Emergency Preparedness - medications, ScriptSave WellRx

by Leah Samera
University of Arizona College of Pharmacy
PharmD Candidate, Class of 2018

Ready, a public service campaign designed to educate and empower citizens to prepare for emergencies such as natural and man-made disasters, proclaims September to be National Preparedness Month (NPM). In the aftermath of Hurricane Harvey and in anticipation of Hurricane Irma, you may be wondering how to go about preparing for such events. This is especially important to consider if you have a chronic disease or condition.

Illness Follows Disaster

Studies have found that upwards of 70% of the Hurricane Katrina survivors had at least one chronic condition. Additionally, 58% of the visits to emergency treatment facilities in New Orleans after Hurricane Katrina were due to illness, 24% of which were associated with chronic diseases. The research on disasters’ effects on chronically ill patients only serves to reinforce the fact that these emergency situations can lead to both exacerbation and death from chronic illnesses due to direct stress of the disaster, interruption of care, or both.

Emergency Plans and Kits

Organizations like the American Red Cross recommend having an emergency plan and kit prepared for use during a disaster. Some obvious items that should be included in such a kit are water, food, and first aid supplies. However, it is also critical that you have a 7-day supply of your medications on hand as well as any other tools or devices used for your health such as hearing aids with extra batteries, syringes, blood pressure cuffs, et cetera. In order to have at least a 7-day supply of your medications, you must order refills of your prescription medications as soon as you are able rather than before you run out. It is best to keep these items together and in a location that is easy to get to in an emergency.

Planning Ahead

Medications should be stored away from heat, light, and moisture; if possible, keep them in their original bottles and store the bottles in a waterproof bag or container. If you have medications such as insulin that need refrigeration, have a freezer pack and cooler available. It is also important to stay up-to-date on all immunizations, including tetanus, especially if you have diabetes. Additionally, because the stress of these disasters can exacerbate your conditions, it is best to also make appropriate lifestyle changes such as restricting salt intake if you have high blood pressure or learning the carbohydrate counting approach if you have diabetes.

Other Handy Emergency Items

Other items that you should have handy in case of an emergency include any over-the-counter medications you may need like pain relievers, as well as your medication list and insurance card. It is important to keep an up-to-date medication list that not only catalogs the names of your current medications but also their strengths, indications, directions, and prescribers; any bad or allergic reactions you may have had to medications in the past should also be documented. Your prescription benefit card may be needed for approval of an emergency supply if you run out of or lose your medications, or if your medications get damaged or contaminated.

In the event that you end up requiring medications and health resources:

  • RxOpen.org maps open and closed pharmacies, American Red Cross shelters, and infusion centers in areas affected by disasters.
  • The charity Direct Relief provides free prescription drugs and medical supplies to low-income patients at community health centers or clinics.
  • Keep a list of nearby pharmacies and hospitals as well as their phone numbers.

By doing what you can to prepare for disasters, you can lower your risk of exacerbations of your health conditions. As the theme for NPM states: “Disasters Don’t Plan Ahead. You Can.”

References:

  • National Preparedness Month. https://www.ready.gov/september. Accessed September 7, 2017.
  • Kessler RC, Hurricane Katrina Community Advisory Group Hurricane Katrina’s impact on the care of survivors with chronic medical conditions. J Gen Intern Med. 2007;22(9):1225–1230. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219784. Accessed September 8, 2017.
  • Sharma AJ, Weiss EC, Young SL, et al. Chronic disease and related conditions at emergency treatment facilities in the New Orleans area after Hurricane Katrina. Disaster Med Public Health Prep. 2008;2(1):27–32. https://www.ncbi.nlm.nih.gov/pubmed/18388655. Accessed September 8, 2017.
  • Be Prepared for an Emergency. Be Red Cross Ready! http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit. Accessed September 7, 2017.
  • Emergency Preparedness for Prescription Medications. http://www.mayo.edu/pmts/mc6000-mc6099/mc6012-39.pdf. Published 2016. Accessed September 7, 2017.

Are you concerned Hurricane Irma
may impact your prescription refills?
The State Law may be on your side; early refills are permissible.

For medications not covered by insurance,
the ScriptSave® WellRx program is here to help.

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Zollinger-Ellison syndrome - stomach image

by Derek Matlock, PharmD

What is Zollinger-Ellison Syndrome?

