Archive For: Medications

COVID-19 Vaccine Update

Experts Weigh In With Reassuring Outlook

The COVID-19 vaccine rollout is in full swing around the country but many questions remain. We reveal the latest answers (as of February 2021) from nationally recognized vaccine experts Dr. Paul Sax, Professor of Medicine, Harvard Medical School and Clinical Director of Infectious Disease, Brigham and Women’s Hospital; and Michael Kinch, PhD, Director of Washington University’s Center for Drug Discovery.

How will the new variants impact the effectiveness of the vaccines?

Sax: Data is emerging daily. The UK variant has a higher level of contagiousness but is mediated just as well with the vaccine; other variants’ stories are still unfolding. Vaccine manufacturers are retooling the antigens to make them effective against a broader group of viruses. Boosters may be provided in the future.

Kinch: The variants show us that the coronavirus is very efficient at mutation, and we’ll likely need to adapt our vaccines every two to five years to provide the right protection.

Is it safe to get vaccinated at large outdoor stadiums?

Sax: Yes, absolutely. People are not being crowded into poorly ventilated indoor spaces at these events.

Which vaccine is best?

Sax: The one that’s offered to you! Don’t wait for a specific vaccine because in the interim, you’re at higher risk for getting a more severe case of COVID-19. Pfizer and Moderna, both mRNA vaccines, are 95% effective after two doses. The J&J vaccine works differently, using a virus that doesn’t reproduce in humans and stimulating an immune response after just one dose. While J&J’s 70-80% rate may not be as high as the others, it’s very effective in preventing severe disease, so you can feel confident about getting it. We are also likely to have a fourth vaccine, Novavax, available soon.

Kinch: We may not have a definitive answer to this question until later this year. But these are incredible vaccine breakthroughs, with exceptionally high rates of effectiveness.

Is delaying the second dose problematic?

Sax: Getting it too early is actually more concerning. The first dose primes the immune system and the second dose gives it a huge boost. Waiting six weeks won’t matter.

Are side effects worse after the second dose?

Sax: Yes, there are more side effects reported but this indicates your body is responding to the vaccine. I experienced headache, fatigue and trouble concentrating immediately afterwards, and then felt totally fine the next day. That’s a trade-off I’d take anytime versus the potentially life-threatening consequences of COVID-19.

What if I don’t experience side effects?

Sax: No need for concern, as the vaccines were shown to be highly effective in trials with thousands of people, including a significant number over age 55. However, older, frailer people weren’t tested, and it’s possible they may not respond as well to the vaccine.

Can I take pain relievers before or after getting the vaccine?

Sax: Don’t take any beforehand as it can blunt the immune response; afterwards, it’s fine.

What is still unknown about COVID-19 and vaccines?

Sax: We don’t know the risk of immunized people transmitting COVID-19, but we’re seeing promising evidence from Israel that vaccinated individuals carry lower amounts of virus. This will significantly reduce but not completely eliminate transmission. Also unknown is whether natural or vaccine-induced immunity is better.

Kinch: The long-term durability of the vaccine’s immune protection isn’t known, but we’ll discover that over time. Preliminary data seems to indicate that recovery from minor cases of coronavirus provides three to nine months of protection.

Is it important to vaccinate younger people?

Sax: Elementary age kids only get mildly sick from COVID-19 and they’re not very contagious, but teenagers are at higher risk for severe disease and are more contagious. The most important group to vaccinate is people in their 20s, who’ve been primary spreaders of the virus.

Should immunosuppressed patients get the vaccine?

Kinch: Yes, and in fact, patients with autoimmune conditions will be prioritized as a higher-risk group. One of the most promising and least discussed aspects of the Moderna and Pfizer trials is that while many patients became infected with the virus, not one was hospitalized, needed intubation or died. This is particularly significant for immunosuppressed patients, because if infection can’t be prevented altogether, the vaccine will lessen disease severity and result in much better outcomes.

Should pregnant women get the vaccine?

Sax: Pregnancy is a severe risk factor for COVID. While theoretically the vaccine is safe, we don’t have all the data yet. I’d recommend it, but also understand if a woman chooses to wait.

What needs to happen to resume normal life?

Sax: We have to be laser focused on mobilizing vaccinations nationally and not expect the states to just figure it out. I feel optimistic that enough vaccine will be available by summer, possibly even by late spring, for everyone to be immunized.

(sidebar)After vaccination, is it safe* to…

  • Visit family and friends? Wearing masks and social distancing is still necessary in large, public settings, but we can relax a bit in small group settings. Although the risk of interacting without masks is not zero, it is low, so go ahead and hug your grandchildren! And if you’re dining indoors with family, simply open the windows for good ventilation.
  • Exercise? Yes, and no need to wear a mask if outdoors and you’re a decent distance away from people. At indoor gyms, wear a mask, keep your distance and avoid areas that are not well-ventilated.
  • Eat at restaurants? Yes, if outdoors; no if indoors.
  • Travel by air? Yes, with precautions. Surprisingly few transmission events haveoccurred aboard planes; however, the boarding process and airport experience are not well controlled, so stay masked and distanced.

Additional post-vaccination guidelines are available from the CDC.*Dr. Paul Sax, Guest Speaker, Lown Cardiology Group Health & Wellness Webinar (2.16.2021)

The post COVID-19 Vaccine Update appeared first on Specialdocs Consultants.

