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New Drugs Approved in 1st Quarter of 2016

Every quarter we strive to educate our customers with new medications that have been approved by the Federal Drug Administration. Among the newly approved drugs are:

Migraine sufferers have a new drug to look forward to trying. Approved in January of this year, Onzetra Xsail is a nasal powder for use in the acute treatment of migraine in adults. The maximum dose in a 24-hour period should not exceed two doses (44 mg) separated by at least two hours. Side effects can include, abnormal taste, nasal discomfort, excessive runny nose, and rhinitis (inflammation of the mucous membrane of the nose, nasal congestion and itching, and sneezing).

For adults and children with hemophilia A, Kovaltry is now available to control bleeding episodes as well as for use ahead of a surgical procedure. It an also be used routinely to reduce the frequency of bleeding episodes. The main side effect of Kovaltry is headache.

Those suffering with hemophilia B, Idelvion has been approved for children and adults and provides control for bleeding episodes both on-demand, and as an on-going preventative treatment. Both medications are to used intravenously. Primary side effects of Idelvion are headache, high fever, and itching.

A new HIV-1 treatment is now available for new patients 12 years and older. Taken orally once daily with a meal, Odefsey is used for those with no antiretroviral treatment history with HIV-1; or to replace a stable antiretroviral regimen in those who are virologically suppressed for at least six months with no history of treatment failure and no known substitutions associated with resistance to the individual components of Odefsey. Common side effects include depression, insomnia, headache, and nausea.

Briviact has been approved for use in partial onset seizures related to epilepsy. Available in tablet, oral suspension and via intravenous administration, Briviact has been approved for patients 16 years and older.  Side effects include dizziness, fatigue, nausea and vomiting, and drowsiness.

If you have been diagnosed with any of these conditions, talk to your doctor about the right course of treatment for you. It’s also important to talk to your pharmacist to make sure any new medications you may be taking don’t negatively impact other medications you are currently taking.

 

Source: CenterWatch

Living with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that typically affects the small joints in the hands and feet. Like other autoimmune diseases, the body’s tissues are mistakenly attacked by their own immune system. In the case of RA, the joints in the body are attacked causing severe pain, joint damage or deformity. Unfortunately at this time, there is no cure for RA. However, there are a number of treatments that can help control and lessen the effects.

RA is the most common type of autoimmune arthritis, and with early diagnosis and treatment, joint pain and swelling can be controlled and lessen joint damage. Signs and symptoms of the disease include:

  • joint pain in the feet, hands, and knees;
  • swollen joints;
  • fever;
  • tender joints;
  • loss of joint function;
  • stiff joints;
  • fatigue;
  • joint redness;
  • rheumatoid nodules ( firm lumps under the skin close to the joints affected);
  • joint warmth;
  • and joint deformity.

During the initial stages of the disease the doctor will usually prescribe medications that are known to have the fewest side effects. As the disease progresses, stronger medications may be required, but more potentially serious side effects can occur.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs (like Advil and Motrin) are used for pain relief as well as reducing inflammation. They can be purchased over-the-counter without a prescription, and they will help treat the pain, but will not slow down the progression of the disease.

Corticosteroids

When NSAIDs do not help, corticosteroids are effective at reducing inflammation and pain, plus they are helpful at slowing down joint damage. If the patient has a single inflamed joint the doctor may inject the steroid into the joint. Effective relief is usually felt rapidly and the effect can last from weeks to months, depending on the severity of symptoms.

Examples include prednisone (Lodotra) and methylprednisolone (Medrol). Corticosteroids are generally used for acute, short term flare ups – then the dosage is gradually reduced.

DMARDs (disease-modifying antirheumatic drugs)

These types of medications may slow down the progression of the disease, as well as prevent permanent damage to the joints and other tissues. The earlier the patient starts taking a DMARD after diagnosis with RA, the more effective it will be.

Unlike a corticosteroid injection, these types of medications take longer to notice reduction in pain. It could take four to six months, to see results, but it’s important to not stop taking the medication. Patients may have to try different types of DMARDs before finding the most suitable one for them.  This medication is usually taken indefinitely.

