Pharmacy Advocates, LLC

Have Diabetes? Know Your Goals!

Josh Neumiller — Sun, 06 May 2012 19:07:50 +0000

If you have diabetes you are probably very familiar with the hemoglobin A1c (A1C) test, which provides an average of your blood sugar control over the last 3 months or so. For a long time people were treated to try to get their A1C below 7.0%. This may be appropriate for some people, but a recent article published by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) titled “Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach” points out that less stringent goals may be appropriate for some people. For instance, if people have had diabetes for a long period of time, have a number of other health conditions, or live alone, it may be appropriate to strive for an A1C closer to 8.0%.

Because people may have different A1C goals, as noted above, it is very important to know what your goal is and communicate that goal to all of your healthcare providers. If everyone on your Healthcare Team is on the same page, they can better work together to optimize your diabetes care and overall health!

NPF’s Aware in Care Kit

Lindy Swain — Sat, 28 Apr 2012 00:20:20 +0000

Going to the hospital can be a frightening thing for anyone, but especially for someone with Parkinson’s. People with PD know how important it is that they receive their medications on time, every time. Unfortunately, this often does not happen in hospitals for various reasons. Nurses are busy, orders may be entered wrong or incompletely, the hospital may not stock the exact PD meds you take, surgery may delay your meds, etc, etc.

The National Parkinson Foundation has created an “Aware in Care” kit that includes several tools to help your hospitalization be a more positive experience, including a fact sheet, hospital action plan, medication list, and even thank-you cards for terrific hospital staff. Go to their website now and order this fantastic kit!

Which medication to take for Alzheimer’s?

Lindy Swain — Fri, 13 Apr 2012 23:21:49 +0000

There are currently about 4 commonly prescribed medications for Alzheimer’s disease. Three fall into the class known as “Cholinesterase inhibitors,” which work to increase the chemical acetylcholine in the brain, which is involved with learning and memory. The fourth medication, Namenda (generic name: memantine), works to reduce glutamate activity in the brain, a chemical that seems to be involved in damaging the brain.

The cholinesterase inhibitors are most commonly used as a first-line therapy. There are three available: Aricept (donepezil), Exelon (rivastigmine), and Razadyne (galantamine). A very important point is that if you have intolerable side effects to one of these medications, you can still try another one and you might do better. Similarly, if you or your loved one does not have a good response to one of these, ask your healthcare provider about trying a different one.

Namenda (memantine) is FDA-approved for moderate to severe Alzheimer’s, although some healthcare providers will also use it in earlier stages. Namenda can be used in combination with one of the above cholinesterase inhibitors, since it works in a different way.

This was a very quick review of commonly prescribed medications for Alzheimer’s. Please let us know if you have specific questions about any of the agents mentioned!

Diabetes and Sexual Health Issues

Josh Neumiller — Tue, 10 Apr 2012 19:05:23 +0000

Check out a blog here by one of our dear friends and colleagues, Professor R. Keith Campbell. He is a wealth of information related to diabetes, and in this short article he discusses sexual health issues often experienced by women with diabetes.

Statins – Friend or Foe to Your Memory?

Lindy Swain — Wed, 04 Apr 2012 20:22:43 +0000

Cholesterol-lowering medications commonly known as statins, including simvastatin (Zocor) and atorvastatin (Lipitor), tend to receive a lot of publicity. We know that the statin medications can reduce total cholesterol and also LDL cholesterol, commonly known as “bad” cholesterol. What’s not as well known are the other effects that statins may have, such as those on our brains.

A recent study gave simvastatin to mice and found that the medication helped to improve blood flow to their brains and also facilitated learning and memory. Terrific, right?!? We should all take a statin to ward off Alzheimer’s…or should we? Unfortunately, it’s too soon to know that yet. Mice are of course much different than humans, so further investigation is needed to look at effects of statins in humans. Additionally, we have also run into clients who have something called statin-induced cognitive impairment, in which taking a statin actually made their thinking and memory worse.

The bottom line in all of this? We do know that keeping your heart and body healthy will help keep your brain healthy. Talk to your doctor and pharmacist about your cardiovascular health to make sure your medications, and lifestyle, are optimized.

Actos (Pioglitazone) and Bladder Cancer

Josh Neumiller — Mon, 26 Mar 2012 18:06:22 +0000

I have been receiving a fair amount of questions about the recent reports of bladder cancer in people taking pioglitazone (Actos) for type 2 diabetes. It is true that the FDA required the manufacturer to revise the drug information for Actos to include a warning of the potential risk of bladder cancer with its use. This warning came after information came to light at the midway point of a study being conducted to assess the long-term risk of this medicine on cancer risk. While the overall risk of bladder cancer was not found to be increased in people taking Actos, people taking Actos for 2 years or more did have a small increase in the number of cases of bladder cancer when compared to people with type 2 diabetes not taking the medication. The FDA has concluded that while the risk appears to be small, people with bladder cancer should not use the drug because of these findings. The following information has been provided by the FDA regarding this potential risk:

There may be an increased chance of having bladder cancer when you take pioglitazone.
You should not take pioglitazone if you are receiving treatment for bladder cancer.
Tell your doctor right away if you have any of the following symptoms of bladder cancer: blood or red color in urine; urgent need to urinate or pain while urinating; pain in back or lower abdomen.
Read the Medication Guide you get along with your pioglitazone medicine. It explains the risks associated with the use of pioglitazone.
Talk to your healthcare professional if you have questions or concerns about pioglitazone medicines.

