medication

Four Components of True Health – Physical Health

Posted on by Michelle Fritsch, Pharm.D.
ThinkstockPhotos-464212219
Physical health – one of four essential components of health

Physical health is the first of the four components of health. True health requires health in all four components. Over the next three weeks we will talk about each separately.

Physical health is the type that is usually thought of first when describing ‘health’. It relates to medical conditions, joint and muscle function, infections, bones, and organ systems. It is the primary reason we go to the doctor.

The main emphasis of health insurance has historically been physical health.

Most of the medications that are prescribed are for physical health. Medications for diabetes, high blood pressure, pain, asthma, etc. are prescribed to improve physical health.

Your physical health is often part of your decision-making. It is the main motivation to choose healthy foods, exercise, avoid smoking, and limit alcohol.

So what can you do to improve your physical health?

First, there are several things you can do to preserve your physical health. Prevention is key. To prevent heart disease and diabetes, diet and exercise are especially important. They help maintain a healthy weight. Lack of exercise and poor food choices lead to excess weight, which adds to risk for many medical conditions.

Avoid smoking. Quit if you smoke now. The negative effects on physical health are enormous.

Limit alcohol intake. An occasional drink is probably fine unless you are genetically at risk for alcoholism. Excess alcohol has many health risks.

If you have been diagnosed with a medical condition, be sure to ask plenty of questions to fully understand your diagnosis and treatment plan. Then, follow your treatment plan while keeping track of your response. Communicate your response and any medication side effects to your healthcare team.

If you have more than one medical condition and/or if you have more than one provider, keep everyone informed. You want healthcare providers who communicate with each other and take time to communicate with you. Each provider needs to know exactly what the others are doing.  Each also needs to know how you actually take each of your medications. It is only then that the safety of all your medications together can be assessed.

For more information about your physical health, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We learn in Genesis we were made in God’s image. Each cell, each hair, each component is specially designed. If you’ve ever experienced the birth of a baby and watched it grow, you have seen the astounding complexities of the human body.

Physical health allows us to perform our daily tasks. It also allows us to pursue the plans to which God has called us. There are several verses throughout the Bible that pertain to health. Here are a few:

1 Corinthians 6:19-20 ESV

Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.

1 Corinthians 3:17 ESV

If anyone destroys God’s temple, God will destroy him. For God’s temple is holy, and you are that temple.

1 Timothy 4:8 ESV

For while bodily training is of some value, godliness is of value in every way, as it holds promise for the present life and also for the life to come.

1 Corinthians 9:27 ESV

But I discipline my body and keep it under control, lest after preaching to others I myself should be disqualified.

3 John 1:2 ESV

Beloved, I pray that all may go well with you and that you may be in good health, as it goes well with your soul.

Consider the steps to maintain your health and the role your health plays in your response to God’s call for your life.

Blessings,

Michelle

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

 

Weight – Less of you might mean less in your medicine cabinet

Posted on by Michelle Fritsch, Pharm.D.

…or at

Medicine doses should be adjusted with weight loss
Medicine doses should be adjusted with weight loss

least lower doses.

Healthy weight loss can lead to decreased doses

Unhealthy weight loss can, too. Actually, sudden, unexpected, or drastic weight loss can be even more hazardous. If it is unplanned please talk with your doctor right away.

Fat loving (lipophilic) medicines distribute throughout all of the extra weight in our bodies. The medication finds places to travel and stay stored in all of these fatty areas. Once we lose fat, it takes a lower dose to get the same effect. If the dose is not changed with weight loss, the same dose you have taken for years can actually be toxic. Rather than being stored in the fat, the amount of medicine stays in your blood where it has more effect. I have seen several cases where someone was getting more confused, more sleepy, having more difficulty thinking with no change in their medicine regimen. Upon further analysis, we found they had lost several pounds over the past several months with no reduction in medicine dose. So talk with your doctor as you lose weight to double check doses of meds.

Medical conditions related to weight

There are also several medical conditions that are related to your weight, especially excess weight. For many people diabetes, high blood pressure, and high cholesterol are found when the person is overweight. They get worse with increased weight. If that person then loses weight, those medical conditions can get better. The need for medicines to control these conditions can go down as the body is better able to manage the blood sugar, blood pressure, and cholesterol on its own. This means the number and doses of medicines might also need to be decreased. Blood pressure medicine doses that are too high can lead to dizziness, especially with standing, and falls. Diabetes medicine doses that are too high can lead to low blood sugar, confusion, dizziness, sweating, or even passing out. Cholesterol medicine doses that are too high might increase risk of side effects like liver damage or muscle pain.

