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by Jamie L. Voigtmann, PharmD Candidate 2019
Saint Louis College of Pharmacy

In 2014, approximately 4 million people in the United States were infected with hepatitis C virus (HCV).1 According to the Centers for Disease Control and Prevention (CDC), acute HCV infections reported in the United States increased approximately 3.5 times from 2010-2016 (from 850 to 2,967 cases).2 The speculated reasons for this massive increase have been due to increased intravenous drug use (IVDU) as well as more specific & sensitive testing.

There are six genotypes of HCV that have been identified; but of these six, only three make up 97% of HCV infections in the United States.1 These three genotypes include Type 1 (both subtypes a & b), Type 2, and Type 3. HCV was initially discovered in 1989 and since then, a search for a cure has become imminent as HCV plays a major role in the development of chronic liver disease, cirrhosis, hepatocellular carcinoma, and commonly ends in the need for liver transplantation.3

Hepatitis Medications Today

Multiple medications have been proven to treat and/or cure of HCV. A cure is defined as a sustained virologic response (SVR) resulting in an undetectable HCV RNA, 12-24 weeks after treatment is completed.1 In the past, a medication called interferons were used to boost the immune system and attack HCV to defend the body; but in the 2017 AASLD/IDSA Guidelines, interferons are no longer recommended in the treatment of HCV.4 Ribavirin has also been used for acute HCV in the past, but now is only indicated for chronic cases of HCV.7 With both interferon and ribavirin, virological response did not often exceed 50%. Since 2014, four once daily HCV medications have been FDA approved for the treatment of acute HCV in naïve patients that exceed a virological response of 90% after 12 weeks of therapy.4

These more novel hepatitis medications consist of multiple drugs with differing modes of action. There are three classes of drugs that are used to treat HCV and they are called direct acting antivirals (DAA) because they directly attack the HCV genome and replication process.4 These three DAA classes include: NS3/4A Protease Inhibitors, NS5A Inhibitors, and NS5B Polymerase Inhibitors (Nucleoside & Non-Nucleoside).4 All of these medications inhibit replication of HCV in the host cell, stopping the life cycle and preventing its transmission to other host cells. Below is a picture that further explains the mechanism of action of each DAA along with each HCV drug and its corresponding DAA class.5

hepatitis c vaccinations - scriptsave wellrx blog imageDirect Acting Antiviral Classes5

  • NS3/4A Protease Inhibitors
    • Boceprevir
    • Telaprevir
    • Simeprevir
    • Asunaprevir
    • Paritaprevir
    • Grazoprevir
    • Glecaprevir
  • NS5A Inhibitors
    • Daclatasvir
    • Ledipasvir
    • Ombitasvir
    • Elbasvir
    • Velpatasvir
    • Pibrentasvir
  • NS5B Polymerase Inhibitors
    • Sofosbuvir
    • Dasabuvir

Comparing Four Novel HCV Medications6

As mentioned previously, there are four HCV medications approved by the FDA that are one pill taken once daily and can result in cure. These medications include Harvoni (ledipasvir/sofosbuvir), Zepatier (elbasvir/grazoprevir), Epclusa (velpatasvir/sofosbuvir), and Mavyret (glecaprevir/pibrentasvir). Harvoni was approved by the FDA in 2014, Zepatier and Epclusa in 2016, and finally Mavyret in 2017. This is relevant because the two more recent drugs, Epclusa and Mavyret, treat all 6 genotypes of HCV while Harvoni and Zepatier are both first line therapy for genotypes 1 and 4.7

Unlike their differing genotype coverage, side effects for all four of these medications are quite similar. The most common side effects include headache, fatigue, and nausea and the instances for these side effects are approximately 16%, 13%, and 9%, respectively. Other more severe side effects (anemia, diarrhea, insomnia, and irritability) have been reported with these medications but only in combination with interferon or ribavirin as well as with prolonged therapy between 16-24 weeks.5

Cost of Therapy

According to current HCV Guidelines, Harvoni, Zepatier, and Epclusa require 12 weeks (84 days) of therapy.7 Mavyret can be either 8 weeks (56 days) or 12 weeks of therapy depending on the patient’s baseline liver disease.7 Unfortunately, considering both the high cost of medication as well as the long duration of therapy does not allow all patient’s to receive treatment. Harvoni and Epclusa have generics available for patients, and the Brand Name options of Zepatier and Mavyret are thankfully in the same price range as the other generic options. The cost of one tablet for these medications is as follows:6

  • Harvoni:
    • Brand Name: $1,350
    • Generic: $500
  • Epclusa:
    • Brand Name: $1,050
    • Generic: $350
  • Zepatier:
    • Brand Name: $300
  • Mavyret:
    • Brand Name: $200

Because these medications are very costly, a 12-week drug treatment regimen of therapy ranges from $16,800 to $113,400. This is a problem. Many patient’s simply do not have this amount of money to spend on one prescription. This further leads to controversial discussions because as mentioned earlier, HCV plays a major role in the development of chronic liver disease, cirrhosis, hepatocellular carcinoma, and commonly ends in the need for liver transplantation.3

Fortunately, there are patient assistance programs and copay cards offered by the manufacturers of these medications which allow a minimum cost of $0 with patient assistance programs and a minimum cost of $5 for copay cards per 4-week supply. Harvoni and Epclusa are manufactured by Gilead Sciences, Zepatier is manufactured by Merck, and Mavyret is manufactured by AbbVie.

Patient assistance programs require paperwork completed by the patient as well as the prescribing physician. Copay cards only work for Brand Name medications and most commonly require private insurance as a primary payor (not government funded insurances such as Tricare, Medicare, or Medicaid). For more information, check out these websites:

If you need help affording other prescription medications, visit www.WellRx.com. Many prices are lower than insurance copay costs!

References

  1. Kohli A, Shaffer A, Sherman A, Kottilil S. Treatment of hepatitis C: a systematic review. JAMA. 2014;312(6):631-640.
  2. Centers for Disease Control and Prevention. Surveillance for viral hepatitis – united states, 2016. https://www.cdc.gov/hepatitis/statistics/2016surveillance/commentary.htm. Accessed on February 13, 2019.
  3. Chen SL, Morgan TR. The natural history of hepatitis c virus (hcv) infection. Int J Med Sci. 2006;3(2):47-52.
  4. Geddawy A, Ibrahim YF, Elbahie NM, Ibrahim MA. Direct acting anti-hepatitis c virus drugs: clinical pharmacology and future direction. J Transl Int Med. 2017;5(1): 8–17.
  5. Dugum M, O’Shea R. Hepatitis c virus: here comes all-oral treatment. Clev Clin J Med. 2014;81(3):159-172.
  6. HCV Treatments: Harvoni, Zepatier, Epclusa, & Mavyret. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Available at: http://online.lexi.com. February 13, 2019.
  7. Recommendations for testing, managing, and treating hepatitis c. Joint panel from the American Association of the Study of Liver Disease and the Infectious Diseases Society of America. https://www.hcvguidelines.org. Accessed February 13, 2019.

