Decoding the Cold & Flu aisle

Disclaimer: I'm only trying to help you be better informed about cold & flu medication. You should always talk to your pharmacist or doctor about any concerns. Do not take medication you may be allergic to. Any choices you make when choosing medication are your own.

You wake up feeling like crap- you know the feeling- achey all over, exhausted, stuffed up, snotty, and slightly disoriented- so you roll out of bed and trek down to the pharmacy. You get to the Cold & Flu aisle, take a look at all of your options, and decide to just grab the nearest box because that will get you back to bed the quickest. Any idea what you just grabbed?

While you may be a little more informed than that, the Cold & Flu aisle can be tricky for anyone- even me, and it's my duty to know what's in that multitude of boxes. Drug companies come out with new products all the time, but they also remarket their current drugs to make things more confus-er to increase their sales. Hopefully, this post will be a good guide for you as we enter cold & flu season.



Malaise
As far as I know, there isn't a medication you can take to decrease that tired-all-over achey feeling. When I'm feeling like this I make sure to get as much sleep as possible, and I drink a ton of water. I usually feel refreshed for a few hours after I wake up, then it gradually gets worse as the day goes on.

Allergy-type symptoms
This includes a runny nose, sneezing, itchy, watery eyes, burning eyes and/or nose. It can also include a sore throat which isn't something you'd think is due to allergy-type symptoms, but when your nose runs, it doesn't just run out of your nose through the front, it also runs out the back and down your throat. That can cause irritation and land you with a sore throat. It's called post-nasal drip. 

For these symptoms you need what we call an antihistamine or anti-allergy medicine. Yes, they're marketed toward allergies because those last year-round for a lot of people. Drug companies make more money marketing them this way. An antihistamine is used to dry up your secretions (mucus). For a cold it should make you less runny and gross. It's usually not potent enough to dry you up completely; THIS DOES NOT MEAN YOU SHOULD TAKE MORE.

*Some of these meds are:

• Zyrtec (cetirizine)
• Claritin (loratadine)
• Allegra (fexofenadine)
• You can also use Benadryl (diphenhydramine), but as it can make you very drowsy, I would only use it at bedtime or if you're at home for the day.

Congestion: nasal/head
This feels like pressure in your face and head. You can't breath well through your nose, and usually when you blow your nose, it's not very productive. For this symptom, you'll need a nasal decongestant to help open up those nasal passages.

You can go two routes with this- topical (sprays) or oral (tablets). The oral medication you have to choose from includes Sudafed (psuedoephedrine) and Sudafed PE (phenylephrine). These two are similar, but there is a difference you should know about. People make meth with Sudafed, so you'll need to purchase it from behind the pharmacy counter, be over 18 years old, and show them your valid and current drivers license. Sudafed PE is out on the shelves and should work just as well as Sudafed.

This medication comes separate (Sudafed, Sudafed PE and generics) as well as in combo products (Zyrtec-D, Claritin-D, Allegra-D). It's included in other combinations, but that can get a little complicated. Just ask your pharmacist.

If you don't want to take a tablet, or if the tablet just isn't quite doing it for you, there are topical nasal sprays that help with congestion. These are sprays like Afrin and Vicks Sinex (oxymetazoline HCl) and Neo Synephrine and Dristan (phenylephrine HCl). One important note: do NOT use these for more than 5 to 7 days as they can cause rebound congestion and make your congestion worse.

So, your choices are:

• Sudafed
• Sudafed PE
• Zyrtec-D, Claritin-D, Allegra-D
• Afrin or Vicks Sinex nasal spray (for only 5-7 days)
• Neo Synephrine or Dristan nasal spray (for only 5-7 days)
• Other combo products

Congestion: chest (or productive cough)
When your congestion is in your chest, you'll feel fluid in your lungs when you breath in and out, and when you cough you'll often cough up mucus. When this happens, you need what's called an expectorant, or something to help you cough all of that goo out of your lungs. It works to thin all of that mucus so it's easier to cough out. Some products that help with this are: Mucinex and Robitussin. These contain guaifenesin, the expectorant.

Make sure to check the label on these two because there are many combination products made by the makers of these drugs. For plain old chest congestion, get the blue box.

Choices here are:

• Mucinex
• Robitussin
• Combo products with guaifenesin

Cough: dry
When you're coughing but not coughing much of anything up, you need a cough suppressant- something to stop that cough. You can go two routes with this one. Like I mentioned above, you may need that antihistamine to dry up your secretions and stop post nasal drip which can not only cause that sore throat, it can also cause you to cough as well.

If you've tried the antihistamine and it's not working, there is a cough suppressant you can use. It's called dextromethorphan.

Meds that contain this:

• Delsym
• Robitussin Cough and Cough Gels
• DayQuil Cough
• Tylenol Simply Cough
• There are a LOT of combo products that contain this in it with other cold medications, so just look closely at the back of the box.