COVID-19 Vaccine Update

Experts Weigh In With Reassuring Outlook

The COVID-19 vaccine rollout is in full swing around the country but many questions remain. We reveal the latest answers (as of February 2021) from nationally recognized vaccine experts Dr. Paul Sax, Professor of Medicine, Harvard Medical School and Clinical Director of Infectious Disease, Brigham and Women’s Hospital; and Michael Kinch, PhD, Director of Washington University’s Center for Drug Discovery.

How will the new variants impact the effectiveness of the vaccines?

Sax: Data is emerging daily. The UK variant has a higher level of contagiousness but is mediated just as well with the vaccine; other variants’ stories are still unfolding. Vaccine manufacturers are retooling the antigens to make them effective against a broader group of viruses. Boosters may be provided in the future.

Kinch: The variants show us that the coronavirus is very efficient at mutation, and we’ll likely need to adapt our vaccines every two to five years to provide the right protection.

Is it safe to get vaccinated at large outdoor stadiums?

Sax: Yes, absolutely. People are not being crowded into poorly ventilated indoor spaces at these events.

Which vaccine is best?

Sax: The one that’s offered to you! Don’t wait for a specific vaccine because in the interim, you’re at higher risk for getting a more severe case of COVID-19. Pfizer and Moderna, both mRNA vaccines, are 95% effective after two doses. The J&J vaccine works differently, using a virus that doesn’t reproduce in humans and stimulating an immune response after just one dose. While J&J’s 70-80% rate may not be as high as the others, it’s very effective in preventing severe disease, so you can feel confident about getting it. We are also likely to have a fourth vaccine, Novavax, available soon.

Kinch: We may not have a definitive answer to this question until later this year. But these are incredible vaccine breakthroughs, with exceptionally high rates of effectiveness.

Is delaying the second dose problematic?

Sax: Getting it too early is actually more concerning. The first dose primes the immune system and the second dose gives it a huge boost. Waiting six weeks won’t matter.

Are side effects worse after the second dose?

Sax: Yes, there are more side effects reported but this indicates your body is responding to the vaccine. I experienced headache, fatigue and trouble concentrating immediately afterwards, and then felt totally fine the next day. That’s a trade-off I’d take anytime versus the potentially life-threatening consequences of COVID-19.

What if I don’t experience side effects?

Sax: No need for concern, as the vaccines were shown to be highly effective in trials with thousands of people, including a significant number over age 55. However, older, frailer people weren’t tested, and it’s possible they may not respond as well to the vaccine.

Can I take pain relievers before or after getting the vaccine?

Sax: Don’t take any beforehand as it can blunt the immune response; afterwards, it’s fine.

What is still unknown about COVID-19 and vaccines?

Sax: We don’t know the risk of immunized people transmitting COVID-19, but we’re seeing promising evidence from Israel that vaccinated individuals carry lower amounts of virus. This will significantly reduce but not completely eliminate transmission. Also unknown is whether natural or vaccine-induced immunity is better.

Kinch: The long-term durability of the vaccine’s immune protection isn’t known, but we’ll discover that over time. Preliminary data seems to indicate that recovery from minor cases of coronavirus provides three to nine months of protection.

Is it important to vaccinate younger people?

Sax: Elementary age kids only get mildly sick from COVID-19 and they’re not very contagious, but teenagers are at higher risk for severe disease and are more contagious. The most important group to vaccinate is people in their 20s, who’ve been primary spreaders of the virus.

Should immunosuppressed patients get the vaccine?

Kinch: Yes, and in fact, patients with autoimmune conditions will be prioritized as a higher-risk group. One of the most promising and least discussed aspects of the Moderna and Pfizer trials is that while many patients became infected with the virus, not one was hospitalized, needed intubation or died. This is particularly significant for immunosuppressed patients, because if infection can’t be prevented altogether, the vaccine will lessen disease severity and result in much better outcomes.

Should pregnant women get the vaccine?

Sax: Pregnancy is a severe risk factor for COVID. While theoretically the vaccine is safe, we don’t have all the data yet. I’d recommend it, but also understand if a woman chooses to wait.

What needs to happen to resume normal life?

Sax: We have to be laser focused on mobilizing vaccinations nationally and not expect the states to just figure it out. I feel optimistic that enough vaccine will be available by summer, possibly even by late spring, for everyone to be immunized.

(sidebar)After vaccination, is it safe* to…

  • Visit family and friends? Wearing masks and social distancing is still necessary in large, public settings, but we can relax a bit in small group settings. Although the risk of interacting without masks is not zero, it is low, so go ahead and hug your grandchildren! And if you’re dining indoors with family, simply open the windows for good ventilation.
  • Exercise? Yes, and no need to wear a mask if outdoors and you’re a decent distance away from people. At indoor gyms, wear a mask, keep your distance and avoid areas that are not well-ventilated.
  • Eat at restaurants? Yes, if outdoors; no if indoors.
  • Travel by air? Yes, with precautions. Surprisingly few transmission events haveoccurred aboard planes; however, the boarding process and airport experience are not well controlled, so stay masked and distanced.

Additional post-vaccination guidelines are available from the CDC.*Dr. Paul Sax, Guest Speaker, Lown Cardiology Group Health & Wellness Webinar (2.16.2021)

The post COVID-19 Vaccine Update appeared first on Specialdocs Consultants.

A Guide to the Power Players in Pain Relief

Which Pain Relievers Work Best?

When you reach for a pain reliever, what are you most likely to find in your medicine cabinet? And does it matter? While aspirin, Tylenol and Aleve may appear similar and aim for the same results, their effects can vary. Below is a quick guide to today’s most recognizable over-the-counter (OTC) pain relief products.

The effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) in alleviating pain and reducing inflammation is well documented. They work by blocking the effects of specific enzymes to decrease the number of prostaglandins made in the body, which cause tissue to swell and increase the pain you experience. While widely used, it’s important to be aware of the limitations of these medications, most notably that all NSAIDs except aspirin carry an FDA warning for increased risk of heart attack, stroke or high blood pressure when used at high doses for long periods of time. They can also cause stomach upset, heartburn, and ulcers which may bleed; because they are blood thinners, should not be taken with medications such as Coumadin. Additionally, NSAIDs provide rapid pain relief for most, but may require a two-to-three week regimen to realize anti-inflammatory effects.

NSAIDs include:

Acetylsalicylic acid/aspirin (Bayer, Bufferin)
Aspirin, the first OTC pain reliever to be mass produced in the early 1900s, is still the most commonly used for headaches, minor aches and pains and inflammation. Unlike other NSAIDs, it is not associated with a higher risk of heart attack.

Ibuprofen (Advil, Motrin)
Ibuprofen is commonly used to treat pain and bring down fever, and alleviates symptoms of migraine, menstrual cramps, toothache, and inflammation with better results than aspirin. Some studies point to a lower risk of ibuprofen causing ulcers and gastrointestinal bleeding than other NSAIDs.

Naproxen sodium (Aleve, Midol)
This NSAID is most effective for alleviating backaches, arthritis, sprains and other types of inflammatory-based pain. In comparable doses, naproxen has a longer-lasting effect than other pain relievers, lasting 8 to 12 hours versus 4 to 8.

The non-NSAID solution:

Acetaminophen (Tylenol, Anacin)
Tylenol, the most well-known brand of acetaminophen, is used to treat pain and reduce fever and is safe for both heart and gut. However, this non-NSAID can’t be used to relieve inflammation-related conditions. Also different from NSAIDs, acetaminophen is broken down and removed by the liver, and taking too much in a 24-hour period can cause liver damage. Be sure to read product labels carefully because acetaminophen, ibuprofen and aspirin are often combined in products to treat cough, flu or sinus infection.

Which pain reliever should you take? There are no easy answers because individual responses to the same type and dose of medication can be considerably different. It’s sometimes necessary to try one drug and then another to determine optimal treatment; or consider prescription medications. Please call our office to discuss your best options.

New Perspectives on Aspirin

The long-accepted use of a daily low-dose aspirin to treat or prevent heart attacks or strokes was re-examined in light of recent studies showing the therapy’s heightened risk of gastrointestinal bleeding or hemorrhagic stroke outweighed its benefits for people who are healthy with no history of cardiovascular disease. Some experts now recommend daily aspirin therapy only for those who’ve already had a heart attack or stroke, a coronary artery stent or coronary bypass surgery, or are at a higher risk for coronary artery disease.

Always using pain relievers to bring down a fever has been challenged, somewhat controversially, by researchers including Dr. Paul Offit, vaccinologist at the University of Philadelphia and author of Overkill: When Modern Medicine Goes Too Far. “Fever is a symptom that occurs for a reason,” he says. “The immune system actually works better at a high temperature, so treating a fever with aspirin can prolong or worsen illness.”

The post A Guide to the Power Players in Pain Relief appeared first on Specialdocs Consultants.

A Guide to the Power Players in Pain Relief

Which Pain Relievers Work Best?

When you reach for a pain reliever, what are you most likely to find in your medicine cabinet? And does it matter? While aspirin, Tylenol and Aleve may appear similar and aim for the same results, their effects can vary. Below is a quick guide to today’s most recognizable over-the-counter (OTC) pain relief products.

The effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) in alleviating pain and reducing inflammation is well documented. They work by blocking the effects of specific enzymes to decrease the number of prostaglandins made in the body, which cause tissue to swell and increase the pain you experience. While widely used, it’s important to be aware of the limitations of these medications, most notably that all NSAIDs except aspirin carry an FDA warning for increased risk of heart attack, stroke or high blood pressure when used at high doses for long periods of time. They can also cause stomach upset, heartburn, and ulcers which may bleed; because they are blood thinners, should not be taken with medications such as Coumadin. Additionally, NSAIDs provide rapid pain relief for most, but may require a two-to-three week regimen to realize anti-inflammatory effects.

NSAIDs include:

Acetylsalicylic acid/aspirin (Bayer, Bufferin)
Aspirin, the first OTC pain reliever to be mass produced in the early 1900s, is still the most commonly used for headaches, minor aches and pains and inflammation. Unlike other NSAIDs, it is not associated with a higher risk of heart attack.

Ibuprofen (Advil, Motrin)
Ibuprofen is commonly used to treat pain and bring down fever, and alleviates symptoms of migraine, menstrual cramps, toothache, and inflammation with better results than aspirin. Some studies point to a lower risk of ibuprofen causing ulcers and gastrointestinal bleeding than other NSAIDs.

Naproxen sodium (Aleve, Midol)
This NSAID is most effective for alleviating backaches, arthritis, sprains and other types of inflammatory-based pain. In comparable doses, naproxen has a longer-lasting effect than other pain relievers, lasting 8 to 12 hours versus 4 to 8.

