clinical pharmacist

board certified geriatric pharmacist

Why would you benefit from a board certified geriatric pharmacist?

Posted on by Michelle Fritsch, Pharm.D.
board certified geriatric pharmacist
How Meds MASH promoted safe, healthy, active living

I started a company that I call Meds MASH in 2015. I am a board certified geriatric pharmacist. That means I specialize in medication use in people over the age of 60.

What Meds MASH doesn’t do for you:

  • Fill your prescription
    • Your local pharmacist will do this
  • Change any of your prescription medications
    • I will make suggestions to your doctors or help you discuss them with your doctor
  • Take over your healthcare
    • You will keep your doctors who will lead your healthcare

What Meds MASH will do for you:

  • Talk with you to find out what are your health and life goals
  • Review all of your medications
    • Prescribed
    • Over-the-counter
    • Vitamins
    • Supplements
    • Herbal remedies
    • Any other substances
  • Obtain your medication history
  • Review your labs to check for medication safety
    • Kidney function
    • Liver function
    • Medical condition control
    • Side effects
  • Review your medicines compared with your allergies
  • Evaluate in-depth for risks of falling
  • Review for some common issues that are often missed
  • Make sure you understand each of your medications and how to best take them
  • Take time and answer your questions
  • Provide you with detailed information you can review later and share with your doctor
  • Talk direct with your doctors at your request and authorization
  • Engage your family at your request and authorization

Does Meds MASH make a difference? On average in an initial review- 

  • We make 4.5 interventions
  • A recommendation is made to improve two medications
  • A recommendation is made to change a medication for 82% of clients
  • Over 98% of the time a significant suggestion about medication is made!

Questions frequently asked

Doesn’t my doctor already do this?

  • Rarely does your doctor know absolutely every medication you take and how you actually take it.
    • Meds MASH specializes in obtaining this before reviewing the medications.
  • Only a small percentage of people over 60 have a doctor board certified in geriatrics.
    • Meds MASH provides a board certified geriatric expert.
  • Most people have 7-15 minutes with their doctor.
    • Most Meds MASH initial visits are 45 minutes.
  • Rarely are people fully prepared for their doctor visit.
    • Part of a Meds MASH review includes specific strategies to get the most out of each medical visit with your doctors.

Doesn’t my pharmacist already review all of my medications?

  • Rarely does your pharmacist know all of the medications you take.
    • They know the prescriptions only, even if you only use one pharmacy.
      • You absolutely should use only one pharmacy!
    • Your pharmacist has a limited time to carefully review your medicines.
    • There are not many geriatric board certified pharmacists in the country.

Contact us today for a free consultation! Meds MASH 410-472-5078 or e-mail michelle@medsmash.com or on the website www.medsmash.com/contact.

BIBLICAL APPLICATION

There is a lot of talk about and emphasis on being ‘transparent’ today in our society. It has taken me months to clearly, succinctly state what we do at Meds MASH. I am still honing the message so that it really makes sense to people. We need to be able to put things in someone’s own perspective to help them really understand.

If an alien from Mars came to visit and talked to you about places, customs, and politics on Mars, it is unlikely you would understand very much of it. You would have no perspective of how things look or operate on that planet.

I had this same thought this week as I was reading the Psalms, especially the ones written by David. David was the king. He was responsible for all of the people. His perspectives were oriented around keeping people safe and alive.

He frequently talks about enemies and God’s protection in wars. I’m sure they were attacked, or at risk of being attacked, most of the time. God made it clear that when the people of Israel went into battle with God’s protection, then they would prevail.

Deuteronomy 28:7 ESV

“The Lord will cause your enemies who rise against you to be defeated before you. They shall come out against you one way and flee before you seven ways.

When they went into battle on their own, the outcomes were not so good.

