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Poison Prevention Week

Not all poisons come with a skull and crossbones to warn you of danger.

Did you know that poisoning is the #1 cause of injury-related death in the U.S.?  While the majority of unintentional poisoning deaths in the United States are attributable to misuse and abuse of drugs, environmental substances, such as carbon monoxide and pesticides, also contribute to the poisoning illnesses and deaths occurring in the United States each year. Carbon monoxide causes the most non-drug poisoning deaths (approximately 524 per year), especially among people over 65 years old and males. The majority of pesticide poisoning exposures are unintentional and occur in children under 6 years old or in adults over 20 years old.

A poison is a substance that can cause illness, injury, or death. Poisons can be swallowed, inhaled, or absorbed through the skin. Some substances are toxic in small doses, but other usually harmless substances can be poisonous if encountered in large enough quantities.

Childhood poison exposures often occur as a result of exploratory behavior. In these cases, the amounts ingested are usually small and the health effects minimal. However, exposures to some medicines and household chemicals even in small amounts can result in serious illness or death.

Adult poisonings, on the other hand, are usually drug-related and result from:

  • Overdoses of illegal drugs and legal drugs taken for nonmedical reasons
  • Poisoning from legal drugs taken in error or at the wrong dose
  • Unanticipated effects from prescription drugs for medical or non-medical reasons

Overall, the majority of unintentional poisoning deaths in the United States are attributable to misuse and abuse of drugs. In recent years, deaths involving prescription narcotic painkillers (e.g., oxycodone, hydrocodone, methadone), have outnumbered the combined total of deaths involving the illegal drugs heroin and cocaine.

How do you prevent drug poisoning?

  • Only take prescription medications that are prescribed to you by a healthcare professional. Misusing or abusing prescription or over-the-counter medications is not a “safe” alternative to illicit substance abuse.
  • Never take larger or more frequent doses of your medications, particularly prescription pain medications, to try to get faster or more powerful effects.
  • Never share or sell your prescription drugs. Keep all prescription medicines (especially prescription painkillers, such as those containing methadone, hydrocodone, or oxycodone), over-the-counter medicines (including pain or fever relievers and cough and cold medicines), vitamins and herbals in a safe place that can only be reached by people who take or give them.
  • Follow directions on the label when you give or take medicines. Read all warning labels. Some medicines cannot be taken safely when you take other medicines or drink alcohol.
  • Turn on a light when you give or take medicines at night so that you know you have the correct amount of the right medicine.
  • Keep medicines in their original bottles or containers.
  • Monitor the use of medicines prescribed for children and teenagers, such as medicines for attention deficit hyperactivity disorder, or ADHD.
  • Do not put your next dose on the counter or table where children can reach them—it only takes seconds for a child to get them.
  • If you have to do something else while taking medicine, such as answer the phone, take any young children with you.
  • Secure the child safety cap completely every time you use a medicine.
  • After using them, do not leave medicines or household products out. As soon as you are done with them, put them away and out of sight in a cabinet where a child cannot reach them.
  • Be aware of any legal or illegal drugs that guests may bring into your home. Ask guests to store drugs where children cannot find them. Children can easily get into pillboxes, purses, backpacks, or coat pockets.
  • Dispose of unused, unneeded, or expired prescription drugs by participating in National Drug Take Back day at our pharmacy on April 28th of this year.

Some household cleaning and lawn care products also contain chemicals that can be poisonous to people. Follow these warning to prevent accidental poisoning:

  • Always read the label before using a product that may be poisonous.
  • Keep chemical products in their original bottles or containers. Do not use food containers such as cups, bottles, or jars to store chemical products such as cleaning solutions or beauty products.
  • Never mix household products together. For example, mixing bleach and ammonia can result in toxic gases.
  • Wear protective clothing (gloves, long sleeves, long pants, socks, shoes) if you spray pesticides or other chemicals.
  • Turn on the fan and open windows when using chemical products such as household cleaners.

Carbon monoxide is an  odorless, colorless and tasteless gas, and is known as the “silent killer”. If you have an oil or gas heating system, water heater or other fuel burning appliance in your home, follow these tips to keep you safe:

  • Have a qualified technician service these systems and appliances every late summer or early fall.
  • Install battery-operated CO detectors in your home and check or replace the batteries when the time changes in the spring and fall. If the detector sounds, leave the home immediately and call 911.
  • Seek medical attention if CO poisoning is suspected or if you feel dizzy, light-headed, or nauseated.
  • Do not use a generator, charcoal grill, camp stove, or other gasoline- or charcoal-burning device inside the home, basement, garage, or outside the home near a window.
  • Never leave a car or truck running inside a garage attached to a house, even if the garage door is left open.
  • Do not use a stove or fireplace that is not vented to the outside.
  • Do not use a gas cooking oven for heat.

What to do if a poisoning occurs?

  • Remain calm.
  • Call 911 if you have a poison emergency and the victim has collapsed or is not breathing. If the victim is awake and alert, dial 1-800-222-1222. Try to have this information ready:
    • the victim’s age and weight
    • the container or bottle of the poison if available
    • the time of the poison exposure
    • the address where the poisoning occurred
  • Stay on the phone and follow the instructions from the emergency operator or poison control center.