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by Cindy Cho, PharmD Candidate Class of 2019,
The University of Arizona College of Pharmacy

When most people think of a diet that leads to poor diabetes control, they may think of a diet high in carbs and sugar. While those types of food do impact your blood sugars, consuming too many saturated fats can be an enemy against diabetes control,too. This is because a hallmark of pre-diabetes, type 2 diabetes, and worsening type 2 diabetes is insulin resistance.

Saturated Fat and Insulin Resistance

First, what is insulin? Insulin is a hormone produced by your pancreas to control your blood sugar levels. Insulin helps move the sugar from the blood into your cells for storage and energy. In other words, insulin is the key that unlocks the door of our muscle cells to let sugars in. Insulin resistance in the state of your body where insulin is not responding properly to move the sugar into the cells, which causes a rise in blood sugars as a result. The pathophysiology of insulin resistance is somewhat convoluted, but what is known is that saturated fat plays a role. It has been known since 1927 that increased consumption of fat delays the process of blood sugars going into the cells, which means that sugars hang around longer in the bloodstream.1 The results of both animal and human studies also show that a high intake of saturated fat is associated with insulin resistance and development of type 2 diabetes.2 This is because an uncontrolled state of insulin resistance leads to a higher risk of getting type 2 diabetes. People are also at higher risk of insulin resistance if they are overweight or obese.

Not All Fats are Bad

Contrary to the connotation of the word, not all fats are unhealthy. Two main sources of fat that we will focus on are saturated and unsaturated fats. Saturated fats are found commonly in animal products, such as red meats and dairy products. On the other hand, unsaturated fats come from mainly plant based sources and consists of foods like olive oil, nuts, and avocados. Studies have shown that in people with diabetes, saturated fats cause insulin resistance whereas unsaturated fats can improve insulin sensitivity.3 Because of this, the consumption of vegetables fats is favored in place of animal fats and processed grains.3 Not only are plant based foods lower in saturated fats, they are generally lower in calories and jam-packed with nutrients and fiber to nourish the body.

Ways to Improve Insulin Resistance

Lifestyle changes, particularly diet, address ones of the root causes of type 2 diabetes: insulin resistance. Following a plant-based diet can be a solution since animal products can contain a high amount of saturated fat. A plant-based diet generally includes legumes, whole grain, fruits, vegetables, and nuts, and discourages most animal products and refined foods.4 The Adventist 2 study, which included about 89,000 people extended across 50 years, demonstrated a substantial decrease in diabetes incidence in those who ate a vegetarian diet. The study also suggested that those who eat meat once or more days a week have significantly higher rates of diabetes.5 Plant-based diets also have been shown to work better in reducing blood sugars, body weight, and cardiovascular risk compared to diets that include animal-based products.6

Plant-based eating patterns, such as the DASH diet, healthy Mediterranean, and healthy vegetarian diets, have been shown to be associated with better health and lower risk for disease according to nutritional epidemiology, randomized controlled intervention trials, and most literature.7 These diets are also appropriate for the vast majority of people. Furthermore, exercise, with or without weight loss, helps improve insulin sensitivity so your body can use the insulin it naturally produces better.8 That in turn can mean lower doses of your diabetes medications, or even coming off the diabetes medications altogether, which can lower your costs on how much you spend on diabetes care. It is shown that after adjusting for population age and sex differences, the average medical expenses for people living with diabetes were about 2.3 times high than people who do not have diabetes.9

Dangers of Uncontrolled Blood Sugars

Controlling blood sugars is important because the longer a high amount of glucose is in the bloodstream, the more damage it can cause to your blood vessels, nerves, and tissues. Therefore, it is very important to have your doctors check your feet, eyes, and kidneys at least yearly if you have diabetes. People with uncontrolled blood sugars are also at higher risk for cardiovascular complications like heart attacks and strokes and are more prone to infections.10 Plant-based diets have demonstrated improvements in blood sugar control, which can possibly reduce or prevent the incidence of long-term complications of type 2 diabetes.

What You Can Do

Talk to your doctor or dietitian about eating more plant-based foods. It may also be easier to think of changes to what you eat as a lifestyle choice instead of as a diet. Small changes to the foods you consume can make a big impact on your health in the long run. Eating healthier doesn’t mean it has to be more expensive either. Shopping for produce in season, or even visiting your local 99 cent store that carries groceries can be helpful methods to save you money and keep you healthy too. You don’t have to be vegan to experience the benefits of a plant-based diet either. Any steps you take to adding more plant-based foods onto your plate can improve your blood sugars.5

Key Takeaways

To summarize, striving to increase the amount of plant-based foods you eat, minimize consumption of animal-based foods, increase your physical activity, along with taking your diabetes medications regularly, can make a positive impact on your blood sugars and overall health!

References:

  1. Dietary Factors That Influence The Dextrose Tolerance Test, J. Shirley Sweeney MD, Archives of Internal Medicine, December 1927
  2. ARIC Study Investigators; Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study, The American Journal of Clinical Nutrition, Volume 78, Issue 1, 1 July 2003, Pages 91–98, https://doi.org/10.1093/ajcn/78.1.91
  3. Rachek, L. (2014). Progress in Molecular Biology and Translational Science (pp. 267-292). Elsevier.
  4. McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017;14(5):342-354.
  5. Tonstad, S., Stewart, K., Oda, K., Batech, M., Herring, R., & Fraser, G. (2013). Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutrition, Metabolism and Cardiovascular Diseases,23(4), 292-299. doi:10.1016/j.numecd.2011.07.004
  6. Trapp, Caroline B., and Neal D. Barnard. “Usefulness of Vegetarian and Vegan Diets for Treating Type 2 Diabetes.” Current Diabetes Reports, vol. 10, no. 2, 2010, pp. 152–158., doi:10.1007/s11892-010-0093-7.
  7. Laddu, D., & Hauser, M. (2019). Addressing the Nutritional Phenotype Through Personalized Nutrition for Chronic Disease Prevention and Management. Progress In Cardiovascular Diseases, 62(1), 9-14. doi: 10.1016/j.pcad.2018.12.004
  8. Duncan GE, Perri MG, Theriaque DW, Hutson AD, Eckel RH, Stacpoole PW: Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care 26:557–562, 2003
  9. Economic Costs of Diabetes in the U.S. in 2017. (2018). Diabetes Care, 41(5), 917-928. doi: 10.2337/dci18-0007
  10. American Diabetes Association. 2019 Standards of Medical Care in Diabetes. http://care.diabetesjournals.org/content/42/Supplement_1. Published December 17, 2018. Accessed December 17, 2018.

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by Katie Tam, PharmD Candidate
Class of 2019, University of Arizona

Do you wake up in the middle of the night feeling as if your lower legs are paralyzed and cramped? Do your lower leg muscles feel as if they are hard to the touch and tight? If you experience these symptoms, you may have nocturnal leg cramps.

What are Nocturnal Leg Cramps?