The non-NSAID solution:

Acetaminophen (Tylenol, Anacin)
Tylenol, the most well-known brand of acetaminophen, is used to treat pain and reduce fever and is safe for both heart and gut. However, this non-NSAID can’t be used to relieve inflammation-related conditions. Also different from NSAIDs, acetaminophen is broken down and removed by the liver, and taking too much in a 24-hour period can cause liver damage. Be sure to read product labels carefully because acetaminophen, ibuprofen and aspirin are often combined in products to treat cough, flu or sinus infection.

Which pain reliever should you take? There are no easy answers because individual responses to the same type and dose of medication can be considerably different. It’s sometimes necessary to try one drug and then another to determine optimal treatment; or consider prescription medications. Please call our office to discuss your best options.

New Perspectives on Aspirin

The long-accepted use of a daily low-dose aspirin to treat or prevent heart attacks or strokes was re-examined in light of recent studies showing the therapy’s heightened risk of gastrointestinal bleeding or hemorrhagic stroke outweighed its benefits for people who are healthy with no history of cardiovascular disease. Some experts now recommend daily aspirin therapy only for those who’ve already had a heart attack or stroke, a coronary artery stent or coronary bypass surgery, or are at a higher risk for coronary artery disease.

Always using pain relievers to bring down a fever has been challenged, somewhat controversially, by researchers including Dr. Paul Offit, vaccinologist at the University of Philadelphia and author of Overkill: When Modern Medicine Goes Too Far. “Fever is a symptom that occurs for a reason,” he says. “The immune system actually works better at a high temperature, so treating a fever with aspirin can prolong or worsen illness.”

The post A Guide to the Power Players in Pain Relief appeared first on Specialdocs Consultants.

Antibiotics Awareness is Good for Your Health

Image of Antibiotics

Antibiotics Awareness

Spurred by Alexander Fleming’s serendipitous discovery of penicillin in 1928, antibiotics have rightfully become wonder drugs, often able to change the course of deadly bacterial infections in a matter of days. But in recent years, their unmatched healing power has become overprescribed and over utilized, leading to concerning findings like these: Nearly 23% of antibiotic prescriptions filled in 2016 were unnecessary, and an additional 36% were prescribed for conditions for which an antibiotic is only sometimes recommended, according to a recent study from the Agency for Healthcare Research and Quality. Antibiotics awareness is good for your health

Unintended consequences far from benign

Patients may needlessly experience the drug’s side effects, such as rash, dizziness, nausea, diarrhea or Clostridium difficile infection (C. diff), which can cause severe diarrhea and may be life-threatening. On a larger, global scale, overuse leads to antibiotic-resistant bacteria, a growing danger that occurs when bacteria that have been exposed to an antibiotic mutate, rendering the drug ineffective against them. The Centers for Disease Control estimates that at least 2 million people are infected with antibiotic-resistant bacteria each year in the US, resulting in approximately 23,000 deaths. In fact, Fleming himself predicted the possibility in his 1945 Nobel Prize acceptance speech, saying: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.”

Antibiotics: Handle With Care

That’s why the World Health Organization’s annual “Antibiotics: Handle With Care” campaign, launched in 2015, and the United States’ “Be Antibiotics Aware” program, launched the following year, are more important than ever in raising awareness as to why antibiotics aren’t always the answer. Becoming knowledgeable about the difference between bacterial and viral infections, and why an observational (“watch and wait”) approach to antibiotic treatment may be considered for conditions like sinusitis or ear infections, is critical to stemming the tide of overuse.

Below is a look at when antibiotics should be the treatment of choice, when they should be considered only after watching and waiting, or when they are not called for at all. Note that antibiotic drugs effectively kill bacteria but not viruses, which is why they are never recommended for viral infections such as colds or flu. However, not all bacterial infections require the use of antibiotics. As always, check-in with our office regarding what’s best for your individual health.

CONDITION ARE ANTIBIOTICS THE ANSWER? SYMPTOM MANAGEMENT
Common cold/upper respiratory infection No, primarily viral Cough expectorants sometimes combined with decongestants; antihistamines; and cough suppressants
Flu No, primarily viral Antiviral drugs by prescription
Bronchitis/chest cold No, primarily viral; thick, yellow or green mucus does not indicate bacterial infection Cough suppressants/expectorants; decongestants; antihistamines
Sore throat Only if diagnosed with group A streptococcal pharyngitis (the cause of just 5-10% of adult sore throats) Over-the-counter (OTC) pain relievers such as aspirin, ibuprofen and acetaminophen; throat lozenges
Sinusitis Only if severe, or if symptoms persist after

10-14 days. Many studies show no difference in recovery rate with or without antibiotics.

Sinusitis infections are primarily viral; even if diagnosed as bacterial, a watch and wait approach may be recommended.

OTC pain relievers
Pneumonia Yes, if diagnosed as bacterial OTC fever reducers/pain relievers
Middle ear infection For mild cases, watchful waiting or delayed antibiotic prescribing may be recommended Extra fluids; OTC pain relievers
Cystitis, a common bladder infection in females Yes, this infection is usually bacterial Fluids; heating pad on lower abdomen; warm bath
Lyme disease Yes, cause is a bacteria transmitted to humans by a bite from an infected tick; treatment with antibiotics in early stages of disease is most effective and prevents later-stage complications

Sources: Up to Date, CDC

About that penicillin allergy

Most people who believe they’re allergic to penicillin can take it without a problem, either because of the rash, they experienced as part of a virus or because the allergy resolved over time. You may want to get tested by an allergist to be certain, as research shows that patients identified as penicillin-allergic are more likely to receive very powerful antibiotics with greater side effects, and are also at higher risk of developing resistant infections that require longer stays in the hospital. It’s interesting to note that when skin tested, approximately 90% of people will test negative for a penicillin allergy.