Sources: CDC and eMedicineHealth

Colon Cancer Awareness Month – Risks, Symptoms and Treatment

Colorectal cancer is cancer that starts in the colon or rectum. The colon and the rectum are parts of the large intestine, which is the lower part of the body’s digestive system. During digestion, food moves through the stomach and small intestine into the colon. The colon absorbs water and nutrients from the food and stores waste matter (stool). Stool moves from the colon into the rectum before it leaves the body.

Most colorectal cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Colorectal cancer often begins as a growth called a polyp, which may form on the inner wall of the colon or rectum. Some polyps become cancer over time. Finding and removing polyps can prevent colorectal cancer.

Colorectal cancer is the fourth most common type of cancer diagnosed in the United States. Deaths from colorectal cancer have decreased with the use of colonoscopies and fecal blood tests, which check for blood in the stool.

Older age is a main risk factor for most cancers. The chance of getting cancer increases as you get older Other risk factors for colorectal cancer include:

  • Family history of colon or rectal cancer
  • Personal history of colon, rectum or ovarian cancer
  • Personal history of colorectal polyps that are 1 cm or larger.
  • Personal history of chronic ulcerative colitis or Crohn disease for 8 years or more.
  • Drinking three or more alcoholic beverages per day
  • Cigarette smoking
  • Being of African descent (black)
  • Being obese

Signs and symptoms of colorectal cancer include:

  • Blood in the stool or a change in bowel habits
  • Diarrhea, constipation, or feeling that the bowel does not empty all the way
  • Stools that are narrower than usual
  • Frequent gas pain, bloating, fullness or cramps
  • Weight loss for not apparent reason
  • Feeling very tired
  • Vomiting

Colorectal cancer treatment and chance of recovery depends on the size, location, and how far the cancer has spread. Common treatments include surgery to remove the cancer, chemotherapy, and radiation therapy. However, researchers have been working for decades on finding new treatments to improve patient outcomes. These efforts include the development of more effective—and less toxic treatments—such as targeted therapies, immunotherapies, and cancer vaccines. Further development of chemotherapy, radiation therapy and surgery are also being improved. Some studies are working to improve the patient’s ability to receive effective cancer treatment by managing the treatment’s toxic effects.

By having a better understanding about how specific types of tumors grow, researchers are able to develop targeted therapies and immunotherapies to expand treatment options available to patients with certain types of cancer.

An important part of the research process is patient participation in clinical trials. If joining a clinical trial is a treatment option you’d like to consider, the best place to start is to talk with your doctor or another member of your health care team. Often, your doctor may know about a clinical trial that could be a good option for you. He or she may also be able to search for a trial for you, provide information, and answer questions to help you decide about joining a clinical trial.

Some doctors may not be aware of or recommend clinical trials that could be appropriate for you. If so, you may want to get a second opinion about your treatment options, including taking part in a clinical trial.

If you decide to look for trials on your own, the following steps can guide you in your search. This information should not be used in place of advice from your doctor or other members of your health care team. This guide takes you through the following steps:

  1. You must know certain details about your cancer diagnosis. You will need to compare these details with the eligibility criteria of any trial that interests you. Eligibility criteria are the guidelines for who can and cannot take part in a certain clinical trial.
  2. Research available trials. There are many lists of cancer clinical trials taking place in the United States. Some trials are funded by nonprofit organizations, including the U.S. government. Others are funded by for-profit groups, such as drug companies. Hospitals and academic medical centers also sponsor trials conducted by their own researchers. Because of the many types of sponsors, no single list contains every clinical trial.
  3. Take a closer look at the trials that interest you. Learn about the main purpose of the trial and determine whether a new treatment is safe and well-tolerated. Find out if your cancer diagnosis and overall state of health matches the trial’s eligibility criteria. Talk with your doctor about how quickly you need to make a treatment decision. Some trials prefer you join prior to having any treatment. The location of the trial is also important. For example, some trials may be close to home and others may require you to travel to the site in order to participate.
  4. Contact the trial team. You can either choose to contact the trial coordinator directly by phone or through their website, or you may have your doctor contact them on your behalf. It is the trial coordinator’s job to decide whether you are likely to be eligible to join the trial. However, a final decision will probably not be made until you have met with a doctor who is part of the trial team.
  5. Ask questions. Whether it’s you or someone from your healthcare team, it’s important to speak with the clinical trial team to get answers to all of your questions so you can decide whether or not to take part in the trial. Also talk to your doctor before you make a final decision. You will want to know the potential risks and benefits of all treatment options available to you. The final decision to join the trial or not is your choice.
  6. Make an appointment. If you decide to join a clinical trial for which you are eligible, schedule a visit with the team running the trial.

Don’t forget to stop by one of our stores and pick up your FREE colon cancer screening kit – while supplies last!

