Month: December 2015

New Year’s Resolution, Take Only In-Date Medications

Posted on by Michelle Fritsch, Pharm.D.
Old medicine bottles
Take in-date medications

The new year is upon us. I hope your 2015 has been full of happy memories and joyous occasions. Now, as we move on to 2016, I have a New Year’s challenge for you. I challenge you to take only in-date medications.

WHY In-Date Medications?

Sometimes we think expiration dates are just there to make us keep buying new medicine. But, in reality, there are TWO big reasons expiration dates are important. Extensive research is done when medications are created to determine for how long they are effective and safe. This date, when either changes, is the expiration date.

Past this date the medicine will not work as well. If you take a medicine to control your blood sugar that is expired, it might not lower your blood sugar as much. If you take an expired medicine for pain, your pain might not go away.

The other risk is a safety risk. Chemicals change over time. Have you ever opened an outdated bottle of aspirin? It smells like vinegar. That is because it changes into new chemicals over time, one of which is vinegar. Other medicines change into chemicals that can be extremely dangerous.

It is not worth the risk.

HOW

Go through ALL of the medications in your house, cars, purse, etc. Check the expiration date on each one. If it is expired, put it in your discard pile. (But don’t throw it in the trash just yet, there are two more steps).

Next remove all labels that contain information about you or your family. Shred or cut up the label. If you can’t get the label off, scratch out your name and prescription number at least. This is one of many forms of possible identity theft.

Now comes the tricky part. What do you do with all of these medications? There is not an easy answer. In order of ‘best options’, dispose of them in one of these ways:

  1. Take them to a ‘Medication Take-Back’ event sponsored by the Drug Enforcement Agency. Or call the DEA’s Registration Call Center at 1-800-882-9539
  2. Talk with your local pharmacist to see if you pharmacy can dispose of medication. Or, your pharmacist should know who in your community does dispose of medication, if there is a source.
  3. Dump them out of their bottles and put with kitty litter, coffee grounds, or something else that you can’t eat. Then, seal the container and put it UNMARKED in a garbage bag and out with the garbage.
    1. DO NOT flush the medication or put it down the drain. This leads to it reaching the water supply. This used to be encouraged, and now many medicines/hormones/chemicals have been found in the water supply.
    2. Ultimately, putting them in the trash can lead to them being in the water supply as the trash breaks down and leaches into the ground.
    3. This is why an official ‘take-back’ event is the safest option.

REPLACE

As you are sorting out your expired medicines, keep a list of those you use so you can replace them. If it is a prescription medicine, your can see on the label if there are refills remaining. Note, for non-controlled medicines, there are usually available for up to a year. For controlled medicines, the time might be shorter. If you are beyond that time, and you still need the medicine, call your physician to inquire about another prescription.

As you are replacing medicine, over-the-counter medicine, vitamins, and supplements, know that generic versions are just as good as brand. I purchase generic for my family. They have been carefully tested and regulated by the Food and Drug Administration to assure they contain the same key ingredients and work the same.

Here at the end of the year, if you have a health-savings account, check the rules to see if you can use that to replace your expired medicines.

This is an important step in your New-Year’s fresh start. It is important for your safety and the safety of your family.

Happy New Year!

For more information about expired medication and proper disposal, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We are entering a new year. It can be a time to think of fresh starts and hope for the future. It is a great time to reflect on how your life has been changed through your faith.

At the moment we give our life to Christ, we know that our old self is gone. We now live a NEW life in Christ.

Ephesians 4:22-24

To put off your old self, which belongs to your former manner of life and is corrupt through deceitful desires, and to be renewed in the spirit of your minds, and to put on the new self, created after the likeness of God in true righteousness and holiness.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

Galatians 2:20 ESV

I have been crucified with Christ. It is no longer I who live, but Christ who lives in me. And the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me.

What a refreshing reminder! Bask in the glow of your new life in Christ as you enter this new year.

I challenge you to take a challenge I FINALLY took in 2015. Read the Bible from cover to cover. I have read my Bible, participated in Bible studies, had several Bible-based lessons, but I had never actually read it start to finish. It has been so enlightening! So many things make more sense. And I hear from those who have done this several times, the insights are new and different each time.

