rising insulin costs - scriptsave wellrx blog image

by Eli Kengerlinski, 2019 PharmD Candidate
University of Florida College of Pharmacy

Over the years, insulin prices have increased in accordance with newly developed insulins that have come to market. Traditional insulins, short and intermediate acting, as compared to newer rapid and long acting insulins, are less expensive in market value.1 Biosimilar traditional insulins with expired patents (some since 2000) may be a better option for some patients, as their market price has significantly dropped over the years. However, many patients are still having trouble affording their monthly Lantus or Humalog due to their high copays.

Why is insulin important?

Insulin plays an important role in managing patients with Diabetes Mellitus (DM). Patients with Type 1 DM have limited ability to produce endogenous insulin due to their pancreas’s inability to properly function. Patients with Type 2 DM can also have increased dependence on insulin therapy use as their disease state progresses. It is crucial for certain diabetic patient populations to have insulin at hand as they cannot control their sugar levels with just oral medications (eg. Metformin) that have no effect on insulin production. Type 1 DM population, there’s a greater need for basal (intermediate or long acting) as well as mealtime (rapid or short acting) insulin.

What options do you have?

Lifestyle modifications towards a healthier diet and exercise can be the most important changes any diabetic can make, and help ensure proper management of your condition. Monitoring your daily sugar levels, managing your weight via carb counting or following the plate method2, as well as exercising 30 minutes a day, five times a week, are all great habits to ensure effective DM management.

From January 2014 to July 2018, short and intermediate acting insulins have dropped in price equaling less than half of rapid and long acting insulins in the market today.1 Even if newer insulins offer better sugar control, their high prices make it difficult for patient access. For these specific patient populations, traditional insulins should be considered to ensure patient adherence to DM therapy and prevent patients using less of their insulin. If you’re having trouble paying for your insulin, then ask your provider if short and intermediate acting insulins would be right for you. Also contact your insurance company to see if you qualify for additional programs (eg. Medicare, Medicaid).

Furthermore, ask your provider if there are generic alternatives to your rapid or long acting insulin. For example, Admelog costs 12 to 15% less than Humalog while Basaglar costs about 15% less than Lantus on a per insulin unit basis.3 Therefore, it is important to ask for biosimilar generics that have the same active ingredient as they are usually cheaper.

Another affordable alternative to ensure access to insulin would be switching patients on high cost insulin pens to vials. Even though pens are more convenient and patient friendly, vials should be considered, especially if you’re having trouble affording your insulin. However, do ensure that you are instructed on how to properly inject your insulin.

If you’re still having trouble affording your insulin, ask your local pharmacist for a manufacturer savings card. If you need help with diabetic medications, visit www.wellrx.com for substantial prescription savings at pharmacies throughout the U.S. and Puerto Rico.

REFERENCES:

  1. Eisenberg Center at Oregon Health & Science University. Premixed Insulin Analogues: A Comparison With Other Treatments for Type 2 Diabetes. 2009 Mar 25. In: Comparative Effectiveness Review Summary Guides for Clinicians [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2007-. [Table], Price of Insulin. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45287/table/clininsulin.tu1/
  2. Lara Hamilton. “How to Create Your Plate.” Diabetes Forecast, Nov. 2015, diabetesforecast.org/2015/adm/diabetes-plate-method/how-to-create-your-plate.html
  3. “Sanofi Launches Follow-On Insulin Lispro, Admelog.” The Center for Biosimilars Staff, 9 Apr. 2018, www.centerforbiosimilars.com/news/sanofi-launches-followon-insulin-lispro-admelog.