Source: National Cancer Institute

Lower Numbers Now Define High Blood Pressure

There’s a new number for high blood pressure and it’s lower than you think.

For decades the numbers that defined high blood pressure were 140/90 mm Hg. But this past November, the American Heart Association (AHA) and the American College of Cardiology (ACC) issued new comprehensive guidelines that indicate high blood pressure should be treated at 130/80 mm Hg. High blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking. It’s known as the “silent killer” because often there are no symptoms, despite its role in significantly increasing the risk for heart disease and stroke.

In the largest study to date, the Systolic Blood Pressure Intervention Trial (SPRINT) began in 2009 and included more than 9,300 participants, recruited from about 100 medical centers and clinical practices from across the United States. The study was designed to determine the best way to treat blood pressure in adults with hypertension, 50 years or older, who are at a high risk for heart disease.

What does this mean?

This means that instead of 1 in 3 (32%) U.S. adults having high blood pressure, now nearly half (46%) of U.S. adults now are defined as having high blood pressure. That’s 14% more adults have hypertension than previously thought. However, the impact of the new guidelines is expected to be greatest among younger people. The prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45 according to the report.

“Damage to blood vessels begins soon after blood pressure is elevated”, said Dr. Paul Whelton, who is the Show Chwan professor of global public health at Tulane University School of Public Health and Tropical Medicine and School of Medicine in New Orleans. “If you’re only going to focus on events, that ignores the process when it’s beginning. Risk is already going up as you get into your 40s.”

This does not mean that everyone will—though some will— be prescribed medication to lower their blood pressure. This simply means that people will be counseled about changes in lifestyle much earlier than previously advised.

Paul K. Whelton, M.B., M.D., M.Sc., lead author of the guidelines published in the American Heart Association journal, Hypertension and the Journal of the American College of Cardiology, noted the dangers of blood pressure levels between 130-139/80-89 mm Hg. “You’ve already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure,” he said. “We want to be straight with people – if you already have a doubling of risk, you need to know about it. It doesn’t mean you need medication, but it’s a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches.”

Blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Top number (systolic) between 120-129 and bottom number (diastolic) less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Top number over 180 and/or bottom number over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

The new guidelines eliminate the category of prehypertension, which was used for blood pressures with a top number (systolic) between 120-139 mm Hg or a bottom number (diastolic) between 80-89 mm Hg. People with those readings now will be categorized as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).

Previous guidelines classified 140/90 mm Hg as Stage 1 hypertension. This level is classified as Stage 2 hypertension under the new guidelines.

Other changes in the new guideline include:

  • Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
  • Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
  • Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.

The successful implementation of these guidelines will lead to improvements in the health of the nation and reduce the risks posed by heart disease and stroke. Stop by one of our pharmacies to get your blood pressure checked and do a medication review. We want to make sure you are taking the right medication and we may recommend you see your doctor if your blood pressure is elevated or if you have other conditions that may affect treatment of hypertension.


Sources: American Heart Association and National Institute of Health.

New Shingles Vaccine soon to be available

In October 2017, the FDA approved a new shingles vaccine, called Shingrix. In January of this year, the CDC officially recommended that adults 50 and over get the new vaccine to prevent this painful, blistering disease instead of the previous one, Zostavax.

Shingles is an infection of an individual nerve and the skin surface that is supplied by the nerve. It is caused by the varicella-zoster virus, the same virus that causes chickenpox. Anyone who has recovered from chickenpox can develop shingles. There are an estimated 1 million cases of shingles each year in the United States, with 1 in 3 people developing shingles during their lifetime.

Healthy adults 50 years and older are recommended to get two does of Shingrix, two to six months apart. The second dose is really important for long-term protection.

If you have already gotten the Zostavax vaccine, you should now get Shingrix as well. Officially, the CDC states that Shingrix is the preferred vaccine over Zostavax. Even if you’ve had shingles, you should get the Shingrix vaccine, since shingles has been known to reoccur.

What’s the difference between Shingrix and Zostavax?

Shingrix is more than 90% effective at preventing shingles and a patient complication called postherpetic neuralgia (PHN) in all age groups. Conversely, Zostavax is only 51% effective against shingles and 67% against PHN.

Zostavax contains a live, but weakened version of varicella zoster—the virus that causes shingles and chickenpox.

Shingrix has a dead version of the zoster virus. It also contains an adjuvant which causes your body to produce more antibodies to fight shingles than Zostavax.

The CDC recommends getting the Shingrix vaccine when your chances of contracting shingles rises. Initial studies indicate that its protection remains strong for at least four years, but researches hope it will last much longer because the immune response is stronger.

Who should get the Shingrix vaccine?

The CDC says healthy adults ages 50 and over should get the Shingrix vaccine, even if you’re not sure if you ever had chickenpox.

The CDC also recommends that you get the Shingrix vaccine if you’ve already had Zostavax, because it’s more effective. However, you should wait at least two months after you have Zostavax to get Shingrix.

If you’ve already had shingles, you should get the vaccine. The Shingles can come back after you’ve had it.

Who shouldn’t get Shingrix?

