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Health Information

While there is no substitute for the professional guidance you receive from your own doctor or pharmacist, the Internet provides many resources for your family’s healthcare needs. Check out some of our favorite sites for additional information.

Pease note: DeGoler Pharmacy is not affiliated with these sites and cannot be responsible for the accuracy of the information provided.

Ask a Pro

The Wyandotte West  newspaper features  a section called “Ask a Pro,” where questions are answered by professionals in their field.  We have partnered with them to have our pharmacists answer one question each month.  Here are some of the questions and their answers that have appeared in recent years.

• My insurance has recently stopped paying for my medications.  I was told I was in my doughnut hole, what is that?
• Why do I have to take all my antibiotics even when I feel better?
• How do I know which sunscreen is best for me?
• Is there a limit on the amount of Tylenol (acetaminophen) I can take in a day?
• What are some over-the-counter (OTC) medication options to help relieve my allergy symptoms?
• My doctor wrote me a prescription for a medication that needs to be compounded.  What is a compound?
• What is the difference in dosing for children’s medications versus adults?
• How can I tell if I have a cold or the flu based on my symptoms?
• What can I do to help treat my constipation?
• Why do I need to avoid eating grapefruit and drinking grapefruit juice with one of my medications?
• Why does my medication bottle say to avoid prolonged sun exposure or artificial sunlight?
• What is MTM and how can I benefit?
• My doctor has said my albuterol inhaler will be changing to an HFA inhaler.  What is an HFA inhaler?

 

My insurance has recently stopped paying for my medications.  I was told I was in my doughnut hole, what is that? 

The "doughnut hole" is a term associated with Medicare Part D.  For those enrolled in a Medicare Part D prescription drug plan, there is a stage of coverage called the coverage gap (also known as the "doughnut hole").  The coverage gap is a stage of coverage when Medicare will not pay for prescriptions and you (the enrollee) must pay the full cost of the prescriptions out of pocket.  The coverage gap starts when the total cost of your prescriptions (what you and your Medicare Part D plan have paid for medications) reaches a certain amount.  For most Part D plans the coverage gap begins when the total drug cost reaches $2,700 and ends when your total out of pocket cost (just what you have paid) reaches $4,350 in 2009 ($2,830 and $4,550 in 2010).  Once you reach this point catastrophic coverage begins (usually you either pay 5% coinsurance or $2.40 copays for generics and $6 copays for brand-name drugs).  Your Medicare D plan keeps track of your prescription costs including what you pay and what the plan has paid.  This should be printed on your monthly statement.  There are some things you can do to help keep cost down during the coverage gap, some assistance programs are available, and a number of resources, such as your healthcare provider or Medicare, are available to answer questions. 

Why do I have to take all my antibiotics even when I feel better? 

Antibiotics are medications prescribed to treat infections caused by bacteria.  These prescriptions are written for the length of time needed to kill the bacteria.  Many times people start to feel better after only a few days of taking the antibiotics and stop taking them.  If an antibiotic is stopped early the bacteria that have not yet been killed can restart an infection or, even worse, lead to antibiotic resistance.  Antibiotic resistance is when certain antibiotics no longer work to treat that bacteria.  This can be caused by antibiotics being used for nonbacterial infections, the wrong choice of antibiotic for an infection or overuse of an antibiotic.  Antibiotic resistance leads to fewer, often more expensive, treatment options for future bacterial infections.  To help avoid this situation, take all of your antibiotics as prescribed.

How do I know which sunscreen is best for me? 

The selection of a sunscreen product should be based on your skin type and intended use.  The SPS (sun protection factor) is an estimate of how long you can stay in the sun without getting an obvious sunburn, which is caused by UVB rays.  The higher the SPF, the more effective at preventing sunburn.  You should also choose a sunscreen labeled “broad spectrum.”  These also protect against UVA rays which: penetrate deeper into the skin than UVB, produce photosensitive reactions (such as those with certain medications) and contribute to skin aging and cancer.  You should apply sunscreen about 30 minutes before sun exposure, apply an adequate amount, and reapply according to label instructions ("water resistant" products are effective for 40 minutes and "very water resistant" are effective for 80 minutes).  Talk to your doctor or pharmacist if you have any questions.

Is there a limit on the amount of Tylenol (acetaminophen) I can take in a day? 