Do you suffer from Zollinger-Ellison syndrome (ZES)? If so, you may be in rare company. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Zollinger-Ellison syndrome is a rare disorder. It occurs in about one in every 1 million people. Normally, when we eat, our body releases a hormone called gastrin, which tells your stomach to make acid to help break down foods and liquids. For patients with ZES, this mechanism is disrupted by tumors or “gastrinomas.” These tumors form in the pancreas or upper small intestine and secrete abnormally large amounts of gastrin from tumors, resulting in peptic ulcers to be formed.

It Might Be Your Genes

Some people with Zollinger-Ellison syndrome may go undiagnosed as the disorder is rare and its cause is not clear. In 75% of cases, ZES is sporadic or random, whereas in 25% it is associated with MEN 1, an inherited condition characterized by pancreatic endocrine tumors, pituitary tumors, and hyperparathyroidism.  Therefore, your doctor may perform a thorough medical and family history to help diagnose ZES. Additional tests may include endoscopy or various imaging and blood tests. They may even measure the amount of acid in your stomach. For patients with sporadic ZES, the most common symptom is abdominal pain. While patients with the inherited form of ZES mostly complain of diarrhea. Other symptoms include, heartburn, nausea, vomiting, stomach bleeding, and weight loss.

Managing Zollinger-Ellison Syndrome

Currently, the goal of managing ZES is to limit complications of the disorder by suppressing acid secretions. Thus, the main medications used in ZES are proton pump inhibitors, or PPIs, like omeprazole (Prilosec®) or pantoprazole (Protonix®), prescribed at high doses. For patients who do not respond to treatment with PPIs, octreotide is used, which stops the secretion of gastrin, the hormone that tells our body to secrete acid for food breakdown. Currently, the only cure for ZES is surgical removal of the tumor or tumors, but this may not be an option in cases where the tumors have spread to other parts of the body. In that case, chemotherapy with medications like streptozotocin, 5-fluorouracil, and doxorubicin are used to shrink tumors.

Zollinger-Ellison syndrome is a rare disorder that may be suspected in patients with multiple or repeat peptic ulcers. Currently, medications like proton pump inhibitors are the main treatment option, while surgery and chemotherapy are options in certain patients. Remember, when taking proton pump inhibitors, they are best taken 30-60 minutes before a meal and may also come with their own unfavorable side effects. Be sure to talk to your doctor or pharmacist about what can be done to best optimize your treatment options for ZES.

Resources:

  1. Medscape: Zollinger-Ellison Syndrome
  2. National Institute of Diabetes and Digestive and Kidney Diseases: Zollinger-Ellison Syndrome
  3. UpToDate: Management and Prognosis of the Zollinger-Ellison Syndrome

For the best prescription savings
on medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

 

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Doctor speaking to patient about medications

TUCSON, AZ–(Marketwired – Aug 9, 2017) – VUCA Health announced today that ScriptSave, a provider of prescription savings solutions and decision support tools helping close the gaps in prescription coverage, will employ its on-demand medication video library to improve medication information and drive better care outcomes for ScriptSave WellRx members.

ScriptSave’s prescription savings program, along with VUCA’s innovative video service, will work together to increase prescription medication adherence by providing patient education in an easy to consume format, thus improving care while enhancing and simplifying the member experience.

Improving Medication Adherence

“It is well documented that two of the key pillars for medication adherence are providing access to affordable medications and the information they need to feel empowered about taking them,” said Shawn Ohri, Vice President, Business Development, ScriptSave. “By implementing VUCA’s on-demand video library, our members can receive accurate health information, in a format that is easy to understand and accessible anytime, anywhere.”

In partnering with VUCA, ScriptSave WellRx members will have access to a robust library of prescription-specific video briefings that deliver information on top-prescribed medications, including proper usage, expected benefits and potential side effects. The videos, available in English and Spanish, are integrated into the ScriptSave WellRx mobile app and website.

“VUCA’s innovative visual education paired with the latest advances in technology is helping individuals across the United States understand how to practice safe administration of their prescription medication,” said VUCA Health CEO David Medvedeff, PharmD, MBA. “By coupling this service with applications like ScriptSave WellRx, members can instantly access their medication information and leverage valuable resources to enhance their overall medication experience.”

About ScriptSave

For more than two decades, ScriptSave has been closing the gaps in healthcare and prescription coverage with innovative savings programs, like ScriptSave WellRx, for the uninsured, under-insured, and insured. Pharmacies, employers, health plans, and other organizations across the nation rely on ScriptSave to deliver prescription savings to their members and customers — yielding $1.3 billion in consumer savings in 2016 alone.

