ESC Drug Drop Off Event A Success

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Eastern Story County residents turned out Saturday, April 29th to help make the ESC Drug Drop Off a success.  Made possible through a partnership between NuCara Pharmacy, Nevada Police Department, YSS of Eastern Story County Board, and the Story County Prevention Policy Board, this event brings awareness to our communities about the issue of medication misuse and abuse.  During the two hour long event, 128.5 pounds of unused and unwanted medications were turned in to be safely destroyed.

With the rise of opioid use in the U.S. more and more people are becoming aware of the concerns related to misuse and abuse of prescription medications.  Misuse or abuse of medications is classified by the National Institute of Drug Abuse (NIDA) as using prescription medications in a way other than prescribed by your doctor, using someone else’s prescription medications, or using the prescription medication to seek a high or euphoria.  While this issue is a concern for all, youth and older adults are all at greater risk for prescription misuse use and abuse.

NIDA states, after alcohol, tobacco and marijuana, prescription medications are the most commonly used drugs among youth.  While males are more likely to misuse medications than women, the number of adolescent females reported to misuse medications exceeds that of adolescent males.  These females are also more likely to meet criteria for substance use disorder for prescription medications.

Older adults are at greater risk for misuse of medications for a number of reasons.  According to NIDA, older adults are more likely to experience multiple chronic health conditions.  Meaning they are more likely to be prescribed more medications.  Many older adults take at least one prescription medication daily and at about 50% take five or more daily.  Also, as we age our bodies metabolize medications differently.

This misuse, intentional or not, can have serious medical consequences.  Ridding our homes of unused and outdated medications is one step we can all take to help prevent misuse and abuse of medications.  You can turn in your unused and outdated medications to an officer at the City of Nevada Police Station.  NuCara Pharmacies are also able to take back medications through their TakeAway program.  For questions about this program please contact your local pharmacist.  The City of Ames Police Department also has a permanent drug drop box located inside the police station entrance.  For other recommendations about how to safely dispose of your expired and unused medications visit the DEA website at http://www.justice.gov/dea/index.shtml.

Additional Information re: DEA Take Back Initiative – www.DEA.gov

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Travel Health

Chair on a beach against a gulf and clouds

By: Alyssa Vosecky, PHC, PharmD Candidate Class of 2017, The University of Iowa College of Pharmacy

Are you planning on traveling out of the country this year? You may be setting up plans for flights, hotels, and must see destination spots. Have you been setting up appointments for your travel vaccines? Every country has different exposures to different types of diseases. It is important to keep yourself informed and healthy for your great adventure.

Your local NuCara pharmacist is able to research your destination and provide a list of recommended vaccines and travel precautions. It is important to keep yourself informed about the health precautions that are in the area you will be visiting.

YELLOW FEVER: Yellow fever is a virus that is transmitted by mosquitos found in tropical areas especially in South American and Africa. Symptoms include mild fever to severe liver disease. Treatment for yellow fever has not been well established, but there are established preventative measures. The yellow fever vaccine that can be given at designated vaccination centers. Most people find that 1 vaccine is good for lifetime without a booster, however it has been found that some people require a booster vaccine to maintain immunity.

TYPHOID: Typhoid is a bacterial disease that causes high fever, fatigue, stomach pains, and loss of appetite. It is transmitted by contaminated water and food. It can kill up to 30% of people who contract the infection. The typhoid vaccine can be given as an oral capsule. It is taken every other day for a week and must be kept refrigerated. This course should be taken at least 1 week prior to travel and should be boosted every 5 years in the common traveler.

Tdap: Tdap is more commonly known as the tetanus shot. Tdap vaccinates against 3 different diseases. Tetanus (T) is also known as lockjaw. The infection causes painful muscle tightening and stiffness. It is spread through cuts and scratches. Diphtheria (d) is an infection that causes a thick coating of mucus in the back of the throat. This leads to breathing problems and can lead to heart failure.  Pertussis (ap), also known as whooping cough, causes severe coughing spells and difficulty breathing. Both diphtheria and pertussis are spread via secretions while coughing or sneezing. Tdap should be given at least once, and a Td booster should be given every 10 years.