Did You Know?

Reactions from antibiotics cause 1 out of 5 medication-related visits to the emergency department.
Source: Centers for Disease Control

The post Antibiotics Awareness is Good for Your Health appeared first on Specialdocs Consultants.

Antibiotics: Are You Aware?

Image of Antibiotics

Are You Antibiotics Aware?

Spurred by Alexander Fleming’s serendipitous discovery of penicillin in 1928, antibiotics have rightfully become wonder drugs, often able to change the course of deadly bacterial infections in a matter of days. But in recent years, their unmatched healing power has become overprescribed and overutilized, leading to concerning findings like these: Nearly 23% of antibiotic prescriptions filled in 2016 were unnecessary, and an additional 36% were prescribed for conditions for which an antibiotic is only sometimes recommended, according to a recent study from the Agency for Healthcare Research and Quality.

The unintended consequences are far from benign. Patients may needlessly experience the drug’s side effects, such as rash, dizziness, nausea, diarrhea or Clostridium difficile infection (C. diff), which can cause severe diarrhea and may be life-threatening. On a larger, global scale, overuse leads to antibiotic-resistant bacteria, a growing danger that occurs when bacteria that have been exposed to an antibiotic mutate, rendering the drug ineffective against them. The Centers for Disease Control estimates that at least 2 million people are infected with antibiotic-resistant bacteria each year in the US, resulting in approximately 23,000 deaths. In fact, Fleming himself predicted the possibility in his 1945 Nobel Prize acceptance speech, saying: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.”

That’s why the World Health Organization’s annual “Antibiotics: Handle With Care” campaign, launched in 2015, and the United States’ “Be Antibiotics Aware” program, launched the following year, are more important than ever in raising awareness as to why antibiotics aren’t always the answer. Becoming knowledgeable about the difference between bacterial and viral infections, and why an observational (“watch and wait”) approach to antibiotic treatment may be considered for conditions like sinusitis or ear infections, is critical to stemming the tide of overuse.

Below is a look at when antibiotics should be the treatment of choice, when they should be considered only after watching and waiting, or when they are not called for at all. Note that antibiotic drugs effectively kill bacteria but not viruses, which is why they are never recommended for viral infections such as colds or flu. However, not all bacterial infections require the use of antibiotics. As always, check-in with our office regarding what’s best for your individual health.

CONDITION ARE ANTIBIOTICS THE ANSWER? SYMPTOM MANAGEMENT
Common cold/upper respiratory infection No, primarily viral Cough expectorants sometimes combined with decongestants; antihistamines; and cough suppressants
Flu No, primarily viral Antiviral drugs by prescription
Bronchitis/chest cold No, primarily viral; thick, yellow or green mucus does not indicate bacterial infection Cough suppressants/expectorants; decongestants; antihistamines
Sore throat Only if diagnosed with group A streptococcal pharyngitis (the cause of just 5-10% of adult sore throats) Over-the-counter (OTC) pain relievers such as aspirin, ibuprofen and acetaminophen; throat lozenges
Sinusitis Only if severe, or if symptoms persist after

10-14 days. Many studies show no difference in recovery rate with or without antibiotics.

Sinusitis infections are primarily viral; even if diagnosed as bacterial, a watch and wait approach may be recommended.

OTC pain relievers
Pneumonia Yes, if diagnosed as bacterial OTC fever reducers/pain relievers
Middle ear infection For mild cases, watchful waiting or delayed antibiotic prescribing may be recommended Extra fluids; OTC pain relievers
Cystitis, a common bladder infection in females Yes, this infection is usually bacterial Fluids; heating pad on lower abdomen; warm bath
Lyme disease Yes, cause is a bacteria transmitted to humans by a bite from an infected tick; treatment with antibiotics in early stages of disease is most effective and prevents later-stage complications

Sources: Up to Date, CDC

About that penicillin allergy
Most people who believe they’re allergic to penicillin can take it without a problem, either because of the rash, they experienced as part of a virus or because the allergy resolved over time. You may want to get tested by an allergist to be certain, as research shows that patients identified as penicillin-allergic are more likely to receive very powerful antibiotics with greater side effects, and are also at higher risk of developing resistant infections that require longer stays in the hospital. It’s interesting to note that when skin tested, approximately 90% of people will test negative for a penicillin allergy.

Did You Know?
Reactions from antibiotics cause
1 out of 5 medication-related visits to the emergency department.
Source: Centers for Disease Control

The post Antibiotics: Are You Aware? appeared first on Specialdocs Consultants.

Manage Prescription Drugs Effectively

Manage Prescription Drugs Effectively

Managing Prescription Drugs: From Pickup to Take Back

If you are not taking your prescription medications as directed (or at all), you’re far from alone. Compliance is estimated at just 50% among U.S. patients. Unfortunately, adherence is a direct impact on quality and length of life, and overall healthcare costs, accounting for up to 50% of treatment failures and up to 25% of hospitalizations each year. The reasons for noncompliance vary, from patients not being convinced of the medication’s effectiveness, fear of side effects, the cost of certain medications to difficulty using tools (such as inhalers) or an aversion to injections. What can be done to manage prescription drugs more effectively?