ScriptSave WellRx is recognized and approved by the National Association of Boards of Pharmacy® (NABP®). Our pharmacy recognition lets consumers know that ScriptSave WellRx meets standards set by a global coalition that includes International Pharmaceutical Federation (FIP) and NABP, which has supported the United States boards of pharmacy in their goal of protecting the public health since 1904.

ScriptSave is a member of the MedImpact, Inc. family of companies. For more information, visit www.wellrx.com. Follow us: @SSWellRx (Twitter), Scriptsavewellrx (Facebook).

About VUCA Health

Based in Lake Mary, Fla., VUCA Health (www.vucahealth.com) provides a gateway to patient engagement that serves as an on-demand extension of pharmacists and other healthcare providers. The company’s MedsOnCue solution leverages advanced mobile, web and on-demand video and communication technologies to deliver trusted patient information that enhances the medication use process. It offers a convenient and cost-effective way for clients to provide on-demand patient medication information and strengthen customer connections with video briefings, web messaging, reminders and alerts and a host of other customizable services that extend and enhance the patient relationship.

Contact Information

You can find the original press release here.


For the best prescription savings
on medications,
visit www.WellRx.com.
Compare prices at more than
62,000 pharmacies nationwide.

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Non-adherence not an option image

  • We think so … and we’ve found others who agree
  • We’ve also released LOTS of tools to help

At ScriptSave WellRx, we’ve lost count of the number of studies and surveys presented that show just how close the relationship is between high out-of-pocket costs for prescription drugs and the rate of prescription abandonment or non-adherence.

It’s one of the core reasons we do what we do – to fill gaps in prescription coverage, in an effort to make medications more affordable to those who struggle in the face of high deductibles, copays and out-of-pocket costs.

Rather than rehashing another set of adherence survey results (if you’re reading this, you probably understand adherence all too well), we have decided to share some first-hand insights to the importance of medication adherence (and some of the related struggles) from a handful of everyday patients.

Adherence matters, and these patients agree. You can read for yourselves the accounts of these patient advocates, as they tell their own stories, in their own words, about why prescription adherence it so vital.

THEN, once you’ve heard these first-hand accounts, we’ve included details of some free tools that we provide to help patients stay adherent. The ScriptSave WellRx program is so much more than just another prescription savings card. Our members are given access (at NO COST) to many adherence-based tools in addition to our fast, easy, free price-check tool. More details below.

Behavioral Health

The first account is from Gabe Howard. Gabe is an advocate for mental health issues and he lives with bipolar and anxiety disorders. As he will attest, life without his psychiatric medications can lead down some pretty dark roads. Read more at …

“Is High Cost Preventing Access to Psychiatric Medication?” – click here

(…and Gabe also posted a short video on this topic via his Facebook feed. You can watch it here – it’s less than 2mins)

Reflex Sympathetic Dystrophy (RSD)

Next up is Barby Ingle. Barbie is a minor celebrity in her own right, but she also deals with chronic pain. Read her take on the idea of non-adherence at …

“Free Programs That Help Pay for Prescription Drugs” – click here

Living with Lupus

Then we have Charlotta Norgaard. Charlotta’s daily struggle includes her fight with Lupus, which led her to set up the Lupus Friends & Family Foundation. Read what she has to say about the mere suggestion of non-adherence in here world…

“Prescription Adherence – and why it matters” – click here

Migraine Sufferer

Finally, there’s Sarah Hackley. Sarah’s insights into the topic of non-adherence will give an idea as to what it’s like to be a prisoner of migraines when the budget doesn’t quite stretch far enough to pick up a new prescription for a non-covered drug. Read about her struggles in …

“Affording Prescriptions When You’re Chronically Ill” – click here

Tools to Help with Medication Adherence

It’s a simple fact: drugs don’t work in patients who don’t take them. The causes of non-adherence, when a patient either accidentally or knowingly does not take medications as prescribed, can be complex. As we’ve already addressed in this blog post, non-adherence is often the result of cost; patients who simply can’t afford their medications. However, good habits and a good understanding of the medication can also be a big part of adherence.

With this in mind, we created the Medicine Chest. Registered ScriptSave WellRx members have free access to a complete suite of tools and resources, including:

  • Ask a Pharmacist
  • Pill Reminders
  • Refill Reminders
  • Medication Info (in both English and Spanish)
  • Medication Videos
  • Mood-tracking (to review side effects, etc.)
  • Price-check and Pharmacy Locator

Plus, registered members can connect directly to their pharmacies, like CVS or Walgreen’s, to automatically import their existing prescription information!

We hope these first-hand accounts on the importance of medication adherence have helped. Download our free app from the iOS app store or the Google Play Store, and get registered to take advantage of our free medication adherence tools. If you’re struggling to afford your medications, visit www.WellRx.com to compare the cash price at pharmacies near you. You may find prices lower than your insurance co-pay!