HEPATITIS A: Hepatitis A is a virus that infects the liver. The virus can contaminate food or water. People may contract the disease by eating or drinking the contaminated food and water. It is also transmitted person to person by fecal oral route. This disease is self-limiting and does not result in chronic liver infection. Up to 80% of those infected have symptoms including nausea and vomiting for about 2 weeks. The hepatitis A vaccine only needs to be given once.

Along with vaccinations, other precautions can be used in preventing diseases transferred by mosquitoes and other insects. Long clothing that covers the arms and legs can prevent insects from coming in contact with the skin. DEET is the active ingredient in most bug sprays. It is important to purchase a spray that contains at least 70% DEET.

Traveler’s diarrhea and malaria prophylaxis can be determined by a pharmacist who is working with a physician. You may need to visit a travel clinic in order to obtain these medications. Keep yourself informed and keep yourself safe during your trip.

 

https://www.cdc.gov/

Medication Adherence – Why does it matter to me?

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By Emily Henningsen, PharmD Candidate, Class of 2018, University of Iowa College of Pharmacy

Medication adherence is defined by the American Pharmacist Association as the extent to which a patient’s behavior (i.e. taking medications at the correct time, dosage and frequency) corresponds with agreed-upon recommendations from a healthcare provider. Studies have shown that up to 50% of patients do not take their chronic medications as prescribed. Nonadherence costs healthcare systems anywhere from $100 to 289 billion annually in extra doctors visits, hospitalizations, and emergency room visits.

People may not take their medications for a variety of reasons:

  • Forgetfulness.
  • Multiple medications with different regimens.
  • Unwanted side effects.
  • Feeling that medication isn’t working or not knowing why the medication is important.
  • Barriers exist like transportation, income or knowledge about disease state.

We are all human, and forgetting to take your medication is okay if it happens every once in a while. It can be hard to take medications when you aren’t feeling any effect from them or you are taking multiple medications at multiple times throughout the day. For example, blood pressure medications may not make you feel any different. If your blood pressure is not under control, however, it can lead to heart disease or stroke later on in life, which will lead to the need for more medications in the future.

Your physician has your best interest in mind and prescribes medications individualized to you and your current medical conditions and needs. If you ever have any questions regarding your medication regimen or the reasons you are on various medications, have a conversation with your doctor. Pharmacists are an excellent resource to utilize when it comes to medications as well. They can offer you with advice on what to do if you forget to take a dose of your medication or the possible side effects of medications if you are experiencing any. Pharmacists also have access to information about the cost of medications and may be able to recommend a cheaper alternative that they can suggest to your doctor that will work just as well as the medicine you are currently taking if cost is an issue.

Here are some helpful reminders that can help you remember to take your medications!

  • Take medications at the same time every day.
  • Take medications with a daily routine like after brushing your teeth or while getting ready for bed.
  • Keep pill bottles in spots you will remember to take them – for medications taken in the after brushing your teeth, leave them by your toothbrush holder or on your nightstand next to your alarm.
  • Use a pill box to organize multiple medications or medications that are taken at different times every day.
  • Keep a medicine calendar with your pill bottles and note each time you take a dose.
  • Talk to your pharmacist about what to do in the event of a missed dose.
  • When traveling, be sure to bring enough medication to cover the entire duration plus a few extra days in case travel plans get delayed.
  • Try a mobile app like Mango Health, iPatientCare, or Dosecast where you can enter your medications and schedule and get notifications sent to your phone when it is time to take them.
  • Talk to your pharmacist about enrolling in a program through the pharmacy that offers automatic refills or medication packaging so you don’t run out of medication.

NuCara Pharmacy Is Now Dispensing Opioid Antidote

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NuCara Pharmacy is now dispensing opioid antidote, naloxone, without a prescription in its Iowa and North Dakota pharmacy locations. This service is available at full-service pharmacies only and is not currently available at telepharmacy locations.

