Bay area pharmacists and pharmacy operators needed for consultancy

Dear Bay area Pharmacists and Pharmacy operators,

Your experience and expertise will help us reduce chronic health care cost. I would like to set up a few minutes of your time on the phone or in person to learn from you and together we can develop a way to help streamline drug delivery, management and operations to the patient level to help reduce health care costs.

Please email me your availability.

Regards,

Connie Dello Buono

motherhealth@gmail.com

Health author and blogger

Owner of Motherhealth Senior care agency providing caregivers to homebound seniors

1708 Hallmark Lane San Jose CA 95124

408-854-1883

 

Long term use of certain pain relief medications linked with hearing loss among women

Asian News International

London [England], Dec. 15 (ANI): Women take note! Taking painkillers for headaches and back pains for twice a week can increase the risk of hearing loss, finds a study.

According to Mail Online, taking two painkillers — paracetamol or ibuprofen– a week for more than six years has been linked with significant hearing loss by nine percent, with the drugs thought to cut blood supply to the inner ear and expose it to noise damage.

The painkillers damage the tiny hairs within the ear, which help us hear, and have been linked in younger and older women with a higher risk of hearing loss.

Researchers examined 55,850 women between the age of 44 and 69 – almost half of whom reported a hearing problem.

The findings, published in the Journal of Epidemiology, backs similar research in men, suggesting middle-aged women, who commonly take paracetamol and ibuprofen for headaches and back pain, should consider cutting down.

“Hearing loss is extremely common and can have a profound impact on quality of life,” said senior study author Dr Gary Curhan from Women’s Hospital in the US.

“Finding modifiable risk factors could help us identify ways to lower risk before hearing loss begins and slow progression in those with hearing loss,” Curhan added.

Around one in six people in London have hearing problems, which can leave people feeling cut off and lonely and has been found to speed up memory loss and dementia.

The study suggests that Paracetamol is believed to deplete antioxidants within the ear, making the cochlea more vulnerable to noise-induced damage.

“Finding modifiable risk factors could help us identify ways to lower risk before hearing loss begins and slow progression in those with hearing loss,” Curhan added. (ANI)

Ibuprofen-like painkillers linked to an increased risk of heart failure

“Ibuprofen could raise the risk of heart failure by up to 83%,” claims the Daily Mirror. But this headline massively overstates the danger of this painkiller.

In fact, new research suggests that taking painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs) – which includes ibuprofen – increases the risk of heart failure by less than 20% overall.

NSAIDs are a group of painkilling medicines commonly taken by people with joint problems, backache and arthritis. They are prescribed to relieve pain and reduce inflammation.

The study found that the risk of heart failure varies between NSAIDsand according to dosage.

While a rarely prescribed NSAID called ketorolac almost doubled the risk of heart problems, the more commonly taken ibuprofen increased the chance of heart problems by just 18%.

The risk was also highest for people who took an NSAID on a daily basis and in very high doses.

Some NSAIDs, such as ketoprofen and celecoxib, did not seem to increase the risk at all at usual doses.

This latest study backs up previous evidence that NSAIDs are clearly linked with an increased risk of heart failure. But it’s important to bear in mind that the risk is, for most people, still very small.

Heart failure is caused by a wide range of conditions, including high blood pressure, heart attacks and obesity.

Where did the story come from?

This was a large study involving more than 7 million people. It was carried out by researchers from seven European institutions, led by the University of Milan, and was funded by the European Union. The study was published in the peer-reviewed British Medical Journal (BMJ).

Some UK media outlets failed to make it clear the study was carried out among people who were taking prescribed NSAIDs, usually for a long-term condition such as backache or arthritis, rather than people taking the occasional over-the-counter painkiller.

The Daily Express headline wrongly says: “Over-the-counter painkillers raise risk by almost 20%,” although at least they used the more credible 20% relative risk figure.

The Daily Mirror’s scaremongering headline stating an increased risk of heart failure of 83% was way above that of most of the NSAIDs studied and was wrongly linked to ibuprofen.

BBC News took a more balanced view, and included interviews with experts who discussed exactly who is and isn’t at risk from NSAIDs and heart failure.

What kind of research was this?

This was a so-called nested case-control study, which used drug databases to identify people who’d been prescribed NSAIDs during a 10 year period. Of these, those who had been admitted to hospital for heart failure were compared with others in the database of the same age and sex.

This type of study helps researchers identify links between individual drugs and outcomes such as heart disease. They don’t directly prove the drug causes the heart disease, but we’ve already seen randomised controlled trials showing NSAIDs in general do seem to raise the chances of heart failure.

What did the research involve?

Researchers used five drug databases from four European countries to identify adults who’d had at least one NSAID prescription between 2000 and 2010. They then identified anyone from that group who’d later been admitted to hospital with heart failure and matched them with up to 100 “controls” – people the same age and sex, who’d started the study around the same time.

They then looked to see whether a current prescription of an NSAID (within the last 14 days) affected someone’s chances of being admitted to hospital with heart failure.