Anyone who has had a severe allergic reaction to any of the ingredient in Shingrix should not get the vaccines.

Anyone who has tested negative for immunity to the varicella zoster virus. If you test negative, you should get the chickenpox vaccine.

If you currently have shingles, you should wait to get the vaccine. This can prevent a second bout with the disease.

If you are pregnant or breastfeeding, you should wait to get Shingrix.

The CDC’s Advisory Committee on Immunization Practices hasn’t confirmed whether the vaccine is safe for people who have a weakened immune system because of a disease or medicine they take. One worry is that taking drugs that weaken the immune system might make the shingles vaccine less effective. It’s also possible that by stimulating the immune system, Shingrix could worsen certain diseases, like leukemia.

What are the side effects of the vaccine?

  • Soreness, redness and swelling where you get the shot
  • Headache or tired after the shot
  • Fever
  • Upset stomach

About 1 out of 10 people said the side effects were severe enough to disrupt their daily life. Yet most felt better within 3 to 5 days.

These side-effects are minimal compared the pain and potentially blistering rash caused by shingles where a typical episode can last from 2-4 weeks.

Once the Shingrix vaccine is available, we’ll let everyone know. Then you can stop by one of our pharmacies and get your shot. We want to keep you healthy!

Sources: CDC, Web MD and Consumer Reports

Smoking and your digestive health

We’ve all heard that smoking increases the risk of many life-threatening diseases—including lung cancer, emphysema, and heart disease. But did you know that smoking also contributes to many cancers and diseases of the digestive system? Estimates show that about one-fifth of all adults smoke, and each year at least 443,000 Americans die from diseases caused by cigarette smoking.

Smoking has been found to increase the risk of cancers of the:

  • Mouth
  • Esophagus
  • Stomach
  • Pancreas

Research also suggests that smoking may also increase the risk of cancers of the liver, colon and rectum.

What are the other harmful effects of smoking on the digestive system?

Smoking contributes to heartburn, gastroesophageal reflux disease (GERD), peptic ulcers, and some liver disease. Smoking increases the risk of Crohn’s disease, colon polyps, and pancreatitis, and it may increase the risk of gallstones.

Heartburn is the painful, burning feeling in the chest caused by reflux. Smoking weakens the lower esophageal sphincter, the muscle between the esophagus and stomach that keeps stomach contents from flowing back into the esophagus. This causes heartburn and can possibly damage the lining of the esophagus.

GERD is persistent reflux can can lead to serious problems such as bleeding ulcers of the esophagus, narrowing of the esophagus that causes food to get stuck, and changes in the esophageal cells that can lead to cancer.

Peptic Ulcers
Smoking increases the risk of peptic ulcers. Peptic ulcers are sores on the inside lining of the stomach. The two most common causes of peptic ulcers are infection with a bacterium called Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen.

Studies suggest that smoking increases the risk of H. Pylori infection, slows the healing of peptic ulcers, and increases the likelihood that peptic ulcers will recur. Smoking increases the production of substances that may harm the lining of the stomach and the duodenum (the first part of the small intestine). Smoking also decreases factors that protect or heal the lining including:

  • Blood flowing to the lining
  • Secretion of mucus, a clear liquid that protects the lining from acid
  • Production of sodium bicarbonate, a salt-like substance that neutralizes acid, by the pancreas.

Liver Disease
The liver is the largest organ in the digestive system. The liver carries out many functions, such as making important blood proteins and bile, changing food into energy, and filtering alcohol and poisons from the blood. Research has shown that smoking harms the liver’s ability to process medications, alcohol, and other toxins and remove them from the body. In some cases, smoking may affect the dose of medication needed to treat an illness.

Smoking may worsen some liver diseases, including:

  • primary biliary cirrhosis, a chronic liver disease that slowly destroys the bile ducts in the liver
  • nonalcoholic fatty liver disease (NAFLD), a condition in which fat builds up in the liver

Crohn’s Disease
Current and former smokers have a higher risk of developing Crohn’s disease than people who have never smoked.

Crohn’s disease is an inflammatory bowel disease that causes irritation in the GI tract. The disease, which typically causes pain and diarrhea, most often affects the lower part of the small intestine; however, it can occur anywhere in the GI tract. The severity of symptoms varies from person to person, and the symptoms come and go. Crohn’s disease may lead to complications such as blockages of the intestine and ulcers that tunnel through the affected area into surrounding tissues. Medications may control symptoms. However, many people with Crohn’s disease require surgery to remove the affected portion of the intestine.

Among people with Crohn’s disease, people who smoke are more likely to:

  • have more severe symptoms, more frequent symptoms, and more complications
  • need more medications to control their symptoms
  • require surgery
  • have symptoms recur after surgery

The effects of smoking are more pronounced in women with Crohn’s disease than in men with the disease.

Researchers are studying why smoking increases the risk of Crohn’s disease and makes the disease worse. Some researchers believe smoking might lower the intestines’ defenses, decrease blood flow to the intestines, or cause immune system changes that result in inflammation. In people who inherit genes that make them susceptible to developing Crohn’s disease, smoking may affect how some of these genes work.