Nocturnal leg cramps (leg cramps at night), also called Charley horses, are involuntary contractions or spasms of the muscles in the legs that usually occur during the night. These leg cramps often involve the posterior calf muscles, but can also involve the feet or thigh muscles. Because the muscles are tightened and knotted, nocturnal leg cramps are extremely painful sensation. Symptoms of straining, tightening, cramping, and knotting may last up to 10 minutes per episode.1 Since leg cramps can last for a while, the patient may experience muscle tenderness and soreness for up to a day after symptoms are gone. Nocturnal leg cramps are more common in women and in adults over the age of 50.1 Laboratory evaluation and specialized testing are usually not necessary to confirm diagnosis.

Are Nocturnal Leg Cramps the Same as Restless Leg Syndrome? 

In a word, no. Nocturnal leg cramps are not the same as RLS (Restless Leg Syndrome).

Nocturnal Leg Cramps Restless Leg Syndrome
Usually occurs at night or at rest Usually occurs at night or at rest
Cause pain and cramping Cause discomfort and crawling sensation
Stretching the muscle relieves pain Moving the legs relieves discomfort

Causes of Nocturnal Leg Cramps

The exact cause of nocturnal leg cramps is often unknown. However, there are several factors that may increase your risk of leg cramps:

  • Sedentary lifestyle
  • Over-exertion of the muscles from exercise
  • Standing for long periods of time
  • Improper sitting position, like crossing your legs1

The following medical conditions are also known to cause nocturnal leg cramps:

  • Pregnancy
  • Endocrine disorders (diabetes, hypothyroidism)
  • Structural issues (flat feet, spinal stenosis)
  • Neurodegenerative disorders (Parkinson’s disease)
  • Neuromuscular disorders (myopathy, peripheral neuropathy)
  • Medications (diuretics, intravenous iron sucrose, raloxifene, statins, naproxen, conjugated estrogens, beta agonists)
  • Dehydration/electrolyte imbalances2

Management and Treatment of Leg Cramps

  1. Stretch: The best method to relive pain and cramps is to stretch the affected muscle and hold the stretch for one minute.
  2. Exercise: Walking around sends a signal to the muscle that it needs to relax after contracting, which will help ease the leg muscle.
  3. Massage: Kneading, rubbing, and massaging the affected muscle can also relieve the cramps.
  4. Apply heat: Other methods that have shown some benefit include taking warm baths and showers, and applying a hot towel or pad to the affected area to relax the tight muscles.2
  5. Over the counter medications: No current medications have shown safe and effective results in patients with nocturnal leg cramps. However, calcium channel blockers (diltiazem), vitamin B12 complex, carisoprodol (Soma) have some good evidence and may be considered in some patients.3 Magnesium have some benefit in pregnant patients and mixed results in non-pregnant patients with leg cramps. No evidence supports the use of nonsteroidal anti-inflammatory drugs (naproxen), potassium, or calcium.3

Prevention and Self-Care Strategies:

  1. Hydration: Drink lots of water and fluids every day to keep your body hydrated and help your muscles contract and relax more. Men should drink 15.5 cups (3.7 liters) of fluids and women should drink 11.5 cups (2.7 liters) of fluids a day.
  2. Stretch before bed: If you experience nocturnal leg cramps, stretch your calf muscles for a few minutes before bed.
  3. Doing light exercise: Walking around your neighborhood or house before bedtime may help prevent leg cramps at night.
  4. Wearing comfortable shoes: Wearing shoes that support your feet can help prevent leg spasms.
  5. Untucking the covers: Loosening the bed covers at the foot of the bed will give your legs more space to move and prevent cramps.1

The next time you experience nocturnal leg cramps, identify the cause. Then, try one of the treatment methods to relieve your leg cramps. After resolving your leg cramps, use the self-care strategies to help prevent future leg cramps. However, if your leg cramps persist for long periods of time and occur every day, talk to your physician to determine whether or not you have leg cramps or other alternative medications that are appropriate.

Resources:

  1. Leg Cramps at Night. https://my.clevelandclinic.org/health/diseases/14170-leg-cramps-at-night. Accessed January 10, 2019.
  2. American Academy of Family Physicians. Nocturnal Leg Cramps. Accessed January 10, 2019.
  3. Abdulla AJ, Jones PW, Pearce VR. Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract. 1999;53(7):494–496.

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shingrix on backorder - scriptsave wellrx blog image

by Katy Winkel, PharmD Candidate Class of 2019
University of Kansas School of Pharmacy

Shingrix was approved in October 2017, nearly 10 years after Shingles Zostavax came to market. Shingrix is an inactivated, 2-dose series that anyone 50 years or older is eligible to receive. With the 2-dose series you will receive the first vaccine, then 2 to 6 months later you’ll receive the second vaccine. The Shingrix series is proven to be up to 90% effective unlike Shingles Zostavax, which is only 51% effective.

Shingrix is given intramuscularly, which means it will be given in your upper arm muscle much like where the flu vaccine is given. The most common side effects from Shingrix are pain, redness, and swelling at the injection site. Also, flu-like symptoms following the vaccine are common such as muscle pain, tiredness, fever, and upset stomach.1

The pharmacy tells me it’s on “backorder.” What does that mean?

The term “backorder” in terms of pharmacy simply means that the pharmacy went to place an order on a specific item and the wholesaler, or company that sells the item, cannot fulfill the order due to shortages. The manufacturer producing Shingrix is now experiencing shipping delays for their vaccine due to the high levels of demand putting it on “backorder.”3 Unfortunately, the Centers for Disease Control and Prevention (CDC), is unsure of the exact date when Shingrix will be available again, and they predict that the manufacturer will continue to only release small amounts through 2019.2

What if I’ve already received the first dose of Shingrix and I’m past the 6-month mark for the second vaccine?

Per the CDC, once the Shingrix vaccine becomes available again you will get the second dose and do not need to restart the series. If you have not received any of the Shingrix series, but are wanting immediate vaccination, the old vaccine, Shingles Zostavax, is still available for use per the CDC. You should wait a minimum of 8 weeks after getting Shingles Zostavax before you receive Shingrix.3

While you wait….

Many pharmacies have started a waiting list for the Shingrix vaccine and prioritize customers who have already had the first dose. Also, any time you are in your local pharmacy be sure and ask if there are any updates on the availability of Shingrix. Pharmacists are here to help!

 

References:

  1. “Healthcare Providers / Professionals.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 19 Nov. 2018, www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html.
  2. “Shingles Vaccine.” SHINGRIX, Apr. 2018, www.shingrix.com/index.html.
  3. “Vaccines and Preventable Diseases.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 20 Nov. 2018, www.cdc.gov/vaccines/vpd/shingles/hcp/shingrix/faqs.html.

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Tucson, AZ. January 23, 2019 – It’s a fact – prescription medications don’t work if patients don’t take them, or fail to take them correctly. Taking medications as prescribed by your physician can help improve the quality and length of your life. The latest release of the ScriptSave® WellRx app can help.

