A Random Pharmacist

Hello! I am a student pharmacist that will be diving into almost anything related to health!

Something important to know about NSAIDs (Advil, Aleve, etc.)! — June 21, 2019

Something important to know about NSAIDs (Advil, Aleve, etc.)!

Non-steroidal anti-inflammatory drugs (NSAIDs) are incredibly common… They are so common, in fact, that it would be difficult to find someone who has never taken an NSAID!

Using myself as an example… I took two ibuprofen tablets this morning before going to work and dispensing dozens, if not hundreds, more.

Pouring pills into a bottle
Pouring pills. Let’s imagine these are NSAIDs!

The point is — NSAIDs are everywhere! And it’s exactly because of this prevalence why I want to make sure that everyone, at least everyone I am capable of reaching, understands what to expect, and look out for, when taking this medication!

I want to mention — NSAIDs are generally safe and well-tolerated, especially at over-the-counter doses. But that’s the catch… Patients will often far exceed over-the-counter dosing to something that is more similar to prescription dosing. This is because, as the dose continues to climb, so does the risk for what are known as “adverse drug reactions.” This essentially means that increasing the dose will also increase the chance of having side effects.

How does this relate to NSAIDs? Well, NSAIDs can often irritate the gastrointestinal system, especially at higher doses. It is important that you protect your stomach, especially if it’s completely empty such as when you’re first waking up, before taking your NSAIDs. This is especially important for anyone taking higher doses of NSAIDs!

So how is this done? Take your NSAIDs with food! That’s it. A lot of the distress can be relieved simply by having food in your stomach. Even a small snack, like crackers, works! I hope this helps!

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Losing weight: Calories in v. calories out — June 20, 2019

Losing weight: Calories in v. calories out

This is definitely a digression from talking about medicine, but diet and exercise are crucially important, especially in the largely sedentary environment of today!

Patients will often come up to me and ask me questions about diet and exercise, and sadly, it has become apparent that healthcare professionals are often sending patients home telling them to “diet and exercise” without elaborating. This leaves the patient having to start the process of digesting the millions of articles, often conflicting, that are out there on the topic of diet and exercise.

There are millions of diet plans and many of them work.

There are millions of exercise plans and many of them work.

I am not here to introduce a diet plan or an exercise plan. I want to dive into the science behind dieting so that, no matter what diet plan you choose, you can be more successful.

Your body, based off your age and gender and such, needs a certain amount of calories daily to function. This is known as your basal metabolic rate. Now, add to this your daily activity, and you arrive at your total daily energy expenditure (TDEE). Your TDEE is how many calories you need daily to maintain your current weight, adjusted for activity level.

Want to gain weight? Eat more than your TDEE.

Want to lose weight? Eat less than your TDEE. And this right here is the key to dieting. All effective diets will share one thing – You will be eating under your TDEE. Because you are taking in less energy than your body needs, your body starts to break down fat to supply itself with energy.

*Your body will also break down muscle for energy, hence why it is key to maintain adequate protein intake while dieting.

Okay, so how do you calculate your TDEE? I use whatever online calculator pops up first on Google.

Here’s what pops up for me: TDEE Calculator

So with this you’ll be able to determine your TDEE. Let’s say it’s… 2,200 calories! A typical diet would see you eating about 500 calories less than you actually need daily, so at this point you would subtract 500 from 2,200 to arrive at 1,700 calories. Quick digression…

Why subtract 500 calories? There are 7 days in a week. So at a 500 calorie deficit daily, you would be losing 3,500 calories per week. Why is that number important? Because that is the number of calories in one pound of fat. So essentially, a deficit of 500 calories daily would result in losing one pound per week!

Okay now back to our example.

2,200 calories – 500 calories = 1,700 calories

So 1,700 calories would be your daily goal. That should raise the question… How do you track calories? Personally, I have always used the MyFitnessPal app.

Just enter the information you got from you TDEE calculator, subtracting roughly 500 calories from that amount if you are trying to lose weight, into MyFitnessPal. You will then be well on your way to a successful diet!

What the difference between the new shingles vaccine and the old one? — June 19, 2019

What the difference between the new shingles vaccine and the old one?

Okay so let’s start with the basics… Differentiating between the new and the old!

Zostavax = Old

Shingrix = New

I will try to keep the rest of the differentiation to just the basics.

Zostavax

  • 60 years or older unless otherwise instructed by healthcare professional
  • One shot series
  • Reduces risk of shingles by 51%

Shingrix

  • 50 years or older unless otherwise instructed by healthcare professional
  • Two shot series
  • Reduces risk of shingles by 91% to 97%

So what’s the verdict?