Colon Polyps
People who smoke are more likely to develop colon polyps. Colon polyps are growths on the inside surface of the colon or rectum. Some polyps are benign, or noncancerous, while some are cancerous or may become cancerous.

Among people who develop colon polyps, those who smoke have polyps that are larger, more numerous, and more likely to recur.

Smoking increases the risk of developing pancreatitis. Pancreatitis is inflammation of the pancreas, which is located behind the stomach and close to the duodenum. The pancreas secretes digestive enzymes that usually do not become active until they reach the small intestine. When the pancreas is inflamed, the digestive enzymes attack the tissues of the pancreas.

Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed.

Gallstones are small, hard particles that develop in the gallbladder, the organ that stores bile made by the liver. Gallstones can move into the ducts that carry digestive enzymes from the gallbladder, liver, and pancreas to the duodenum, causing inflammation, infection, and abdominal pain.

It’s never too late to quit!

Quitting smoking can reverse some of the effects of smoking on the digestive system. For example, the balance between factors that harm and protect the stomach and duodenum lining returns to normal within a few hours of a person quitting smoking. The effects of smoking on how the liver handles medications also disappear when a person stops smoking. However, people who stop smoking continue to have a higher risk of some digestive diseases, such as colon polyps and pancreatitis, than people who have never smoked.

Quitting smoking can improve the symptoms of some digestive diseases or keep them from getting worse. For example, people with Crohn’s disease who quit smoking have less severe symptoms than smokers with the disease.


Be Heart Smart

A healthy diet and lifestyle, along with making smart healthcare decisions, can be a pathway to a healthier heart. Your family history can have some impact on your chances of heart disease, but there are some simple steps one can follow that, if you stick to them, can offer long-term heart-health benefits.

The American Heart Association notes that a heart-healthy diet should include:

  • A variety of fruits and vegetables
  • Whole grains
  • Low-fat or non-fat dairy products
  • Skinless poultry and fish
  • Nuts and legumes
  • Non-tropical vegetable oils

Make sure the foods you eat are “heart healthy.” Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard and foods made with palm oil or coconut oil. Limit foods with trans fat, such as snack foods and commercial baked goods. Limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If you choose to eat red meat, select lean cuts.

Use up at least as many calories as you take in. Find out how many calories you should be eating and drinking to maintain your weight. Nutrition and calorie information on food labels is typically based on a 2,000-calorie diet. You may need fewer or more calories depending on your age, gender and level of physical activity. Control your calories through portion control. Eat until you are comfortably full but not stuffed. If you eat out, this can lead to yummy leftovers.

If you aren’t sure how to eat right, ask us about our new Creative Pharmacist program. We can help you with planning meals to help lower fat and calorie content in your diet to reach and maintain a healthy weight. This program also provides specific exercises tailored to your specific goals.

Lifestyle choices are important. Smoking significantly increases your chance for heart disease. If you smoke, quit. Your doctor can tell you about ways to help you quit smoking. Try to avoid even secondhand smoke. And avoid drinking too much alcohol. This can raise your blood pressure and increase your risk of heart disease.

Regular exercise can help you maintain your weight, keep off weight that you lose and help you gain greater cardiovascular fitness. Each week, try to get at least 150 minutes of moderate physical activity, 75 minutes of vigorous physical activity or an equal combination of both. Aim for at least 30 minutes of exercise most days of the week. Sounds like a lot for you? This is easier than you think! Take a half-hour walk every day. Or walk for 10 minutes after each meal. Use the stairs instead of the elevator. And park at the far end of the lot. If you are not able walk for long periods of time or take the stairs, talk to your doctor about other exercises that will work for you.

If you don’t know your numbers for cholesterol, blood pressure or blood sugar, make an appointment with your doctor and have them checked. Your healthcare provider should test your blood levels of cholesterol at least once every five years. If you have already been diagnosed with high cholesterol or have a family history of the condition, you may need to have your cholesterol checked more frequently.

If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease. These can be diet or lifestyle changes, and/or medications prescribed by your doctor.

Ask your doctor whether you should take an aspirin every day. Studies have shown that taking a low dose of aspirin every day can help reduce your risk of heart disease and stroke.


Sources: American Heart Association; Centers for Disease Control and the U.S. Department of Health and Human Services


Know Your Numbers

Your Body Mass Index (BMI) is the number used to assess if you are underweight, normal weight, overweight, or obese. It is calculated using your height and weight and is a good gauge for the risk of diseases that can occur with more body fat. The higher your BMI, the higher your risk for  diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. The recommended range is 18.6 x 24.9.

Although BMI can be used for most men and women, it does have some limits:

  • It may overestimate body fat in athletes and others who have a muscular build.
  • It may underestimate body fat in older persons and others who have lost muscle


Blood Sugar
Blood sugar, or glucose, is the main sugar found in your blood. It comes from the food you eat, and is your body’s main source of energy. Your blood carries glucose to all of your body’s cells to use for energy.  When your blood sugar levels are too high, it causes diabetes. Over time, diabetes can cause other health problems and put you at higher risk for heart disease. A healthy blood sugar level should be less than 100 following an 8-hour fast.