Numbers 14:39-45 ESV

Israel Defeated in Battle

When Moses told these words to all the people of Israel, the people mourned greatly.  And they rose early in the morning and went up to the heights of the hill country, saying, “Here we are. We will go up to the place that the Lord has promised, for we have sinned.”  But Moses said, “Why now are you transgressing the command of the Lord, when that will not succeed?  Do not go up, for the Lord is not among you, lest you be struck down before your enemies.  For there the Amalekites and the Canaanites are facing you, and you shall fall by the sword. Because you have turned back from following the Lord, the Lord will not be with you.”  But they presumed to go up to the heights of the hill country, although neither the ark of the covenant of the Lord nor Moses departed out of the camp.  Then the Amalekites and the Canaanites who lived in that hill country came down and defeated them and pursued them, even to Hormah.

Our personal battles aren’t with swords, but they are still battles. And if God is for us and leading us, then our outcomes are infinitely better than when we do battle on our own without Him.

David also makes frequently reference to rain, crops, vineyards, and grain. We don’t tend to spend our days focused on those things. Our grocery stores and markets are filled with all we need.

But what are the daily struggles in your life that mean just as much to you as ability to grow crops meant in David’s time? Is it your finances, your job, career opportunities, relationships, finding your meaning in life? Our daily struggles are no less important that David’s. Our world and our perspectives are just different.

So, whatever your battles, lay them before the Lord. Honestly lay it all out there. Be completely transparent and clear in your requests before God. He already knows. He loves the trust you place in Him as you bring it all to Him.

Psalm 71:14-17 ESV

But I will hope continually

    and will praise you yet more and more.

My mouth will tell of your righteous acts,

    of your deeds of salvation all the day,

    for their number is past my knowledge.

With the mighty deeds of the Lord God I will come;

    I will remind them of your righteousness, yours alone.

O God, from my youth you have taught me,

    and I still proclaim your wondrous deeds.

If you’re ever at a loss for what to pray, consider the Psalms. They are the prayers and songs of praise of David. Put it in today’s perspective, and you’ll find they are completely relevant to your needs today.

Blessings,

Michelle

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Getting Better – It Takes More than a Prescription

Posted on by Michelle Fritsch, Pharm.D.

ID-10093880Do you have a health issue? If so, you just need a prescription, and you’ll be all better, right?

Huey Lewis sang that he ‘wanted a new drug’. His proposed ‘new drug’ had no side effects and made him feel like he felt when falling in love.

Does that describe the prescriptions that you take?

Unfortunately it’s just not that easy.

All medications have side effects. Many medications have very specific instructions to use them in a way that leads to the best possible outcome.

But, we are all busy. Who has time for those pesky details? Does it REALLY matter if you take it with food or first thing in the morning when you brush your teeth? If you take two when you remember them vs one in the morning and one at night, that’s ok, right? Do you really have to breathe in some special way when you use an inhaler? You just squirt it in, right?

To get the most benefit from your medications – and – to minimize your side effects, these details are very important. Let’s explore some of the types of important details.

Timing – If your medication is to be taken more than one time per day that means it doesn’t last a full 24 hours. To keep the medication active in your body, you need to take it more than once. If you take it too close together, you will get more than a full dose while the two doses overlap. This can increase your side effects or even be dangerous because you have too much medication. If you miss a dose, you will have time with little or no medication in your system to treat your condition.

Food – Some medications will bind to medication in the stomach and not be absorbed. So, you will get no medication in your body if you take it with food. Other medications will make you sick to your stomach if you don’t take them with food. Food will decrease or prevent that side effect of feeling nauseous.

Finishing early – Some conditions require that the whole bottle/set of medications be taken. Often we think once we feel better we’ll just stop taking the medication. Sometimes we even keep the extra in case we need them another time. Some medications, like antibiotics, need to be taken until all are gone. You start feeling better when the bacteria is made weak, but it is not gone yet. If you stop the antibiotic when you feel better, the bacteria can get strong again. Often that same antibiotic won’t weaken the bacteria the next time, so you will need to be on an even stronger antibiotic.

Finishing too quickly – Other medications need to be gradually taken away rather than stopped all at once. Your body can’t take back over all at once if you have been taking these medications. Examples are beta blockers for high blood pressure and prednisone for inflammatory reactions. The gradual taper of these medications is essential to avoid severe side effects. (Note, this DOES NOT mean you are addicted.)