I am praying you will be richly blessed in 2016,

Michelle

 

Image Source:  National Library of Medicine; National Institutes of Health; U.S. Department of Health and Human Services

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The Season of Giving and Receiving – To Your Health

Posted on by Michelle Fritsch, Pharm.D.

GiftsAs you work through your to-do lists, travel to your holiday destination, and settle in for the holiday season, here are some additional ways to give and receive.

RECEIVE

Following is a list of things that can help you feel your best.

  • Plenty of fluid
    • Avoid dehydration in the busy-ness of your holidays.  This can help avoid headaches, constipation, and feeling lethargic.
  • Fiber in your diet
    • This can help you avoid constipation and and issues with diverticulosis (little pockets in your colon which are more common over age 50).
  • Veggies and fruits for vitamins
    • These are colorful, packed with vitamins, help you feel alert and energetic, and are another source of fluids.
  • Rest
    • Getting plenty of sleep will help reduce your feelings of stress and being overwhelmed.
  • The love and support of family and friends
    • This helps with perspective, reduces stress, allows you to relax, helps to focus beyond your own needs and wants.

GIVE

  • Helping other people can reduce your stress levels
  • Volunteering and caring about other people improves your health
  • Altruism, giving to others, is linked to improved health and longevity (living longer)
  • Time with friends and family. Feeling the love and time with others raises our spirits.

GIVE (UP)

  • Excess alcohol
    • It might relax you for a bit, but then will interrupt your sleep, increase your risk of dehydration, and actually make you feel more tired
  • Tobacco
    • The health risks are just too great. You’ll enjoy many more happy new years if you give up the tobacco.
  • Too much fatty party food
    • A balanced diet, plenty of fruits and vegetables, and exercise will keep you feeling better.
  • Isolation and brooding.
    • Everyone has experienced or will experience hard times, disappointments, betrayal, and/or loss.
    • Your attitude, your source of hope, the support of others will determine whether these events stop you.
    • You can grieve and experience these negative events and also pick yourself back up and continuing living a hopeful, happy life.

Wishing you joy, peace, and love from Meds MASH, LLC. www.medsmash.com

BIBLICAL APPLICATION

Acts 20:35 (NIV)

In everything I did, I showed you that by this kind of hard work we must help the weak, remembering the words the Lord Jesus himself said: ‘It is more blessed to give than to receive.’ 

Throughout the Bible we learn about the importance of giving. The message is consistent. The more we GLADLY give, the more we are blessed, and the more we receive.

Note, giving is not meant to be divisive. Wanting more for yourself is not a reason to give so that you’ll get more in return.

Rather, our giving is a sign of gratitude and love and honor to our Father in Heaven.

Luke 6:38 ESV

Give, and it will be given to you. Good measure, pressed down, shaken together, running over, will be put into your lap. For with the measure you use it will be measured back to you.

Proverbs 3:9 ESV

Honor the Lord with your wealth and with the firstfruits of all your produce;

2 Corinthians 9:11 ESV

You will be enriched in every way to be generous in every way, which through us will produce thanksgiving to God.

As the Bible is coming to a close, John takes this concept of grateful giving to a new depth:

1 John 3:16-18 ESV

By this we know love, that he laid down his life for us, and we ought to lay down our lives for the brothers. But if anyone has the world’s goods and sees his brother in need, yet closes his heart against him, how does God’s love abide in him? Little children, let us not love in word or talk but in deed and in truth.

Giving is a beautiful expression of our gratitude and the love that is spilling over in us.

I’m praying you know God’s ever-sufficient, extravagant, glorious peace and love this Christmas!

Blessings,

Michelle

Holiday Stress and Anxiety – Your Healthiest Treatment Options

Posted on by Michelle Fritsch, Pharm.D.

fireworks_black_150_thmThis is such a joyous exciting season! Many faiths have reason to celebrate this time of year. Many people have long-held precious traditions. Family and friends make special effort to be together. Receptions, parties, brunches, gatherings, and meals are planned.

Do find that this season gives you energy and good, warm feelings?