If you have never received a shingles vaccine and are at least 50 years old… Go start your Shingrix series!

If you have received the Zostavax vaccine but never the Shingrix… Go start your Shingrix series! That extra 40% reduction in shingles risk is worth it!

And for those that have received their Shingrix vaccine… Congratulations! Staying up-to-date on vaccinations is one of the most important ways to manage your health!

Further reading courtesy of the CDC: Zostvax and Shingrix

Melatonin… Does it help you sleep? —

Melatonin… Does it help you sleep?

Melatonin is actually a hormone that is naturally produced by the body meaning, at least under normal circumstances, that supplementation is not necessary.

That being said, there are definitely instances in which melatonin supplementation can be beneficial! What instances you ask? Well let me first try to clear up some confusion about melatonin.

Think of melatonin more like a medication that helps normalize sleep and less like a medication that helps you fall asleep. Melatonin isn’t Benadryl, Xanax or Ambien… It’s not going to knock you out the second it hits your tongue.

Remember how I mentioned melatonin is a hormone earlier? Well hormones always have jobs within our bodies. What’s the job of melatonin? Well it spikes, according to your circadian rhythm, to tell the body to begin the process of falling asleep. Also, once asleep, it helps maintain that sleep.

Now, I mentioned that I would list instances in which melatonin supplementation can be beneficial… Well here are some instances!

  • Jet lag — This is one of the most scientifically backed uses for melatonin! So if you have jet lag or fear that you might fall victim to it, bring some melatonin along with you!
  • Naturally low levels of melatonin — Remember how I said supplementation is not necessary under normal circumstances? Well you just might be an abnormal circumstance! And by this, I mean that you might have lower levels of melatonin than the average person and would benefit from supplementation.
  • Sleep — Just in general, if you need to improve your sleep, melatonin will help. But remember, it’s nothing like Benadryl in making you fall asleep!

Further reading courtesy of PubMed: Melatonin for the prevention and treatment of jet lag.

My advice?

Always try non-pharm before pharm.

What does this mean? It means that you should always try and do things for yourself that are not medication-related before turning to medications.

  • Are all the lights turned off, or at least dimmed, well before you try and fall asleep?
  • Are you sticking to a routine sleep schedule?
  • Are the screens on your phone/TV/tablet interfering with your ability to fall asleep?

There could be a whole host of things interfering with your sleep that can be fixed without medication. Try to fix those things first, and only if those fail, should you start thinking about melatonin supplementation.

Further reading courtesy of The Mayo Clinic: Melatonin

Why does the color/shape of my medication keep changing? —

Why does the color/shape of my medication keep changing?

Now this has to be one of the most common questions that I get working in the pharmacy, especially lately due to all of the recalls. So what’s going on?

Essentially, especially in the case of all the recalls going on currently, the pharmacy that you are filling at is no longer able to get the exact same manufacturer for a particular medication as what they have been getting in the past. There could be many reasons this occurs… Recalls, discontinuations, natural disasters, etc.

Wondering why I made a point to include natural disasters in that list? Well that’s actually one of the largest reasons that so many medications are having to be changed around currently! Puerto Rico, as you unfortunately already know, has been hit by a series of hurricanes and has yet to fully recover. This has resulted in widespread drug shortages; and therefore, pharmacies have had to adjust and find something that they can dispense in the place of the shorted drug.

Further reading courtesy of The New York Times: U.S. Hospitals Wrestle With Shortages of Drug Supplies Made in Puerto Rico.

Essentially, all of that was to say that, due to some issue, the pharmacy can no longer get their hands on their preferred manufacturer of a certain medication. They will then turn to other manufacturers to supply that same medication, but usually, that manufacturer adds their own unique filler/color. This is why pills can go from green to blue to large to small and all be the exact same medication at the end of the day!

*As a side note, I recommend that if you ever have any questions about whether or not you received the right medication, you should definitely get into contact with the pharmacy. While it may be due to what I listed above, it could also be due to an error, and I am never inconvenienced to answer the questions of any patient that is concerned about their health!

Welcome! —

Welcome!

Hello!

I am a student pharmacist, and I have been working in a retail pharmacy for the past seven years. Most of those years were as a pharmacy technician, as only recently have I started practicing as a student pharmacist.

I mention this for the following reason… I get asked an endless amount of questions throughout my shifts as a student pharmacist!

Now don’t get me wrong. I love questions! It challenges me and drives me to stay up-to-date on current research so I can help my patients. But this got me thinking… What if I was able to help people, not just within the community that my pharmacy serves, but anywhere!

Well this blog is the result of that idea! I want to answer the questions that I get asked frequently, and hopefully, supply you with information that can help positively impact your health!

I look forward to beginning this journey!

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