Importance of Taking Your Medications

According to the Centers for Disease Control and Prevention (CDC), nearly 50% of Americans have used at least one prescription within the last 30 days. If you fall into this half of the country, you’ve probably already had the discussion with your doctor & pharmacist about the importance of following instructions, with insights on why it matters. One recent study, for example, shows that patients who were compliant with taking their statin medications for at least two years had a 30% reduction in the risk of hospitalization for heart attacks.1

Even with all the benefits medications can have on a patient’s health, there is still an issue with adherence to medication therapy.

scriptsave wellrx medication reminders - app imageThe ScriptSave WellRx App

 

Not only does the new ScriptSave WellRx app release provide prescription price transparency, it also allows patients to set alerts for when they’re due to take their next pill, as well as when it’s time to order their next refill from the pharmacy. Meanwhile, built in functionality helps patients track side-effects that they might want to share with their doctor (using the ScriptSave WellRx Mood Log, which can be launched from the virtual Medicine Chest).

In addition, the newest enhancement for users of the WellRx platform also provides free access to some potentially life-saving functionality:

  • Drug Interaction Warnings: Patients can receive and share warnings when drugs in their personal in-app Medicine Chest might interact with each other.
  • Lifestyle Interaction Warnings: This includes warnings about potential drug interactions with certain foods patients eat, or activities they might engage in.
  • Expanded Drug Information: Patients can view detailed information, images, and videos for drugs within the Medicine Chest. Much of this information is available in English and Spanish.

The new release also caters to users who wish take advantage of the added security afforded by biometric login. Users can set up fingerprint password management for the app, making signing in quick, easy and secure.

About ScriptSave WellRx

ScriptSave WellRx, owned by parent company Medical Security Card Company, LLC (MSC) and a member of the MedImpact, Inc. family of companies, offers savings on prescription medicines at more than 62,000 local and chain pharmacies, nationwide. ScriptSave WellRx is an online resource that makes prescription medicines more affordable and easier to manage for people who are uninsured, underinsured, or insured with high deductible plans.

References:

  1. Lansberg, P., Lee, A., Lee, Z., Subramaniam, K. and Setia, S. (2018). Nonadherence to statins: individualized intervention strategies outside the pill box. Vascular Health and Risk Management, Volume 14, pp.91-102.

 

 

————–Addendum (13 Mar, 2019)————–

Check out what Dr Max Gomez had to say on CBS News, including an interview with ScriptSave’s Dr Dan Johnson.

 

 


 

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by Jenny Bingham, PharmD, BCACP; Heather Lee, PharmD Candidate; Mitchell Welton, PharmD Candidate

In such a competitive cholesterol medication market, manufacturers have been forced to make drastic cuts to their medication costs. Amgen lowered its product by 60%, followed by a 45-70% reduction from Regeneron. The price reductions occurred in response to the national consumer’s options to trial a multitude of more affordable options for cholesterol management, based on their clinical goals.

To better understand each product, a comparison should be made between each medication’s indication, effectiveness, and price.

Praluent

Praluent is an adjunct for patients who have uncontrolled cholesterol levels despite the presence of high intensity statin therapy.1 It is indicated for patients with atherosclerosic cardiovascular disease (ASCVD) who would benefit from an additional reduction of low-density lipoprotein (LDL) cholesterol. Praluent has been reported to reduce cholesterol levels by >=40% of patients who taking a maximally tolerated dose of statin.2 It was also reported to be effective at reducing cardiovascular outcomes and all-cause death by 15% in patients who have acute coronary syndrome.3 The primary patient population that would obtain the most benefit from Praluent are patients who have high LDL cholesterol levels.3 A recent price reduction by Regeneron and Sanofi occurred in May 2018. The price decreased from $14,600/year to a range of $4,500 to $8,000/year via rebate.4

Repatha

Repatha is indicated for the treatment of hyperlipidemia and has been reported to reduce the risk of heart attack and stroke.6 Evidence demonstrates the potential for plaque reduction if used with statin therapy. Amgen recently followed suit with lowering the price of Repatha after competitors Regeneron and Sanofi lowered the price of their competing product as mentioned above. Prior to the lowered cost in October the annual price of Repatha was $14,100/year. Amgen initially offered a prescription savings card for eligible patients, however patients with federal, state, or government-funded healthcare insurance were excluded. The new cost is $5,850/year, a nearly 60% decrease in cost. Amgen recently announced new opportunities for Medicare patients to benefit from therapy as the result of the price cut. 7

What to Ask Your Provider and/or Pharmacist

With the new, more affordable prices, you might be curious if these medications are best for your cholesterol management and cardiovascular health. It’s important to maintain routine appointments with your provider to ensure your cholesterol levels are monitored appropriately. Based upon your lab results and medication history, your provider and/or pharmacist may deem it appropriate to trial one of the above noted medications. However, it’s also important to adhere to provider recommendations about lifestyle changes, like diet and exercise.

References:

  1. Accessdata.fda.gov: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/125559Orig1s000lbledt.pdf. Published 2018. (accessed 29 Nov 2018)
  2. Alirocumab (Praluent) to Lower LDL-Cholesterol. JAMA. 2015;314(12):1284. doi:10.1001/jama.2015.11372
  3. American College of Cardiology: https://www.acc.org/latest-in-cardiology/articles/2018/03/05/15/53/sat-9am-odyssey-outcomes-cv-outcomes-with-alirocumab-after-acs-acc-2018 (accessed 29 Nov 2018)
  4. CNBC. https://www.cnbc.com/2018/05/01/regeneron-sanofi-chop-cholesterol-drug-price-in-express-scripts-pact.html. Published 2018. (accessed 29 Nov 2018)
  5. Repatha (Evolocumab Injection, for Subcutaneous Injection): Side Effects, Interactions, Warning, Dosage & Uses. (n.d.): https://www.rxlist.com/repatha-drug.htm#indications.
  6. CBS News: https://www.cbsnews.com/news/drug-repatha-with-a-statin-could-help-reverse-heart-disease/ (accessed 4 Dec 2018)
  7. CNBC: https://www.cnbc.com/2018/10/24/amgen-cuts-price-of-cholesterol-drug-by-almost-60percent.html (accessed 4 Dec 2018).

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by Mitchell Welton, PharmD Candidate 2019
University of Arizona

The use of marijuana draws a wide range of strong opinions out of people. Its advocates will tout all of its potential benefits of medical marijuana, while its opponents try to draw from the negative stigma that surrounds it. As in all hotly contested topics, the truth usually falls somewhere in between the opposing viewpoints. While the use of marijuana still remains illegal at the federal level, there are many states that have approved its medical use for qualifying individuals to treat certain conditions, and even fewer states have approved its recreational use.

California was the first state to legalize marijuana for medical use in 1996 and since then many states have followed suit. About a dozen states have legalized marijuana for medical use. The difference between medical and recreational use warrants its own discussion and the disagreement can be seen at a legislative level with more leniency being extended to medical over recreational. This author would generalize medical marijuana in this article as containing a higher concentration of CBD over THC, for all intents and purposes, in order to discuss medical marijuana compared to FDA approved cannabinoids.