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Your child's medication during school hours - ScriptSave WellRx blog image

by Pattiya Wattananimitgul

How to Handle Your Child’s Medication During the School Year

In the United States, more than 263 million prescriptions are dispensed each year for pediatric patients.1 Chances are, your child may need to take their medications at school. If your child has a medication that they need to take during school hours, whether it is a long-term, short-term, or emergency medication, here are some helpful tips for parents and guardians:

Prior to the School Year1,2

  • Ask the pharmacist to put your child’s medications into two different bottles, each with its’ own label. One to be kept at home and one to be kept at school, if school policy allows.
  • Make sure all the prescription medications kept at school are in an original container (ie., no zip-top bags or foil) and labeled by a pharmacist.
  • Make sure all over-the-counter medications (including supplements) kept at school are in the original containers. Some states require a physician’s written consent and a parent written permission for over-the-counter medications. Be sure to check with your school.
  • It is also important for your child to play active roles in their medication. They should be educated about the effective and safe use of their medicine to help avoid improper administration, dosing errors, and non-adherence.

At the Beginning and During the School Year2,3

  • Provide the school with a full list of your child’s medications, including over-the-counter medicines and supplements. Be sure to update the school with any changes throughout the school year.
  • Talk to the school nurse or teacher ahead of time to make sure your child’s medication will be administered correctly (icorrect medication, dosage, route, frequency). Define who will administer the medication, and who will carry the medications during field trips.
  • School staff are not allowed to determine when to administer “as needed” medications. Be sure that your child’s medication includes specific instruction on when to administer and for what indication (ie., every 6 hours as needed for headache).
  • All medications should be transported by adults to adults. DO NOT let your child carry the medications unless they are capable and responsible to self-administer their medication to carry their own medications, especially for emergency medications that need immediate access, as deemed appropriate by the school.

Emergency Medications2

  • Be sure your child is able to get instantaneous access to emergency medications, like epinephrine injections for allergic reaction, glucagon for low blood sugar, or albuterol for an asthma attack.
  • Acetaminophen, ibuprofen, antihistamines are usually available at school in case your child experiences sudden pain or fever such as headaches, toothache, or menstrual cramps. It is important to sign a waiver granting the school permission to administer these medications in case your child experiences these symptoms.

Lastly, most schools and school districts have policies regarding student’s medication handling. It is important for you to check with your school for specific protocols that you need to follow to make sure that your child is getting the proper care.

 

References

  1. Abraham, O., Brothers, A., Alexander, D. S., & Carpenter, D. M. (2017). Pediatric medication use experiences and patient counseling in community pharmacies: Perspectives of children and parents. Journal of the American Pharmacists Association, 57(1), 38-46. doi:10.1016/j.japh.2016.08.019
  2. Administering Medication at School: Tips for Parents. (2016, December 19). Retrieved July 25, 2018, from https://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Administering-Medication-at-Child-Care-or-School.aspx
  3. Guidelines for the Administration of Medication in School. (2003). American Academy of Pediatrics, 112(3), 697-699. doi:10.1542/peds.112.3.697

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Go Red For Women 2018 - American Heart Association

It’s a new year and you’re probably trying to do this “healthy” thing. You’re going for long walks or runs, limiting your donut calories and not smoking. You may be thinking you’ve eliminated your risk for, for heart disease, but wait. There’s more.

According to the American Heart Association (AHA), the biggest risk factors for heart disease include obesity, lack of exercise, smoking, high blood pressure or cholesterol, a poor diet, and stress.

For many women there are other factors for heart disease and stroke that you can’t control that may not even be on your radar. Your love life, a strong family history, race, and increasing age are all on the list of contributing factors.

CVS Health is continuing their support of the AHA’s Go Red for Women movement. They’ll be offering no cost “Know Your Numbers” health screenings at their MinuteClinics every Wednesday in February.

Visit a CVS MinuteClinic on February 14, 21, and 28 and receive a no-cost heart health preventative screening. If you go, you’ll get screenings to help determine your risk for heart disease – total cholesterol, HDL cholesterol, blood pressure, blood sugar, and body mass index (BMI).