Examples include leflunomide (Arava), methotrexate (Rheumatrex, Trexall), sulfasalazine (Azulfidine), minocycline (Dynacin, Minocin), and hydroxychloroquine (Plaquenil).

Immunosuppressants

Because rheumatoid arthritis is an auto-immune disease, suppressing the immune system helps reduce the damage to good tissue. Examples include cyclosporine (Neoral, Sandimmune, Gengraf), azathioprine (Imuran, Azasan), and cyclophosphamide (Cytoxan).

Tumor necrosis factor-alpha inhibitors (TNF-alpha inhibitors) are used for the reduction of pain, morning stiffness and swollen or tender joints. Results are usually noticed within two weeks of starting treatment. Examples include (Enbrel), infliximab (Remicade) and adalimumab (Humira).

Surgery

If the treatments listed above have not been effective enough, the doctor may consider surgery to repair damaged joints, allowing the patient to use that joint again. Surgery may also help correct deformities, or reduce pain. The following procedures may be considered:

  • Arthroplasty – total replacement of the joint. The damaged parts are surgically removed and a prosthesis (artificial joint) made of metal and plastic is inserted.
  • Tendon repair – if the tendons around the joint are loosened or ruptured, surgery may help restore them.
  • Synovectomy – this involves the removal of the joint lining, if the synovium (lining around the joint) is inflamed and causing pain.
  • Arthrodesis – if a joint replacement is not an option, the joint may be surgically fixed to promote a bone fusion; the joint is realigned or stabilized. Also called artificial ankylosis, syndesis.

 

When a flare-up occurs the patient should rest as much as possible — this is not a time to work through the pain as the exerting of very swollen and painful joints frequently results in worsening symptoms.

However, if the patient is not experiencing a flare-up, regular exercise will help their general health and mobility. If rheumatoid arthritis has caused muscles around the joints to become weak, exercise will help strengthen them. Exercises that do not strain the joints are best, such as swimming. Physical therapy can also help to improve mobility.

Rheumatoid arthritis can affect people of all ages and more than 200,000 cases are diagnosed each year. Anyone can get this disease, though it occurs more often in women. Rheumatoid arthritis often starts in middle age and is most common in older people. But children and young adults can also get it.

If  you are experiencing any symptoms listed above, please visit your doctor. The sooner you can begin treatment, the sooner you can effectively treat your pain.

Kidney Stones: How to prevent and treat them

Have you ever experienced a kidney stone or known someone who has? I’ve heard it’s as painful as childbirth, if not worse.

So, what exactly is a kidney stone? A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. They are fairly common in that one in 20 people will develop kidney stones at some point in their life. They form when there’s a decrease in urine volume and/or too much of the stone-forming substance in the urine.

A major risk factor for forming a kidney stone is dehydration. For example, if you do not drink enough water or other fluids, or perhaps perform strenuous exercise without replacing the fluid lost, you will increase the risk of kidney stones. If you have some sort of obstruction to the flow of urine in your body, it can also lead to the formation of kidney stones. Those of you living in a hot and dry climate are more likely to develop kidney stones due to a higher risk of dehydration.

Symptoms of a kidney stone include severe pain in your side and blood in your urine. The pain is usually sudden and excruciating. You can also experience cramping in your lower back and/or side, groin, or abdomen. The pain does not subside even when you change positions, and it can be so severe that it can be accompanied by nausea and vomiting. If you also have a urinary tract infection along with the stones, you may experience chills and a fever. You may also experience difficulty urinating, feeling like you have to urinate even when you don’t need to go, and men may experience penile or testicular pain.

Other health factors can also increase your changes of developing stones.

  • Certain medical conditions will increase your risk:
    • Gout
    • Diabetes
  • Diet and hereditary factors are also related to stone formation:
    • High intake of animal protein
    • High-salt diet
    • Excessive sugar consumption
    • Excessive vitamin D supplementation
    • High doses of Vitamin C (1 gram or more daily)
    • Excessive intake of spinach.

Most stones develop in people 20 to 49 years of age. And, for those who have already had more than one kidney stone , you are more prone to developing further stones.