The databases were from the UK, Italy, the Netherlands and Germany. For the UK and the Netherlands, the databases also recorded the daily dose prescribed, so the researchers used this information to calculate the effect of low, normal, high or very high prescribed doses.

The researchers corrected their figures to take account of factors such as previous diagnosis of heart failure or other medical condition and other medicines being taken.

What were the basic results?

The study found 92,163 people who’d been admitted to hospital with heart failure among the 7.6 million people prescribed an NSAID who were included in the study. People admitted with heart failure tended to be older, with an average age of 77, and many of them also had high blood pressure, high cholesterol, cardiovascular disease or diabetes.

Compared to others of about the same age and sex, those who’d been admitted for heart failure were more likely to be currently taking a prescribed NSAID.

In fact, nearly one in five (17.4 %) of heart failure patients and one in seven (14.4 %) of the matched control groups had a current prescription. This meant that having a current prescription for any NSAID raised the risk of heart failure admission by almost 20% (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.17 to 1.22).

However, more interesting was the information about individual drugs. Nine NSAIDs had a raised risk of heart failure: ketorolac, etoricoxib, indomethacin, rofecoxib, piroxicam, diclofenac, nimeluside, ibuprofen and naproxen.

The degree of increased relative risk varied between them, from ketorolac at 83% to naproxen at 16%.

Some of the NSAIDs, including the commonly used ketoprofen and celeocoxib, did not show any increased risk.

The risk was highest for people taking very high daily doses (twice the usual daily dose) of NSAIDs.

How did the researchers interpret the results?

The researchers said their study results showed that the risk of heart failure in people taking NSAIDs “appears to vary between individual NSAIDs, and is dose dependent”.

They say their findings “might apply to NSAIDs obtained over the counter”, although they only looked at prescription drugs.

“Although over-the-counter NSAIDs are probably typically used at lower doses, by younger people, and for shorter durations than prescribed NSAIDs, they are sometimes available at the same doses,” they observe, adding “they may be inappropriately over-used.”

They call for research into the safety of over-the-counter NSAIDs “under the conditions they are typically used”.

Conclusion

This useful and well-conducted study isn’t the first to say NSAIDs may raise the risk of heart failure. We’ve known for some time that NSAIDs can have side effects, especially when used at high doses and for long periods.

What this study does help show is the different levels of risk between different NSAIDs, and confirms that the risk depends partly on the dose. It’s important to remember that the study only included people who were prescribed NSAIDs and not people who’d bought them over the counter.

The information is most useful to older people taking prescribed NSAIDs long-term for conditions such as gout or arthritis. These are the people most likely to be affected by heart problems linked to NSAIDs.

The study shows that some NSAIDs are less risky than others, and doctors can use this information to discuss with patients which is the most suitable drug if they need long-term anti-inflammatory painkillers.

For people who take NSAIDs over the counter, it’s a reminder that these drugs are not risk-free. While an otherwise healtlhy 20-something taking ibuprofen for a day or two to get over back ache is highly unlikely to get heart failure as a result, long-term use of NSAIDs at high doses can cause problems.

Sensible advice is to take the lowest dose that works for the shortest period you need it. If you find you need to take NSAIDs very often, or you’re taking doses higher than those recommended, you should talk to your doctor about your pain.

http://www.nhs.uk/news/2016/09September/Pages/Ibuprofen-like-painkillers-linked-to-an-increased-risk-of-heart-failure.aspx

Cut your drug costs

Consider an over-the-counter (OTC) drug first for these conditions.

Heartburn $225 per month
Insomia $145
Seasonal Allergies $113 per month
Migraine headaches $13.90 per month
Joint Pain $177 per month

Consult your doctor regularly. For the young, up your intake of Vit C, sleep before 10pm, cut alcohol and drugs and eat well (more on alkaline rich food). The above health issues will be prevented when we apply healthy habits while we are still young and maintain it when we are older.
My mom loves dietary supplements with calcium and magnesium, Vit D and C, turmeric, MSM, glucosamine and lemon grass for her joint pain. She also uses massage oil and homeopathic creams from Hyland.
For insomnia, there are many healing ways that one can tailor fit to suit the body’s needs. Melatonin and calcium with magnesium with Vit Bs help.

Shop around before using your insurance. Be aware of coverage changes. Take advantage of the new healthcare law. Use your insurer’s preferred pharmacy or mail-order service. Take care of your body now before any signs and symptoms occur.

——————————————

We are hiring people savvy and ambitious bayarea pros in the financial service arena to help others with long term care, retirement income, protection and more, contact Connie 408-854-1883 motherhealth@gmail.com  http://www.pfaonline.com

Best drugstore Meds for Men and Women

There’s safety in the prescription pad: Doctor’s orders remove all doubt about which pill to pop. But without the chicken scratch on that scrip to guide you, do you know which meds are best?

