Month: February 2016

Over-the-counter NSAID pain medicines – how safe are they?

Posted on by Michelle Fritsch, Pharm.D.

Slide1Some people think medicines that are available over-the-counter are always safe.   I don’t want you to be one of those people. Ibuprofen and naproxen are a class of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). They can treat pain, inflammation (swelling and redness), and fever. Hundreds of million of Americans take them every year. You probably have some in your home right now.

The NSAIDs that you can buy without a prescription are ibuprofen (brand names Motrin, Advil) and naproxen sodium (brand name Aleve). They are part of a class of over 20 medications that are available by prescription.

5 IMPORTANT THINGS about NSAIDs

There are five important things I want to make sure you know about these medicines:

  1. They do work to treat mild to moderate pain, fever, and inflammation. They all work the same way. No measurable difference between them in how they work has been found. So one is not better than another.
  2. They irritate your stomach lining. If you already have reflux, gastroesophageal reflux disease (GERD), ulcers, or have ever had a stomach bleed, please tell your doctor. Whether or not you already have stomach problems, always TAKE NSAIDs WITH FOOD.
  3. They cause you to retain extra fluid. This can raise your blood pressure. It can also make heart failure worse and increase your risk for a heart attack if you have heart problems. Talk with your doctor if you have high blood pressure or heart problems BEFORE you take an NSAID.
  4. They can worsen kidney function. If you already have diminished kidney function, talk with your doctor before you take an NSAID.
  5. They make your platelets less sticky. This lowers your chance of have a clot. But, NSAIDs do this for a limited time. ASPIRIN can make your platelets less sticky for the entire life of the platelet. That is why aspirin, usually 81mg baby aspirin, is used to help prevent a clot that leads to a heart attack or stroke.

I always buy the generic version. It will save you some money and give you the very same effect.

If you have pain or fever, there is an option that does not have the stomach, heart, or kidney issues. That option is acetaminophen (brand name Tylenol). For pain that does not include inflammation (redness, swelling), acetaminophen controls the pain similarly to the NSAID.

The problem you do have to watch with acetaminophen is it can hurt your liver. The most you should take in a day is 4 grams (2 extra strength tablets four times daily). The Food and Drug Administration might even recommend that you not take more than 3 grams per day soon. Also, if you drink alcohol more than 2 drinks per day or have any liver condition, then acetaminophen might not be your best choice. Please talk to your doctor before you take it if you have liver issues or drink more than 2 drinks per day.

For more information about safe pain medicine options, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Many people think that any medication you can buy on your own, without a prescription must be safe. I hope you now realize this isn’t always true. In some patients, with some other conditions, a relatively safe medication can be downright dangerous.

So, how do we know what is true? On what can we truly rely?

“Voice of Truth” by Casting Crowns took on a whole new meaning for me this week. I love this song. I have heard it countless times. On this particular day, when it came on the radio I wasn’t even listening very intently.

Then, the words, ‘this is for my glory’ hit me suddenly in a whole new, EXTREMELY POWERFUL way. I have been working through a large, unexpected life transition over the past couple of years. It is not a bad situation. It is just a very big transition leading down a path I can’t really see yet. The whole experience has been and continues to be a real faith walk. I often pray for guidance, help with decision-making, and peace while waiting.

Then, out of the blue, I hear the lyrics, “The voice of truth says, “This is for My glory”. It hit me; none of this is even about me. If I could be in the future looking back, I would be telling myself to “stop it, be quiet, just wait and see, God is doing something here.” It’s not about me at all. It’s all about God working through this situation for HIS glory.

I felt a wave of peace, a wave of admonition, and a lot of emotion. I fluctuated between laughing and crying.

I just love such spontaneous GOD moments!

Proverbs 16:9 ESV

The heart of man plans his way, but the Lord establishes his steps.

Acts 18:9 ESV

And the Lord said to Paul one night in a vision, “Do not be afraid, but go on speaking and do not be silent,

Listen to the ‘voice of truth’ and wait to see what He is cooking up that is for His glory in your life.

Blessings,

Michelle

 

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I have diabetes – let the pills fix it!

Posted on by Michelle Fritsch, Pharm.D.
ID-10093880
Diabetes – let the pills fix it

 

Medications to treat diabetes have revolutionized the treatment of this condition. The number of people with diabetes has been increasing for many years. So, a lot of emphasis has been put on finding new treatments. The number of new types of medications to treat diabetes has greatly increased even in the last five years. This is GREAT news!