Acetaminophen (APAP) is one of the most widely used medications for pain and fever.  It is a safe and effective drug if used at recommended doses.  The maximum recommended dose for the average, healthy adult is 4000 mg per day with a maximum of 1000 mg per dose.  The amount of APAP a child can take is different and depends on the age and weight of the child.  Acetaminophen is available in varying dosages and over 200 drugs contain APAP (prescription and over-the-counter).  This makes it very important to read labels to determine if the product contains APAP and the amount of APAP in the medication.  Taking more APAP than recommended can cause liver damage, so it is important to know how much you are taking daily.  Patients should not drink alcohol while taking APAP as this may increase the risk of liver damage.  Ask your doctor or pharmacist if you have any questions.

What are some over-the-counter (OTC) medication options to help relieve my allergy symptoms? 

Allergic rhinitis is triggered in response to an inhaled allergen.  Common airborne allergens include pollen, mold, dust mites, and animal dander.  When our body is exposed to an allergen we are sensitive to, it releases a chemical called histamine.  Histamine is responsible for many of our allergy symptoms.  Antihistamines are first choice treatment.  They work by blocking the histamine released and reduce symptoms of sneezing, runny nose, and itchy, watery eyes.  Older antihistamines such as diphenhydramine and chlorpheniramine have been available for years but do have unwanted side effects of drowsiness, dry mouth, urinary retention, and frequent dosing.  Newer antihistamines, Claritin (loratidine) and Zyrtec, are now available OTC, do not cause drowsiness and are dosed once daily.  Antihistamines are also available in eye drops to help relieve red and itchy eyes.  Nasal congestion is another allergy symptom that many experience.  Decongestants such as phenylephrine, pseudoephedrine, and oxymetazoline help relieve congestion.  Topical decongestants such as nasal sprays should not be used for greater than 3-5 days.  Normal saline solutions are a safe, alternative option to help relieve nasal irritation and dryness.  Cromolyn is another OTC option, which stops cells in your body from releasing histamine in response to an allergen.  Many OTC products contain multiple medications; make sure you read the labels when choosing a product to treat your symptoms.  Antihistamines and decongestants are not safe for everyone – please consult your doctor or pharmacist if you have any questions.

My doctor wrote me a prescription for a medication that needs to be compounded.  What is a compound? 

A compound is a drug that is customized for an individual to specifically meet their needs and provide the medicine in a way that may not be commercially available.  There are a number of reasons to compound a medication:  a patient needs a strength of medicine that is not manufactured by a drug company, a patient needs a different method or form for receiving a medication (troche, cream, lollipop, suppository, etc), a patient is allergic to a dye or preservative, a patient wants bio-identical hormone replacement, etc.  Compounding is often a good option in children, elderly, and animals that may have a hard time swallowing pills.  Talk to your physician or pharmacist to see if compounding may be right for you.

What is the difference in dosing for children’s medications versus adults? 

Children are unique individuals and not small adults.  Children require special dosing based on age, weight, and other factors.  With the new concern surrounding children's cough and cold products the issue of dosing children’s medications has been brought to light even more.  Because of these concerns the FDA recently issued recommendations in regards to children's cough and cold medications, but these principles could be applied to all medications:

• Always follow labeled instructions
  
• Talk to your doctor or pharmacist if you have any questions about using products in children
  
• Always use the dosage device that comes with the medicine to ensure accuracy
  
• Keep all medicines out of reach of children and use child-resistant safety caps- accidental ingestion by children contributes to nearly two-thirds of all injuries and deaths involving children's medications
  
• Know the medicine's active ingredients and the symptoms for which they are indicated
  
• Don't give your child more than one medication intended to treat the same symptom at the same time
  
• Never use OTC cough, cold, or allergy medications to make your child sleepy
  
• Always verify the dose twice, as children's weight changes and the dose may not be the same as the last time the medication was given

How can I tell if I have a cold or the flu based on my symptoms? 

It is hard for many to tell if they have a cold or the flu.  There are many key differences between the symptoms.  With a cold you will see a stuffy nose, sore throat, hacking cough, sneezing, and gradual onset.  With the flu the symptoms are more of a dry cough, fever, headache, muscle pain, weakness, exhaustion, chest discomfort, and sudden onset.  There are different ways to decrease your risk of getting a cold or the flu.  These include:  avoid close contact with someone who is sick, encourage those who are sick to stay at home, cover your mouth and nose when you are coughing or sneezing, wash hands regularly, maintain adequate sleep, avoid touching your eyes, nose, or mouth, and receive a flu vaccine.