If you have diabetes, high blood pressure, or high cholesterol and have lost at least five pounds, ask your doctor if you could take fewer medicines or lower doses.

What are other benefits of weight loss?

Data has shown that a 5% weight loss can help prevent high blood pressure. It can also help control your blood pressure, your diabetes, and your cholesterol. So, if you weigh 200 pounds, this would be a 10 pound weight loss. This can be accomplished through diet and exercise. Fast weight loss fad diets are NOT the diets of choice. Eating healthy foods, vegetables, fruits, and low-fat options are the safest diet changes. Also, exercise does not mean running a marathon tomorrow. Increased movement several times each day can have a huge positive benefit.

I had one patient once who took this message to heart. He gradually changed his diet and started walking. None of his changes were extreme. Over time, he lost weight. We were able to remove EIGHT medicines from his regimen as his own body resumed control of his conditions. Not everyone will have results this dramatic, but small changes can have big positive impacts.

For more information about healthy weight loss and associated medicine reductions, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

In line with these thoughts about the positive benefits of weight loss, consider the benefits of guilt loss! How much of your daily activity is influenced by guilt? Do ayou feel worthy, accepted, loved, precious, and good enough? Or, do doubts cast a shadow over you? Do feelings of guilt or shame impact your confidence and your attitude? Are you as positive and hopeful s you could be?

If you could shed guilt and shame, can you even imagine how much lighter your load would be? Think how much freer you would be to rejoice and praise and live the life you were meant to live!

Here are some of the thoughts in the Bible about guilt.

Romans 8:1 ESV

There is therefore now no condemnation for those who are in Christ Jesus.

Romans 3:23 ESV

For all have sinned and fall short of the glory of God,

Romans 5:1 ESV

Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ.

Rather than being burdened and weighed down by guilt, consider this offer from Jesus.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”

The past is gone. You are forgiven! You do not need to carry around this guilt and shame. Shed it and see how good you can feel!

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.

Ephesians 4:22-24 ESV

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.

Blessings,

Michelle

Image Source:  National Center for Complementary and Integrative Health; National Institutes of Health; U.S. Department of Health and Human Services

Are you meds making your memory better or worse?

Your Medications and Your Memory – making things better or worse?

Posted on by Michelle Fritsch, Pharm.D.
Are you meds making your memory better or worse?
Memory

Do you ever feel like your memory is slipping? Are you getting forgetful?

Prescription Medications and Memory

Which of your medicines is helping preserve your memory? There are several medical conditions that can make your memory worse. The medicines that treat those conditions then help preserve your memory. Some examples include medicines for heart disease, seizures, blood thinners, asthma inhalers, or emphysema and bronchitis inhalers. Oxygen is a common theme with many of these medications. If you have a medical condition that could decrease the oxygen getting to your brain, this could worsen your memory.

Which of your medicines is actually making your memory worse? Unfortunately, there are many medications that can do this. Any medication that can make you sleepy or slow your thinking can make it harder to remember things. Any medicine that impacts how your brain functions can alter clear thinking. This does not mean all of these medications should be avoided. It does mean to not assume you have dementia when you have foggy thinking while on these medications. There are many examples; some common ones are medications for pain, anxiety, and depression. Anticholinergic, or very drying, medicines cloud your thinking. Recently, statin medications for cholesterol have also been associated with memory impairment.

There are currently two classes of medicines approved for use in Alzheimer’s Disease. For many medical conditions, once diagnosed, you are prescribed a medication(s) to treat that condition. This is not as simple with the dementia medications. They do NOT cure or prevent dementia. They do NOT help all people with dementia. The best impact they have is to slow the progression of dementia, and again, not everyone who takes them will have this result. They have cholinergic side effects that include nausea and diarrhea. If they are stopped after they have been taken, there can be a rapid decline in the dementia. It is not known if the decline is to the point the person would have been if they had not taken the medicine, or if it is an even sharper decline. So there is much to discuss with your physician and healthcare team before deciding to take these medicines.

How about vitamins?