For most, non-compliance is simply an unintentional consequence of forgetfulness or lack of organization. When faced with the need to keep track of a growing lineup of daily doses – and 77% of older adults manage two or more chronic conditions according to the National Council on Aging – it can become challenging to keep up. Fortunately, many solutions are available, from old school pen and paper to high-tech smartphone apps, that make it easy to reap the benefits of and manage your prescription medications.

Pick up

  • At the pharmacy, check your prescription instructions and make sure you fully understand dosage and timing; if best taken with food; interactions with other drugs, supplements, foods and alcohol; and side effects. If you have questions, ask the pharmacist or call our office.

Organize

  • Tried and true, a pill organizer with compartments divided into sections for days of the week is most helpful in managing multiple medications. Keep the original bottles so you can quickly access any dosing and refill information printed on the bottle or packaging.
  • Create a dosing schedule chart to keep next to the pill organizer, with a physical description or visual image of each pill. Use a spreadsheet or word processing program to make a list of all medications, times to take, and a check off space to indicate when taken. A number of pre-formatted charts are available online for download from the American Heart Association, the Food and Drug Administration and others.
  • Online pharmacies are entering the mix, offering delivery of monthly medications sorted by dose.

Smartphone Reminders 

Free smartphone apps can serve multiple functions. A few of the best:

  • Medisafe medication management and pill reminder, highly rated by pharmacists for its comprehensiveness and usability, includes videos for many frequently used medications illustrating use, side effects, contraindications and other information, and emails you a history of your medications and doses in an Excel spreadsheet.
  • Care Zone Health Information Organizer enables you to take pictures of your prescription and over-the-counter (OTC) drugs and supplements, populates with details, and sends reminders to take medications and refill prescriptions.
  • Drugs.com also sends reminders, keeps your medication history, includes an interaction checker for other drugs and foods and provides access to updated information for more than 24,000 prescription and OTC drugs and supplements.
  • Ask your pharmacist about preparing blister packs for daily or weekly medications; timer caps for pill bottles that beep to remind you when to take medications; gadgets that “talk” and relay the information verbally; and stand-alone electronic pill devices enabling easy input of medication name and measures, with an alarm that notifies you when the next dose is needed.

Properly Store your Prescription Drugs

  • Pick a location that is up and away, like a kitchen cabinet (not the bathroom, unless it is well ventilated). Keep medications cool and dry and in a well-lit area to ensure you’ll reach for the right ones.
  • Open the medicine bottle on a flat surface to prevent dropped pills from being lost down a drain or landing on the floor.
  • Make a discard pile of medicines that are discolored, dried out, crumbling, leftover from a previous illness or past their expiration date—particularly biologic products, insulin, refrigerated liquids, eye drops, injectables or specially compounded medications.

Discard with care: Toss, flush or Take Back

Most prescription and OTC medicines can be thrown away in the household trash, with these important procedures:

  • Do not crush tablets or capsules.
  • Mix the medicines with kitty litter or used coffee grounds to prevent thievery or diversion of medicines from the trash. Then, place the mixture in a container such as a sealable plastic bag, and throw away.
  • Remove the label and/or scratch off all personal information when disposing of a prescription vial.
  • Check instructions included with prescription drugs such as narcotic pain relievers e.g. the fentanyl patch and other controlled substances, which must be flushed instead of discarded.

Even more convenient and environmentally sound are programs such as National Prescription Drug Take Back Day, sponsored by the U.S. Drug Enforcement Administration (DEA) in communities nationwide. The next one is scheduled for October 26, 2019: Find a collection site near you at https://takebackday.dea.gov, dispose of your unused or expired drugs safely and easily.

Did You Know?

Approximately 50% of medications for chronic disease are not taken as prescribed.
*Source: Annals of Internal Medicine

11.8 million pounds of prescription drugs collected since Take Back Day began in 2010.
*Source: Drug Enforcement Administration

The post Manage Prescription Drugs Effectively appeared first on Specialdocs Consultants.

Prescription Drugs, From Pickup to Takeback

Safe Passage: Navigating Your Prescription Drugs, From Pickup to Takeback

If you are not taking your prescription medications as directed (or at all), you’re far from alone: Compliance is estimated at just 50% among U.S. patients. Unfortunately, adherence is a direct impact on quality and length of life, and overall healthcare costs, accounting for up to 50% of treatment failures and up to 25% of hospitalizations each year. The reasons for noncompliance vary, from patients not being convinced of the medication’s effectiveness, fear of side effects, the cost of certain medications to difficulty using tools (such as inhalers) or an aversion to injections.

For most, however, non-compliance is simply an unintentional consequence of forgetfulness or lack of organization. When faced with the need to keep track of a growing lineup of daily doses – and 77% of older adults manage two or more chronic conditions according to the National Council on Aging – it can become challenging to keep up. Fortunately, many solutions are available, from old school pen and paper to higher-tech apps, that make it easy to reap the full benefits of your prescription medications.

Pick up

  • At the pharmacy, check your prescription instructions and make sure you fully understand dosage and timing; if best taken with food; interactions with other drugs, supplements, foods and alcohol; and side effects. If you have questions, ask the pharmacist or call our office.

Organize

  • Tried and true, a pill organizer with compartments divided into sections for days of the week is most helpful in managing multiple medications. Keep the original bottles so you can quickly access any dosing and refill information printed on the bottle or packaging.
  • Create a dosing schedule chart to keep next to the pill organizer, with a physical description or visual image of each pill. Use a spreadsheet or word processing program to make a list of all medications, times to take, and a check off space to indicate when taken. A number of pre-formatted charts are available online for download from the American Heart Association, the Food and Drug Administration and others.
  • Online pharmacies are entering the mix, offering delivery of monthly medications sorted by dose.