What can I do to help treat my constipation? 

Constipation affects people of all ages and presents differently among individuals. Constipation can result from numerous conditions such as poor diet, inadequate fluid intake, sedentary lifestyle, use of certain medications, or an underlying disease. Determining the cause of constipation and looking at symptoms will help in selecting appropriate treatment. There are lifestyle changes that should first be considered. These include increasing fiber in the diet, increasing fluid intake, and regular exercise. There are many different over-the-counter options for relieving constipation. There are bulk-forming laxatives (psyllium,methylcellulose), stool softners (docusate), hyperosmotic agents (glycerin,miralax), stimulants (bisacodyl, senna), saline laxatives (magnesium citrate, sodium phosphate), and lubricants (mineral oil). These differ by the way they work, how fast they work, side effects, interactions, who can take them, forms they come in, cost, etc. Laxative use should be short-term (less than 1 week). Please consult your healthcare provider if you have any questions.

Why do I need to avoid eating grapefruit and drinking grapefruit juice with one of my medications? 

Grapefruit and grapefruit juice contain a chemical that can interact and affect certain medications.  This chemical has been shown to inhibit an enzyme that metabolizes (breaks down) many drugs.  Decreasing the amount of drug metabolized  leads to greater amount of drug available in the body and may result in unwanted side effects.  A few examples of drugs in which grapefruit should be avoided are amiodarone, amitriptyline, atorvastatin, carbamazepine, diazepam, nifedipine, verapamil, and many others.  Talk to your pharmacist about potential interactions and side effects that may occur.

Why does my medication bottle say to avoid prolonged sun exposure or artificial sunlight? 

There are many medications known to cause photosensitivity reactions.  There are two types of reactions that may occur, phototoxic or photoallergic.  Phototoxic is the most common type of reaction and causes patients to be more sensitive to the sun and tanning beds.  A phototoxic reaction occurs when the drug reacts with UVA light and causes cellular damage on the exposed areas.  There are a number of medications reported to cause photosensitivity reactions.   A few common examples are:  retinoids (Accutane, Retin-A), thiazides (hydrochlorothiazide), quinolone antibiotics (Cipro, Levaquin), tetracyclines, sulfonamides (Bactrim), NSAIDS (ibuprofen), estrogens (oral contraceptives), amiodarone, certain antidepressants, and many more.  To reduce sun damage patients should:  minimize or avoid sun exposure, avoid high-intensity lights such as tanning beds, use a broad-spectrum sunscreen, and wear protective clothing.  Some of these reactions may be dose related and a decrease in dose may help minimize reactions.  If minimal sun exposure is not an option an alternative medication should be prescribed.  Talk to your pharmacist or doctor if you have any questions.

What is MTM and how can I benefit? 

Medication therapy management (MTM) is a patient oriented service that focuses on identifying, preventing, and solving drug-related problems.  The process of MTM is conducted by your pharmacist and involves many activities such as:  detailed review of medications, identifying drug therapy problems such as interactions or unnecessary therapy, looking for cost saving alternatives, providing patients with a “personal medication record,” helping a patient formulate a plan for health concerns and medications, working with other health care providers to resolve any medication or health concerns, and following up with patients.  MTM is a service which is provided by Medicare Part D plans for patients which meet certain criteria.  Any patient can do a MTM review, but the service may not be paid by your insurance company so the cost would be out of pocket.  Talk to your pharmacist if you are interested or have any questions.

My doctor has said my albuterol inhaler will be changing to an HFA inhaler, what is an HFA inhaler? 

HFA stands for HydroFluoroAlkanes.  It is an alternate propellant to CFC (ChloroFluoroCarbon) which has been widely used in inhalers for years.  The FDA and United States have been phasing out CFC propelled inhalers as the CFC is harmful to the earth's ozone layer.  After December 31, 2008 albuterol will only be available as an HFA inhaler.  There are three approved albuterol HFA inhalers:  Proair HFA, Proventil HFA, and Ventolin HFA inhalation aerosols.  These HFA albuterol inhalers are brand name and not available as generics and therefore cost more.  There are a few differences with the HFA propelled inhalers, such as:  they taste and feel different than CFC inhalers, the mouthpiece needs to be cleaned weekly to prevent clogging, they have different priming requirements, and they are better for the environment.  Over the next several years HFA inhalers will replace all CFC inhaler; many already are available as HFA.  Ask you pharmacist or doctor if you have any questions