Monthly Archives: January 2016


The Flu or an Imposter? [Show Notes]

5 other viruses that cause “flu” symptoms

  1. Rhinovirus (cold) – most colds don’t come with a high fever, but the other symptoms are present.
  2. Coronavirus (SARS) – includes gastritis, nausea, and vomiting on top of the other symptoms
  3. RSV – usually prominent in kids and leads to hospitalization due to the respiratory inflammation that can lead to an emergency
  4. Adenovirus – first isolated in the adenoids; responsible for viral tonsillitis
  5. Parainfluenza virus – in the 50’s, they would swab the mouth or throat to determine what was making a person sick.  There was a group of kids sick with the “flu” symptoms.  The doctors swabbed all these kids and noticed that some showed a virus that wasn’t the influenza virus they were used to seeing, so it’s name essentially means “around influenza”.

These viruses have nothing in their makeup similar to influenza, therefore, the flu shot will not protect you against these.

Are flu shots really worthwhile?

The short answer, yes.  It not only keeps the shot-getter protected (and even a little protection is better than none at all), it keeps healthy people from being carriers of the virus from spreading it to weaker members of the population (little kids, elderly, immunocompromised).  And while the flu isn’t the primary reason people end up hospitalized or dying, the secondary complications (i.e. pneumonia) are what can kill people.  Getting the flu shot is a simple and quick process, and is also relatively painless.

And there is absolutely NOTHING in the flu shot that can give you the flu.  Your body can have an immune response because that’s the point of the shot, to activate your immune system so it’ll learn what to do if the real flu shows up.  But obviously there are 5 other viruses you can catch that will give you symptoms identical to the flu.

Do more people get sick now than a few years back?

More people on the planet means more people probably get sick.  But if we have a preventable disease and people choose not to prevent it (in themselves or their kids), then more people will start getting it (aka measles).  We had almost eradicated measles from the US until a larger group of people decided not to get their kids vaccinated, and now it has resurged.  Children worldwide die from measles, why would we want to put our own kids at that risk?

Despite the poorly matched vaccine in recent years, those that got the flu reported shorter duration and milder symptoms.

And obviously, the flu shot is not the only thing that is going to protect you from the flu this winter.

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Punctures and Cellulitis [Show Notes]

Puncture Wound

A wound that is deep but a small point of entry (i.e. nail).   This allows the bacteria to get stuck inside.  Thus it won’t always bleed cuz the opening is too small for it to make it out.   So if the blood can’t get out, then antibiotic ointments can’t get in.

Signs of Infection

  • Swelling
  • Redness
  • Pain
  • Warm
  • “Lumpy” or “Dimpled”
  • Oozing
  • “Running” or “crawling” veins

Lockjaw anyone?  Tetanus is an opportunistic infection that gets into the body from dirty objects and then causes muscle rigidity (among other things).  It is very easy to prevent with a booster shot.

Cellulitis is not the same as cellulite, but does affect the same layer of the skin! It’s an infection caused by the normal bacteria that live on your skin.  As long as it’s on your skin – cool, we’re friends.  If it gets in your skin – that’s trouble.  Staph or strep – friends on the outside, enemies on the inside.  Requires oral antibiotics, and sometimes, even IV antibiotics.

Necrotizing fasciitis – bacterial infection gets so deep into the skin layers that it starts eating away the dermis and muscles below it.

Risks for Cellulitis

  • surgical sites
  • cuts and abrasions
  • puncture wounds!!!!
  • skin ulcers (from prosthetics, wheelchairs, or being bedridden)
  • spider and insect bites (bugs aren’t sterile, plus toxins – ick!)
  • cracked dry skin
  • hangnails
  • athlete’s foot (skin changes, including cracking)

Takeaway

Puncture wounds should not be treated at home – especially if you were stuck by something dirty.

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“Fluffing a Duck” Kevin MacLeod (incompetech.comLicensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/


How to Become a Pharmacist

How did you become a pharmacist?  How many years did you have to go to school?  Was it hard?  Do you have to be good at math? I get asked all the time, whether at the pharmacy counter, on Facebook, or just out and about in town.

What does it take to be a Pharmacist?

  1. Decide you want to be a pharmacist.
  2. Go to college and make Pre-Pharmacy your area of focus.
  3. Take lots of chemistry, biology, anatomy, and physics. Take a little history, literature, and speech communications, and probably some PE…
  4. Research and apply to Pharmacy Schools.
  5. Take the PCAT (only after taking Organic Chemistry).
  6. Get invited for an interview.  Dress nice, comb your hair, practice good eye contact, and not saying “um, like” so much.
  7. Get accepted! *You don’t have to graduate with a degree before starting Pharmacy School*
  8. Start Pharmacy school. Move across town or across the country, if necessary.
  9. Study your brains out.
  10. Gain experience in different pharmacy settings through practical rotations and getting a job in a pharmacy.
  11. Pass all your classes (even if just barely).
  12. Graduate and get called Doctor.
  13. Study your brains out some more.
  14. Take a 3-hour test called the NAPLEX (North American Pharmacy Licensure Examination).
  15. Take a slightly shorter test called the MPJE (Multistate Pharmacy Jurisprudence Exam) – aka Pharmacy Law.
  16. Pass your board exams and become a licensed Pharmacist.
  17. Start work.  *Somewhere between your last year of school and passing your exams you should have applied for and accepted a job*

This is not the only path to becoming a pharmacist.  It is just one option, the straightest option.  You can take many other paths to become a pharmacist, and any path you choose is going to give you personalized experiences and a unique story.

