Month: March 2017

You are not ready to become a mother, or yet, you are still a teenager and you made a mistake. You had unprotected sex and now you would like to go back and fix it. Well, now you can. It doesn’t require a prescription from your physician, and you don’t need to go to a hospital. There is a backup plan called Plan B One Step or more commonly known as the morning-after pill. So when do you need to use morning-after pill? Plan B One Step will give you a chance to go back in time and undo things. If you forgot to use your birth control pills, if your condom broke, if you missed 2 or more birth control pills that month, you can prevent pregnancy with Plan B One Step.  It WILL not protect you if you are already pregnant, Will not protect you against STD (sexually transmitted diseases) or if you had sex AFTER you took the morning after pill. Also, don’t take Plan B if you are allergic to an active ingredient in the pill, or you are already pregnant or have a history of abnormal vaginal bleeding. So what is the morning after pill and how does it work? It is a high dose of levonorgestrel-1.5mg, which is found in regular birth control pills. It helps prevent pregnancy when taken within 72 hours (3 days) after unprotected sex or birth control failure. The sooner it’s taken, the better it works. After the dose is consumed it works in two different ways: it prevents ovulation and it interferes with fertilization of an egg. Plan B is affective 89% after 72 hours and 95% after 24 hours. Please note that if you vomit with 2 hours of taking the pill, the method might not be effective. You should expect some side effects associated with this regimen. The most common side effects are nausea and vomiting. You may also experience headaches, dizziness, fatigue, and unexpected bleeding.

We all have choices to make and we want to make sure we have all possibilities to choose from.  As a pharmacist I am always here for my patients to educate them and to help them to choose the most effective and safe method for them.

Have you ever had a family member, friend, or someone you know that has gone through a surgery or just had chronic untreatable pain?  Every day people suffer from excruciating pain and we as  pharmacists or physicians can only help them minimally.  Throughout my 17 years of being a pharmacist, I have seen many patients who slowly developed tolerance towards pain killers and increase daily dose intake.  The most common pain killer amongst narcotics  is Norco which is a combination of acetaminophen and hydrocodone.   The usual dose is 1-2 tablets every 4 hours and not to use more than 8 tablets in 24 hours.  However, after taking this dose for a week or two, many patients develop tolerance and most often the frequency becomes every 2 hours instead of every 4 hours.   This is where the warnings of overdose,  liver toxicity, and even death become more real.  Overdose symptoms may also include extreme drowsiness, pinpoint pupils, cold and clammy skin, muscle weakness, fainting, weak pulse, slow heart rate, coma, blue lips, shallow breathing, or no breathing.   It has been reported that over 100 million American adults suffer chronic pain.  Every day I see patients with chronic pain and different chronic pain types: pain associated with chronic musculoskeletal conditions, such as osteoarthritis and osteoporosis; and neuropathic pain, such as diabetic neuropathy, postherpetic neuralgia, postlaminectomy pain, and small fiber neuropathy.   Every day I ask myself how do  I address their pain, how do I   provide the greatest benefits for my patients  with minimal risks?  As with every medication, I evaluate their risks and benefits before I hand it to my patients.

Have you ever wondered how would it feel to have a good night’s sleep? I think we are all deprived of good night sleep, waking up tired and exhausted. Sleep is a complex process and it has a direct impact on a variety of health conditions. Although there is no consensus of what constitutes enough sleep and individual needs will vary, the National Heart, Lung, and Blood Institute and the National Sleep Foundation have recommended that most adults get 7 to 8 hours of sleep a night.   About 10-20% of the adult population suffers from insomnia and 60 million prescriptions are written each year for insomnia. Patients often approach pharmacists for questions and recommendations requests for OTC products to treat insomnia. As a pharmacist, it is our first recommendation to offer non-pharmacological interventions and behavior changes such as

regular sleep schedule
adjusting bedtime environment
avoiding alcohol and nicotine usage near bedtime,
caffeine usage afternoon
daytime naps
avoiding electronics usage in bed

There are few OTC products available to address insomnia and sleep irregularities; however, they are not meant to be used long term.  Antihistamines, such as diphenhydramine (Benadryl) and doxylamine (Unisom) are available to help with insomnia by promoting sedation. Those products need to be used with caution and not in combination with other products that contain the same active ingredient. Also, patients need to be aware of their side effects such as sedation, decrease in cognitive function, and development of tolerance.  Another OTC production is a naturally occurring hormone called Melatonin. This agent is not regulated by the FDA because it considers a dietary supplement. Melatonin helps insomnia by balancing the circadian rhythm and pretty benign. Another herbal product is Valerian which has been used centuries treating nervous system, stress, and sleep disorders. Valerian is generally very safe.

People who suffer from insomnia become very irritable and anxious throughout the day. Often they need medication to regulate their cycle, however there are times that we are able to help them by assessing their daily routines and offering them non-pharmacological advice.