Blog

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

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.

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