According to CDC, “Drug overdose deaths in the United States have more than doubled since 1999. From 1999 to 2014, more than 165,000 people have died in the U.S. from overdoses related to prescription opioids.”

A new law allows trained Iowa and North Dakota pharmacists to dispense naloxone to an individual at risk of an opioid-related overdose, or a person who may be in a situation to help an individual at risk of an opioid-related overdose. This law is intended to offer expanded access to a safe and effective opioid reversal medication in hope to help save lives through drug overdose prevention and education.

What is naloxone?

Naloxone hydrochloride, also called naloxone, is an opioid antidote used for reversing opioid-related overdose in the incident of consumption of one or more opioid drugs causing a drug overdose event.

The pharmacist determines the appropriate naloxone product to be dispensed. Naloxone products include:

  • Intranasal naloxone with atomizer
  • Intranasal naloxone spray
  • Intramuscular auto-injector naloxone

Who can eligible to obtain naloxone?

  • An individual at risk of an opioid-related overdose
  • A family member, friend or any person in situation to help an individual at risk of an opioid-related overdose
  • A first responder employed by a service program, law enforcement agency or fire department
  • If eligible recipient is a minor, a parent or guardian should provide consent.

Signs and symptoms of an individual experiencing opioid-related overdose:

  • A history of current use of narcotics or opioid or fentanyl patches on the skin or needle in the body
  • Unresponsive or unconscious individuals
  • Individuals who are not breathing or have slow/shallow respirations
  • Individuals who have snoring or gurgling sounds
  • Blue lips and/or nail beds
  • Pinpoint pupil
  • Clammy skin

Note that individuals in cardiac arrest share many of the same symptoms as those experiencing opioid-related overdose. Individuals who have no pulse, are in cardiac arrest and require CPR.

If you or another individual experience an opioid-related overdose, call 911 or seek emergency medical attention immediately.

How to Seek Help for Addiction to Prescription Drugs

Information and referrals for prescription drugs and other substance abuse services:

Drug Rehab Services allows you to locate help from drug and alcohol centers in the United States. Their helpline provides free and confidential information and referrals for alcohol and other drug abuse problems and related concerns.

24/7 service: 1-800-304-2219

http://www.addicted.org

Other ways for confidential treatment:

  • Talk to your doctor.
  • Talk to your health insurance company.
  • Many employers offer employee assistance programs that help support and direct individuals experiencing problems with substance abuse towards the right path.

 

What should I do if I get the flu?

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By: Pamela Wiltfang, PharmD, MPH, BA, CHES

It’s that time of year where Influenza is going around. Fortunately, there are steps you can take to make your experience with the flu a little more bearable, and to prevent it spreading to other friends or loved ones.

Influenza is a viral infection, and cannot be treated by antibiotics. Oftentimes your body just needs time to fight off the virus, and most people who get the flu will have mild illness and will not need medical attention. In more severe cases a doctor may prescribe you antiviral medication, such as Tamiflu. These can work to make the illness milder, and decrease the amount of time that you are sick. Antivirals work best if they are started within 2 days of when you start to show symptoms of the flu, but can still be helpful if started later. If you are prescribed antivirals, follow your doctor’s direction for taking the drug.

The use of over the counter acetaminophen or NSAIDs such as ibuprofen can help relieve some flu symptoms such as sore throat, headache, muscle ache, and fever. Decongestants such as pseudoephedrine can help relieve congestion symptoms, but shouldn’t be used if you have a history of high blood pressure or other heart problems. Antihistamines such as chlorpheniramine or diphenhydramine (Benadryl) can provide relief for a runny nose, but should be used with caution in people older than 65 due to side effects such as drowsiness, confusion, and dizziness. Always use the recommended dosage of over the counter medications, and check with your pharmacist if you have any questions or concerns.

In order to prevent the spread of the flu to your loved ones, make sure to take steps to prevent their exposure to the virus.