Waste Size
Having extra body fat around your stomach increases your risk of heart disease and diabetes. The target for women is less than 35” and for men less than 40”.

Blood Pressure
High blood pressure has no warning signs or symptoms, and many people do not know they have it. So, it’s important to measure your blood pressure regularly. It is quick and painless, and it is the only way to know whether your pressure is high. You can check your blood pressure at a doctor’s office, at a pharmacy, or at home.The top number (Systolic) should be under 130. The bottom number (Diastolic) should be under 80.

Did you know that 1 in 3 American adults has high cholesterol? Are you one of them? Too much cholesterol puts you at risk for heart disease and stroke, two leading causes of death in the United States. High cholesterol has no signs or symptoms, so the only way to know if you have it is to get your cholesterol checked.

Schedule an appointment and talk to your doctor about your all of your numbers and how they impact your overall health.


Sources: CDC and NIH

Tips for healthy skin

Your skin is the largest organ in your body and performs many important functions. It holds in fluid to prevent dehydration. It keeps harmful microbes out, which prevents you from infection. It’s covered in nerve endings that allow you to feel pain, heat and cold. Without being able to feel these sensations, you could cut yourself, get burned or even frostbite, and not even know it.

Your skin also helps your body regulate temperature. If you get too hot, blood vessels (capillaries) near the surface of your skin enlarge to let the warm blood cool down. Vitamin D is also produced by your skin when exposed to sunshine. Vitamin D is really important for bone health.

So, it’s really important to take care of your skin and make sure you pay attention to any changes that may be sending you messages of a bigger problem.

Keep it clean
Washing your skin, especially your hands, is important to keeping your health—particularly during cold and flu season and after using the bathroom. Hand washing keeps you from spreading germs to other parts of your body. Washing your hands also helps prevent spreading germs to other people. When bathing or showering, be sure to use water that’s warm and not too hot. Water that is too hot can dry out your skin. If your skin is dry and itchy, use a moisturizing cream or lotion and use it after every bath and handwashing.

Prevent sun damage
If you are exposed to intense sunlight, you are at risk of damaging or burning your skin. Sunlight contains UV light that causes sunburn and makes your skin age faster. Want to look younger for longer? Protect your skin from the sun. Wear hats and other protective clothing and always use sunscreen with a SPF of at least 30. Limiting time in the sun during late morning and early afternoon hours when sunlight is strongest is another way to prevent sun damage. And never use tanning beds or sunlamps. They emit the same harmful UV radiation as the sun and are no more safer than lying out on the beach.

Avoid dry skin
Staying hydrated by drinking plenty of water is the best way to avoid dry skin. Using gentle soaps, moisturizers, lotions, or creams will also keep your skin from getting too dry. You can also try using a humidifier to make the air in your home less dry.

Reduce stress
Stress is known to cause a chemical response in your body that makes skins more sensitive. It can also make it harder for skin problems to heal. Stress can aggravate psoriasis, rosacea, and eczema. It can also cause hives and other types of skin rashes and trigger a flare-up of fever blisters.

Get enough sleep
During sleep, your body’s hydration rebalances. Skin is able to recover moisture, while excess water in general in the body is processed for removal. Not getting enough sleep results in poor water balance, leading to puffy bags under your eyes and under-eye circles, as well as dryness and more visible wrinkles. Experts recommend about 9 hours a night for teens and 7-8 hours for adults.

Look for signs
Your skin may be showing signs of other health issues. For example, red, itchy rash might signal allergies or infections, and a red “butterfly” rash on your face might be a sign of lupus. A yellow tint might indicate liver disease. And dark or unusual moles might be a warning sign of skin cancer. Be on the lookout for unexpected changes to your skin, and talk with your doctor if you have concerns.

Have questions about anything you’ve read here? Talk to your doctor or one of our pharmacists. We’re always here to help you feel better.

Risks and prevention of COPD

If you have ever smoked cigarettes, you are at a high risk for chronic obstructive pulmonary disease (COPD)—a leading cause of death in the United States. COPD is a serious lung disease that makes it hard to breathe. Symptoms include shortness of breath, a constant cough, and wheezing.

What causes COPD?

Long-term exposure to lung irritants that damage airways and lungs are the most common causes of COPD. 75% of people who have COPD smoke or have smoked during their life. Cigarette smoking is the most common irritant, followed by pipe, cigar and other types of tobacco smoke, especially if the smoke is inhaled. People who have a family history of COPD are more likely to develop the disease if they smoke.

Secondhand smoke, air pollution, or chemical fumes or dust from the environment or workplace can also contributed to COPD. Please do not smoke in your home or car with children present. You are only increasing their risk of developing this deadly disease.

Though rare, a genetic condition called alpha-1 antitrypsin (AAT) deficiency may also be a cause of COPD. People with this condition have low blood levels of AAT which is a protein made in the liver. If you have this condition and couple it with smoking, COPD can worsen very quickly.