A list of CVS MinuteClinic locations is available on the MinuteClinic website. For more information on the AHA Go Red for Women movement, visit GoRedForWomen.org.

Click to read the CVS press release.


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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! https://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit. Accessed September 7, 2017.
  • Emergency Preparedness for Prescription Medications. https://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.

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ScriptSave WellRx - Heliobactor Pylori stress image

Heliobacter pylori Eradication and Antibiotics

by: Derek Matlock
Pharm.D. Candidate 2017
Washington State University

Heliobacter pylori is a bacteria highly prevalent worldwide and is closely linked to duodenal ulcers (which affect the upper section of your small intestine), gastric ulcers, and peptic ulcer disease. It is also linked to an increased risk of developing gastric cancer in an infected person. Despite being more common in developing countries with poor socioeconomic conditions, the American College of Gastroenterology states that 30-40% of the U.S. population is infected with H. pylori, putting them at risk for conditions such as peptic ulcer disease — which affects the stomach lining — and gastric cancer.

Anitbiotics for Ulcers?

Numerous research studies and testing have not only supported these correlations, but they have also demonstrated the benefits of eradication using medications, specifically antibiotics, for patients suffering from complications of H. pylori.

Prior to the discovery of H. pylori, lifestyle factors such as smoking, eating spicy and acidic foods, and stress, were considered the major causes of ulcers. Thus, the main treatment choices were popular acid suppressing medications such as ranitidine (Zantac®) or omeprazole (Prilosec®). These medications can help improve ulcer-related pain and symptoms, and might even heal the ulcer, but they do not treat the underlying H. pylori infection. Without treating the infection, symptoms and complications are likely to reappear.

Triple Therapy for Ulcers

After the discovery of the bacteria causing these conditions, appropriate antibiotics have been able to eliminate the infection in the majority of individuals, thus resolving the infection and its complications. The following antibiotic regimens are being used, and the triple therapy is the most common.

  1. Triple therapy: Omeprazole 20 mg twice daily + Clarithromycin 500 mg twice daily + Amoxicillin 1,000 mg twice daily or Metronidazole 500 mg twice daily
  2. Concomitant quadruple therapy: Omeprazole 20 mg twice daily + Clarithromycin 500 mg twice daily + Amoxicillin 1,000 mg twice daily + Metronidazole 500 mg twice daily
  3. Bismuth quadruple therapy: Omeprazole 20 mg twice daily + Bismuth subsalicylate 262 mg four times daily + Tetracycline 500 mg four times daily + Metronidazole 250 mg four times daily

Although the triple therapy remains an effective choice, a preference for quadruple therapies may soon become more common, as the risk for patients to fail treatment due to antibiotic resistance becomes a growing concern in the science community.

As the United States prevalence of H. pylori continues to decline, the resistance to antibiotics, specifically Clarithromycin, makes the infection more difficult to treat. As a patient, it is essential to inform your doctor about any recent antibiotics you may have taken, as this may help in the selection of a better treatment option.

References:

  1. American College of Gastroenterology Guideline on the Management of Heliobacter pylori Infection
  2. CDC: Heliobacter pylori Fact Sheet for HCPs
  3. Medscape: Heliobacter pylori Infection
  4. WebMD: What is H. Pylori?

 

Have questions? Ask a Pharmacist!

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about drug interactions, and other medication-related questions.


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generic aspirin tablets

by: Rick Lasica, BS
University of Arizona College of Pharmacy PharmD Candidate, Class of 2017

Many people take aspirin occasionally to provide relief from various conditions (e.g. pain, inflammation, fever, headaches), but what about taking a low-dose aspirin every day for prevention reasons? As with all medications, aspirin poses various benefits and risks that need to be taken into consideration before you start taking it. Studies have shown that certain individuals would benefit the most from taking a low-dose aspirin and others shouldn’t take it at all.

Why Take Low Dose Aspirin?