Remind

Free smartphone apps can serve multiple functions. A few of the best:

  • Medisafe medication management and pill reminder, highly rated by pharmacists for its comprehensiveness and usability, includes videos for many frequently used medications illustrating use, side effects, contraindications and other information, and emails you a history of your medications and doses in an Excel spreadsheet.
  • Care Zone Health Information Organizer enables you to take pictures of your prescription and over-the-counter (OTC) drugs and supplements, populates with details, and sends reminders to take medications and refill prescriptions.
  • Drugs.com also sends reminders, keeps your medication history, includes an interaction checker for other drugs and foods and provides access to updated information for more than 24,000 prescription and OTC drugs and supplements.
  • Ask your pharmacist about preparing blister packs for daily or weekly medications; timer caps for pill bottles that beep to remind you when to take medications; gadgets that “talk” and relay the information verbally; and stand-alone electronic pill devices enabling easy input of medication name and measures, with an alarm that notifies you when the next dose is needed.

Store

  • Pick a location that is up and away, like a kitchen cabinet (not the bathroom, unless it is well ventilated). Keep medications cool and dry and in a well-lit area to ensure you’ll reach for the right ones.
  • Open the medicine bottle on a flat surface to prevent dropped pills from being lost down a drain or landing on the floor.
  • Make a discard pile of medicines that are discolored, dried out, crumbling, leftover from a previous illness or past their expiration date—particularly biologic products, insulin, refrigerated liquids, eye drops, injectables or specially compounded medications.

Toss, flush or take back: Discard with care

Most prescription and OTC medicines can be thrown away in the household trash, with these important procedures:

  • Do not crush tablets or capsules.
  • Mix the medicines with kitty litter or used coffee grounds to prevent thievery or diversion of medicines from the trash. Then, place the mixture in a container such as a sealable plastic bag, and throw away.
  • Remove the label and/or scratch off all personal information when disposing of a prescription vial.
  • Check instructions included with prescription drugs such as narcotic pain relievers e.g. the fentanyl patch and other controlled substances, which must be flushed instead of discarded.

Even more convenient and environmentally sound are programs such as National Prescription Drug Take Back Day, sponsored by the U.S. Drug Enforcement Administration (DEA) in communities nationwide. The next one is scheduled for October 26, 2019: Find a collection site near you at https://takebackday.dea.gov and dispose of your unused or expired drugs safely and easily.

Did You Know?

Approximately 50% of medications for chronic disease are not taken as prescribed.
*Source: Annals of Internal Medicine

11.8 million pounds of prescription drugs collected since Take Back Day began in 2010.
*Source: Drug Enforcement Administration

The post Prescription Drugs, From Pickup to Takeback appeared first on Specialdocs Consultants.

Medical Marijuana Myths

Smoking Out the Myths: Medical Marijuana

Does medical marijuana offer a solution to treating epilepsy, chronic pain, anxiety and neurogenerative diseases? Or is it an untested, potentially unsafe treatment that will eventually turn out to be more of a pipe dream? As with so many of today’s biggest questions, the truth is somewhere in between. We bring you a down-to-earth view of this much-discussed and yet oft-misunderstood topic to separate the hype from the hope.

While the marijuana or hemp plant has been used for more than 3,000 years, research and treatment today is primarily focused on the extract known as CBD, a cannabinoid. Unlike one of the other chemicals in the plant, THC (tetrahydrocannabinol,) CBD has no psychogenic effects and does not produce the “high” commonly associated with marijuana. Hundreds of CBD-related tests are now in progress, and CBD products are available at dispensaries, online and are making their way into everything from coffee and yogurt to pet treats.

Last June, a major milestone was reached when the U.S. Food and Drug Administration (FDA) approved the CBD drug Epidiolex for two rare, severe forms of treatment-resistant epilepsy.  Epidiolex, along with dronabinol and nabilone (which are synthetic cannabinoids previously approved to treat nausea from chemotherapy that has not responded to standard therapy), are now the only FDA-approved cannabis-based drugs.

The FDA was careful to note about Epidiolex: “This approval serves as a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies. Controlled clinical trials testing the safety and efficacy of a drug, along with careful review through the FDA’s drug approval process, is the most appropriate way to bring marijuana-derived treatments to patients. Because of the adequate and well-controlled clinical studies that supported this approval, prescribers can have confidence in the drug’s uniform strength and consistent delivery.”

High hopes

The FDA’s cautionary tone was necessary because of the many well-publicized clinical and preclinical trials underway to test marijuana and its extracts. Interest continues to grow, as evidenced by the numerous research projects in progress. The most prominent studies are focused on chronic pain, trying to evaluate whether marijuana is a safer and less addictive alternative to opioids.Other research is aimed at testing if cannabinoids improve the symptoms of multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, anxiety and insomnia, as well as its potential role in anti-inflammatoryand antiviral activity, blocking cell growth and preventing the growth of blood vessels that supply tumors.1

As promising as the research appears, it’s important to realize that at this time, not enough large, clinical trials have been conducted to show that the benefits of marijuana outweigh the potential risks.  Research is still preliminary and much remains unknown about CBD and other cannabinoids’ optimal dosing range and the best route of administration (by mouth, inhaled, topically or sprayed under the tongue). Importantly, because they are not FDA-approved, the levels of THC or CBD can differ greatly from one dispensary to another or one batch to another.