Those with asthma can also develop COPD, but with treatment, inflammation and narrowing of the airways can be reversed.

What are the symptoms of COPD?

Most people who have COPD are at least 40 years old when symptoms begin. Although uncommon, people younger than 40 can have COPD. This may occur, for example, if a person has a health issue, such as the AAT deficiency. In the beginning stages of COPD, symptoms may be mild or even absent. As the disease progresses, symptoms usually become more severe. Common signs and symptoms include:

  • An ongoing cough or a cough that produces a lot of mucus; this is often called smoker’s cough
  • Shortness of breath, especially with physical activity
  • Wheezing or a whistling or squeaky sound when you breathe
  • Chest tightness
  • More prone to colds and or other respiratory infections such as the flu

Not everyone who has the symptoms described above has COPD. Likewise, not everyone who has COPD has these symptoms. Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions.

Sometimes, simple changes to your lifestyle may help make breathing easier. You may opt to take the elevator rather than use the stairs. But over time, the symptoms won’t go away and they will only get worse and become severe enough for you to see a doctor.

Once you do see a doctor, there’s a simple breathing test, called spirometry, for COPD. It’s fast and painless. You take a deep breath and blow as hard as you can into a tube connected to a small machine, called a spirometer. The machine measures how much air you breathe out. It also measures how fast you can blow air out.

Based on this test, your health care provider can tell whether you have COPD. The test also shows how severe it is. Health care providers who specialize in lung rehab can work with you to help you breathe better and stay more active.

If you keep smoking, the damage from COPD will occur faster than if you stop smoking. In severe cases of COPD, you can have symptoms such as:

  • Swelling in the ankles, feet, or legs
  • Weight loss
  • Lower muscle endurance
  • Weight loss; and lower muscle endurance

The most severe symptoms may require treatment in a hospital. You should seek emergency care if you are experiencing the following:

  • You are having a hard time catching your breath or talking
  • Your lips or fingernails turn blue or gray, a sign of a low oxygen level in your blood
  • People around you notice that you are not mentally alert
  • Your heartbeat is very fast
  • The recommended treatment for symptoms that are getting worse is not working

How do you treat COPD?

There is no cure for COPD, but with medications, you can breathe a little easier.

Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier. Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day.

Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. Ask your health care providers to show you the correct way to use your inhaler.

If your COPD is mild, your doctor may only prescribe a short-acting inhaled bronchodilator. In this case, you may use the medicine only when symptoms occur.

If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators.

In general, using inhaled steroids alone is not a preferred treatment. If your COPD is more severe, or if your symptoms flare up often, your doctor may prescribe a combination of medicines that includes a bronchodilator and an inhaled steroid. Steroids help reduce airway inflammation.

Your doctor may ask you to try inhaled steroids with the bronchodilator for a trial period of 6 weeks to 3 months to see whether the addition of the steroid helps relieve your breathing problems.

Pulmonary rehabilitation is a broad program that helps improve the well-being of people who have chronic breathing problems. Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program’s goal is to help you stay active and carry out your daily activities.

Your rehab team may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. These health professionals will create a program that meets your needs.

If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, oxygen is delivered through nasal prongs or a mask.

You may need extra oxygen all the time or only at certain times. For some people who have severe COPD, using extra oxygen for most of the day can help them:

  • Do tasks or activities while experiencing fewer symptoms
  • Protect their hearts and other organs from damage
  • Sleep more during the night and improve alertness during the day
  • Live longer

Keeping up with vaccinations is very important for patients with COPD due to the risk for more severe complications. Talk to your doctor about getting the flu shot and the pneumococcal pneumonia vaccines.

Can you prevent COPD?

Yes. The best way to prevent COPD is to not start smoking in the first place. If you are a smoker, it’s ever too late to stop. Tried quitting in the past? Try again. Many people who have trouble quitting on their own find support by joining a group with other smokers who are also trying to quit. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Talk to your doctor about programs and products that can help you quit, too. Asking your family and friends to support your efforts is important to your success in fighting the addiction to nicotine.

Source: NIH

Benefits of Folic Acid

If you have ever been pregnant, chances are you have heard about the importance of getting enough folic acid in your diet for the health and development of your baby. But folic acid can be also beneficial to men, women, and children.

Folic acid acts by helping the body produce and maintain new cells. In particular, red blood cell formation is dependent upon adequate levels of this vitamin. Folic acid deficiency is a known cause of anemia in both adults and children. Folate may also help cells resist changes in their DNA associated with the development of cancer.