Our bodies make cells called platelets, which help stop us from bleeding uncontrollably. In order to stop this unnecessary bleeding, a blood clot is formed. In this case, the blood clot is beneficial, but sometimes blood clots are formed when they aren’t needed, which have the potential to lead to a heart attack or stroke. Aspirin is a non-steroidal anti-inflammatory drug (NSAID) commonly referred to as a “blood thinner” because it stops platelets from working together to form a blood clot.

Even though aspirin has many potential benefits, it also has many side effects, some serious, that might occur. Most importantly, it can increase your risk of bleeding, both inside and outside of your body. This might be noticed through your gums bleeding while brushing your teeth, any unexplained bruising on your body, or black/tarry stools. Other side effects that might occur are ringing in the ears, nausea/vomiting, dizziness, or yellowing of the eyes/skin.

The United States Preventive Services Task Force (USPSTF) recommends that people aged 50-59 years with an increased risk of heart problems who have never had a heart attack or stroke in the past would likely benefit from taking a daily low-dose aspirin in order to help reduce the chance of one from happening. Also, people who have had a heart attack or stroke are at an increased risk of having another one, and would likely benefit from it as well.

However, you should never start taking aspirin, or any medication, before talking with your physician or pharmacist about it. They will make an assessment of your condition and weigh the benefits and risks of you taking it and make the ultimate decision of whether or not you should take it as part of your daily regimen. Certain people should not take aspirin if they have had any serious bleeding events, are on certain medications, have a high fall risk, or have specific medical conditions. So, next time you interact with your doctor or pharmacist, ask them if they think it is appropriate for you to take a daily low-dose aspirin.

References:

  1. United States Preventive Services Task Force Recommendations on Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer
  2. WebMD: Aspirin
  3. FDA: Safe Daily Use of Aspirin

 

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ScriptSave WellRx - diabetes glucose monitor check image

by:
Cherokie S. Boyd
Pharmacy Intern P1
SinfoniaRx Florida

What a time to be a person with diabetes! These days there are more medications on the market than ever to help you control your diabetes. But how do you know which medication is right for you?

Of course you should always consult your physician or your local pharmacist for medical advice. However, here is some information about these new medications so that you don’t feel out of the loop.

Some of the current insulin medications that you are used to are Lantus, Humalog, and NovoLog. These medications deliver the hormone insulin to your blood so that insulin can tell your cells to take in more glucose. This keeps your blood sugar down.

Then there are oral medications, like Metformin and Januvia. They both work by making your liver produce glucose less often. Metformin also makes your body more sensitive to the insulin that is already made in your body, while Januvia works to help your body increase insulin production. All of that keeps your blood sugar down.

Now we have the new kids on the block. The GLP’s (glucagon-like peptides), sometimes referred to as Incretin mimics. The GLP’s that are available by brand name are Victoza and Saxenda, Byetta and Bydureon, Tanzeum, and Trulicity. These medications work in three ways.

  • They increase the hormone incretin which triggers your pancreas to make its own insulin
  • They inhibit the hormone glucagon which is responsible for telling your liver to make more blood glucose
  • They make you feel fuller for longer by delaying gastric emptying, which helps you lose weight.

Now that last point is what has caught most people’s attention. It is true that some of these GLP’s can be used for weight loss, too. If you have type 2 diabetes, you know that losing weight is a benefit to help control blood sugar in overweight patients. These medications in particular can also affect your natural insulin production, which means you can get a lower dose of your insulin medications. It’s a win-win! But these medications are not to be used as a first line of defense against your diabetes. These medication’s main claim to fame is that they lower your A1C by 1% in most patients.

Your A1C is a blood test you get at the doctor’s office. It’s a measurement that can detect how well your blood sugar is being controlled over a period of 3 months. Usually you want this result to be somewhere under 7%. This reflects that your blood sugar is being controlled for a longer amount of time. Controlled blood sugar limits your risk for complications such as nerve pain and kidney problems.

