How to Find Your Own Drug Interactions: A Drugs.com Tutorial

25 February, 2013 by 2 Comments

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Today I’m sharing a tutorial I posted on YouTube on drug interactions. 

As I’ve shared in my last few blog posts, drug interactions are becoming a huge problem due to the increasing number of prescriptions people take.

Take a few minutes (it’s short, I promise) to watch the video and then practice with your own prescription medications to see if there are any problems taking them together.

If you do find interactions, don’t panic, and don’t abruptly stop taking your prescription.

Print off the information (I show you how in the video) and take it to your pharmacist or doctor and let them help you evaluate the results.

Feel free to leave comments and questions and I’ll answer any questions or concerns you may have.

Hope this is helpful!

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Filed Under: From the Pharmacy, Prescription Drugs Tagged With: , , , ,

Seven Reasons to Become Your Own Pharmacist…Well, Sort of…

22 February, 2013 by 10 Comments

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Working in retail pharmacy for 21 years, I saw the following scenario way too many times. The circumstances and drugs were different, but the result was the same. The patient had been placed in danger due to the pitfalls that can occur when getting a prescription filled. And I’m talking about when the prescription is filled correctly from the first step to the last. These pitfalls go beyond the actual filling of the prescription.

In the busy, prescription-hungry culture we live in, it’s necessary to become our own pharmacist…sort of. (Care to tweet that?)

Consider the following steps we take to get a prescription filled (with a little animation from me):

1. How often do we go to the doctor with the prescription we want already in mind? We are paying. Our doctor typically wants to make us happy, so if the prescription makes sense, we typically get it.

2. When we take the prescription to the pharmacy, do we sit and wait? I don’t know aout you, but the CVS’s, Walgreen’s, and Wal-Mart’s around here are never busy. Right? Ha! I take mine to the drive-thru to be picked up hours later.

3. When we pick up the prescription do we stroll leisurely up to the counter, chat with the pharmacist about the prescription, ask all of our questions, pay, and then leave? Typically not. Often it’s 5:30pm, after work, the line is at least five people deep to the counter, the kids are picking up everything on the shelves, and we just want to get the heck out of there! Are we concerned about the prescription? Only the fact that it will make us better. At the moment, that’s all that matters. Oh…and that it went through on the insurance card of course.

4. We get home, unload the car, take the prescription bottle from the bag and throw everything else away. After all, who wants all that paperwork on the counter? We know we’ll never read it.

5. We look at the directions of the antibiotic and take one. And of course we’ve also taken cough syrup and cold medicine to help us get through homework, supper, and getting the kids to bed.

6. Did we remember to tell the pharmacist that we were on Cymbalta for depression that we got filled at another pharmacy? It was cheaper at Wal-Mart than at our regular pharamacy. But it really has nothing to do with a sinus infection anyway, right?

7. And what about the Imitrex we took earlier for a migraine? We only need it like once a month, so it probably doesn’t even matter.

Did anybody think about what could very possibly and probably happen?

Confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea.

Would  you have ever guessed? The drug interactions in this particular example caused Serotonin Syndrome. How could this have been avoided?

  • IF all of the prescriptions were filled at the same pharmacy
  • IF the physician were aware of all the medications currently being taken.
  • IF the pharmacist wasn’t so busy with the 100’s of prescriptions they fill daily, they would have caught the interaction.
  • IF we weren’t so busy and distracted when we took and picked up the prescription, we might have asked a question or two.
  • IF we carefully read the medication insert that came in the bag with the prescription.

Let’s be realistic. No way all of those could actually happen.

With the help of a computer (our loved friend and dreaded enemy), anyone can determine if there are interactions, side effects, if warnings, etc. It is very important to know your source—make sure the website you are using is reputable.

Here’s what you would find on a search of the prescription drugs used in the example above:

When the interactions for these drugs are searched, there are four pretty major interactions found. Then, be sure to scroll down to the section that says, “Other drugs that your selected drugs interact with.” That’s a real eye-opener. And then there are food interactions to worry about too.

 

 

 

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Interactions between your selected drugs

dextromethorphan ↔ duloxetine   

major inx

 

Applies to: Tylenol Cold (acetaminophen/chlorpheniramine/dextromethorphan/pseudoephedrine), Delsym (dextromethorphan), Cymbalta (duloxetine)

Talk to your doctor before using dextromethorphan together with DULoxetine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

sumatriptan ↔ duloxetine  major inx

Applies to: Imitrex (sumatriptan), Cymbalta (duloxetine)

Talk to your doctor before using SUMAtriptan together with DULoxetine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

chlorpheniramine ↔ duloxetine  moderate inx

Applies to: Tylenol Cold (acetaminophen/chlorpheniramine/dextromethorphan/pseudoephedrine), Cymbalta (duloxetine)

