer of closed toe shoes?
by Tamara Dulin, R.Ph.
Another summer of closed toe shoes? Treatment options to get nails in tip-top shape

Sandal season is upon us in the Midwest. Feet and toes should be in tip-top shape, especially at this time of year. Unfortunately, toenail fungus will prevent many from enjoying the “open-toe” feeling this season due to unsightly discoloration, thickened, brittle, flaky, distorted, and possibly odorous nails. Onychomyocosis, or toenail fungus, affects nearly 30-35 million Americans.
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Treating GERD
by Tamara Dulin, R.Ph.
If looking for relief of mild, occasional heartburn, the first available treatment option is the antacids.

Frequently pharmacists are approached for help in treating heartburn. Heartburn, a symptom of Gastresophageal Reflux Disease or GERD, allows stomach acid to splash back up into the esophagus. The acid causes a burning sensation and can result in some inflammation to the esophagus as well. Some patients detect a sour taste in the back of their mouths lending to the term “sour stomach.”
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FDA examines...Tylenol® dosage
by Tamara Dulin, R.Ph.
FDA examines...Tylenol® dosage It is imperative to administer only the recommended dose.

The FDA recently re-examined the recommended doses of acetaminophen, the active ingredient in Tylenol®. Acetaminophen is the most common pain reliever and fever reducer in the United States, yet the drug is the leading cause of liver toxicity.
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Nasal Wash: An alternative for decongestion medications
by Tamara Dulin, R.Ph.
Nasal Wash: An alternative for decongestion medications A major advantage to this solution is that it is preservative-free which again, ensures a soothing, and safe, solution.

There is an alternative to decongestant medications for the relief of nasal symptoms. It’s called a nasal wash. This process flushes the nasal passages with an isotonic solution to relieve congestion, eliminate excess mucous, and reduce inflammation in the nose.
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There is more to know than just the SPF
by Tamara Dulin, R.Ph.
There is more to know than just the SPF

For a mother, this time of year brings some relief, but also anxieties. Relief comes from the loosening of school schedules, along with homework, tests, sports practices, recitals, and games. Anxiety comes in many forms, but one in particular is protecting children from the harmful effects of sun exposure. As a pharmacist, I thought I knew the basic, most important rules of sunscreen: choose the right protection factor or SPF, apply sunscreen liberally prior to sun exposure, and reapply frequently especially after swimming and exercise.
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Watch out for the touted MAGIC PILL!
by Tamara Dulin, R.Ph.
Watch out for the touted MAGIC PILL! Unfortunately, only one over the counter (OTC) weight loss medication is FDA approved.

With New Year’s weight loss resolutions in full swing, or struggling at this point, it is often hard to resist the aid of weight loss remedies. Our society tends to seek the “quick-fix” or “magic pill” to solve obesity problems. Unfortunately, only one over the counter (OTC) weight loss medication is FDA approved, and as a pharmacist, it is hard for me to recommend any medication, dietary supplement, or herbal medication that does not have the Food and Drug Administration’s seal of approval. For this reason, I will focus on only approved, prescription and non-prescription, weight loss medications.
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Solving the Generic Riddle
by Tamara Dulin, R.Ph.
Solving the Generic Riddle Recently, I was asked to speak to a group of seniors about generic drugs. What are they? Why are they cheaper? Are they just as effective? This topic, alone, prompted many questions for me and brought to light several different issues relating to prescription medications. What about Internet purchasing? What about medications that come from other countries? Many questions.
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From the Pharmacy ... Fall Allergies
by Tamara Dulin, R.Ph.
From the Pharmacy ... Fall Allergies Ah, Fall! A most beautiful time of year! For me, not only does fall mean the glorious “changing of the leaves” (here in the Midwest), but also the start of football season! (Go Colts!). But, to others, fall and returning to school marks a time to prepare. Those who suffer from allergies and asthma must prepare in other ways for the season, which is worst for triggering attacks. Indeed, ragweed, pollen, mold, and dust are at their peaks due to spring and early summer rains followed by intense heat of the long, hot summer days. And unfortunately, these allergens circulate maximally starting in August and lasting through the first frost, typically in November.
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It’s Poison Ivy Season ... be prepared
by Tamara Dulin, R.Ph.
It’s Poison Ivy Season ... be  prepared Are you starting to itch, yet?

Like most people in the Midwest, I am looking forward to the warmer days and the anticipation of beautiful spring blooms. Like many others, I also look forward to “spring cleaning” my yard and weeding my flowerbeds to prepare for summer. What I do not like, however, is the possibility of encountering that “dreadful” poison ivy! Unfortunately, it has started to grow in my landscaped beds, through my hostas, alongside the base of my front porch. Of course, I found out about it the hard way! (Are you starting to itch, yet?)
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Drug Disposal
by Tamara Dulin, R.Ph.
Drug Disposal In addition to environmental concerns, prescription drug abuse has been on the rise so disposal now must address the accessibility of the unwanted drugs.