Did I mention that these GLP medications can cost you around $700 a month? Not to worry. If these medications sound like something you want to add to your regimen don’t hesitate to talk to your doctor about them. They might be on your health plans insurance formulary, or you might qualify for a prescription discount with the ScriptSave WellRx savings program. Compare it to your insurance copay. It may be cheaper!

Keeping your diabetes in control can be a struggle. Never forget the amazing impact that a diet full of vegetables can have for your body. Keep your body moving. Ample exercise each week is another natural way that you can get your prescribed insulin dose lowered.


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ScriptSave WellRx - American Heart Month exercise image

On average, someone dies of Cardiovascular Disease (CVD) every 40 seconds. That is about 2,200 deaths of CVD each day. Heart disease is the leading cause of death for men and women.February has been designated as American Heart Month to raise awareness about heart disease and how people can prevent it — both at home and in the community. It’s a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health.

The term “heart disease” is used broadly to describe a number of diseases of the heart and blood vessels. Cardiovascular disease is a condition in which plaque, which is made up of fat, cholesterol, calcium and other things in the blood, builds up inside the coronary arteries which supply oxygen-rich blood to the heart muscle. If the plaque gets big enough, it can cause a heart attack or even sudden cardiac death.

Heart Disease Across the US

The statistics on the prevalence of CVD are staggering2:

  • 7 million, or 34.0% of US adults are estimated to have hypertension
  • 5 million, or 11.9% of US adults are estimated to have total serum cholesterol levels ≥240 mg/dL
  • 4 million, or 9.1% of US adults are estimated to have diagnosed diabetes
  • Stroke accounted for ≈1 of every 20 deaths in the United States
  • On average, someone in the US has a stroke every 40 seconds. This is about 795,000 new or recurrent stroke each year. On average, someone died of a stroke every 4 minutes.

The way to avoid becoming part of these statistics starts with some basic ideas. If you smoke, stop. If you don’t exercise, then it’s time to start (but talk to your doctor first). Strive for 30 minutes of moderate aerobic exercise each day. And if you’re eating high-fat fried foods, it’s time to give your diet a workout. Even the pharmacy chain, CVS, is making a move to carrying snacks without trans-fats, which have been linked to increases in heart disease, with its branded food products.

Heart Healthy Foods

The American Heart Association has identified foods that meet their certification program requirements. Research shows that eating these foods can lead to fewer heart disease risk factors.3 The Heart-Check mark, the front-of-package icon of the American Heart Association’s Food Certification Program, has been helping shoppers make healthier food choices for more than 20 years. It’s a useful tool for consumers constructing a healthier diet.

Whether you’re grocery shopping or dining out, the Heart-Check mark makes spotting heart-healthy foods simple. Some examples of foods in the Heart-Check Certification Program include4:

 Product  Company
 America’s Choice Roasted Turkey Breast  Smithfield Foods, Inc.
 Boar’s Head Black Forest SmokeMaster
Beechwood Smoked Ham
 Boar’s Head Provisions Company, Inc.
 Simply Orange Original Pulp Free 100% Orange Juice  The Coca-Cola Company
 Darling Clementines  LGS Specialty Sales LTD
 Fresh Sweet Potatoes (US grown, orange flesh varieties)  The United States Sweet Potato Council, Inc.

If you’re planning a grocery store trip, look for the Heart-Check mark and get started on the road to a healthier heart. And take the first important step – talk to your doctor about your risks.