While these warnings can be alarming, it is important to follow the 5th bullet point above, always make sure to discuss your concerns and wishes with your primary care provider and/or endocrinologist! It is important to keep everybody in the loop and always let your providers know when you are considering starting or stoping a medication.

Help With Eye Drops

Lindy Swain — Sat, 17 Mar 2012 00:15:46 +0000

Many people struggle with administering eye drops. It can be particularly difficult for older adults that may have limited dexterity, or especially for people with Parkinson’s who may have rigid muscles and tremors. Often eye drops are a necessary part of everyday living – for example, to treat glaucoma or a variety of other eye conditions.

Luckily, there are devices available that help with getting that pesky drop into your eye. There are products that can help you squeeze the bottle, as well as products that help keep your eye open to get the medication in. Below, we have links to some products you might consider if this is a struggle for you:

Eye Drop Squeezer – this would be particularly helpful if you have difficulty squeezing the bottle
Eye Drop Guide - this product helps you aim the eye drop into your eye, especially if your hands are unsteady or you tend to close your eyes
Ezy-Drop Guide – this is similar to the above product, helping you administer the eye drop
Auto Drop Guide – another similar product to help keep your eye open

If you have used these products or other products to help administer eye drops, let us know how they worked! Or if you have other tips and tricks, we’d love to hear them!

Great Tool to Track Your Meals

Josh Neumiller — Mon, 12 Mar 2012 03:51:13 +0000

One important component of managing diabetes is understanding how food and activity affects your blood sugar levels. I was referred to a nice resource that can be extremely helpful in tracking what you eat, which can be very helpful when trying to determine how your blood sugars react to certain foods. Lose It! is a very nice website that allows you to track both the food you eat and the phyical activity you engage in each day. For people with smart phones, an app is even available that allows you to scan UPC labels of the food you eat. When taking this record taking with your blood glucose readings, you may be able to find some informative trends in how your blood sugars react to your meals and activities.

Affording your Medications

Lindy Swain — Fri, 02 Mar 2012 23:57:34 +0000

Unfortunately, taking the medications your doctor prescribes often includes some barriers. One big obstacle that many people face is the cost of medications. For many, even with insurance coverage, their medications are still too costly to afford. Below are some tips to try to save money on prescription medications:

Ask the pharmacist whether the pills you take can be split in half. If they can, you can often save money by purchasing a smaller quanitity of a larger strength, and then cutting the tablets in half. For example, if you take Lipitor 40 mg daily, you might want to look into getting Lipitor 80 mg and then taking 1/2 a pill each day.
Ask the pharmacist if there is a similar product that is less expensive. Using the example above, although Lipitor is now available generically, it is still quite pricey. There are several other statin-type medications, like simvastatin, pravastatin, and lovastatin that are much less expensive. Talking to your pharmacist and prescriber may mean you can save a lot of money!
Look into prescription assistance programs. One good place to look is the Partnership for Prescription Assistance (PPRA). Also check out Together Rx Access and NeedyMeds, which can provide savings on your prescriptions.
Sometimes your insurance will offer a lower price if you fill a 90-day supply instead of a 30-day supply. Or, if you are willing to use a mail order pharmacy you might be able to save money.
If you find that you can’t switch your expensive brand-name product for a less expensive generic, or that you can’t split the pills, ask your doctor if he/she has any samples from the manufacturer that you can have.
Lastly, if your prescriptions are costing too much and you think you might be taking too many, have a consultant pharmacist review your medications and make recommendations about ways to simplify and reduce your medication regimen.

Bydureon – A New Treatment for Type 2 Diabetes

Josh Neumiller — Sat, 25 Feb 2012 07:19:47 +0000

A new injectable medication for the treatment of type 2 diabetes was recently approved. The new product, called Bydureon, is in a class of medications known as incretin mimetics. Incretin mimetics help lower blood sugar and can also help people lose weight. Bydureon actually contains the same active ingredient as another product that has been on the market for several years known as Byetta. One of the main differences between Bydureon and Byetta is that Bydureon is injected once weekly and Byetta is injected twice daily. Because Bydureon is long-acting, it tends to have more of an effect on fasting blood sugar, while Byetta targets postprandial (or after meal) blood sugars to a larger degree.