Drug discount cards

I love a good deal as much as the next person, but buyer beware when you use the free ones that come in the mail. Your information is sold to third parties - including your address, phone number, and drugs you run through the discount card.
I recommend the website needymeds.com or going to the website of the maker of the drug to find coupons. Also be aware that you can't use coupons if you have a government issued insurance (Medicare, Medicaid, Tricare, etc.).
Your local pharmacist is also a great resource for cheaper alternatives!
Happy shopping!

Christmas for another year

As Christmas comes for another year, remember to take care of yourselves so your family can see you next year as well!

The next tidbit of advice comes from a few days ago. Try to keep your medicine out of reach of children - even the medicine meant for kids.  Gummy multivitamins look like candy to little kids and could be bad in high doses.

I have decided that making long blog posts takes more time than making a daily fact post. So from now on I will be posting short tidbits of information that I am asked about.

So here's the first one:

"Tdap is short for Tetanus, Diphtheria, and Pertussis. Due to outbreaks in the past years, we are pushing Tdap for all unless contraindications exist - like an allergy to pertussis vaccines."

Overview of Common Blood Pressure Medications

As I said in my last blog post, this week I thought I might go over the most common medications to treat blood pressure. The algorithm to the left is one of many that physicians use to decide what medications- if any- to use. To make all these drugs easier to understand, I will break them up into categories (classes). Your doctor will take into account not only the extent of your high blood pressure, but your other conditions as well. For example, if you have diabetes as well, they will most likely start with an ACE inhibitor or ARB for their protective effects to the kidney. This is by no means an exhaustive list, but it will be a great overview so you will understand your medication better.

The “pril’s” – These drugs commonly end in ‘pril’ like lisinopril, benazepril, or enalapril. For those wanting the technical term they are the ACE inhibitors. Very common drug as a first line agent as it is cost effective (lisinopril is a $4 medication for 30 tablets) and easy to take (once daily dosing to start). I won’t give you an exhaustive list of side effects, but commonly causes dizziness (all blood pressure lowering medications do), and sometimes an annoying tickle in the throat that makes you cough. The dizziness should go away as your body gets used to your new blood pressure, but if you get the dry cough, that won’t disappear so easily. The next medications work very similarly, but do not cause a cough.

The “sartan’s” – Examples include losartan, valsartan (Diovan®), and irbesartan. Technical term is the ARBs. These medications are more expensive because they are newer, but they do not cause that annoying cough. Some insurances will want you to try an ACE inhibitor first too because of cost so be aware. The cheapest is the losartan of these medications.

The “water pills” – Named for their ability to remove water from your body which causes that need to go to the bathroom often. Examples include furosemide (Lasix®), spironolactone (Aldactone®), and hydrochlorothiazide (HCTZ). These medications have multiple subclasses, but I lumped them together to reduce confusion. Lasix is probably the one of the strongest ones of the bunch, but it is commonly used. Aldactone® – in addition to causing you to urinate more often – can also cause breast enlargement and other hormonal problems in some cases. HCTZ is more common than Lasix, but not quite as strong. It is also one of the first line agents used when first diagnosed. It is pretty important to take these medications in the morning or early afternoon because they will have you going to the bathroom more often; it is no fun to be getting up all night because you took your medication late in the day. Lasix and HCTZ are both $4 for 30 tablets.

The “olol’s” – examples of these are metoprolol, labetalol, and carvedilol. These are the Beta Blockers. Very well studied drug and also a good first line agent. These are also commonly given twice daily, or there is an extended-release product of metoprolol that is more expensive and is given once-daily. Labetalol can be used in pregnant women for blood pressure and the class of drugs has been well studied in heart failure patients. These also have some $4 medications for 60 tablets.

When it comes to choosing a blood pressure medication, I would tell patients to try the generics out first just for the fact that they have more studies on them, and to lessen the cost burden on both you and healthcare costs as a country. There are very few novel drugs coming out for blood pressure at this time, and most of the new drugs are what we like to call “me-2” drugs. This means that they are just adding to a list in a particular class that is already out on the market. Bystolic®, for example, is adding to the class of Beta Blockers. Not to say that these new ones out are less useful, but if it were me, I would try metoprolol or carvedilol first.

If you have questions about your blood pressure medications or are looking for other options, contact your local pharmacist for suggestions to ask your doctor about. The pharmacist is much more readily available to talk to, and we give out free advice just because we love helping our patients!

Does anyone have any questions about a specific medication? I would love to help!



Basics of Blood Pressure

So why is having a normal blood pressure important?

I like comparing your blood vessels to a water hose with thin walls. If you turn the water pressure up too high, you can bust a hole in the hose (vessel) as well as cause the sprayer (heart) on the end to break. So how do you read and understand what your numbers mean? Imagine you are turning the spigot up and down fairly quickly (60-100 times per minute). The higher number, or systolic pressure, is when your heart is pushing the blood forward through your vessels; this is the pressure your heart muscle is having to pump against. The lower number, or diastolic pressure, is what pressure is put on your vessels when your heart is filling up.