References:

  1. NCHS. Deaths, percent of total deaths, and death rates for the 15 leading causes of death in 10-year age groups, by race and sex: United States, 1999-2013 .
  2. American Heart Association – https://newsroom.heart.org/events/february-is-american-heart-month-5712350
  3. Choosing foods that meet Heart-Check certification requirements linked to better diet quality, study finds https://news.heart.org/choosing-foods-that-meet-heart-check-certification-requirements-linked-to-better-diet-quality-study-finds/
  4. Heart-Check Food Certification Program  https://www.heart.org/idc/groups/heart-public/@wcm/@fc/documents/downloadable/ucm_474830.pdf

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ScriptSave WellRx image - save on diabetic glucagon kits

by Benita M. Daniel
University of Arizona, College of Pharmacy
PharmD Candidate, Class of 2017

Weakness, anxiety or irritability, a general sense of confusion — these are signs of low blood sugar, or hypoglycemia. It often happens when diabetics take too much insulin.

Hypoglycemia happens to many people with diabetes, and it can be serious or even fatal.

Severe hypoglycemic episode, also referred to as insulin shock, can occur when the body has too much insulin that can lead to low blood sugar levels.

The possible causes for insulin shock include:

  • Overdose of insulin
  • Long interval time between each meals
  • Exercising without eating
  • Consumption of alcohol without eating food

If you’re experiencing a hypoglycemic episode, don’t panic. Most incidents of low blood sugar and can be treated at home.

One of the fastest, most effective treatments is with a glucagon injection. Glucagon is a natural hormone that is produced by the pancreas in response to high levels of insulin in the blood. The administration of glucagon injection is indicated for emergency uses only especially in patients who are experiencing severe hypoglycemic symptoms.

Severe hypoglycemia often results when early low blood sugar symptoms are untreated. It is recommended to use Glucagon if you experience:

  • Irritability
  • Tremor
  • Excessive sweating/hunger
  • Seizures
  • Weakness
  • Confusion
  • Unconsciousness

Glucagon pen injections are typically dispensed in Glucagon Emergency kits that contains a vial of glucagon (powder form), syringe with attached needle containing the sterile diluting agent with instructions on how to mix it prior to administration. It is important to ensure that you and your family including close relatives are properly instructed on how to use glucagon injection in the case of an emergency. A detailed instruction for use is provided by the manufacturing company. Since, glucagon products are currently available in market primarily in powder form, it is necessary to make sure that these necessary steps are taken prior to the administration of glucagon injection:

  • Inject the diluting agent contained within the syringe into the glucagon vial/bottle
  • Gently swirl the glucagon vial/bottle until it is a clear liquid. It is important to make sure that glucagon is not administered until it has a clear and water-like consistency
  • Using the same needle as before, draw up all the contents within the glucagon bottle
  • Sterilize the preferred injection sites: buttock, arm or thigh with an alcohol swab. Insert the needle into the injection site immediately after the reconstitution occurs.
  • If the patient does not respond to the first dose of glucagon, call 911 and physician and administer another dose of glucagon
  • After the administration, make sure to discard any remaining unused contents of the injection since the glucagon is typically unusable.

It is critical to treat the early signs and symptoms of hypoglycemia in order to prevent the progression of severe symptoms of hypoglycemia. Here are some helpful tips to help you prevent low blood sugar levels or hypoglycemia:

  • Identify early signs and symptoms of low blood sugar levels
  • Carry glucose tablets or sugary snacks such as candy or regular soft drink
  • Make sure to take insulin doses after each meal
  • Avoid exercising for longer periods of time without eating any sugary snacks
  • Avoid drinking alcohol without eating
  • Test blood sugar levels regularly as recommended by the doctor in order to ensure blood sugar levels are within goal.
  • Ask your doctor for glucagon injection if in case of emergency

There have been recent developments of newer agents such as Glucagon pens (G-pens) that are currently in Phase 3 of Clinical trials. As per the manufacturing company, Xeris Pharmaceuticals, “Glucagon pen is a highly stable, ready-to-inject glucagon solution as an alternative to the existing glucagon emergency kits and to provide various products addressing the broader problems of hypoglycemia in both the diabetic and non-diabetic population.”

Glucagon pens are prefilled auto-injectors that will activate immediately with the contact of the human skin and works in similar methods to that of an Epi-pen.  Additionally, it does not require multiple steps prior to the administration of the medication to ensure the patient receives the active form of glucagon.