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Feed You Bones [Show Notes]

Basics

Calcium is a natural element (yep, one of those periodic table guys).  Our teeth and our bones are made strong by it.

For most healthy adults, daily recommended amount is 1000 mg.  For females approaching 50 years old, recommendation increases to 1200 mg to 15oo mg per day.

The trick to supplementation is knowing that your body can only absorb 500 mg of elemental calcium at a time.  So you gotta split it up.  When you get it from your diet, then this is NBD because it will naturally be spread out between your meals and snacks.

These supplements always go with Vitamin D.  Vitamin D is responsible for helping with calcium absorption.  If you’re low on D (and more people are than might realize b/c very few jobs have you working out in the sun – and Vitamin D is synthesized and activated by UV exposure), calcium can’t be absorbed and used like it should.

2 types of OTC supplements

  1. Calcium carbonate (Caltrate) – a base (also what makes up OTC antacid tablets [i.e. Tums] so a bonus if you have heartburn); requires the acid in your stomach to break out of the tablet for your body to use.
  2. Calcium citrate (Citracal) – an acid; doesn’t require extra stomach acid to be absorbed. A good supplement for those who had gastric bypass, because the stomach has been shrunk and there are less acid pumps to break down medications that require acid to work.  Bad for people with reflux or ulcers.

The labels can be tricky.  It will say “600 mg Calcium Carbonate”, but you have to look for the hint of how much elemental calcium that is equal to.  This is because your recommended daily dose is in milligrams of elemental calcium.  So, doctors don’t always tell you that when they recommend it.  Your calcium-rich foods are going to provide you with 250-300 mg of elemental calcium per serving (about 25% of your daily requirement).

Random dietary sources (between 6-20% of your daily requirement)

  1. White Beans
  2. Black-eyed Peas
  3. Sardines (cuz you eat their bones?!)
  4. Dried Figs
  5. Bok Choy
  6. Molasses
  7. Kale
  8. Turnip Greens
  9. Almonds
  10. Oranges
  11. Sesame Seeds

Calcium-fortified foods

  1. Instant Oatmeal
  2. Mainstream orange juices
  3. Soy products (because you’re using them instead of dairy and animal products)
  4. Cheerios

Vitamin D helps your stomach absorb the calcium into the blood.  And then in the blood, keeps the calcium from binding with other things, so it’s free when the body needs it in other places.

Unfortunately, pounding supplements is not going to reverse osteoporosis.

Recommended dose for kids

  • 1 to 3 years old — 700 milligrams daily
  • 4 to 8 years old — 1,000 milligrams daily
  • 9 to 18 years old — 1,300 milligrams daily

Usually not hard for kids to get the right amount with their diet plus a vitamin.  Babies don’t need supplementation since their main source of nutrition is milk (breast milk or formula).

Seasonal Affective Disorder – is partly due to a Vit D deficiency, because Vit D also helps with mood.  The sun exposure is the best way to supply your body with Vit D.  A bonus is that sunlight stimulates serotonin production in your brain which is also responsible for good mood.

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Medication Disposal [Show Notes]

The Regulation

The FDA and EPA agree that certain medications are okay to flush.  The comparison being, the medication, though diluted, are still being present in tap water after filtration and purification, or a kid or petor junkie eating it out of your trash and getting really hurt or dying.

This is usually the advice for extended release pain medications (tablets, liquids, or patches), narcotics, and other controlled substances.

Homemade Disposal

The goal of disposing medications at home is to make it unappetizing to anyone who may find it and try to eat it.

Ingredients:  Unwanted medications, Water,  Sand, Cat litter, or coffee grounds

Crush the tablets or capsules in a ziplock bag.  Add water to dissolve.  Add sand/cat litter/coffee grounds to absorb water.  Throw in trash.

Available for purchase

If you don’t want to DIY at home, Medaway bags are available at a pharmacy.  They have an activated charcoal compound in it.  Add pills, add warm water, and shake.  Adsorption = when one compound adheres to another compound and they can’t be separated.

Privacy Recommendations

It is advised to throw away the medications separate from the prescription bottle.  Best option is to remove labels and shred with other personal information.  At the very least, black out all of your personal information and the drug information before putting in the trash.  Even if your bottle is empty, if someone finds a bottle that previously held pain pills, that person may think you have more and it puts you at higher risk for crime.

Syringes

For syringe disposal, you can buy Sharps containers at a pharmacy.  All the instructions for using, and packing and shipping, including a prepaid return label, are included in the box.  If you don’t use an official Sharps container, it’s best to use an opaque jug or carton that 1) you can’t see through to see the needles easily, and 2) that has a small opening so it’s difficult for the needles to come back out (either by someone reaching in for them or by spillage).  Once it’s full, just seal it and put it in the trash (do not try to recycle that jug!).

National Prescription Drug Take-Back Day – local law enforcement agencies are set up to take back unused or unwanted medications from the public and will dispose of them properly.  Only certain locations will take controlled substances (check the website for your zip).

Holla

“Stoned raccoons aren’t funny!” – @kendh

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