So, with all of these new and the older tried and true treatments, diabetes is in good control, right? Surely with all of these options, diabetes is a problem of the past.

Unfortunately, it’s more complex than that. The same things that are causing this increase in number of people with diabetes need to be at the core of the treatment. So what are these things?

At the core of diabetes management

The primary link to the growing number of people with diabetes is the growth of the population. I’m not referring to number of people, I’m referring to SIZE of people.

Obesity has been on the rise. As a population we have gained significant weight. This is one of the main risk factors for diabetes. It is also a risk factor for high blood pressure, high cholesterol, heart disease, and stroke.

So, besides medications to treat diabetes, changes in diet, exercise, and weight are key parts of treatment. Diet and exercise changes are the best way to manage weight. They are not always the most fun and certainly not the easiest. There are all sorts of ‘quick fix’ schemes for weight management that sound very enticing. But, after all is considered, none of these are as safe or effective as true, daily, positive changes in food and movement.

Daily changes

Move every day. Spend less time in a chair and more walking, participating in dance or games, cleaning, or doing other things that are active.

Diet changes are best made in moderation. Sudden, huge diet changes are very hard to sustain. A few simple changes can make a big different. Try some of these:

  • Avoid second helpings
  • Eat a bit smaller portions
  • Cut back on white bread, crackers, pasta
    • Replace with those with higher grain content
  • Eat some more vegetables in place of bread and sweets
  • Eat some more fruit in place of sweets

It is important to make changes that you can make new habits. Keep up these gradual changes over time.

Be good to yourself. If you occasionally slip and fall back in old habits, pick yourself up, forgive yourself, and try again. As you adopt healthier habits, your weight decreases, and you move more, you will start to feel better and more energetic. That will made it easier to continue to make positive changes.

If you want to talk about more details aobut how you can start making these changes, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as it is tempting to let pills fix medical health, it is tempting to let Sunday church fix our spiritual health.

If you go to church most Sundays, you have all you need for spiritual growth and development, right?

Peter had some very insightful instruction about spiritual growth.

1 Peter 2:1-5 ESV

So put away all malice and all deceit and hypocrisy and envy and all slander. Like newborn infants, long for the pure spiritual milk, that by it you may grow up into salvation— if indeed you have tasted that the Lord is good. As you come to him, a living stone rejected by men but in the sight of God chosen and precious, you yourselves like living stones are being built up as a spiritual house, to be a holy priesthood, to offer spiritual sacrifices acceptable to God through Jesus Christ.

I encourage you to read the rest of this chapter of 1 Peter.

2 Peter 1:5-8 ESV

For this very reason, make every effort to supplement your faith with virtue, and virtue with knowledge, and knowledge with self-control, and self-control with steadfastness, and steadfastness with godliness, and godliness with brotherly affection, and brotherly affection with love. For if these qualities are yours and are increasing, they keep you from being ineffective or unfruitful in the knowledge of our Lord Jesus Christ.

2 Peter 3:18 ESV

But grow in the grace and knowledge of our Lord and Savior Jesus Christ. To him be the glory both now and to the day of eternity. Amen.

Another verse with some instruction about spiritual growth is:

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

Growing in your faith is a lifelong quest. With each new thing you learn, your perspective changes and you realize there is so much more to learn.

Sundays, church, and fellowship are incredibly important! And so are all of the other ways you spend time with God and the Bible and other growth opportunities.

Blessings,

Michelle

Sugar, Pressure, and Lipids…Oh My! Metabolic Syndrome

Posted on by Michelle Fritsch, Pharm.D.

Slide1Do you have diabetes, or have you been told you have pre-diabetes? Are you overweight, especially around your midsection? Do you have high blood pressure? Do you have high cholesterol? Did you know they often go hand-in-hand? As a group they are called ‘metabolic syndrome’.

Metabolic Syndrome

This term describes a collection of medical conditions that each impacts the other. These conditions have many negative effects on your body. The primary risks have to do with your possibility of heart disease and stroke.

Risk factors

The biggest risk factor seems to be weight. Our population as a whole has been gaining weight over the last several years. As that has occurred, the number of people with diabetes has rapidly climbed. The number of people with metabolic syndrome has also climbed. Family history of high blood pressure, diabetes, heart disease, and/or high cholesterol also increases your risk of developing these conditions.