More than 100,000 are available over the counter and contain over 1,000 active ingredients—which you probably ignore. In fact, a new Northwestern University study reveals that 59 percent of people don’t always check the contents of their OTC drugs. “Most people shop by symptom, not ingredient,” says study author Michael Wolf, Ph.D., M.P.H.

It’s time to stop buying blind. We asked Men’s Health writer Paige Greenfield to hit the drugstore, talk to the experts, and decode the labels. Below are the best over-the-counter remedies for 8 of your most common symptoms. Check out the complete list here: The 20 Best Over-the-Counter Medicines.

ALLERGIES

Your OTC solution: Loratadine
Try: Claritin

Allegra, Claritin, and Zyrtec are equally effective at fighting allergy symptoms. But Claritin still wins by a nose, says Lauren Schlesselman, Pharm.D., a pharmacy professor at the University of Connecticut. Zyrtec can make you sleepy, and while both Claritin and Allegra are labeled “non-drowsy,” Claritin is slightly less likely to cross the blood-brain barrier and cause sleepiness. Dose up daily at the same time to keep blood levels steady. Sinus pain? Opt for Claritin-D.

CHEST CONGESTION

Your OTC solution: Guaifenesin
Try: Mucinex

Feel like rubber cement is coating your lungs? Grab guaifenesin. This ingredient thins mucus, making it easier to expel, and may even halt mucus production. Take the maximum number of doses for 3 or 4 days, even if you feel better, says W. Steven Pray, Ph.D., D.Ph., a professor of pharmacy at Southwestern Oklahoma State University. But skip guaifenesin/cough suppressant combos; these make it tough for you to expel thinned out mucus, say Wake Forest University researchers.

DANDRUFF

Your OTC solution: Ketoconazole
Try: Nizoral A-D

If it snows wherever you go, you can blame a fungus called Pityrosporum ovale. Change the forecast with Nizoral A-D, the only nonprescription shampoo that contains the anti-fungal ketoconazole, says Pray. Just limit your lathering to once every 3 days; any more can cause irritation. The rest of the time, Pray recommends shampooing with Head & Shoulders, which contains zinc pyrithione, a compound that slows the shedding of skin cells on your scalp.

DRY COUGH

Your OTC solution: Dextromethorphan
Try: Delsym

To quell a cough, you need to target your brain, not your lungs. “Dextromethorphan acts on your brain’s medulla to raise the cough threshold, so it requires more irritation to produce a cough,” says Stefanie Ferreri, Pharm.D., a pharmacy professor at the University of North Carolina at Chapel Hill. To avoid hacking at 2 a.m., take the extended-release stuff—it lasts for up to 12 hours. Take it with honey to boost saliva production and lubricate your airway, suggest British scientists.

ACID REFLUX

Your OTC solution: Immediate-Release Omeprazole
Try: Zegerid

Apparently all acid-reflux drugs must begin with a P or a Z: Prilosec OTC, Prevacid, Zantac. Now there’s Zegerid, possibly zee best yet. It contains a quick-release form of the omeprazole found in Prilosec OTC. Taken before breakfast, it was more effective than lansoprazole (Prevacid) at quelling acid over 24 hours, a Northwestern University study found. A word of caution: Zegerid has 304 milligrams of sodium per pill, so if you have to restrict your salt, stick with Prilosec.

INSOMNIA

Your OTC solution: Doxylamine
Try: Unisom SleepTabs

Insomnia doesn’t have to keep you up at night. First, try these natural remedies: 6 Foods that Will Help You Sleep Better Tonight! But if they don’t work, pop an antihistamine. Benadryl and other diphenhydramine-based drugs can help you drift off; however, the antihistamine doxylamine is more sedating. Plus, it’s less likely to cause “paradoxical wakefulness,” when your sleeping pill leaves you wide awake, says W. Christopher Winter, M.D., the Men’s Health sleep advisor. Take a 25-milligram tab about a half hour before bedtime, he says.

PAIN & FEVER

Your OTC solution: Ibuprofen
Try: Advil

Whether you need it for pain or fever, ibuprofen has the edge on acetaminophen, a 2010 Wake Forest University review concluded. It also beats out other NSAIDs; aspirin is now recommended almost exclusively for cardio protection. And while Dr. Schlesselman suggests limiting naproxen (Aleve) to once every 12 hours, you can swallow ibuprofen every 4 hours, reducing the chance of between-dose pain. Ibuprofen may trigger GI trouble, so always pop your pill with a meal.

HEARTBURN

Your OTC solution: Calcium Carbonate
Try: Caltrate

Most heartburn meds will douse the flames in your esophagus, but at what cost? Calcium carbonate rapidly neutralizes stomach acid with fewer side effects than sodium bicarbonate (Alka-Seltzer), which can cause gas and bloating, or magnesium hydroxide (Maalox), which can cause diarrhea. Dr. Schlesselman recommends chewing the tablets thoroughly and then chugging a glass of water to help them dissolve.

Crowdfunding for Motherhealth –> http://www.indiegogo.com/projects/413184/wdgi/3335495