Technique – Inhalers, eye drops, ear drops, injections, patches, suppositories, and other medication forms can be difficult to use correctly. If you don’t use them just right, you won’t get the full benefit of the medication. This is a waste of money, and more importantly, won’t help you feel better. For some of these medications, correct use can even be the difference between getting better and calling 911.

So, I highly encourage you to pay attention to these details about your medications. If you see instructions you don’t understand or know their purpose, ask your pharmacist. Pharmacists are there to explain, demonstrate, and help you get the most from your medications.

For more information, contact us at www.medsmash.com

BIBLICAL APPLICATION

What are the quick fixes to Heaven? What is the way to assure entry then get on with the busy-ness of life?

First, God’s every desire for you to live eternally in Heaven is clear in the Bible. The basics of the path to God are below.

John 3:16 ESV

“For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.

John 14:6 ESV

Jesus said to him, “I am the way, and the truth, and the life. No one comes to the Father except through me.

Ephesians 2:8-9 ESV

For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast.

Once you have had the amazing experience of finding God, and you have welcomed Him in to your life, what next?

Do you then work hard to earn God’s love? No, God loves you no matter what. His grace covers anything you do or do not do.

Do you then go on about your business now that this task is done?

Timing – Filling your life with God is an all-of-the-time, every day, all times of day opportunity. I don’t think any of us take advantage of this fully. Not a single one of us is perfect. But, God’s grace is always there for you!

Food – The Bible, the word of God, is your nourishment. This is not a one-time read that then goes on the shelf. Each time you read it, you will learn new things. God has so much to share with you!

Finishing early – It can be tempting to make this life-altering, life-filling decision to dedicate yourself to God. It can then be easy to move on to other things. God wants to be in close contact with you all of the time, good times and bad, busy times and leisure. I highly encourage you to experience this close daily walk with your God!

Jesus states there are two main rules for life for us.

Mark 12:30-31 ESV

And you shall love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.’  The second is this: ‘You shall love your neighbor as yourself.’ There is no other commandment greater than these.”

This prescription to walk with God is a daily, sometimes even minute-to-minute, dose that is always available. And the side effects are wonderful!

Blessings,

Michelle

Image courtesy of rakratchada torsap at FreeDigitalPhotos.net

Medications and Falls

Posted on by Michelle Fritsch, Pharm.D.

Did you know that taking some medications can increase your risk of falling?

Did you know not taking some medications can increase your risk of falling?

Did you know some medical conditions can increase your risk of falling?

Did you know not getting enough of some vitamins can increase your risk of falling?

Wow, fall risks are so complicated!

The Centers for Disease Control recently created and released a tool for healthcare providers and patients to help screen for and diminish fall risk. You can find it at http://www.cdc.gov/steadi/patient.html. I encourage you to use these tools to minimize your risks.

Some of the things addressed are clutter in your home that can trip you, the importance of exercise to stay strong, use/add grab bars, sturdy hand rails, wear shoes or nonslip slippers, improve lighting, and more.

In addition, have a medication expert review all of your medications to minimize the fall risk caused by drugs that you take.   This is an area where all of your healthcare team can work together to make sure your risks are minimized.

Some types of medication are more likely than others to make falls occur more easily. Then, if you take several of these medicines, your risk is even higher.

The vitamin associated with falls is vitamin D. If you have too little vitamin D your risk is higher. If your doctor has not checked your vitamin D level, request that be done at your next visit. Most adults have a deficiency.

If you would like a thorough fall risk assessment, please contact Meds MASH at www.medsmash.com.

Biblical Application

I have been struck lately by the words to a song sung by Jason Gray, “More Like Falling in Love”. If you have not heard it, I highly encourage you to check it out.

The lyrics say,

“More like falling in love

than something to believe in

more like losing myself

than pledging my allegiance.”

“It’s like I’m falling in love.”

I adore this description of meeting and giving it all to Christ.

If you’re going to fall, what’s better than falling in love? And what’s better than falling deeply in love with Christ?

Luke 10:27 ESV

And he answered, “You shall love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind, and your neighbor as yourself.”

1 John 4:18 ESV

There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love.