Medical Marijuana (MMJ) Uses

The two chemicals of interest found in marijuana are tetrahydrocannabinol (THC) and cannabidiol (CBD) although the plant itself may contain up to 400 different chemicals. A recreational smoker would be looking for a higher concentration of THC which is the psychoactive component delivering the “high” that users seek. 1 CBD is the cannabinoid that doesn’t produce the “high” and has recently been approved by the FDA as an oral solution, called Epidiolex, to treat seizures. There are currently only three FDA approved, cannabinoid medications on the market. 2

The first of these medications was approved in 1985 by the FDA known as Marinol or dronabinol. A synthetic form of THC first approved for the treatment of chemotherapy induced nausea and vomiting. Its indication was expanded to include the treatment of weight loss and anorexia in people with AIDS. Other studies have found efficacy in achieving pain relief in patients with multiple sclerosis (MS) and treating other neuropathic pain. 3 Cesamet, or nabilone, is another synthetic cannabinoid that mimics THC also approved in 1985 for the treatment of chemotherapy induced nausea and vomiting with off label use to treat fibromyalgia shown in a 2011 systematic review of cannabinoids for chronic pain. 4 The third, Epidiolex, has already been mentioned which is the first FDA approved drug derived from marijuana. The previous two drugs where synthetic. Epidiolex is used in the treatment of two rare, but severe forms of epilepsy. 2

MMJ Safety Factors

There are multiple factors to consider when thinking of safety between the two types of marijuana. First that comes to mind is the administration. Let’s take dronabinol for example as it has been around the longest from an FDA approval standpoint and such has been examined in multiple studies. This is a liquid filled capsule taken by mouth. Like many oral medications it may take some time for it to be absorbed which means a delay in its effect. This is something to keep in mind as a quick onset of action would be preferred when treating nausea and vomiting. Once the capsule is taken by mouth and absorbed the next consideration is its excretion from the body.

Dronabinol has an elimination half life of 19 to 36 hours meaning there will be a therapeutic level of the medication in the blood for a significant period of time. Other considerations I would bring to attention of the reader is the environment in which the medication is produced. Part of the FDA requirement is the manufacturing standard the medication is subjected to. Conditions must be controlled in its production which would allow us to assume there would be little tainting or contamination. Lastly, this synthetic medication is a pure isomer of THC meaning the end user is not consuming the potential 400 other chemicals found in the marijuana plant which could account for less of a “high” from any other psychoactive cannabinoids. 5

Marijuana in contrast when smoked has a much more rapid onset of action however may be inappropriate for use in patients with asthma or COPD. Ingesting marijuana will have a slower onset and more unpredictable absorption. Once in the system the body would eliminate marijuana faster than dronabinol. Though its production is not regulated like the FDA approved medications, each state has its own laws limiting the cultivating of your own marijuana and licensing of larger cannabis farms. 5

No matter where you might stand on the issue, there is a place in healthcare for the use of marijuana. The question lies in the best way to regulate and manage it. It is important to always evaluate safety and efficacy with any treatment used. Patients should always be treated with evidence-based methods and in accordance to state and federal laws. For better or for worse marijuana, and its use, continues to garner support and opposition in larger numbers. This is a landscape that will continue to change as we look for developments in the application of its use.

 

References:

  1. What Is the Difference Between Medical and Recreational Marijuana? (2018, September 10). Retrieved from https://docmj.com/2017/06/05/difference-medical-recreational-marijuana/
  2. Office of the Commissioner. (n.d.). Press Announcements – FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. Retrieved from https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm611046.htm
  3. Dronabinol: Marinol. (n.d.). Retrieved November 19, 2018, from Micromedex.
  4. Nabilone: Cesamet. (n.d.). Retrieved November 19, 2018, from Micromedex.
  5. Morrow, A. (n.d.). Marinol or Marijuana: Which Is Better? Retrieved from https://www.verywellhealth.com/is-marinol-better-than-smoked-marijuana-1132483

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by Heather Lee, University of Arizona PharmD Candidate

With flu season upon us, make sure you pencil in a date to get your flu shot. You may wonder why this is so important, and why your healthcare providers are always asking whether you received it. Influenza (the flu) is a huge threat to public health. It has been shown that around 5 to 20 percent of the United States population get the flu during flu season.1 Hospitalization rates and death rates are quite high, with more than 200,000 people being hospitalized and around 36,000 deaths every year. Getting the flu vaccine not only lowers your risk of getting sick, but it also protects the people around you, too.2 With the risk of it turning into a serious and fatal threat, you should vaccinate against it to protect yourself and the ones you love.

What is the flu?

The flu is a disease that is caused by a virus. It is contagious, meaning it can be spread from person-to-person. It is spread when someone who has the flu sneezes, coughs, or talks and spread droplets. The droplets land on the noses or mouths of nearby people, or on surfaces that were near the sick person. If other people touch the surface and then touch their mouth, nose, or eyes, they can also get infected with the flu.2

Some common flu symptoms include:

  • Fever and chills
  • Cough
  • Sore throat
  • Runny/stuffy nose
  • Muscle/body aches
  • Headache
  • Feeling tired2

More serious complications of flu include:

  • Pneumonia
  • Inflammation of the brain or heart
  • Worsening of a health condition, such as asthma or heart failure
  • Sepsis (a life-threatening infection)2

Who Needs It?

It is recommended that everyone who is able to get the vaccine who is 6 months of age or older should receive the vaccine every season.3 There are some people who are at high risk of developing flu complications, so it is important to receive the vaccine if you fall into the following categories:

  • Children younger than 5 years, but especially children younger than 2 years
  • Adults 65 years and older
  • Pregnant women
  • Women up to 2 weeks postpartum
  • Residents of nursing homes and other long-term care facilities
  • American Indians and Alaska Natives
  • If you have certain medical conditions (asthma, heart disease, chronic lung disease, etc).4

Children who are between 6 months to 8 years require 2 doses of the vaccine if they are getting vaccinated for the first time or if they have only gotten one dose.5 Receiving two doses will provide children with a better immune response and more protection.5 The two doses should be separated by at least 28 days. For adults, only one dose per season is necessary. Research has shown no benefit in boosting immunity in adults who have received two doses in the same flu season, even in elderly people who have weakened immune systems.6

*There are some groups who should not get the vaccines. These include children younger than 6 months, if you have had a life-threatening allergic reaction to the flu vaccine or an ingredient it contains (eggs or gelatin), or if you have Guillain-Barrré Syndrome (an immune system disorder).2

Side Effects of Flu Shot

The most common side effects usually affect the area of injection, such as redness, pain, or swelling of where you received the shot.2 Other side effects are headaches, muscle aches, fever, or an upset stomach. These side effects usually go away in a few days. It is rare to get a serious side effect from the flu vaccine, but the person administering the vaccine can observe you for any serious side effects. The flu shot will not cause you to get the flu; it serves to boost your immune response to prevent the flu.