Treatment

No matter what medications are used, DIET and EXERCISE are key components of treatment. In particular, less fat, salt, sugar, carbohydrates, and overall calories can help you control this syndrome. Simple carbohydrates are foods like white bread, white pasta, sweets, honey, and fruits.

There have been many new types of medications to treat diabetes in recent years. This is great news if you have type 2 diabetes! The different types of medication help control your blood sugar in different ways. So, you might find that more than one medication is used.

The situation is similar with high blood pressure. There are several different types of medications to lower blood pressure.  These impact the blood pressure from different mechanisms. Using more than one can better lower blood pressure in some patients.

The best type of cholesterol medication depends on which parts of the lipid profile are to be treated. Which are selected is also impacted by liver function.

In addition to those medicines, often a low-dose aspirin is added to further lower risk for heart attack or stroke.

So, if you have metabolic syndrome, you are probably taking several different medications. You also hopefully monitor parts of the syndrome at home – blood pressure and/or blood sugars.

If you would like to better understand your medication regimen, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

There are multiple different types of medications that approach the control of some medical conditions from different angles. Similarly, there are multiple ways to worship. In what ways do you worship the Lord?

Colossians 3:14-17 ESV

And above all these put on love, which binds everything together in perfect harmony. And let the peace of Christ rule in your hearts, to which indeed you were called in one body. And be thankful. Let the word of Christ dwell in you richly, teaching and admonishing one another in all wisdom, singing psalms and hymns and spiritual songs, with thankfulness in your hearts to God. And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.

John 4:24 ESV

God is spirit, and those who worship him must worship in spirit and truth.”

Psalm 95:6 ESV

Oh come, let us worship and bow down; let us kneel before the Lord, our Maker!

Isaiah 12:5 ESV

“Sing praises to the Lord, for he has done gloriously; let this be made known in all the earth.

Worship is so much more than going to church on Sunday. God wants you to get to know Him and to worship in multiple ways. Fully experience the glory and joy of God!

Blessings,

Michelle

Too hot, too cold? Do you have hypothyroidism?

Posted on by Michelle Fritsch, Pharm.D.

Thyroid glandThere can be several reasons you are cold or hot more than the people around you. One of those reasons can be your thyroid.  If your thyroid is underactive, you could have hypothyroidism.

Normally, your body has this ingenious feedback loop that keeps your thyroid hormone levels just right. The two key hormones produced in your thyroid are triiodothyronine (T3) and thyroxine (T4). When these are at the correct levels, your thyroid stimulating hormone (TSH) controls their production. When more is needed, it stimulates more. When no more is needed, it does not stimulate more.

Hypothyroidism

The most common thyroid medical condition is hypothyroidism, or an underactive thyroid. In this case, the TSH keeps going up and up but the needed amounts of extra T3 and T4 are not produced.

Some of the common symptoms of hypothyroidism are:

  • feeling cold all the time
  • feeling sluggish or tired
  • brittle nails and hair
  • weight gain

The most common and very effective treatment for hypothyroidism is levothyroxine. A common brand name is Synthroid. It is T4 that is given to replace the T4 your thyroid is no longer producing. Giving T4 in this form is enough to bring your TSH back to normal levels. It is not necessary to take both T4 and T3; several studies have now demonstrated this. Each dose has a different color. This helps you and your prescriber keep track of exactly what dose you are taking.

When you are first started on levothyroxine, your prescriber will probably have you get blood drawn to check your TSH about 2 months after you start therapy, every 3-6 months until your dose has your TSH right in the goal range, then it will be checked at least yearly. It is common for your dose to change several times, in the first year especially, until the correct dose is identified to keep your TSH at the target level.

When you take levothyroxine, you should take it either first thing in the morning about an hour before breakfast or at the last part of your day at least 3 hours after your last meal. There are several foods and other medications that can interact with levothyroxine. Keeping it separated from your other medicines and meals helps to avoid these interactions.

Note, you especially to do not want to take it near milk or other dairy products, vitamins, or some cholesterol medicines. Taking levothyroxine too close to some of these foods and medicines can make the levothyroxine less effective.