Psalm 85:10 ESV

Steadfast love and faithfulness meet; righteousness and peace kiss each other.

May you be enveloped with this wonderful love!

Blessings,

Michelle

Know before you decide

Posted on by Michelle Fritsch, Pharm.D.

What is a tmedication-sliderhorough medication evaluation? Would you benefit from one? Don’t other people already
evaluate your medications on a regular basis? Do you worry about hurting someone’s feelings if there is a difference of opinion about your medication regimen?

You likely have several different healthcare providers – your primary care doctor, any nurse practitioners or physician assistants in that office, your specialist doctor(s), your local pharmacist, and maybe a chiropractor, physical therapist dietician, and others. Surely between all of them someone is providing you with a very thorough evaluation of your medications?

Do you take anything for a cold? Or a stomachache? Or to help you sleep? Or for pain?

Do you tell your healthcare providers about these things you take only once in awhile?

Do you take vitamins or supplements or herbal therapies that you select for yourself? Do you tell your healthcare providers about these?

Do you always take your medications at the same time every day? What do you do when you forget to take them? Do you take some of them only when you feel like you need them? Have you ever stopped taking a medication without telling your providers?

A thorough medication evaluation will cover all of these things. Our research has shown that in 98% of visits there is at least one thing that you didn’t know about your medication that you really should know.

As a clinical pharmacist, I am looking at all of your prescribed medications and other substances you take to assure none of these nine problems exist:

  • Each dose is not too high (You have more side effects than needed or even have toxicity.)
  • Each dose is not too low (You take it but it doesn’t work for you.)
  • All conditions that should be treated with a medication are being treated with the best medication(s) based on current medical studies.
  • Each medication you take is actually necessary. (Sometimes there are medications that have been on your list for a long time but no one remembers why.)
  • No medications interact with each other making your health worse. Also, your diet and supplements don’t interact with your other medications or each other.
  • You are able to obtain and take each prescribed medication. (Sometimes pills are too big, inhalers are hard to use, eye drops are hard to get into the eye, or medications are too expensive or not covered by insurance.)
  • None of your medications for one condition make another condition worse.
  • You are able to safely take all of your medications. Allergies and medication intolerances will be reviewed and clarified for your healthcare team.
  • You are taking each medication at the optimal time in relation to food, other medications, and potential side effects.

Clinical pharmacists have extensive training specific to all aspects of medications and how they work., more than any other health professional. Often, having a clinical pharmacist working with the rest of your providers will further assure that all of your medication use is necessary, safe, and effective.

For more information about a thorough medication assessment, contact www.medsmash.com.

Biblical Application

Just like medication intended for good can sometimes actually cause harm, are there elements of our spiritual lives that can be more harmful than good?

There are many interpretations of the content of the Bible. There are many preachers and teachers and blogs and radio programs and television programs and articles written.

Are they all true and accurate?

How do you determine what to believe and what to implement in your life?

Jesus, Paul, John, and others warned us about false teachers and the importance of discernment. Well, that sounds good, but how do you actually do it?

First, here is what the Bible says.

1 John 4:1 (MSG)

My dear friends, don’t believe everything you hear. Carefully weigh and examine what people tell you. Not everyone who talks about God comes from God. There are a lot of lying preachers loose in the world.

John 7:24 ESV

Do not judge by appearances, but judge with right judgment.

Proverbs 2:1-5 ESV

My son, if you receive my words and treasure up my commandments with you, making your ear attentive to wisdom and inclining your heart to understanding; yes, if you call out for insight and raise your voice for understanding, if you seek it like silver and search for it as for hidden treasures, then you will understand the fear of the Lord and find the knowledge of God.

Discernment might sound difficult or only for those with advanced theological training, but the Bible encourages us to pray about it. When you hear or read something that you’re not sure about, pray and ask God to guide you. Jesus says that the Holy Spirit is with us at all times.

Matthew 28:20 ESV

Teaching them to observe all that I have commanded you. And behold, I am with you always, to the end of the age.

Joshua 1:9 ESV

Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.

(And there are several more such verses throughout the Old and New Testament).

Let God lead you with discernment and love.

Blessings,

Michelle