The elimination of the reconstitution will help in the fast and efficient administration of glucagon and this can prevent further complications of hypoglycemia including coma. G-pens seems to be a promising area of research and it will be fascinating to see the positive outcomes that would result due to the development of Glucagon pens.

Recheck your blood sugar after 15 or 20 minutes. If it’s still low, take another 15 to 20 grams of a quick-acting sugar, and eat something if you can. If your sugar level stays low after 2 hours or if your symptoms don’t get better, seek medical attention.


References:

https://www.healthline.com/health/diabetes/insulin-shock#Overview1

https://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?loc=lwd-slabnav

https://pi.lilly.com/us/rglucagon-ppi.pdf

https://www.xerispharma.com/pipeline


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ScriptSave WellRx Impact of Healthcare Repeal

**update**

As the House of Representatives gets set to vote again on repealing the Affordable Care Act (ACA), commonly referred to as Obamacare, consumers are still unsure of the impact to their healthcare. The vote will come almost two months after the aborted first vote on bill.

House Democratic Leader Rep. Nancy Pelosi noted that the new bill had not yet been analyzed by the Congressional Budget Office (CBO), which will ultimately estimate what the bill will cost, as well as how it will affect premiums and the number of people covered by insurance.

A previous analysis by the CBO on the effects of repealing the ACA, indicated it would impact millions of Americans.

The Congressional Budget Office (CBO) has analyzed the effects of healthcare repeal, and estimates 32 million Americans will lose health coverage if a repeal plan, like the one passed in 2015 by Congress, were to become law. The non-partisan Congressional Budget Office is responsible for scoring the impact of legislation on the deficit.

The study shows the number of people who are uninsured would increase by 18 million in the first plan year following enactment of the bill. The CBO also estimated that premiums for policies purchased through the marketplaces or directly from insurers would increase by 20 to 25 percent that year. The elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces would increase that number to 27 million in following years, and then to 32 million in 2026.

Medicare and Medicaid enrollees may also see the stresses of change with possible increases in premiums and deductibles. The bill’s effects on insurance coverage and premiums would be greater once the repeal of the Medicaid expansion and the subsidies for insurance purchased through the marketplaces took effect, roughly two years after enactment.

With the loss of insurance coverage, many patients will no longer be able to afford the prescription medicines they need to stay healthy. ScriptSave® WellRx can help.

ScriptSave WellRx is a prescription savings and adherence program that offers up to an 80% discount on generic and name brand prescription medications.

More than half a million people already take advantage of the savings through ScriptSave WellRx. It’s available free on the web (www.wellrx.com) and as Apple and Android apps. WellRx enables individuals to compare prices for prescription drugs at local pharmacies, look up drug information, and consult with a pharmacist about their medications.


For the best Rx price on medications, like
Crestor (rosuvastatin),
Celebrex (celecoxib),
ProAir HFA,

visit
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photo ScriptSave WellRx vitamin supplements

by Sandra Leal, PharmD, MPH, CDE, FAPhA

The US supplement industry is a $30 billion dollar business.1 The Council for Responsible Nutrition estimates that almost 70% of US adults use dietary supplements.2 Before I continue, I must state that I do not have any conflicts of interest and rest assured, although I am a pharmacist, I do not support ‘Big Pharma’ when it comes patients unnecessarily being prescribed medication.

Personally, I use caution when it comes to dietary supplements for one simple reason – they are not regulated like prescription medications. The FDA is the administration that regulates the approval and use of prescription medication. What this means is that on a prescription bottle labeled with a specific amount of ingredients, you can be certain that the actual amount in a given tablet, capsule, cream, suppository, solution, etc. is between about 95% and 105% of what the label actually states. As an example, if you are prescribed to take a tablet that is 100mg in strength, then you can be certain that the amount is between 95mg and 105mg of that medication.