Behavioral health medications for anxiety or depression - image

Jenny Bingham, PharmD
University of Arizona College of Pharmacy

There are a number of mental conditions that shape mood and behavior. Any condition that affects a person’s thinking, feeling or mood, falls into a medical classification of Behavioral Health.  Such conditions may affect someone’s ability to relate to others, or maintain reasonable function every day. Each person may have different experiences, even if they have the same diagnosis as someone else.

Depression is the most common behavioral health condition in the general population1. Without treatment, depression can lead to decreased quality of life2, increased suicidal thoughts, and overall worsened health outcomes. The most common method of treating depression is to target serotonin and how the body uses it.  Serotonin regulates mood and ultimately is what makes you feel happy. When we have low serotonin levels, you can feel depressed or anxious. Antidepressants each have their own unique mechanism of action that are specific to certain neurotransmitters in the brain.

Anxiety can affect our ability to function due to excessive worry. Without treatment, anxiety can also lead to a worsened quality of life and can even be debilitating for some patients3. Anxiolytics are the medication class used to treat anxiety. The most common method of treating anxiety is to target serotonin and/or norepinephrine.  Norepinephrine is responsible for motor action, cognition, the body’s alert system, and feeling energetic.  When we have low norepinephrine, it is harder to cope with every day stressors and things that are beyond our control.

How do these medications work?  

These medications are often classified as reuptake inhibitors. They target the neurotransmitters serotonin and norepinephrine, to name a few.  Medications prevent the body from recycling these neurotransmitters. By preventing them from being recycled too soon, it allows the body a better chance to use them to improve mood and/or relieve anxiety.

What can you do to make them work better for you?

We know that the body needs certain building blocks to make serotonin and norepinephrine. An important concept to remember is that no matter how many medications are prescribes to treat these conditions, they don’t stand a chance at being effective without the right precursors; an interesting concept in today’s world. The majority with these conditions take more than one medication.

Step 1: What is your protein source?

The greatest building blocks for serotonin are things that you might already have in your kitchen.

Complete proteins are the main precursor for tryptophan, which is later turned into serotonin. You might think that tryptophan only comes from turkey on Thanksgiving, but did you know that you can also get it from eating beef, venison, buffalo, pork, fish, shellfish, cheese, cottage cheese, milk, yogurt, and eggs? 

The building blocks for norepinephrine are also found in your kitchen.

In addition to eating complete proteins, it’s also important to eat incomplete proteins as well. You can find these in nuts, grains, beans, legumes, and soy.

Step 2: What else is included on your meal plan?

When we think about serotonin building blocks, key vitamins play an important role as well.

  • Vitamin B6. Great nutritional sources of this vitamin are found in whole grains, vegetables, and nuts.
  • Vitamin B12. This vitamin is found in meats, fish, liver, and milk.
  • Folic acid and Vitamin D3 are often found in fortified foods.
  • Omega-3 Fatty Acids are found in fish, dairy, and grains.

Step 3: Don’t forget about your supplements and vitamins.

Over-the-counter supplements can help you fulfill your dietary need of the vitamins mentioned above. But, there is a caveat.  Did you know that you can actually take “too much” of a vitamin? When in doubt always review your supplements and medications with your pharmacist for safe use.

As a patient, take comfort knowing that you can control how well your medications work for you. You are the rate limiting factor in the equation. These simple modifications can make a world of difference with managing depression and anxiety. After all, the best investment you’ll ever make is in yourself.

References:

  1. Kessler RC, Ormel J, Petukhova M, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry 2011; 68:90.
  2. Daly EJ, Trivedi MH, Wisniewski SR, et al. Health-related quality of life in depression: a STAR*D report. Ann Clin Psychiatry 2010; 22:43. 
  3. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62:617.

For the best Rx price on prescription
depression or anxiety medications,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

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Is your blood pressure too high?

by Rick Lasica, PharmD
Post-Graduate Year 1 Resident

High blood pressure, also known as hypertension, affects nearly 1 in every 3 adults in the United States. Hypertension is often referred to as the “silent killer,”  because for the most part, hypertension doesn’t have any warning signs or symptoms. You might not even know you have it. If left untreated, hypertension increases your risk for heart disease and stroke, two of the leading causes of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). So when is high blood pressure too high?