I was recently asked: “What is the proper way to dispose of medications?” Unfortunately, I was not able to answer quickly because I know that times have changed. Back when I graduated from pharmacy school, medications were just “flushed” down the toilet. We didn’t stop to think about what the medicinal waste was doing to the sewer system, the water supply, or even the environment. I distinctly remember that some tablets or capsules would begin to break down so quickly that we even suggested “flushing” the toilet first and then throwing the medications in as the toilet water began to swirl to prevent the coatings from adhering to the bottom of the toilet bowl!
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Are you protected?
by Tamara Dulin, R.Ph.
Are you protected? Each year, in the United States, approximately 65,000 deaths are attributed to pneumococcal disease, and that number is on the rise.

Fall has come and gone and you have probably already received your annual flu shot. This vaccination will protect you against the flu virus, but what about other illnesses such as pneumonia? Did you know that there is a vaccine to help protect you from pneumococcal disease...the bacteria that cause pneumonia? Did you know that older Americans, who get the flu, are also prone to getting pneumonia? Did you also know that those who have a preexisting condition such as heart disease, lung disease, or diabetes are more likely to get pneumonia?
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Chickenpox virus is not just a kid’s concern
by Tamara Dulin, R.Ph.
Chickenpox virus is not just a kid’s concern Many of us never give the chickenpox a second thought, unless we are exposed to the virus by a child or relative who has it. In that case, it is probably the topic of conversation…where or who they contracted it from, the extent of the blisters, the itching, and the overall general miserable feeling associated with it. However, most people do not consider the chickenpox virus as a risk factor for another disease, shingles. In fact the two primary risk factors for contracting shingles are
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For Best Results TIME MEDICATIONS PROPERLY
by Tamara Dulin, R.Ph.
For Best Results TIME MEDICATIONS PROPERLY Medications are typically dispensed with a detailed patient information sheet. Patients should read these!

Timing of medication is important. With the average healthy, older American taking four prescription medications at once plus two OTC medications, some problems may arise.

In some instances, chronic illnesses such as hypertension are treated with a combination of drugs. Anti-hypertensions should be taken together to obtain optimal clinical effects. Unfortunately, this practice is not a universal standard. The Centers for Disease Control and Prevention recently announced that drug interactions have grown to the second leading cause of accidental deaths nationwide, behind auto accidents.
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Best defense for allergies is Plan Ahead
by Tamara Dulin, R.Ph.
Pharmacy With the start of spring comes the start of seasonal allergies. Frequently called hay fever, seasonal allergic rhinitis affects nearly 36 million people in the United States and accounts for over $3 billion in medication and physician bills. Hay fever is triggered by allergens such as pollens or molds and is characterized by sneezing, watery eyes, nasal congestion, and itching.

There are three major groups of medications that are used to treat hay fever. These include antihistamines, decongestants, and nasal sprays.

Over the counter (OTC) antihistamines like Benadryl®, Chlortrimeton® and generic equivalents have been the “gold standard” for classic allergy symptoms for years.
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Side effects of Antidepressants ...
by Tamara Dulin, R.Ph.
If you and your doctor have determined that an antidepressant medication is the right choice for you, the side effect profile and potential for interaction with other medications should be taken into consideration. For this reason, it is imperative that a few “essentials” be followed. (These tips are good, general practices for anyone who is managing their own medical condition)
  1. Keep a current list of medications (including over-the-counter medications). Personal pocket medical journals are available.
  2. Use one particular pharmacy so that interactions may be detected quickly. Get to know your pharmacist(s) so he/she will better help manage your health conditions with an accurate medication history.
  3. Keep all follow-up appointments with your doctor so that needed adjustments can be made in a timely manner. Your doctor needs to monitor your response or lack of response, as well as side effects to determine optimal dosage or medication changes.

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Where are the OTC cold remedies?
by Tamara Dulin, R.Ph.
Have you gone to the drug store lately to purchase your favorite decongestant, only to find that it is no longer on the shelf?

Federal law recently began regulating the sale of certain decongestants as part of the Combat Methamphetamine Epidemic Act. The regulation was instituted as an attempt to curb the illegal production of methamphetamine. Many over-the-counter (OTC) remedies, which contain pseudoephedrine, are now located “behind the counter” at drug stores nationwide.

Because methamphetamine can be manufactured or “cooked” using common household ingredients, including oral decongestants, limits have now been set to decrease the availability of these over-the-counter drugs to deter the illegal manufacture of meth.
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Ask The Pharmacist
by Tamara Dulin, R.Ph.
I have heard that I should avoid grapefruit juice because of some of the medications that I take. Why?

Grapefruit There are chemicals in grapefruit juice that prevent the breakdown of certain drugs in your digestive system by interfering with digestive enzymes. This allows more of the medication to reach the bloodstream which, in turn, results in higher drug levels. The higher drug levels may cause an increased (or toxic) clinical effect and/or increased side effects.
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