On the contrary, dietary supplements are regulated by the Dietary Supplement Health and Education Act of 1994. Since they are not regulated like drugs, companies that manufacture and produce dietary supplements are able to put whatever claims they want on their bottles. It is possible and highly likely that what is stated on the supplement label is not what is in the actual tablet or capsule. In fact, the New York Attorney General and the Federal Trade Commission have recently filed suit against Prevagen for their claims of memory boosting.

Moreover, many weight loss dietary supplements contain botanicals and plant-derived ingredients that can cause and make health problems worse. Sometimes, these supplements can interact with prescription medicines that you are prescribed. St. John’s wort, in particular, can negatively interact with a number of medications, including Statins (Crestor, Simvastatin), Warfarin (Coumadin), and Tricyclic antidepressants, like Elavil or Pamelor.

I believe there are great health benefits and medicinal properties of nutraceuticals, however there is a great need for credible research and evidence before I would be comfortable recommending these products to my patients. Throughout my years of practice, I have found that many patients do not consider dietary supplements, OTC products, and vitamins as medications. I would recommend that the next time you have an appointment with your doctor, inform him/her of everything you take, even those that you purchase in a store or online, just to ensure that they are safe for you and do not interact with your prescription medications.

The next time you think of taking a supplement, remember that right now you have no way of knowing for sure what’s really in your supplement bottle. And despite the promising on the labels, the pills probably won’t make you any healthier (unless you have a medically diagnosed deficiency), and they might even be hurting you.

 

References:

  1. https://www.vox.com/2016/3/10/11179842/dietary-supplements-medical-evidence
  2. https://www.crnusa.org/CRNPR14-CRNCCSurvey103014.html
  3. https://annals.org/article.aspx?articleid=1789253
  4. https://www.iflscience.com/health-and-medicine/23000-people-us-end-er-annually-because-supplements

For the best Rx price on Crestor (rosuvastatin), Zocor (simvastatin), Lipitor (atorvastatin) and other statins,
visit www.WellRx.com.

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ScriptSave WellRx - avoid holiday stress with prescription medication savings

The holidays are a time of good cheer and family gatherings, but they can offer plenty of reasons to be stressed out — the gifts still need wrapping, the office party invites, and maybe the biggest — the family.

With potential anxiety looming on your calendar, what are some ways that you can prepare yourself and cope better this season?

Controlling Holiday Stress

  • Donate to a charity in someone’s name.
  • Give homemade gifts.
  • Start a family gift exchange.
  • Plan ahead. Set specific days for shopping, baking, and other activities. Plan your menus, make your shopping list, and then hit the store. That’ll help prevent last-minute scrambling to buy forgotten ingredients.
  • Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed.
  • Don’t abandon healthy habits. If you let the holidays become a free-for-all, overindulgence only adds to your stress and guilt.
  • Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend, then stick to your budget.

Other de-stressing ideas include:

  • Have a healthy snack before holiday parties so that you don’t go overboard on sweets, cheese or drinks.
  • Get plenty of sleep.
  • Make time for regular physical activity each day.
  • Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.

And finally, seek professional help if you need it. If, despite your efforts, you find yourself feeling persistently sad or anxious, talk to your doctor or a mental health professional. They may medication for your anxiety or depression.

The medication your doctor prescribes for your anxiety — if any — will depend on your symptoms and type of anxiety disorder.

There are two overall types of medications used to treat anxiety disorders:

  • Anti-anxiety medications.
  • Antidepressants

Don’t let the holidays become something you dread. Taking steps to prevent the stress and depression can prevent problems ahead of the holidays. Recognize your holiday triggers, like financial pressures or family demands. That way you can sidestep them before they lead to a breakdown. May you only find peace and joy during the holidays!

 

References: National Institute of Health – https://newsinhealth.nih.gov/issue/nov2016/feature1


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