A common question is about brand versus generic when taking levothyroxine. Either is truly fine. What you don’t want to do is switch back and forth. There can be a very tiny variance (2.5%) between medicine made by different manufacturers. For most medicines that makes no difference. Levothyroxine is a ‘narrow therapeutic index’ medication. This means the range from too little to too much is very small. So, the tiny variation between products can make a difference. I recommend generic, but ask your pharmacist to always give you the generic from the same manufacturer.

If you suspect you might be hypothyroid, please talk with your doctor. The most common age to be diagnosed with hypothyroidism is in your 40’s and 50’s, but it can be identified at younger or older ages.

For more information about your thyroid and medications to treat thyroid conditions, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We just read about the amazing feedback loop of the thyroid gland. It is a perfectly designed system that keeps itself in constant check. (Unless it is harmed by disease or other outside influences).

This makes me think of a feedback loop described by Paul. It is not necessarily a comfortable feedback loop, but I know I have seen the truth of it in my own life. And, when I look at those people that have been big spiritual mentors to me, I can definitely see the realities of this feedback loop in their lives. I have yet to find a spiritually mature person who hasn’t experienced this feedback loop more than once.

So, what is the loop?

Romans 5:3-5 ESV

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.

Slide1

The part that we sometimes miss is that this is a continuous loop. It’s just each time you go through it, the better you are able to ‘REJOICE’ in the suffering knowing that the love is continuous. The loop always involves suffering – something bad is happening to you. But, the more you embrace the love that is yours no matter what, the braver and more joyful you can be with each time around the loop.

So buckle up. The next round is coming! Experience it with the joy that God’s love never fails.

Blessings,

Michelle

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

Snowed – Are you missing out on life needlessly?

Posted on by Michelle Fritsch, Pharm.D.

 

Winter
Avoid that ‘snowed’ feeling from medication

 

How often do you feel “snowed”? Do you feel a lack of motivation? Is your thinking sharp? Is it hard to get the energy to get off the couch? Do you nod off when you sit down? Does your thinking seem fuzzy? Do you have trouble keeping up with conversations?

Medications can make you feel ‘snowed’

Now I ask you, do you take medicine for:

Your ‘snowed’ feeling could be a result of your medication. Many of the medicines used to treat these problems have this side effect. This is especially true if you take more than one or if the dose is too high.

Sometimes there are other medicine or non-medication options that will avoid these side effects. At least a trial of a lower dose might help.

Be sure to discuss your concerns with your doctor before making any changes.

Do you wonder if you might be taking one of these medicines or experiencing this type of side effect? Contact us at www.medsmash.com.

As you might imagine, where I live we had about 30 inches of snow recently. Everywhere we look we see snow.   It is beautiful for a while. It is fresh and clean and bright. The ability to take a break is refreshing. When you know you can’t go anywhere, it is easier to give yourself permission to read a book or relax in front of a favorite movie.

There are times, especially with certain injuries or emotional traumas, when medication-induced relaxation is warranted. In these cases, extra care for safety from falls and avoidance of driving are important.

But, this is not a long-term desirable state. So, again, if you are experiencing this ‘snowed’ feeling on your regular daily medication regimen, let’s see what can be done to wake you back up.

BIBLICAL APPLICATION

Do you feel like you’re lacking focus and clarity?

Are you distracted by negative thoughts and/or worries?

Do you find you are working from one to-do to another with no time to think or plan?

Do distractions and daily activities override prayer? This is a common excuse for not spending time with God and in the Bible. I have certainly made this excuse and continue to do so.

Yet, there is more than enough evidence day after day that walking closely with God, daily prayer, surrendering worries is how we are designed to live. Life is more joyful. There is much more peace. Worries don’t slow you down.

There are many Bible verses that reassure us that this is exactly what we are called to do.

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 15:7 ESV

If you abide in me, and my words abide in you, ask whatever you wish, and it will be done for you.

Mark 11:24 ESV

Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

1 Thessalonians 5:17 ESV

Pray without ceasing,

Romans 8:26 ESV

Likewise the Spirit helps us in our weakness. For we do not know what to pray for as we ought, but the Spirit himself intercedes for us with groanings too deep for words.

I challenge you to dedicate time each day to God. I challenge myself as well.

God knows you, everything about you, and loves you no matter what. So, hand it all over, accept the peace that is yours, and take a break from the worries.

Blessings,

Michelle