Or, do elements of this season make you anxious?

Do the preparations, busy calendar, and financial outflow give you stress?

I hope not. But if they do, you are definitely not alone. About 44% of women and 31% of men report an increased level of stress at holiday time. Some rate the hype, finances and issues as mentioned above, as the source of their stress. Others point to discomfort with social situations.

I want to share something helpful I recently read. It is interesting that we each feel like others are looking at and judging us in such situations. In reality, all of those people are having the same self-conscious feelings about themselves.

So, if you are feeling additional stress, what are your best alternatives to manage it?

Alcohol may seem like a good option, but it actually puts you at risk for a fall or a driving accident. Then, it makes you feel even more tired the next day. And, alcohol and drugs can make your stress worse rather than better.

A class of medication used for stress for decades is benzodiazepines. These medications include alprazolam, lorazepam, diazepam, and brand names like Valium and Xanax. They have made the lists of medications that are not safe for most people over the age of 65. They aren’t good options for people under age 65 either with very few exceptions. They make it hard to think clearly, increase risk of falling or other injury, and increase risk of driving accidents. When these are taken regularly, dependence develops. Then it becomes hard to get back off of them. So, I recommend you DO NOT use benzodiazepines to manage holiday stress.

A good night of sleep can be very helpful in dealing with stress. But, using medicine to get to sleep can put you at risk. These medicines include zolpidem/Ambien, zaleplan/Sonata, and eszopiclone/Lunesta. This list also includes over-the-counter sleep aids like diphenhydramine found in Benadryl, Tylenol PM, and Aleve PM. Doxylamine is another ingredient found in sleep aids and cold/flu combinations that has strong anticholinergic side effects. This means it can cause constipation, dry eyes, falls, and can cause slowed thinking.

So what are some safer ways to manage holiday stress?

Take care of yourself :-).

Healthy tips

  • Eat healthy foods, including plenty of fruits and vegetables. Limit fattening party foods.
  • Drink plenty of water/fluids to avoid dehydration while running around busy. Limit the caffeine to avoid the ‘crash’ later and to protect your heart.
  • Get some exercise to clear your head and improve your mood.
  • Get a good night’s sleep. Note, the exercise and avoiding alcohol will help with your sleep.
  • Take a break. Taking some time to relax, pray, meditate, or get a massage can help you recalibrate.

For more information about manageing holiday stress, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Does the Bible give any guidance about managing stress? Oh yes, from the dawn of time people have had fears, doubts, stress, and anxiety. Repeatedly, God has called us back to him. He repeatedly tells us that HIS peace is sufficient and beyond our understanding. Let some of these verses bring you a new perspective.

Philippians 4:6 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

John 14:27 ESV

Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid.

Psalm 55:22 ESV

Cast your burden on the Lord, and he will sustain you; he will never permit the righteous to be moved.

Psalm 118:5-6 ESV

Out of my distress I called on the Lord; the Lord answered me and set me free. The Lord is on my side; I will not fear. What can man do to me?

Romans 8:31 ESV

What then shall we say to these things? If God is for us, who can be against us?

In addition, an interesting ‘tip’ is given to help us find more peace. Reaching out to other people benefits both them and us.

Galatians 6:10 ESV

So then, as we have opportunity, let us do good to everyone, and especially to those who are of the household of faith.

John 13:35 ESV

By this all people will know that you are my disciples, if you have love for one another.

Proverbs 12:25 ESV

Anxiety in a man’s heart weighs him down, but a good word makes him glad.

The list of related Bible verses goes on and on. We were not created to live in anxiety and stress. May the peace of our Lord and Savior be yours this Christmas!

Blessings,

Michelle

 

The Naughty List – Medications to AVOID when over age 65

Posted on by Michelle Fritsch, Pharm.D.

Slide1Did you know there is a list of medications to avoid over age 65? A group of physicians and other experts first published this type of list in 1991. Since that time, the list has been updated several times. The most recent update was released this October of 2015. The list is of medications for which there were safer, as effective options. Mark Beers is the physician who took the lead with these lists, so they are often called the ‘Beers List’.