Sore Throat:
This is the symptom that makes me laugh the most when talking to patients. They'll always come in and say, "My throat hurts." When I ask them what they've tried they'll say cough drops and nothing else. My response is always, "What do you take when your head hurts? Or when your back hurts?" Pain is pain, and those meds that take care of your other pain will help with a sore throat. You can take Tylenol (acetaminophen), Advil (ibuprofen), or Aleve (naproxen). I personally recommend tylenol because people with sore throats often have fevers and tylenol is better when it comes to reducing fevers, but you can take any of them and get some relief. Note: don't forget to take Advil and Aleve after food!

Meds:

• Tylenol
• Advil (with food)
• Aleve (with food)

Fever:
I'm not sure what other people think about this, so this is my personal opinion. It's nothing anyone has told me specifically in class before, but I've come to this conclusion based on what I've learned about our immune system. You get a fever when your body is actively fighting off something that doesn't belong inside of it- usually bacteria or a virus. Your immune system is doing what it what made to do; it's actively searching out the invader and killing it or getting it out of your system.

With that said, there are two types of fevers in my eyes- a low-grade fever and a high fever. If you have a high fever, you should be doing everything you can to bring it down. Fevers can cause long-lasting damage when they get too high. The fever I'm talking about is a low-grade fever...like 1 degree higher than normal. Personally, I think that suppressing that low of a fever is only setting back your body's natural defense and may allow you to either get sick or become more sick. I don't take medicine until it gets to be in the upper 99s or higher. You may think differently.

Anyway, like I said before, tylenol is usually the best medicine for this. You can also use ice packs on your head or a cold bath to lower your temperature if the tylenol isn't taking care of it. Ibuprofen is also a possible treatment for fever if the tylenol isn't working. Make sure to take (or give) it with food.

Meds:

• Tylenol
• Ibuprofen
• Cold packs/cold bath

There are limits to how much you can take of all of these medications. Pay attention to the labeling on the package- READ it all- and remember that the pharmacist and pharmacy interns are always right behind the counter to help you out. 

It's only the 12th...

Nablopomo has taught something about myself...I'm just not very good about consistently doing things that aren't really necessary. I mean, it's only the 12th & I'm having a hard time with this whole posting a blog post every day thing.

I don't NEED to post a blog post every day, but I said I'm doing it & I should. But around this time every night I remember- I forgot to write a blog post, again. The next thought is, "Do I have to?" Like a whiny little 5 year old. No, I guess I don't have to, but I said I would.

Maybe if I had a more interesting life I'd have plenty to write about here, but I just don't have enough material to keep myself interested in blogging daily.

The only thing I can come up with today is complaining about my job. Don't get me wrong- I LOVE my job. In the grand scheme of things, there are people I'm helping that do appreciate what we do. Somewhere, they exist...I hope. But on most days I deal with people who don't understand exactly what we do, but they think they know exactly what my job is & how to do it. They also seem to think they're the only person we're dealing with. Those people really get me down some days- like today. We really do try hard to do everything right for every patient, but sometimes things just go wrong.

My only wish is that they didn't assume we did it on purpose to hurt or upset them.

I had the best post

After something that happened at work tonight, I had the best post ever. But then I realized I can't even post about it because it technically has to do with one of our patients.

The gist of it is that there are some scary people in Lawrence, and I'm getting the hell out as soon as I graduate...maybe sooner. I know there are scary people everywhere, but I think there are much safer places I could move than here. While doing my job, even though we have things that a lot of people really want, I've never felt like I was in danger before. After tonight, I'm not going to be as naive. I'm definitely going to be more aware of my surroundings & not assume the best in every person.



(stealing this from @nesbik) Do tell: have you ever felt you're in danger at work?

Health Literacy

Restaurant workers say "on the fly" and "86" on a daily basis. Others have no idea what that means. Every field has their own lingo, but the use of most of that lingo never affects anyone in a bad way. If a server says "86 the mayo," no one will be any worse off because of it.

In health care, however, it's a different story. There is a medical language that takes years of school to fully understand. Since most health care professionals have been through all of the schooling necessary to learn the lingo, it is commonplace to them and they use it in day-to-day interactions.

The problem with this is when they forget to translate what they're saying into something their patients can understand. Most health care professionals forget that this is even an issue because they have forgotten what it's like to listen to someone spout off something at them and have no idea what was just said. It's hard to go back to before they had the knowledge they do, and explain what they have to say in a manner that will make it easy for anyone to understand.

So how can we solve this problem? It's obvious that patients and doctors/pharmacists/nurses/surgeons/etc need to be able to communicate and fully understand each other. Without a full understanding, there will continue to be a high number of mistakes and misunderstanding that could majorly affect a patient's life. Even the relationship between manufacturer and patient can be difficult. Instructions on bottles often make little sense or are so dense with information that the necessary information can't even be located.