–  Limit contact to others as much as possible to avoid infecting them.

–   Cover your mouth and nose when you cough or sneeze either with a tissue or the corner of your elbow.

–   Wash your hands frequently with soap and water, or use an alcohol based hand sanitizer.

–  Disinfect all surfaces and objects that you have come into contact with that might be contaminated with the flu.

–  Stay home until at least 24 hours after your fever is gone except to get medical care or for other necessities.

–  In addition to the steps listed above, always remember to get your yearly flu shot to decrease the chances of being infected with the influenza virus.

If you have any other questions always feel free to ask your local NuCara Pharmacist.

Cold and Cough Over the Counter RELIEF

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By: Carley Castelein, PharmD Candidate 2018,Drake University

Walking the aisles near the pharmacy can be a daunting when you are sick and seeking something to make you feel better. There are so many products and each presents its own claim to fame. Here is a short breakdown of a few common active ingredients to look for when you are trying to treat a certain symptom:

  • Sinus and nasal congestion: Pseudoephedrine (commonly known as Sudafed) can be purchased at most pharmacies. It should not be used if you have high blood pressure.
  • Running noses: Antihistamines such as Allegra (fexofenadine), Claritin (loratadine), and Zyrtec (cetirizine) can be used to dry up nasal passageways.
  • Persistent cough: Dextromethorphan, commonly written as DM on products packaging labels can help decrease your coughing frequency and can cause some drowsiness. If you have a dry cough it would be appropriate to use this but if your cough is productive (a lot of mucus) you do not want to suppress it and keep that mucus inside of you! If you have asthma or COPD it is not recommended that you use products with this ingredient.
  • Tight chest caused by mucus: Mucinex (guaifenesin) loosens and thins your mucus secretions making your cough more productive to release the mucus from your body.
  • Nasal irritation: Menthol, found in Vicks, will create an anesthetic (insensitivity to pain) for your nose.

As for zinc, it can block the adhesion of the virus to the nasal tissue and potentially slow the replication process but it must be taken within 24hours of onset and at least every 2 hours while awake. However, it can also irritate your stomach. Vitamin C supplementation for prevention and treatment is very controversial, it may not prevent the cold but it could reduce the duration.

Many of these products come in combination and my advice is to stick to what your symptoms are—if you don’t need it, don’t buy it! Non-pharmacologic treatments are always the safest treatment: stay hydrated, use throat lozenges, and utilize a cool mist vaporizer at night.

Have a Cold? Consider This…

Little girl blows her nose

By: Carley Castelein, PharmD Candidate 2018, Drake University

Cold season is upon us so it is important to know when you should go to the doctor.

It is easy to know when you aren’t feeling well from a cold: your throat is sore, your nose is stuffed up or running like crazy, and then a cough appears by day four or five. However, did you know the average cough lasts about 17 days and that if your cold lasts less than 10 days, there is about a 2% chance it is caused by bacteria?

Many people seek a doctor within a week of getting sick, hoping for some antibiotics to relieve their suffering and return to normal. However, prescribing antibiotics for a viral infection is causing larger problems. Not only are the side effects, such as diarrhea and yeast infections, of some antibiotics bothersome, they are also making antibiotics less powerful against certain bacteria.

Each year about 2 million people become sick because of bacteria that are resistant to antibiotics, and at least 23,000 people die as a result of these infections. It is important to think about your symptoms and take care of your body when you aren’t feeling well to protect yourself and loved ones, so consider plenty of fluids, rest, and some symptomatic relief to see if you can avoid a trip to the doctor and unnecessary antibiotics.

For more information visit the Centers for Disease Control and Prevention’s Get Smart campaign at https://www.cdc.gov/getsmart/community/materials-references/print-materials/adults/b-general-color.pdf.

References:

Ebell MH, Lundgren J, Youngpairoj S. How long does a cough last? Comparing patients’ expectations with data from a systematic review of the literature. Ann Fam Med. 2013;11(1):5-13.

 

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1-S39.