How are stones diagnosed and treated?

The best way to diagnose kidney stones is via ultrasound, intravenous pyleography (IVP), or a CT scan. Most kidney stones will pass through your body on their own time and usually within 48 hours, with plenty of fluids. During this time and in addition to drinking fluids, treatment includes medication (such as Acetaminophen and in some cases a narcotic pain medication) to control pain. When stones do not pass on their own, a procedure called lithotripsy (where ultrasound shock waves break the stones into small particles that can be passed out by the body), or other surgical procedures, are used.

It is best to avoid kidney stones in the first place when possible. It can be especially helpful to drink more water, since low fluid intake and dehydration are major risk factors for kidney stone formation.

The National Kidney Foundation advises people with kidney disease, people who are on dialysis, and people who have received a kidney transplant to avoid all herbal supplements. The foundation also warns that some minerals, like potassium, may be present in supplements in which you may not expect them, like turmeric rhizome, evening primrose, noni and garlic leaf can all contain potassium.

Depending on the cause of the kidney stones and your medical history, changes in the diet or medications are sometimes recommended to decrease the likelihood of developing further kidney stones. If you have passed a stone, it can be particularly helpful to have it analyzed in a laboratory to determine the precise type of stone so specific prevention measures can be considered.

 

 

Sources: Medicine Net and the National Kidney Foundation.

 

Eat Your Vitamins

We see a lot of commercials and print ads for vitamins that encourage us to take the supplements  for what is missing in our regular diet.  “Pills might seem like an easy fix, but food provides an abundance of nutrients, as well as fiber, that pills lack”, says Mary Ryan, a registered dietitian in Jackson Hole, Wyoming.

With some many people and families going in eight different directions, it can be difficult to have a balanced diet, and many of us take a daily multi-vitamin as nutritional insurance. But, the downside to this is that many  multivitamins may contain micronutrients in amounts in excess of those recommended in the government’s Dietary Guidelines for Americans. In some cases, these levels may result in unsafe intakes.

So, the best way to get the vitamins and nutrients you need is by eating the right foods in the right amounts. Below we cover some of the vitamins that are needed for a healthy diet and what to eat to get your daily value.

Vitamin A:
Vitamin A plays a key role in immunity, reproductive system, and especially vision. A vitamins include beta-carotene which helps the retina, cornea, and membranes of the the eye to function properly.

Just one medium size Sweet Potato contains 561% of your recommended daily value of Vitamin A. Beef liver, spinach, fish, milk, eggs, and carrots are also good sources.

Vitamins B6 and B12:
The B complex of vitamins (especially B6 and B12) keep blood, nerves, and the immune system functioning properly. They help stabilize blood sugar, guard against anemia, and make antibodies that fight disease. Deficiency in these may be a risk factor for heart disease and stroke.B6 is found in whole grains, bananas, beans, nuts, wheat germ, chicken, and fish. One cup of canned chickpeas contains 55% of your DV for B6.Animal products are the best way to get your B12. Cooked clams have the highest concentration of all with 1,402% of your DV in just 3 ounces! You can also find B12 in beef, pork, poultry, eggs, fish, and dairy. It’s also added to many breakfast cereals.You can also eat one cup of plain yogurt and a banana, one ounce of sunflower seeds, and three ounces of roast beef to fill your B12 and B6 quotas. B12 is found only in animal products, so vegans should take a supplement.Vitamin C:
Vitamin C is an antioxidant that has been shown to fight DNA-damaging free radicals. It may help to maintain a healthy immune system and boost HDL, the so-called “good” cholesterol.Most people think of citrus when they think about vitamin C, but did you know that sweet red peppers contain more vitamin C than any other food? Orange juice is a close second, but you can also get your DV from foods including kiwi, brocolli, brussels, sprouts, and cantaloupe.

If you eat your recommended five servings a day of fruits and vegetables and you shouldn’t be lacking in C.

Calcium
Calcium is essential for bone health and plays an important role in preventing osteoporosis. Its the most abundant mineral in your body. More than 99% of calcium is stored in your teeth and bones and the rest is used for blood vessels and muscle function, cell communication, and hormone secretion.