Sign Me Up

The benefits of getting the flu vaccines drastically outweigh the risks of the vaccine. Even though you may risk getting a sore arm or a headache, you still walk out with a lower chance of getting infected with the flu. Preventing the flu helps to keep you from developing the more serious complications, such as being in the hospital with pneumonia or even death. The best time to get vaccinated is usually the end of October, but you can still get vaccinated throughout the flu season.6

Receiving the flu shot in January or later is still better than nothing, since flu season can last as late as May. Your local pharmacy should have the flu vaccine available during flu season, and there is usually no appointment necessary. The next time you step into your local pharmacy, stop by and ask your pharmacist when you can get the flu vaccine so you can protect you and your loved ones.

Resources:

  1. NIH Fact Sheets – Influenza. National Institutes of Health. https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=133. Accessed November 28, 2018.
  2. S. Department of Health and Human Services. Flu (Influenza). Vaccines.gov. https://www.vaccines.gov/diseases/flu/index.html. Published October 11, 2006. Accessed November 28, 2018.
  3. Influenza (Flu). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/professionals/vaccination/vax-summary.htm. Published September 6, 2018. Accessed November 28, 2018.
  4. Influenza (Flu). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/disease/high_risk.htm. Published August 27, 2018. Accessed November 28, 2018.
  5. Influenza (Flu). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/protect/children.htm. Published November 8, 2018. Accessed November 28, 2018.
  6. Influenza (Flu). Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/qa/misconceptions.htm. Published September 25, 2018. Accessed November 28, 2018.

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When winter rolls around, the holidays and the festivities that accompany the season follow suit. Turkey, the new year, and family, all of these jolly terms invoke the feeling of celebration and happiness. If you find yourself getting moody when the snow starts falling every year, do not fret. You are not alone. If you feel depressed during certain seasons, this is called seasonal affective disorder (SAD). About 5% of adults in the US experience SAD, and this usually lasts for approximately 40% of the year.1 This usually starts in the late fall and early winter and goes away during the spring and summer.2 This typically corresponds to when there is less sunlight, and symptoms improve with the returning sunlight that spring provides.1 The most challenging months for people tends to be January and February. It can even happen in the summer months, but this is less common.

Risk Factors

There are some characteristics that may increase your risk of getting SAD. If you are a female, you are four times more likely to develop this than men.2 In addition, where you live can play a role. If you live farther (north or south) from the equator, you are more likely to develop it. For example, it was seen that 1% of those who live in Florida can develop it versus 9% of those who live in Alaska.3 If your family has a history of other types of depression, this can play a role.2 Along with this, if you have been diagnosed with depression or bipolar disorder, your depression may worsen with the seasons. It has also been observed that younger adults have a higher risk. The age of onset is typically between 18 to 30 years of age.3

Seasonal Affective Disorder Signs And Symptoms

In order to be diagnosed with SAD, you must fulfill the criteria for major depression that occurs during specific seasons for at least 2 years. This may be more frequent than non-seasonal depressions.2 The symptoms of SAD typically look like those of major depressive disorder.

The typical symptoms of depression include:

  • Feeling depressed most of the day, nearly every day
  • Feeling hopeless/worthless
  • Having low energy or feeling sluggish
  • Losing interest in previously enjoyable activities
  • Trouble with sleep
  • Changes in appetite or weight
  • Difficulty concentrating
  • Frequent thoughts of suicide or death2

It is surprising that even the symptoms associated with winter SAD and summer SAD can differ. The typical winter SAD symptoms include:

  • Having low energy
  • Excessive sleepiness throughout the day (hypersomnia)
  • Overeating with possible weight gain
  • Craving for carbohydrates
  • Withdrawing from social activities (feels like “hibernating”)2

The typical summer SAD symptoms include:

  • Poor appetite with associated weight loss
  • Difficulty sleeping or staying asleep (insomnia)
  • Agitation, restlessness, or anxiety
  • Violent behavior2

Treatment and Therapies

There are a couple treatment options to help resolve the symptoms quicker and make you feel better, rather than just waiting it out. SAD is mainly treated through light therapy.4 Light therapy involves you sitting in front of a light box for 20-60 minutes daily in the mornings.2 The idea behind this is so you can replace your reduced intake of sunlight during the fall and winter months. However, this may not be enough and you may be treated through a different method, such as antidepressant medications, talk therapy, vitamin D supplementation, or a combination of the therapies. Medications include the selective serotonin reuptake inhibitors (SSRI) and bupropion, which are types of antidepressants. Common SSRI’s include sertraline (Zoloft), fluoxetine (Prozac), and citalopram (Celexa). You may have to follow up with your doctor whether this is an appropriate treatment for you, and you may have to switch antidepressants around to determine which is the right one that works for you. It may take several weeks for the medications to work, so your doctor may recommend to start taking it before your symptoms usually start every year.5

Another treatment option is talk therapy, which is also known as psychotherapy. A type of talk therapy that is used for SAD is cognitive behavioral therapy (CBT). CBT involves you talking with a mental health counselor to identify negative thoughts and replacing them with positive thoughts. They will help you identify activities that are enjoyable to help you cope with the winter and to help you manage stress. Vitamin D supplementation itself is not regarded as an effective treatment, but there have been some studies that suggest it may be as effective as light therapy.2 On the other hand, there are some studies that oppose that thought. The reason why you might be supplemented with this is that low levels of vitamin D were found in people with SAD.

Following up with your Doctor

If you find yourself nodding to these symptoms and thinking they sound like what you are experiencing, don’t worry. Schedule an appointment with your doctor to discuss your signs and symptoms. If you are taking any medications at home, such as prescription, over-the-counter, and herbals, be sure to update them with this information, because this may change what treatment you receive. From there, your doctor can discuss with you what treatment options may be appropriate. It may take a couple tries to figure out what treatment works best, but this is common. With treatment, you will soon be able to tackle the winter with renewed vigor.

 

References:

  1. Warning Signs of Mental Illness. https://www.psychiatry.org/patients-families/depression/seasonal-affective-disorder. Accessed November 9, 2018.
  2. Seasonal Affective Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml. Accessed November 9, 2018.
  3. Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depress Res Treat. 2015;2015:1-6. doi:10.1155/2015/178564
  4. Seasonal Affective Disorder. MedlinePlus. https://medlineplus.gov/seasonalaffectivedisorder.html. Published March 6, 2018. Accessed November 9, 2018.
  5. Seasonal affective disorder (SAD). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/diagnosis-treatment/drc-20364722. Published October 25, 2017. Accessed November 9, 2018.

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As a nation, we spend over $5 trillion a year to feed our bodies.[1] That’s the value of food sold each year in the United States through retail and food service including nearly 38,000 supermarkets, an estimated 150,000 convenience stores, and over one million restaurants. The U.S. food industry is immense, touching every person in the nation every day.

We then spend trillions more each year taking care of ourselves. The U.S. healthcare industry is massive, projected to be over $5 trillion a year by 2025 and representing an estimated 20% of the country’s GDP.[2]

So we have two titanic industries that touch each consumer… and yet food and healthcare are largely disconnected. Plus, with 40,000+ unique products in a typical grocery store, the choices are overwhelming to the average consumer trying to shop for foods to appease any number of nutrition-sensitive health conditions.