Did you know that kidney function starts to decline – in the healthiest of people – around age 40? The liver also slows down as we age. The efficiency of the heart pumping is more than we need until about age 30, then it starts to slowly decline.

This is not all bad news. The body is designed to function for a very long time, even with the changes that occur with aging.

The more you keep yourself, and your body, healthy, the better you will feel for many years.

Getting back to the naughty list, these body changes slow how medications get out of the body. So often, a single dose will last longer in your 70’s than it did in your 30’s. This means some medications are dosed at a lower dose. Other medications are taken less often. And the Beer’s list medications should not be taken at all.

Beer’s list medications:

  • Anticholinergic medicines are very drying, increase risk of falls, increase confusion and constipation. A common example is diphenhydramine found in Benadryl, Tylenol PM, Aleve PM, and most over-the-counter sleep aids.
  • Certain blood pressure medicines that can make you very dizzy when you stand up – doxazosin, prazosin, terazosin, clonidine, methyldopa, nifedipine
  • Digoxin – if used, should be used a very low dose such as 0.125 mg daily
  • Some depression medicines like amitriptyline, imipramine, notriptyline, paroxetine have a lot of side effects. There are some effective antidepressants that are safe, have fewer anticholinergic (drying and confusion) effects, and less drop in blood pressure.
  • Benzodiazepines include alprazolam, lorazepam, oxazepam, temazepam, triazolam, clonazepam, diazepam. If you are taking one of these for anxiety, please talk with your doctor at your next visit about reducing and gradually coming off of this medication. They greatly increase your risk of falls, difficulty thinking, car crashes, and delirium.
  • Mineral oil. There are much safer remedies for constipation or any other use of mineral oil.
  • Meperidine is one of the most risky pain medications in older adults due to the slower ability of the body to get rid of it. Talk with your doctor about one of the many safer options.
  • Skeletal muscle relaxants include cyclobenzaprine, methocarbamol, orphenadrine, carisoprodol. These have anticholinergic (drying) effects, make you sleepy, and increase your risk of falls and fractures. In addition, they don’t have very good evidence that they are actually helpful.
  • Nonsteroidal pain medicines, especially indomethacin and ketorolac, can cause stomach bleeding and dizziness. Other common nonsteroidals are ibuprofen, Naprosyn, meloxicam, or etodolac.  If you take one of these, talk with your doctor about taking it with an acid blocking medication to help protect your stomach.

There are other medications on the list. Some are specifically hazardous if you have certain other medical conditions.

DO NOT STOP or change the way you take any medicine without first talking with your doctor.

This is a long list. Please discuss this with your doctor if you are taking any of these medications.

Or, please contact us at www.medsmash.com. We are experts in medications for adults over age 60. We can explain the list and any hazards in your medication list to you. Then, we can work with your doctors to make safer changes.

BIBLICAL APPLICATION

Here are two key ‘Nice Lists’. In these times of holiday activities and worldwide turbulence, I hope these bring hope and joy. The Bible says these are to help us glorify our God in Heaven.

THE FRUIT OF THE SPIRIT

Galations 4:22-23a ESV

But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, self-control

THE BEATTITUDES

Matthew 5:3-12 ESV

3 “Blessed are the poor in spirit, for theirs is the kingdom of heaven.

4 “Blessed are those who mourn, for they shall be comforted.

5 “Blessed are the meek, for they shall inherit the earth.

6 “Blessed are those who hunger and thirst for righteousness, for they shall be satisfied.

7 “Blessed are the merciful, for they shall receive mercy.

8 “Blessed are the pure in heart, for they shall see God.

9 “Blessed are the peacemakers, for they shall be called sons[a] of God.

10 “Blessed are those who are persecuted for righteousness’ sake, for theirs is the kingdom of heaven.

11 “Blessed are you when others revile you and persecute you and utter all kinds of evil against you falsely on my account. 12 Rejoice and be glad, for your reward is great in heaven, for so they persecuted the prophets who were before you.

Some of the greatest gifts of the season can be love, tolerance, patience, and peace.

I will be praying for each of these for each of us.

Blessings,

Michelle