Vitamins are perfectly safe, right? The more the better, right? For many vitamins, taking more than you need is just a waste; your body gets rid of what it doesn’t need. But some other vitamins are not easily cleared, and too much can cause problems. Vitamin E is a vitamin that has been studied to see if it can help with memory. Although some studies have had mixed results, there is no evidence that vitamin E can prevent dementia. There is some data that suggests it might help slow the progression of Alzheimer’s disease. But, there have also been reports of increased risk of death with vitamin E. This is because it can interact with several medications, especially those that can cause bleeding such as medicines that prevent clots. It is also one of the vitamins that the body can’t easily expel, so it is possible to get too much.

Vitamin B12 is another that has been studied.  If your vitamin level is low, then vitamin B12 can help.  However, if your B12 level is normal  supplements will not help.

The best way to get vitamins is through your diet.

And what about herbal remedies, natural remedies, or supplements?

There have been some studies looking at gingko biloba. It does not appear to prevent Alzheimer’s or other forms of dementia. There is some data that suggests it might help stabilize dementia. In particular, some studies show that it can help stabilize mood. Healthy people who take gingko report feeling more alert. However, there are several medication interactions to consider before you take this. It can increase risk of bleeding and can impact blood sugar control if you have diabetes.

Other substances that will change your ability to think clearly are alcohol, marijuana, and illicit substances. They may not be prescribed (yet), but they can definitely impact how sharply you think. Include these when you talk with your physician and your pharmacist about your medicines.

Some medications can help preserve your memory, and some medications can make your memory worse. Vitamins, over-the-counter medicines, supplements, and herbal remedies all should be considered medications. Share all that you take with your primary care provider and your pharmacist. That will allow them to make sure there are no medicines or interactions that are negatively changing your memory.

For more information about your medications and your memory, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as medication can cloud our thinking and memory, what can cloud our spiritual life? Do you ever feel that you are just not fully connected with God? Does it ever feel like something is clouding the connection? Or do you find it’s easier to just ignore the connection?

In my life the most common culprits are:

  • To-do lists
  • Crazy schedules
  • Worries

Martha got caught up in similar tasks. She was fretting so much about hosting Jesus that she failed to experience Jesus.

Luke 10:38-42 ESV

Now as they went on their way, Jesus entered a village. And a woman named Martha welcomed him into her house. And she had a sister called Mary, who sat at the Lord’s feet and listened to his teaching. But Martha was distracted with much serving. And she went up to him and said, “Lord, do you not care that my sister has left me to serve alone? Tell her then to help me.” But the Lord answered her, “Martha, Martha, you are anxious and troubled about many things, but one thing is necessary. Mary has chosen the good portion, which will not be taken away from her.”

There are several verses that help us realign our thoughts and hearts.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.

1 John 2:17 ESV

And the world is passing away along with its desires, but whoever does the will of God abides forever.

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.

To use a sports analogy, keep your eyes up and focused on the long game. Daily struggles become easier to navigate when your focus is on God. He will lead you step by step according to His plan for you.

For it is impossible to be in the presence of Jesus and not be changed.  

– Joanne Weaver

This might sound contrite, but truly give your day to Him, keep your focus on Him, and see what happens.

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

Medications to avoid when over age 65

Posted on by Michelle Fritsch, Pharm.D.

Slide1

Since 1991 there has been a group of geriatricians and other physicians identifying medicines that might be inappropriate in people over age 65. Dr. Mark Beers originally led this group, so it is called the ‘Beers Criteria’. This list has been updated every few years. The most recent update was this month.

The medications on this list have SAFER and/or MORE EFFECTIVE options available.

Some of the reasons for medications to make the list include:

  • blood pressure lowering medicines that cause more dizziness and falls than other options
  • medicines with anticholinergic (very drying) effects that can have several negative effects including worsening memory
  • anxiety medicines that cause thinking/memory problems and falls
  • depression medicines that cause several problems
  • allergy medicines that cause drowsiness, driving accidents, and falls
  • medicines that are cleared from the body through the kidneys which slow down with age
  • medicines that are cleared from the body through the liver which can slow down with age
  • medicines that are ok at low doses but dangerous at high doses
  • medicines that can cause delirium
  • medicines that can worsen memory
  • medicines that can cause constipation
  • medicines that can make urination with prostate enlargement even more difficult

This year, for the first time, guidelines for safer options to replace these dangerous medicines were written. This is exciting news!