Personalized Wellness

At ScriptSave, our vision of personalized wellness aligns managed care organizations, healthcare providers, employers, food manufacturers and retailers to improve and maintain the wellness of each individual. The power of the personalized wellness vision lies in the economic benefits provided to each member of this ecosystem.

hippocrates quote - food - scriptsave wellrx blog image

The personalized wellness food-health supply chain begins with the individual consumer, an understanding of his or her health condition, and food products beneficial to that condition. As the source of food, retailers become, in a sense, an extension of personalized healthcare, and a trusted partner in wellness for each individual. What better loyalty for a retailer than helping customers live healthier lives?

Public Health Implications

The implications from a public health perspective are enormous. 70% of Americans are on at least one prescription drug and 60% of the U.S. population is dealing with at least one chronic health condition. Our aim is to evaluate food products based on their nutritional attributes and provide insight to possible grocery alternatives that are more favorably aligned with each shopper’s personal health and wellness goals.  Our vision is no less ambitious than to improve health outcomes for millions of individuals.

ScriptSave is mobilizing key participants to realize the Personalized Wellness vision. Purchase validation of beneficial products creates a powerful feedback loop:

  • Improves future recommendations
  • Powers performance-based incentives provided by managed care organizations
  • Helps providers drive improved outcomes
  • Provides brand manufacturers powerful insight to shopper needs

holistic food focus on health - scriptsave wellrx blog image

The Rise of Artificial Intelligence

It is only recently that artificial intelligence data and technologies are available to personalize, at a product level, food recommendations that are beneficial to each individual. Deconstructing nutrition information to countless data attributes enables powerful linkage between health conditions and the hundreds of thousands of food products available across the United States. What makes it all work is the ability to convey personalized food guidance to the individual via the smartphone in their hand while in the store aisle.

“Food is the area consumers really want to deal with the most,” states Jane Sarasohn-Kahn, health economist for Think Health. “Nobody really wants to take medicine. People would rather project-manage health through food as prescription.”[3] A recent meeting with a physician group highlighted the shortcomings of efforts to date as doctors explained patients forget nearly everything within 24 hours of leaving the office.

Perhaps what is most powerful about the personalized wellness vision is that everyone across the food-healthcare supply chain benefits from improved health outcomes and quality of life for the individual. Retailers gain stronger customer relationships as they come to be viewed as true partners in wellness, and consumer goods brand manufacturers have a path to redemption from the processed foods abyss.

About ScriptSave:

For more than two decades, ScriptSave has been closing the gaps in healthcare and prescription coverage with innovative savings programs for the uninsured, under-insured, and insured. Headquartered in Tucson, ScriptSave solutions, analytics, and unique expertise save consumers money and increase medication adherence, while attracting and retaining loyal, profitable customers, members, and patients for our clients. ScriptSave is a member of the MedImpact, Inc. family of companies. For more information on ScriptSave WellRx – Personalized Wellness, go to www.wellrxplus.com. Follow us: @SSWellRx (Twitter), ScriptSave WellRx (Facebook).

References:

[1] “U.S. Food Retail Industry – Statistics & Facts”, Statista, www.statista.com/topics/1660/food-retail/

[2] Mark Hagland, “Medicare Actuaries: U.S. Healthcare Spending to Soar to $5.631 Trillion and 20.1 Percent of GDP in 2025”, www.healthcare-informatics.com, (July 18, 2016)

[3] Drug Store News, Future Trends: Self care, wellness shift to drive innovation in new, emerging health segments, www.drugstorenews.com, (August 18, 2017)


This blog post has been excerpted from the ScriptSave WellRx Personalized Wellness Whitepaper. You can read the full whitepaper content at Winsight Media:

http://www.winsightgrocerybusiness.com/wellness/health-wellness-gets-personal

http://www.winsightgrocerybusiness.com/wellness/personalized-wellness-virtual-dietitian

http://www.winsightgrocerybusiness.com/wellness/healthcare-food-align-benefit-individual

 

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obesity in the U.S. - scriptsave wellrx blog image

by Randall Flores, PharmD Candidate 2019
University of Arizona

In the past few decades, there has been an alarming and steady increase in obesity rates in the U.S. This affects people of all races and ages. More Americans live with obesity than breast cancer, Alzheimer’s, Parkinson’s and HIV all together. The medical community has been aware of the rising epidemic for many years, yet its response has not been effective at addressing the problem.

What is a Healthy Weight (BMI)?

Obese or overweight is defined as weight that is higher than what is considered a healthy weight for a given height measured as Body Mass Index (BMI)1. The levels of weight measured by BMI are listed below:

  • BMI < 18.5 = underweight
  • BMI 18.5 to <25 = within normal weight
  • BMI 25 to <30 = overweight
  • BMI >30 = obese

The Facts About Obesity

With an estimated population of 328.73 million people in the U.S.,6 the prevalence of obesity was 39.8% between 2015-2016, affecting nearly 93.3 million people.1 The estimated health care cost of obesity was $147 billion in 2008 which was $1,429 higher than those of normal weight. Obesity seems to have a racial/genetic link as Hispanic and non-Hispanic blacks had the highest prevalence with 47% and 46.8% respectively.2 Much of the obesity seen in the U.S. starts at a younger age and transcends into adulthood with a prevalence of 18.5% (ages 2-19) nearly affecting 13.7 million children.2 Similar to adults, obesity in children is more common in certain populations; Hispanics having the highest prevalence (25.8%) followed by non-Hispanic blacks (22%).2

Obesity-Related Health Conditions

The most common obesity-related diseases that result in premature deaths include type 2 diabetes, heart disease, stroke, and certain types of cancers such as colorectal, pancreatic, and endometrial cancer.1,4 People who have obesity are also at increased risk for serious diseases including the following;3

High blood pressure Low quality of life
High levels of bad cholesterol &
low levels of good cholesterol
Sleep apnea & breathing problems
Gallbladder disease Mental illness, depression, anxiety, &
other mental disorders
Osteoarthritis Body pain & difficulty with physical functioning

A Push for Prevention

The epidemic of overweight and obese citizens in the nation is complex and has no simple solution. There are many factors that play a role in obesity. Due to its complexity, the epidemic of obesity needs to be approached through multiple outlets, with tactics in local, state, and federal organizations as well as professional health organizations.5 The long-term goal to decreasing obesity is shifting to norms of a healthy lifestyle, which include healthy eating and regular physical activity.5 Healthcare should also shift more of its efforts towards preventing obesity. Another key player in reversing the obesity epidemic is implementing community efforts that support a healthy lifestyle, such as food services, schools, childhood care, and clinics/hospitals.

Obesity and being overweight affects millions of people in our nation and worldwide. Obesity is associated with an increased risk of many serious diseases that are otherwise preventable. We must shift our efforts to the epidemic of obesity to halt its progression and strive towards a healthier future for younger generations to come.