According to the British Dietetic Association (BDA), folic acid is vital for making red blood cells, as well as:

  • the synthesis and repair of DNA and RNA
  • aiding rapid cell division and growth
  • enhancing brain health, although the evidence is mixed and more research is needed
  • age-related hearing loss

For pregnant women (or women of childbearing years, ages 15-49) who have a folic acid deficiency, many health problems may develop in the unborn child if there is a folic acid deficiency. Getting enough folic acid before and during pregnancy can prevent major birth defects of her baby’s brain or spine. Risks include:

  • anemia
  • congenital deformities
  • a higher risk of developing clinical depression
  • possible problems with memory and brain function
  • a higher risk of potentially developing allergic diseases
  • a higher potential long-term risk of lower bone density

The following foods are known to be rich in folic acid:

  • asparagus
  • baker’s yeast
  • broccoli
  • Brussels sprouts
  • cabbage
  • cauliflower
  • cereal (check the box for the daily allowance)
  • egg yolk
  • lentils
  • lettuce
  • liver, although women should not consume this during pregnancy
  • many fruits, especially papaya and kiwi
  • milk
  • oranges
  • parsnips
  • peas
  • spinach
  • sunflower seeds
  • whole wheat bread, as it is usually fortified

If you don’t get enough folic acid from the foods you eat, you can also take it as a dietary supplement.

Folic acid is available in multivitamins and in prenatal vitamins. The U. S. Public Health Service and CDC recommend that all women of childbearing age consume 400mcg of folic acid everyday to prevent two common and serious birth defects: spina bifida and anencephaly. If you are pregnant, the CDC recommends 600 mcg/day.

All women between 15 and 49 years of age should consume folic acid daily because half of U.S. pregnancies are unplanned and because these birth defects occur very early in pregnancy (3-4 weeks after conception), before most women know they are pregnant.

The CDC estimates that most of these birth defects could be prevented if this recommendation were followed before and during early pregnancy.

About 35% of adults and 28% of children aged 1 to 13 years in the United States use supplements containing folic acid. Children’s multivitamins commonly contain between 200 and 400 mcg folic acid. Adults aged 51 to 70 years are more likely than members of other age groups to take supplements containing folic acid. Use is also higher among non-Hispanic whites than non-Hispanic blacks or Mexican Americans, which generally due to a lack of knowledge of the importance of getting your daily allowance of folic acid.

Groups at Risk of Folate Inadequacy

Folate deficiency is rare in the United States, but some individuals might be at risk for marginal folate status due to a medical condition or when taking certain prescription drugs.


People with alcohol dependence frequently have poor-quality diets. Alcohol also interferes with folate absorption and metabolism, and accelerates its breakdown. Even moderate alcohol consumption of 240 ml (8 fluid ounces) red wine per day or 80 ml (2.7 fluid ounces) vodka per day for 2 weeks can significantly decrease serum folate concentrations in healthy men.

Women of childbearing age

All women capable of becoming pregnant should obtain adequate amounts of folate to reduce the risk of Neural Tube Defects (NTD) and other birth defects. Unfortunately, some women of childbearing age obtain insufficient folate even when intakes from both food and dietary supplements are included. Women of childbearing age should obtain 400 mcg/day of folic acid from dietary supplements and/or fortified foods in addition to the folate present in a varied diet.

Pregnant women

During pregnancy, demands for folate increase due to its role in nucleic acid synthesis. The recommended daily allowance of folic acid in pregnant women is 600 mcg throughout the pregnancy. This level of intake might be difficult for many women to achieve through diet alone. The American College of Obstetricians and Gynecologists recommends a prenatal vitamin supplement for most pregnant women to ensure that they obtain adequate amounts of folic acid and other nutrients.

People with malabsorptive disorders

Several medical conditions increase the risk of folate deficiency. People with malabsorptive disorders—including celiac disease, and inflammatory bowel disease—might have lower folate absorption than people without these disorders. Diminished gastric acid secretion associated with atrophic gastritis, gastric surgery, and other conditions can also reduce folate absorption.

Interactions with Medications

Folic acid supplements can interact with several medications. Individuals taking these medications on a regular basis should discuss their folate intakes with their healthcare providers.


Methotrexate (Rheumatrex®, Trexall®), a medication used to treat cancer and autoimmune diseases, is a folate antagonist. Patients taking methotrexate for cancer should consult their oncologist before taking folic acid supplements because folic acid could interfere with methotrexate’s anticancer effects. However, for patients taking low-dose methotrexate for rheumatoid arthritis or psoriasis, folic acid supplements might reduce the gastrointestinal side effects of this medication.

Antiepileptic medications

Antiepileptic medications, such as phenytoin (Dilantin®), carbamazepine (Carbatrol®, Tegretol®, Equetro®, Epitol®), and valproate (Depacon®), are used to treat epilepsy, psychiatric diseases, and other medical conditions. These medications can reduce serum folate levels. Furthermore, folic acid supplements might reduce serum levels of these medications, so patients taking antiepileptic drugs should check with their healthcare provider before taking folic acid supplements.


Sulfasalazine (Azulfidine®) is used primarily to treat ulcerative colitis. It inhibits the intestinal absorption of folate and can cause folate deficiency. Patients taking sulfasalazine should check with their healthcare provider about increasing their dietary folate intake, taking a folic acid supplement, or both.

If you have questions or are not sure if you are getting enough folic acid in your diet, talk to your doctor or ask one of our pharmacists.


Sources: CDC, MNT, NIH