One thing I know it that health care professionals need to continually work on that most important word: care. They need to take time to listen to their patients' complaints and acknowledge their worries. The need to come up with a plan to take care of the patients' medical problems, but in doing that they must make certain the patient fully understands certain things like how they should take it, what they're taking it for, and how long they're expected to stay on it.

Imagine two people. Both are 25 years old. One has played basketball competitively for many years; the other has never seen a basketball before. One is going to fly through a basketball drill with ease while the other one will fumble around foolishly. One will leave with a great sense of accomplishment; another will leave embarrassed and discouraged. One will have known exactly what was going on during the drill; the other will still be confused and never really understand what happened during the drill.

Apply this analogy to a patient and a doctor. Can you see how a doctor's visit can be experienced in two very different ways by different people? Obviously navigating health care won't be as difficult for some people as it is for others, but that doesn't mean we can just overlook it.


A friend linked me to this video that talks about this topic. While it's a bit dated, we still face the same problems they show.


As a patient, what do YOU feel can be changed to make health care make more sense? What are some times that you feel like a complete health care klutz? Is there anyone that is a part of your care team (doctor/nurse/pharmacist/etc) that you feel can help you understand if you have problems?

If you have time, I'd really like to know your answers. As a student, I have obviously seen health care professionals go from driven young people to overworked workers in a matter of years. It's no different from other careers- people get burnt out doing what they do. But as health care professional we can't let our level of care slip because we have forgotten what it's like to really care if our message gets through. I'd love it if you can offer me some insight. Thanks!

Increase Your Pharmacy Knowledge!

I have realized by working in a pharmacy that many people don't know very much about pharmacy. That's totally understandable- where would you learn it? So I decided to write a blog about it with some information you should know about pharmacy. I've created a quiz below so you can test how much you know! Before you take the quiz though, there are a couple of things not in the quiz that I think you should know.

If you are on chronic medication, make sure you know what each one is used for. Also know at least one of the names of the drug(s) (brand or generic)you are taking. Be able to associate the color/shape of the pill with its name and use.

Read the instructions written on the bottle. REALLY read them. Many people think they've read them, but there are a lot of people who are taking their medication incorrectly. Your doctor has often written the instructions so they are tailored to you and your condition, so if you're taking them a different way than prescribed, your condition may not be controlled. I see this most often with antibiotics. A lot of people assume that they are all to be taken once a day, but many antibiotics are taken differently. If you don't take them as prescribed, you will most likely be sick for a longer period of time.

Take responsibility for your medicine. Make sure you know when you are almost of it pills, when your refills will run out, how to take them, etc. The pharmacy can usually help you with a lot of this, but you should take responsibility for your health. Before you take your medication from the pharmacy, read the labels or pamphlet and make sure you are getting the right medication and the strength you are usually on. If anything has changed, ask the pharmacist.

One more thing- many patients come in, drop their prescription off and get very angry when we tell them it will be 15 minutes. I wanted to give you a glimpse into the process that happens once you drop off your prescription so you know what to expect.

-You drop your prescription off.
-If you haven't filled at that pharmacy before, they will need to get basic information from you including any allergies to medication and your insurance card.
-Once entering you into their computer system or finding your profile, they will enter the prescription into the computer.
-Once it's entered, they check to see if insurance accepts or rejects the claim. Unlike most doctor's offices, pharmacies usually communicate electronically with insurance companies so it takes less than a minute to see this.
-Once they get the claim back from the insurance they either begin the filling process or they have to figure out why it was rejected. If they have to call insurance, you might have to add 30 minutes or so onto your wait time.
-Once the prescription is entered and is approved by your insurance, the techs will print the label for your drug. The correct drug is pulled and it is checked against the drug that it lists on the label.
-The drug is counted and put into a pill bottle. If it is a controlled drug, it is counted a second time.
-A label is put on the pill bottle and handed to the pharmacist.
-The pharmacist begins the verification procedure and makes any changes if needed.
-The prescription is ok'ed and sold to the patient.

Throughout this whole process, many other things happen- the phone rings, people are picking up prescriptions in the store and at drive thru, doctors & nurses are calling in prescriptions and responding to questions, patients are asking questions about over the counter meds, and insurance rejections are being taken care of. All of these things add to the time you have to wait for your prescription.

The important thing to remember is that we know you have been waiting at the doctor for a long time and that you don't feel well. We want you to have your prescription as fast as possible. We also hate it when you have to wait longer than you think you should. If you can, try to be as patient as possible. Waiting is easier if you aren't mad. And remember: we (the pharmacy staff) are here to help you!

Ok, enough babbling: take the quiz!! (You have to put your cursor on the question to see the whole thing)

Quizzes by Quibblo.com