 

References:

  1. Adult Obesity Facts | Overweight & Obesity | CDC. (2018). Retrieved from https://www.cdc.gov/obesity/data/adult.html
  2. Children Obesity Facts | Overweight & Obesity | CDC. (2018). Retrieved from https://www.cdc.gov/obesity/childhood/index.html
  3. Adult Obesity Causes & Consequences | Overweight & Obesity | CDC. (2018). Retrieved from https://www.cdc.gov/obesity/childhood/index.html
  4. Obesity and Cancer. (2018). Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obesity-fact-sheet
  5. Strategies to Prevent Obesity. (2015). Retrieved from https://www.cdc.gov/obesity/strategies/index.html
  6. S. and World Population Clock. (2018). Retrieved from https://www.census.gov/popclock/

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what to tell the dentist about medicine you take - scriptsave wellrx - blog image

by Heather Lee, PharmD Candidate
University of Arizona

A Guide to Medication Warnings

When you visit the dentist, you expect to answer typical questions regarding your oral health, such as how often you are brushing your teeth or the infamous question of whether or not you floss. It may surprise you when your dentist asks what medications you take at home. Why would it matter if the dentists knows what you’re taking? Many medications, which includes prescriptions, over-the-counter, and even herbal medications, can affect your oral health and it is important for the dentist to know what you take so they can determine the best course of action for your oral health.

Blood Thinners

Many patients are currently on blood thinners or antiplatelet therapy to prevent the risk of blood clots. Common examples of blood thinners include warfarin (Coumadin), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), and edoxaban (Savaysa). Common examples of antiplatelet medications include clopidogrel (Plavix), ticlopidine (Ticlid), prasugrel (Effient), ticagrelor (Brilinta), and/or aspirin. Taking these medications is important to prevent blood clots, but they can also increase the risk of bleeding, especially during a dental procedure. The risk increases if you are taking multiple medications to prevent clots.  It is important for the dentist to know if you are taking these medicines so they can take extra precautions to prevent bleeding, such as stopping the medication temporarily or controlling the bleeding through local measures. They can control the bleeding through various methods, such as mechanical pressure, agents that stop the bleeding, or suturing. The dentist can make a more informed decision with what they want to do with the medication when they have a better knowledge of the type of medication you’re taking, your bleeding risk, and what procedure you’re going in for.1

Dry Mouth

Having a dry mouth can be caused by a variety of different factors, such as a medication’s side effect, having a certain medical condition, or personal habits (mouth breathing and alcohol/tobacco use).

Saliva plays an important role in maintaining your oral health through multiple ways by:

  • Reducing the population of bacteria in the mouth
  • Neutralizing acid caused by bacteria, which damages your teeth
  • Repairing tooth enamel that may have been damaged by acid
  • Washing food particles away2

A lack of saliva can cause dry, cracked lips, bad breath, infections in your mouth, and cavities. Medications that can cause this include medications used to control allergies, asthma, blood pressure, pain, and depression.

Your dentist can help by:

  • Recommending a special gel or rinse to keep your mouth moist
  • Prescribing or applying a fluoride containing toothpaste or mouthwash to prevent cavities3

Other ways to relieve this symptom can include:

  • Chewing sugar-free gum or sucking on sugar-free hard candies to increase the flow of saliva
  • Sucking on ice chips
  • Drinking water with meals to help with chewing and swallowing food
  • Using alcohol-free mouthwash
  • Avoiding carbonated drinks, caffeine, tobacco, and alcohol
  • Using a lanolin-based lip balm to soothe dry lips3

Enlarged Gum Tissue

There are some medications that may increase your risk of getting enlarged gum tissue, which is also known as “gingival overgrowth”. This is usually associated with antiseizure medications (phenytoin), immunosuppressive drugs (cyclosporine), and calcium channel blockers (including nifedipine, verapamil, diltiazem, and amlodipine). If your dentist is aware you are taking these medications, they may encourage you to do professional cleaning more often throughout the year and educate you on how to improve your brushing technique.4

Jaw Pain

There have been some reports of individuals who had difficulty healing or jaw pain after going through invasive dental procedures or even a tooth extraction. This can be due to bone death caused by a lack of blood supply (osteonecrosis). The common factor in these individuals were that they were taking a medication from the bisphosphonate class. Bisphosphonates are usually used to prevent bone weakening or destruction and are commonly prescribed to treat osteoporosis. Examples include risedronate (Actonel), zoledronate (Zometa), alendronate (Fosamax), and ibandronate (Boniva).

Over 90% of cases were in patients receiving an IV form of the drug. The risk is thought to be less than 1% of patients receiving an IV form, but they were at least ten times more likely to be affected than those who took the oral form. If you are on this medication, your dentist can discuss ways to minimize the risk of needing invasive procedures, such as tooth extractions and surgery. They may consider more conservative treatments, such as a root canal procedure. They can provide preventative advice regarding whether you need professional cleaning more often, how to observe any changes in your mouth, and how to be more careful with taking care of your teeth and gums.5

The following may increase your risk of developing jaw pain:

  • Older age (greater than 65 years)
  • Treatment with chronic corticosteroids
  • Long-term use of bisphosphonates
  • Gum infection that damages the gum and can destroy the jawbone (periodontitis)6

Signs to watch out for:

  • Gum wounds that heal very slowly or do not heal for six weeks or more after a procedure
  • Exposed bone
  • ”Roughness” on gum tissue
  • Pain if the open wound becomes infected
    • Pus or swelling
    • Numbness, especially in the lower jaw, if the infection lasts long enough5

Current treatment options include:

  • Antiseptic rinses to help prevent the growth of bacteria
  • Antibiotics
  • Cleaning/removal of dead bone from the affected area
  • Possible referral to a specialist or a surgeon for further evaluation5

Updating Your Dentist Regarding Medications

These are just a few of the reasons of why it is important to inform your dentist regarding what medications, over-the-counters, and herbal supplements you take. Your dentist can take extra precaution when you come in and educate you as to the best way to maintain your oral health when they are aware of what medications may be affecting it. The next time you go in, bring an updated medication list so your dentist is on the same page as to what you are taking at home.

References:

  1. Anticoagulant and Antiplatelet Medications and Dental Procedures. https://www.ada.org/en/member-center/oral-health-topics/anticoagulant-antiplatelet-medications-and-dental-. Accessed October 31, 2018.
  2. Department of Health & Human Services. Teeth and drug use. Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/teeth-and-drug-use. Published June 30, 2014. Accessed November 1, 2018.
  3. Managing dry mouth. The Journal of the American Dental Association , Volume 146 , Issue 2 , A40
  4. Staff SBI. Gingival Enlargement. The American Academy of Oral Medicine. http://www.aaom.com/index.php?option=com_content&view=article&id=132:gingival-enlargement&catid=22:patient-condition-information&Itemid=120. Accessed November 2, 2018.
  5. Staff SBI. Bisphosphonate Therapy. The American Academy of Oral Medicine. http://www.aaom.com/index.php?option=com_content&view=article&id=78:bisphosphonate-. Accessed November 2, 2018.
  6. Dental management of patients receiving oral bisphosphonate therapy. The Journal of the American Dental Association. 2006;137(8):1144-1150. doi:10.14219/jada.archive.2006.0355.

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