Side effects are also hard to predict because potential impurities and variations in dosage are not addressed as they are in all FDA-regulated products. We are only starting to evaluate side effects which may range from minor dry mouth and dizziness, to death.  It is also unclear if the products interact with other medications. An added concern is that older and sicker people may be more vulnerable to the drug’s side effects.

Our bottom line: although CBD is readily obtainable in most parts of the United States, and laws legalizing its use for medicinal purposes continue to pass, we need to take a step back and realize the process is far from complete. The fact is the scientific evidence does not yet support many of the claims to ease symptoms of certain diseases, improve quality of life and relieve pain, nor has it been approved for use as a cancer treatment. As Cleveland Clinic’s head of Employee Health Services recently pointed out, medical marijuana has not yet undergone extensive clinical trials, public hearings and approval by the FDA, or been thoroughly tested for safety and efficacy. His recommendation is one we can all support – focus on research that isolates specific compounds found in marijuana, produces a dose-specific medication, and submit it to testing and regulatory processes.

1 National Cancer Institute, 2019

Did You Know?

330

Number of cannabinoid research projects supported by the National Institutes of Health in 2017

34

Number of states (including the District of Columbia) that have approved the medical use of cannabis as of 2018

The post Medical Marijuana Myths appeared first on Specialdocs Consultants.

Medical Marijuana Myths

Medical Marijuana Myths

Smoking Out the Myths: Medical Marijuana

Does medical marijuana offer a solution to treating epilepsy, chronic pain, anxiety and neurogenerative diseases? Or is it an untested, potentially unsafe treatment that will eventually turn out to be more of a pipe dream? As with so many of today’s biggest questions, the truth is somewhere in between. We bring you a down-to-earth view of this much-discussed and yet oft-misunderstood topic to separate the hype from the hope and dispel some Medical Marijuana Myths.

While the marijuana or hemp plant has been used for more than 3,000 years, research and treatment today is primarily focused on the extract known as CBD, a cannabinoid. Unlike one of the other chemicals in the plant, THC (tetrahydrocannabinol,) CBD has no psychogenic effects and does not produce the “high” commonly associated with marijuana. Hundreds of CBD-related tests are now in progress, and CBD products are available at dispensaries, online and are making their way into everything from coffee and yogurt to pet treats.

Last June, a major milestone was reached when the U.S. Food and Drug Administration (FDA) approved the CBD drug Epidiolex for two rare, severe forms of treatment-resistant epilepsy.  Epidiolex, along with dronabinol and nabilone (which are synthetic cannabinoids previously approved to treat nausea from chemotherapy that has not responded to standard therapy), are now the only FDA-approved cannabis-based drugs.

The FDA was careful to note about Epidiolex: “This approval serves as a reminder that advancing sound development programs that properly evaluate active ingredients contained in marijuana can lead to important medical therapies. Controlled clinical trials testing the safety and efficacy of a drug, along with careful review through the FDA’s drug approval process, is the most appropriate way to bring marijuana-derived treatments to patients. Because of the adequate and well-controlled clinical studies that supported this approval, prescribers can have confidence in the drug’s uniform strength and consistent delivery.”

High hopes

The FDA’s cautionary tone was necessary because of the many well-publicized clinical and preclinical trials underway to test marijuana and its extracts. Interest continues to grow, as evidenced by the numerous research projects in progress. The most prominent studies are focused on chronic pain, trying to evaluate whether marijuana is a safer and less addictive alternative to opioids.Other research is aimed at testing if cannabinoids improve the symptoms of multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, anxiety and insomnia, as well as its potential role in anti-inflammatoryand antiviral activity, blocking cell growth and preventing the growth of blood vessels that supply tumors.1

As promising as the research appears, it’s important to realize that at this time, not enough large, clinical trials have been conducted to show that the benefits of marijuana outweigh the potential risks.  Research is still preliminary and much remains unknown about CBD and other cannabinoids’ optimal dosing range and the best route of administration (by mouth, inhaled, topically or sprayed under the tongue). Importantly, because they are not FDA-approved, the levels of THC or CBD can differ greatly from one dispensary to another or one batch to another.

Side effects are also hard to predict because potential impurities and variations in dosage are not addressed as they are in all FDA-regulated products. We are only starting to evaluate side effects which may range from minor dry mouth and dizziness, to death.  It is also unclear if the products interact with other medications. An added concern is that older and sicker people may be more vulnerable to the drug’s side effects.

Our bottom line: although CBD is readily obtainable in most parts of the United States, and laws legalizing its use for medicinal purposes continue to pass, we need to take a step back and realize the process is far from complete. The fact is the scientific evidence does not yet support many of the claims to ease symptoms of certain diseases, improve quality of life and relieve pain, nor has it been approved for use as a cancer treatment. As Cleveland Clinic’s head of Employee Health Services recently pointed out, medical marijuana has not yet undergone extensive clinical trials, public hearings and approval by the FDA, or been thoroughly tested for safety and efficacy. His recommendation is one we can all support – focus on research that isolates specific compounds found in marijuana, produces a dose-specific medication, and submit it to testing and regulatory processes.

1 National Cancer Institute, 2019

Did You Know?

330

Number of cannabinoid research projects supported by the National Institutes of Health in 2017

34

Number of states (including the District of Columbia) that have approved the medical use of cannabis as of 2018

The post Medical Marijuana Myths appeared first on Specialdocs Consultants.