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The Pharmacist Answers Podcast

Have a question for the pharmacist? Get your answers here! Clear explanations about complicated medical topics that anyone can understand. Disclaimer: The information contained in this blog and related podcast are not to be taken as medical advice, they are for informational and educational purposes only. If you resemble anything that is mentioned in this blog or related podcast, contact your doctor. The information contained in this blog and related podcasts is the opinion of the author and does not relfect the views of her employer, Walgreens. If you want to know what Walgreens thinks, ask Walgreens!
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Now displaying: February, 2016
Feb 29, 2016

Diarrhea is not fun, diarrhea in kids is not fun, diarrhea in kids in diapers is certainly not fun.  Diaper rash can flair in just one or two diaper changes.

Diaper rash products come in a couple varieties:

  1. Protectant ointments: like vaseline, kind of greasy but provide a moisture barrier to keep the skin's moisture levels from getting out of balance.
  2. Zinc Oxide: like Desitin, white or opaque and thick, keeps the moisture in the skin in, and the moisture outside the skin out.  More completely covers diaper rash so really sore spots can heal faster.

Some diaper rashes are caused by a yeast imbalance, so doctors may recommend an OTC or prescription yeast cream.

Sometimes diaper rashes can be really itchy (even though little babies can't tell you they itch, so all they do is cry), so OTC or prescription steroid creams can be used.

Diaper rash from diarrhea is usually caused by acid that is released in the liquid stool.  For babies in diapers, when acidic diarrhea exits the body, it hurts; but then it sits in the diaper and continues to hurt and irritate the skin.  Not to mention the irritation that may have already occurred due to frequent diaper changes.

A frequently recommended fix for diaper rash is air.  Letting the rash air dry and not be closed up in a diaper can work a lot of times.  That doesn't sound like a great solution if baby has diarrhea.

There's a butt paste that pharmacies can compound with a doctor's prescription:
- Aquaphor ointment (OTC) - kind protectant
- Mylanta (OTC) - antacid to neutralize acid
- Cholestyramine powder (Rx) - medication that treats cholesterol by trapping up lipids in the intestines so the body doesn't absorb it - it can trap up bile that comes out in the stool

You can use 2 out of the 3 ingredients and do this yourself with a couple tools in your kitchen!

  • Heat the tub of aquaphor on a hot plate, or warm it in a double boiler, until melted.  (You don't want to have to remove all the ointment from the tub to melt b/c you'll waste some and it'll be really gooey).
  • Add 2 Tbsp (30 ml, 1 fl. oz) of Mylanta to liquid Aquaphor and stir well.
  • Let it cool!  Do not put warm ointment on your baby!
  • Apply to baby bum as needed for diaper rash.

Doesn't have to be just for babies....

Anyone who has had diarrhea and experienced the burn from the acid and irritation from frequent stools can benefit from this product.

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Feb 29, 2016

2 things you can do to help your pharmacist help you better:

  1. Have patience: the pharmacist is one person, and they have one mouth and one set of ears, and can only listen and talk to one person at a time.  You want undivided attention, and we want to give you undivided attention, and to get that, there may be a short wait.
  2. Be honest: about health conditions, allergies or intolerances, and questions or concerns about anything related to your health.  Pharmacists in most states have a legal responsibility to counsel or offer counseling to patients in certain situations, but they can't read your mind.

Sorry for the soapbox!

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

 

Feb 22, 2016

Three characteristics of people who are starting to take charge of their health:

  1.  They stop placing blame - it's not my fault electronics malfunction, and it's not my fault the nurse hasn't returned a phone call.
  2. They get the whole story - they find out what I've done, they find out what the doctor's office staff has done, they find out what their insurance has done... because there's more than 2 sides to a story.
  3. They take decisive action - if they learn something new about their situation based on the 2 things above, they take action to make progress towards getting problems solved.

The big picture: they take responsibility for their own health.  If there are steps you can take on your own to get the outcome you desire, take them.  If someone on your team isn't meeting expectations or doing their part on your team, you get to choose: do you talk to them and get on the same page, or do you choose someone else to be on your team.

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Feb 15, 2016

Gastroesophageal Reflux Disorder = GERD.  Or just Reflux

Refux is a word that is used to describe something in your body that flows backwards.  The fluids in your body have a certain direction they naturally flow for your body to work properly.  If they start flowing backwards, it's called reflux, and can lead to problems.

Is that like heartburn?

Yes, heartburn is a type of mild reflux.  Something (like a certain type of food or overeating) causes the stomach acid to bubble back up into the esophagus.

 

Overeating or other physiological disorder can cause the lower sphincter to not close tightly or completely.

They lining of your stomach produces the acid, thus it's intended to be resistant against the acid.  The lining of the esophagus is not intended to handle that acid.  And stomach acid is way more acidic that our saliva or acidic foods that we may eat.

Now, if the acid-producing (and acid-resistant) lining of the stomach wall gets injured, and the layers underneath come in contact with the acid, it causes pain.

Would that cause someone to throw up blood?

Yes, it possibly would.  Any tissue that is living and working in your body, requires a blood supply to bring in nutrients and carry out waste.  So, the walls of your stomach is full of blood vessels.  If the acid, eats through the layers and gets to the blood vessels, that blood will spill into the stomach.  Unfortunately, your digestive system isn't intended to digest large amounts of blood.  The pain from the acid plus the large amounts of blood can lead to nausea and vomiting.