If you are over 65, please talk with your prescribers about these lists of potentially inappropriate medicines and these lists of safe alternatives.

For a personal evaluation of your medicines, please contact www.medsmash.com.

Biblical Application

In your daily walk with God, what are the most effective steps and activities? What does the Bible say you should do regularly?

And, where are the pitfalls? What should you avoid?

Just as the Beers List guides prescribers to select the most beneficial and safest medicines, the Bible guides our spiritual practices. Your heart, your tongue, your thoughts, your study, your time, and your actions are included in this guidance.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Colossians 3:5-10 ESV

Put to death therefore what is earthly in you: sexual immorality, impurity, passion, evil desire, and covetousness, which is idolatry. On account of these the wrath of God is coming. In these you too once walked, when you were living in them. But now you must put them all away: anger, wrath, malice, slander, and obscene talk from your mouth. Do not lie to one another, seeing that you have put off the old self with its practices and have put on the new self, which is being renewed in knowledge after the image of its creator.

James 1:19-20 ESV

Know this, my beloved brothers: let every person be quick to hear, slow to speak, slow to anger; for the anger of man does not produce the righteousness of God.

Ephesians 4:32 ESV

Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you.

James 1:22-27 ESV

But be doers of the word, and not hearers only, deceiving yourselves. For if anyone is a hearer of the word and not a doer, he is like a man who looks intently at his natural face in a mirror. For he looks at himself and goes away and at once forgets what he was like. But the one who looks into the perfect law, the law of liberty, and perseveres, being no hearer who forgets but a doer who acts, he will be blessed in his doing. If anyone thinks he is religious and does not bridle his tongue but deceives his heart, this person’s religion is worthless. Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows in their affliction, and to keep oneself unstained from the world.

There are certainly many more verses that guide our lives. These can be a start in developing a strategy to avoid inappropriate, dangerous behaviors and replace them with life-giving, holy options.

Blessings,

Michelle

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

Center of Gravity – Preventing Falls

Posted on by Michelle Fritsch, Pharm.D.

ps_weebles_playPicture a supermodel in her heels walking heel to toe. Now try it. Do you feel unsteady? When your feet are that close together, or even nearly crossing, it is easy to fall. Your center of gravity is very high. The bulk of the weight is up high with a narrow base. Now think of a Weeble – remember those toys with the rounded bottom wider than the top? They have a very low center of gravity (most of the weight in the bottom). They can tip over on their side and still return to standing.

If you’re ever feeling unsteady when walking, think about your center of gravity. Stand and walk with your feet farther apart. Take shorter steps. Lift your feet to avoid catching on grass, rocks, and other low obstacles.

When someone has fallen or is afraid of falling, you can notice these changes. As we become fearful we widen our stance, bend a little, and shuffle.

  • Arthritis in hips, knees, ankles, and feet can increase falls risk.
  • Dizziness, inner ear problems, or medications that make us dizzy can increase risk of falls.
  • Lack of sleep, getting up at night without light, and medications that make us sleepy can increase risk of falls.
  • Not drinking enough, especially during these hot summer months, can lead to dehydration making us dizzy.
  • Medicines that lower blood pressure can make us feel dizzy when we first stand up or turn.
  • Pets under our feet can be a source of tripping. So can throw rugs.

See the home falls prevention checklist under Resources at www.medsmash.com.

Biblical Application

The location of our faith has similar implications. When all of our knowledge of God is in our head, our center of gravity is high. When our center of gravity is high, it is easy to fall. Small things can whip and blow us about. Do you ever feel battered and blown from all directions?

  • work
  • relationships
  • finances
  • too busy
  • not feeling good

But with prayer, reading the Word, study, focus, faith enters our heart. And then it’s in our gut and our whole being.

As our faith gets deeper and deeper, our center of gravity deepens and we can handle heavy blows from any direction. The bad things still happen, but we can maintain our upright faith and dependence on God.

Then Christ will make his home in your hearts as you trust in him. Your roots will grow down into God’s love and keep you strong. Ephesians 3:17 New Living Translation

Let your roots grow down into him, and let your lives be built on him. Then your faith will grow strong in the truth you were taught, and you will overflow with thankfulness. Colossians 2:7 New Living Translation

May you grow deep roots!

Blessings,

Michelle