You heart is essentially a muscle; it's good to workout your muscle to keep it strong and healthy. But have you ever seen a bodybuilder that had done so much they couldn't even turn their neck? It's the same problem when your heart is constantly having to push against a higher pressure than normal. Eventually your heart can't move as well as it used to; it's just too big. That's when heart failure becomes a problem.

So what is normal blood pressure?

If you haven't been diagnosed already, it is less than 120/80 mm Hg. If you have, then it should be less than 140/90 or 130/80 depending or other conditions.

How do you take a good blood pressure?

If you don't have a machine at home:
     1) Head to the nearest pharmacy and locate the automated machine.
     2) Make sure you are relaxed and try not to talk while the machine is working.
     3) Pull your sleeve up so it doesn't end up inside the cuff.
     4) I usually recommend taking your blood pressure at least 2-3 times to make sure it is a good number.

There are many reasons for your numbers to be abnormally high, though.
     1) Machines are continually played with by children and can be miscalibrated.
     2) If you just ran a marathon, or feel like you have, you may have to sit for longer period of time.
     3) Your sleeve may be too tight on your arm or could have gotten in between you and the cuff.
     4) Your arm may be too big/small for the cuff. The automated machines are built for the "average" person.

Consequences of Hypertension

 

Most know it can affect your heart, but many do not know about the other consequences. The long-term effects of uncontrolled high blood pressure can affect everything from your brain (increased risk for stroke, headaches), eyes (glaucoma/loss of vision), lungs (fluid buildup from heart failure), kidneys (can cause kidney failure), and erectile dysfunction just to name a few.

 

 

So the take home message is to take care of those tickers! 

 

 

Tune in next week for a look into how to control your blood pressure - including non-drug therapies!





 

How to read a label

I thought I would start with something that is a very basic concept, but often not understood.
The first part of the label is the ingredient and class of medication it is from. The big things to know are:

1) Brand is therapeutically equivalent to the generic active ingredient +/- 10%. This means that you can feel safe using a store generic knowing that it will work like the brand name. The only differences may be the dyes and inactive ingredients in them.

2) There are very few types of medications available over-the-counter (compared to prescription medications) - allergy treatments, acid reducers, pain relievers, anti-diarrheals and laxatives, antifungals, itch relievers, cough medicine, eye treatments, and so on. Try to only treat the symptoms you have. For example, don't use Tylenol Cold and Flu if all you have is a cough. Go for something that either has a cough suppressant or expectorant - or a cough drop.

The uses just give you more information about the class of medication's uses; if you are unsure as to whether you have the right box in your hand, this is where you look. You do not need to have all the symptoms listed in order to use the drug.

Warnings are to be read before you buy the medication. This is especially important if you have a medical condition or take other medications.  If you are unsure about anything in this section, consult the pharmacist. They have a plethora of information and can help you decipher whether any warnings pertain to you.

Directions are important to read if you are getting a medication for a child or if you are deciding between medications. Children cannot have just any medication on the shelf. If next to your child's age it says consult your physician, it just means they may be able to use the medicine at a different dose. For example, on allergy medicine I have dispensed for children as young as a few months old. That being said, please ask your pediatrician first for a dose and whether the medicine is right for them. If you ask a pharmacist to give you a dosage that is not on the label, most will feel uncomfortable giving out that information; it's not that we don't know a dosage or that we don't want to help. We are worried about hurting a child without knowing the full picture of your child's history and to have that liability on our shoulders if something goes wrong.

The other part of reading the directions is if you are still deciding between medications. Some medicines must be taken more often than others. For example, if you have a cough that lasts all day and you don't want to be popping pills or cough drops all day, try a long acting medicine like Robitussin gel caps or Delsym cough medicine that lasts 12 hours. Or if your cough is sporadic or just at a certain time of day, try a shorter acting medication like menthol cough drops, throat sprays, or cough syrups.

The last part of the label just states how to store your medication and inactive ingredients. In general, you want to store the medication in a cool, dry place. Most importantly not in your bathroom medicine cabinet. The moisture from showers and baths will cause the medication to possibly break down faster than its shelf life. Inactive ingredients are important if you are allergic to certain dyes, for example, or if you have phenylketonuria (if you do, you will already know this).

All of this only applies to FDA approved drugs. Others may tell you some of this information, but cannot guarantee what is on the label. That isn't to say you cannot use non-FDA medications, but buyer beware.

I hope this post wasn't too long-winded and was helpful to you! Stay tuned for future posts!

To start with...

I decided after much agonizing about my first blog post to start with why I decided to start a blog in the first place. I love my profession and most of my job in the retail field. That is to say I love my coworkers and most of my thousands of patients I help every week. Just like most professions - there are a few bad apples.

Because my store is such a high volume store, I feel that I don't have the time to devote to my patients like I would like to. This blog is for me to fill that void in my career. I could start another blog devoted to the crazy antics that happen in a pharmacy, but I feel that there aren't enough blogs out there that really try to help the lay public understand their mediations and diseases. That is what I am passionate about. I love to talk about diabetes, hypertension, asthma, smoking cessation, etc. I hope to someday be able to get paid for my MTM services. Until that day comes, this is my way of helping people.

I hope that my first posting has piqued some interest to read what comes next!