Up to age 50, women should get at least 1,000 milligrams daily; those over 50 should get at least 1,200. The body can’t absorb more than 500 milligrams of calcium at a time, so small doses are best.

An eight-ounce glass of skim milk, one cup of yogurt, one cup of cooked spinach, and one fig will get you to your calcium goal. If you don’t eat dairy, look for calcium-fortified soy milk or orange juice. Dark, leafy vegetables are another source of natural calcium.

Vitamin D
Our bodies generates vitamin D on its own when our skin is exposed to sunlight. It helps our   calcium absorption and bone growth. It also helps with the reduction of inflammation. A vitamin D deficiency can lead to osteoporosis and has been linked to certain cancers, as well as to multiple sclerosis, type 1 diabetes, and other chronic illnesses.

Swordfish, tuna and salmon, and mackerel are among the naturally occurring dietary sources of vitamin D. But most people get their vitamin D comes from fortified foods, like milk, cereal. and yogurt.

If you’re under 50, one 3 1/2-ounce serving of salmon or two cups of fortified milk will give you your daily allowance. Ten to 15 minutes of sunlight (with no sunscreen) two to three times a week is usually sufficient, too.

Vitamin E
Vitamin E is a powerful antioxidant that protects cells from harmful free radicals. Recent studies point to positive effects on eye health and the prevention of Alzheimer’s disease.

Wheat germ oil has more vitamin E than any other food source, but most people find it easy to get their DV from sunflower seeds or almonds.  You will also find vitamin E in avocados, broccoli, vegetable oil (such as safflower, sunflower, cottonseed, canola, and olive), almonds, and most other nuts.

Folic Acid (Folate)

If you are pregnant, or planning on becoming pregnant, folic acid can help prevent birth defect. Even if you’re not pregnant, it helps new tissues and proteins form. Deficiencies may be a risk factor for some cancers, heart disease, and stroke.You can find Folic Acid in leafy vegetables like spinach which has 33% of your DV, strawberries, wheat germ, broccoli, asparagus, whole grains, beans, and foods that have been fortified with folic acid, such as cereals and breads.A 3/4-cup serving of fortified breakfast cereal contains 100 percent of what you need. A cup of peas, a cup of cooked spinach, and about five spears of asparagus also add up to the RDA.

Iron
Proteins in our body use iron to transport oxygen and to grow cells.There’s also evidence that it helps support a healthy immune system. A deficiency may be linked to impaired memory and an inability to focus.

Iron is most plentiful in and best absorbed from red meat, fish and poultry. It’s also found in lentils and beans.

A large spinach salad, a cup of lentil soup, and a small (three-ounce) serving of red meat will give you adequate iron.

Vitamin K
Vitamin K helps maintain healthy blood clotting and promotes bone density and strength. Without it, your body would not be able to stop bleeding when you bruise, scratch or cut yourself.

Dark green, leafy vegetables and vegetable oils, such as olive, canola, and soybean. Kale contains the most, but collard greens and spinach are a close second.  Eating about a cut of raw broccoli or spinach salad will provide you with what you need.

Magnesium
Magnesium helps maintain normal muscle and nerve function, regulate blood sugar levels, and keep bones strong. A lack of it in your diet may contribute to heart disease or high blood pressure.

Wheat bran has the highest amount per serving. Other sources include whole-grain breads and cereals, legumes, spinach, broccoli, dates, raisins, bananas, almonds, cashews, peanuts, walnuts, and pecans.

If you have two slices of whole-wheat toast for breakfast, snack on three ounces of almonds and raisins in the afternoon, and for dinner try three ounces of grilled halibut with a baked potato, you’ll get your daily allowance.

Zinc
Zinc plays an important role in supporting a healthy immune system. It’s been known to shorten and lessen the severity of cold symptoms, but it’s also important for your sens of taste and smell.

Oysters contain more zinc per serving than any other food, but you can also get it in red meat and poultry.

 

Talk to your doctor or pharmacist about your diet. They may recommend certain supplements to be sure you’re getting what you need on a daily basis.