Blood Pressure by the Numbers

Blood pressure is reported as two numbers: systolic blood pressure (top number) and diastolic blood pressure (bottom number). Systolic pressure is the pressure of your blood against the walls of your heart when it beats, while diastolic pressure is when it rests (between beats). Normal blood pressure is less than 120/80 and pre-hypertension (the range before an actual diagnosis of hypertension) is between 120-139 for the top number and 80-89 for the bottom number. A consistent blood pressure reading of 140/90 or greater means you have hypertension.

Preventing and Treating Hypertension

Luckily, there are many ways to prevent and treat hypertension. Lifestyle factors such as smoking tobacco, eating foods high in sodium, not exercising enough, being obese, and drinking alcohol, all increase the likelihood of developing hypertension. These are manageable risk factors that should be minimized or avoided. If all of these lifestyle factors for hypertension are modified in a positive manner and your blood pressure is still high, your doctor might start you on a medication to help it stay controlled. There are several classes of hypertension medications, all of which work differently in the body. Each class of medications works differently to lower your blood pressure, and has unique side effects you should be aware of. Your doctor or pharmacist can discuss these with you.

Common High Blood Pressure Medications

The angiotensin II receptor blocker Valsartan (Diovan) is one of the top high blood pressure medications, followed by the beta blocker Metoprolol Hydrocholorothiazide (Lopressor HCT), Olmesartan (Benicar), and Olmesartan and HCTZ (Benicar HCT).

Other frequently prescribed high blood pressure medications are the ACE inhibitor, Lisinopril (Prinivil, Zestril), Amlodipine besylate (Norvasc), a calcium channel blocker, and the generic diureticHydrochlorothiazide (HCTZ).

See Your Doctor for High Blood Pressure

It’s important to see your healthcare provider regularly so that they can monitor your blood pressure. Let them know all of the medications you are taking, including anything that doesn’t require a prescription, such as herbals and supplements, since these might be contributing to your high blood pressure. Also, if a new medication to treat your high blood pressure is needed, they will work with you to find a blood pressure medication that doesn’t interact with a medication you might already be taking.

By working with your healthcare provider, you can keep your blood pressure under control to help ensure a long and healthy life!

Resources:

  1. Centers for Disease Control and Prevention
  2. Mayo Clinic
  3. WebMD

For the best Rx price on all of your blood pressure medications,
visit www.WellRx.com.

Compare prices at more than
62,000 pharmacies nationwide.

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Photo of large amounts of Tylenol for ScriptSave WellRx

Can You Take Too Much Tylenol?

There are many over the counter pain medications often taken to treat minor aches and pains. One of the most frequently purchased pain medicines is Tylenol, which is also known by its common generic name, acetaminophen. You may also see acetaminophen abbreviated as APAP on certain medication labels.

Not only is there acetaminophen in pain relievers, but there is also acetaminophen in many over the counter cold, flu and headache medications. Acetaminophen is often combined with prescription medication as well. This makes it easy for a person to unintentionally ingest too much acetaminophen. Because acetaminophen is sold over the counter, many people think this is a safe medicine and overdose is not possible, however when taken in large doses, acetaminophen can cause liver toxicity, and possibly even death. According to the U.S. National Library of Medicine, acetaminophen overdose is one of the most common poisonings that can happen to consumers worldwide.

How Much Tylenol Can You Take in One Day?

Be cautious of how much acetaminophen you take in one day. This includes any acetaminophen you take in prescription products as well as in any over the counter products. The maximum recommended dose of acetaminophen for an adult is 4,000mg per day. This sounds like a lot, but when combining products that contain acetaminophen, this dose can easily be ingested in one day. Try not to combine any products containing acetaminophen together. Common strengths of Tylenol or acetaminophen include:

Tylenol 325mg (adults should not take more than twelve 325mg tablets in one day)

Tylenol Extra Strength 500mg (adults should not take more than eight 500mg tablets in one day)

Tylenol Arthritis 650mg (adults should not take more than six 650mg tablets in one day)

Acetaminophen Toxicity

Signs and symptoms of acetaminophen toxicity may not occur until 12 or more hours after the medication has been ingested. Some signs and symptoms of acetaminophen toxicity include abdominal pain, nausea, vomiting, diarrhea, appetite loss and/or convulsions. It is important that you do not take more than the recommended dose of acetaminophen to avoid any damaging affects to your organs, especially your liver.

If you feel like you are not getting sufficient pain relief on the maximum doses of acetaminophen, speak to your doctor or pharmacist.

Reference:
http://livertox.nih.gov/Acetaminophen.htm
https://www.nlm.nih.gov/medlineplus/ency/article/002598.htm


How Much Tylenol is Too Much?

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