Using chlorpheniramine together with DULoxetine can increase the effects of either medication. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

pseudoephedrine ↔ duloxetine  moderate inx

Applies to: Tylenol Cold (acetaminophen/chlorpheniramine/dextromethorphan/pseudoephedrine), Cymbalta (duloxetine)

DULoxetine may increase your blood pressure and heart rate, and using it with pseudoephedrine may further increase those effects. Your blood pressure should be monitored while you are on DULoxetine. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

Interactions between your selected drugs and food

duloxetine ↔ food moderate inxApplies to: Cymbalta (duloxetine)

DULoxetine may cause liver damage, and taking it with alcohol may increase that risk. You should avoid or limit the use of alcohol while being treated with DULoxetine. Call your doctor immediately if you have fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, dark colored urine, or yellowing of the skin or the whites of your eyes, as these may be symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Are  you starting to see why it’s necessary to “sort of ” become your own pharmacist? Time to take some responsibility for your health and don’t just assume it’s in capable hands of others.

This post was just a little precursor to wet your appetite for the screen cast tutorial coming up on Monday. There are way too many prescriptions being filled and consumed these days for you not to know how to inform yourself. So check in Monday for the tutorial and I’ll show you how to check all of this yourself.

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Filed Under: From the Pharmacy, Prescription Drugs Tagged With: , , ,

Drug Interactions~What Your Pharmacist & Doctor Might Not Tell You

18 February, 2013 by 7 Comments

 

Have you ever thought about the number of prescriptions your pharmacy fills every day?

The smaller, independent pharmacies are on the lower end of the scale, but it’s not uncommon for your corner CVS or Walgreens to fill 700-1500 prescriptions every day.

The use of prescription drugs in the United States on the rise and the statistics are staggering. Check out what the Centers for Disease Control reported in 2010:

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Over the last 10 years, the percentage of Americans who took at least one prescription drug in the past month increased from 44% to 48%.

The use of two or more drugs increased from 25% to 31%.

The use of five or more drugs increased from 6% to 11%.

In 2007-2008, 1 out of every 5 children and 9 out of 10 older Americans reported using at least one prescription drug in the past month.

In the United States, spending for prescription drugs was $234.1 billion in 2008, which was more than double what was spent in 1999.

One of the most alarming statistics reported is the rise in the number of prescription drugs used by the elderly population. Working in home health care now, I’ve seen this first hand. Most of the clients I manage medications for take between 10 and 25 prescription drugs. The following graph from the CDC depicts this increase based on age:

What percentage of Americans used multiple prescription drugs in the past month and how did this vary by age?

The use of multiple prescription drugs in the past month varied by age (Figure 2).

Figure 2 is a bar chart showing the number of prescription drugs used in the United States from 2007 through 2008.

 

There are several pitfalls in the medical system that prevent possible drug interactions from being realized.
  • Patients often use different pharmacies due to price or prescription availability, therefore prohibiting pharmacists from having all of the medications on file being taken. 
  • Pharmacies are often so busy, patients just want to get their prescriptions and get home, not taking the time to talk to the pharmacist about their medications.
  • Patients use different physicians depending on their specialties, and the physicians aren’t always aware of all other medications prescribed.

Due to this increased prescription volume per patient and the pressures of busy pharmacies and doctors offices, it has become necessary for patients to take some responsibility for their

own health, and learning how to discover possible drug interactions can be a life-saving tool.

Drugs.com is a reputable website to learn about your prescriptions. Tools available are:

    • Pill Identification
    • Drug Interactions
  • Drug Use Information
  • Side Effects
  • Dosage Information

Over the next few weeks I’m going to provide tutorials to help you learn how to discover what your pharmacist or doctor may not have time to tell you. Some of the information is easy to understand, and some you will need to ask your doctor or pharmacist about.

You know your body—how you feel—better than anyone. And God tells us to take care of that body because it’s his temple. 

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You don’t have to be a medical professional to know when something is not right. The tutorials I will provide here about Drugs.com hopefully will educate you about your prescriptions enough to answer some questions on your own, but also to ask your pharmacist or doctor specific questions you want a
nswered. Don’t hesitate to ask. You are paying them, and they are there to answer your questions.

Join me on Mondays for the next few weeks to educate yourself about prescription dr

ugs and don’t get caught in the pitfalls!

And PLEASE feel free to ask questions along the way. I’m a pharmacist. It’s what I’m here for!