Questions I ask to help assess whether it's ulcer or reflux:

Where does it hurt?
- Reflux: in the esophagus or throat (even to the point of hoarseness)
- Ulcer: Stomach

Does it hurt worse when you're hungry or after you eat?
- Reflux: hurts after food has gone into stomach or you lay down at night because you don't have gravity holding the acid down into the stomach.
- Ulcer: hurts when the stomach is empty because the acid only comes in contact with the stomach lining, rather than having food to work on.

The treatment for both is the same.  The goal for both is to reduce the acid production.  People will try to self-treat by taking tons and tons of OTC antacids (liquid or tablets).  Antacids are bases, so they goal is to neutralize the acids, but once that amount has moved into the intestines, the base is gone and the acid is till there.  Other acid reduces are OTC as well.  Histamine 2 Receptor Blockers (Pepcid, Zantac) can start to work within 30 minutes.  Proton Pump Inhibitors (Prilosec, Prevacid, Nexium) can take up to 2 weeks to reduce the acid, so not intended for instant treatment.

Whether it's ulcers or reflux, your doctor needs to know what's going on so they can monitor your progress.  Anything that manipulates cells in your body (whether stomach cells damaged in an ulcer or esophageal cells being corroded by acid) can cause cellular changes that may become cancer.

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"Radio Martini" Kevin MacLeod (incompetech.comLicensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Feb 8, 2016

Myth #1: Having lice means that you're dirty
- Truth: Lice like clean hair.  When you shampoo, the soap strips your hair of it's natural oil.  So while you think your hair is clean, it is also very grippy.  Thus, lice can hang on better to move around.
- Solution: Don't wash your hair - ha!  At least allow your natural oils to stay in your hair, or use a leave in conditioner or other product that makes the hair "slippery".

Will dry shampoo attract lice if you're not washing your hair?
- Dry shampoo works like baby powder - it absorbs the excess oil and moisture, but doesn't dry out the roots of your hair as soapy, foamy shampoos.

Jump on the no 'poo bandwagon!

Myth #2: Live for a long time off your hair.
- Lice require a warm place and a blood supply for survival.  They like to hang out at the base of the head/neck and around your ears.  They may fall off on couches, and backpacks, and car seats, but they rarely survive there long enough to transfer to someone else.  It is mostly spread by head to head contact (sharing a bed, sharing a hairbrush).  

Myth #: Pets can't carry lice.
- They are only spread human to human.  Other parasites that like humans (i.e. mosquitos, fleas, ticks) can be spread by pets, but lice cannot.

The overuse of over the counter pesticide products that kill lice is encouraging them to build up resistance.  Critters, large and small, will change and mutate to ensure their survival.  This is why the news introduced them as "super lice".

Good news:  They're not resistant to vinegar.  Diluted vinegar is not harsh on your hair and doesn't strip oils, but it can dissolve the glue that hold the eggs, or nits, onto the hair shaft.  This will allow the eggs to wash out or be combed out easily.

Tea tree oil is intended to suffocate them or repel them completely.  No proof that it's really effective.  But it can be mixed with the vinegar to help your hair smell better.

Some of the standard chemical products can be very strong and not intended to be used on children under a certain age.  Some of the chemicals work by disrupting their DNA and their neural system, humans are just way bigger than lice so it would take way more to hurt humans, but the risk is there.

Lice furniture spray - intended to be used on furniture that has long exposure (4+ hours) with the infected person.

If there are positive signs of lice, it may take more than one round of treatment and combing to get any new ones that hatch.

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"Radio Martini" Kevin MacLeod (incompetech.comLicensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Feb 1, 2016

Cold virus aka Rhinovirus.  Rhino = nose.  The cold virus accesses the body through the nose and mouth, and it uses the cells in the sinuses and throat to replicate.

Viruses require a host cell to replicate, therefore they don't live very long outside of a host.  The cold virus can live on a surface for about 3 hours.

During the initial infection and multiplication stages (first 3 days), you are the most contagious even though you have no symptoms of being sick.

Cold symptoms:

  • Runny Nose
  • Scratchy throat
  • Cough
  • Sinus congestion
  • Tiredness
  • Mild fever
  • Possible body aches

"Morning sniffles" not a cold.

Your tonsils are a major hub of your immune system. So, when your body recognizes that it's been infected by a virus, the immune system is activated.  Sometimes, the first symptom people experience with a cold is a sore throat because the tonsils go into hyperdrive when the immune system is activated.

Always wash your hands (in soap and water or hand sanitizer).  Touching your face can allow germs to enter your body but can spread your germs to other surfaces or people.

Learn to sneeze or cough into your elbows.  It keeps the spray from getting on your hands or surfaces and items around you. 

Use sanitizing wipes to clean surfaces you may touch regularly or that you know someone sick has touched.

Why don't we vaccinate for the cold?

Vaccines are prioritized a few ways.  We want to vaccinate against things that:

  • kill people.
    Colds don't kill a lot people, they just make us miserable and miss work.
  • spread really fast.
    Flu, measles, chicken pox all spread rapidly through the population due to droplet exposure.
  • have slow-changing characteristics.
    There are 99 different version of the "cold" virus, but each one is fundamentally different.  So you would have to get 99 vaccines!

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"Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

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