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Filed Under: From the Pharmacy, Prescription Drugs Tagged With: , , ,

America on Drugs

4 August, 2011 by 3 Comments

Bear with me here guys, this is a long post, and this comes from years of being a pharmacist and the personal experience of being a patient…but for anyone on an antidepressant or other “brain” drug, you need to read this:


Your Brain on Drugs…no, I won’t be showing you a picture of a fried egg, though I must say it’s a great analogy! We know street drugs fry your brain, that’s a no-brainer! (Sorry =o)
I’m talking about prescription drugs…and not just the “controlled” ones. I’m talking about all of the psychotropic drugs prescribed in the United States today. As a pharmacist, it has made me crazy to see this huge increase in my years in this industry. As a patient, I fell right into the trap. Let me give you just a few statistics from reputable sources to put it in perspective for you…


A study was done by the American Medical Association from 1988 to 1994, during which time the visits to a physician for depression increased from 10.99 million in 1988 to 20.43 million in 1994. Visits for stimulant drugs increased from .57 million to 2.86 million. In a much more recent study, the Centers for Disease Control the percentage of people who use five or more prescriptions drugs increased by 70% in the last 10 years. It’s obvious to me that this increase is largely due to the increase in psychotropic prescription visits. 


Our society is in danger. Real danger. Christians and non-Christians alike. Many physicians  are prescribing narcotics, antidepressants, anticonvulsants, and other miscellaneous psychotropic drugs like candy, and do not realize the true danger they are putting their patients in. Different doctors and different pharmacies lead the way to missed information and drug interactions. Doctors cannot possibly keep up with all of the drug interactions possible between the thousands of prescription drugs on the market today. Even as a pharmacist, I ended up with a potentially life threatening drug interaction that my doctor(s) and pharmacist missed. I had not been working in pharmacy during the time Cymbalta was approved and put on pharmacy shelves, and due to an interaction with my migraine prescription medication, I ended up in a state for 24 hours where I did not know what was real and what wasn’t. I didn’t know if this world was real, or if I was dead or alive. At one point, I did not know David was my husband. Marlee was laying next to me in the bed and I actually asked David if she was dead. It was the scariest night of my entire life. I know this sounds crazy, and even when I was in the midst of it I felt sure that I would wake up in a straight jacket staring at four white walls!  


When my reality began to become more clear, due to my pharmacy training I knew what happened. I immediately began researching the medications I had taken, and quickly discovered I’d experienced serotonin syndrome. Now I must say should have known the possibility of this interaction, but in this case, my brain was, well, sick. Seizures, migraine, depression, and medication did not leave me in the mind to catch these things…my doctor and pharmacist should have caught it. I know that when my prescription was filled, the pharmacist was required to manually override a drug interaction possibility, which means they just overrode it by habit, without really looking, or just neglected to mention it. Last summer,in a total of approximately eight days working as a relief pharmacist, I called doctors on four separate occasions to warn them of this exact same interaction. All four times the prescriptions were changed. 


This incident is just one of millions that happen daily. While there are definitely patients that require psychotropic drug therapy, these drugs are widely overused. I’m not sure why doctors feel so much more comfortable prescribing these drugs now than in the past, but where therapy was once first course of treatment, doctors now tend to give the drug first, to “dial things down” before therapy is started. Once the patient gets the prescription, they do not want to follow up with expensive therapy. Our society of immediate gratification and prescription drug advertising on every venue possible lead us to the “quick fix.” After all, “Depression Hurts, Cymbalta can help.” Right? 


Due to the depression I experienced during my years of seizures, my doctors kept trying to get me to take an antidepressant. I finally conceded and began taking Cymbalta. If I wasn’t miserable before, I sure was then! After about a month on the Cymbalta, I felt horrible and was still depressed, so I decided I would wean off of it. Ha! Now that was a joke. The “non-addictive, harmless” antidepressant was everything but. I know you have all seen the commercial for Cymbalta, but in my research I stumbled across a youtube video that really makes the point.  It is a little on the extreme side, but only a little. 


Depression hurts, Cymbalta hurts more


Before I conclude, let me just say this…there is certainly a need and a place for antidepressants. We have just come to rely on the quick fix of drugs way too much. If you happen to be on Cymbalta and doing well, Yay! For me, many of the side effects of Cymbalta were front and center. As patients, we have just become too trusting:


First,we trust our doctors to know everything we need to know. No one can know everything. 


Second, we expect our pharmacists not to be too busy to counsel us every aspect of the drug, but they can’t control the 15 people waiting on prescriptions at once (and I can assure you, the chain pharmacies push the limit on the number of prescriptions allowed per pharmacist), nor can they control the hurry we are in to get out of the pharmacy.


Third, we trust the FDA not to put anything on the market that could harm us. It is sad we cannot depend on our government to keep our best interests at heart, but unfortunately, the almighty dollar often takes priority.


And yet, we are not trusting enough in God. We don’t believe and trust that God is all that we need. I know I used the verse on this prescription in another post, but it says so much. When God created the earth, and created man to inhabit the earth, he gave us everything we’d ever need. With so much emphasis placed on the synthetic psychotropic drugs available today, we lose our focus. We need to think simply and eternally at the same time. More talking, more prayer, more God. Put God at the head of your medical team, and let him lead you in the very best way to restore your mind…for eternity. 


From my heart, 
Celeste

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Filed Under: Beating Depression, God's Pharmacy, Living in Faith, Managing Prescription Drugs, Overcoming Addiction Tagged With: , , , , , , , , ,