Archive for April, 2009

When it comes time for patients to get back on their feet after injury or illness, walkers are likely to prove quite useful. When making a selection, look for a wide, deep frame with multiple height adjustments for enhanced legroom. Also, look for ergonomic folding mechanisms that make opening and closing easier. To gain increased flexibility, add fixed or swivel wheel attachments to the front legs of a standard walker and glide tips or extensions to the rear legs. Swivel wheel mounts allow the three-inch wheels to turn in a complete circle. This makes the walker easier to maneuver in confined areas, such as elevators, apartments, and retail stores. Wheelchairs, crutches, and canes are also available  if deemed more suitable.

HINT: Walkers can be outfitted with pouches, baskets, and other storage options to make getting around easier.

If you have eyelashes of insufficient length or thickness, you may have a condition known as hypotrichosis of the eyelashes. To treat this condition, the FDA recently approved an eyelash-thickening drug known as Latisse, the active ingredient of which is bimatropost, the same ingredient used in the glaucoma treatment Lumigan. Eyelash growth is a known side effect of Lumigan, which prompted its study for new use. However, the two drugs are used differently. While Lumigan is an eyedrop, Latisse is applied to the lash line of the upper eyelid with a sterile, single-use-per-eye disposable applicator. According to the drug’s manufacturer (Allergan), Latisse produces longer, fuller, darker eyelashes  in as little as eight weeks. Full results come in 16 weeks.    

HINT: The most common side effects of Latisse are eye redness, itchy eyes, and skin hyperpigmentation.

            Drug and alcohol addiction are problems that affect families, which makes it all the more important to diagnose and treat these complex life-threatening problems. Because most people are unfamiliar with chemical dependency, drug addiction, and/or alcoholism, they are encouraged to seek professional help in dealing with these problems. The first step is recognizing that there is a problem, whether it is you with addiction or a family member or close friend. Coming to this realization takes courage, after which perseverance, understanding, and support are needed to guide those affected through an often difficult course of recovery. Pharmacists can be enlisted in this effort by explaining how such medications as disulfiram (Antabuse), naltrexone (Revia and Depade), and acamprosate (Campral) may help.

P.S. The anti-seizure drug topiramate (Topomax) may prove useful in helping alcohol-dependent individuals stop drinking

            A drug recently approved by the FDA for the treatment of advanced prostate cancer provides a new avenue of treatment. Degarelix is an injectable drug that belongs to the class of drugs known as gonadotropin-releasing hormone (GnRH) receptor antagonists. Degarelix works by blocking the body’s production of testosterone, which slows the growth of prostate cancer. According to a year-long randomized trial, patients treated with degarelix had testosterone levels that were comparable to surgical removal of the testes (which produce testosterone). In addition, even though PSA (prostate-specific antigen) levels are not always a definitive indicator, men receiving degarelix experienced an average 64% decrease in PSA levels two weeks after starting treatment, 85% after 1 month, and 95% after 3 months. 

HINT: Commonly reported side effects of degarelix use include pain, redness, and swelling at the injection site; hot flashes; weight gain; fatigue; and increases in some liver enzyme levels.

            Patients may ask themselves what harm can come of drinking a glass of wine when taking prescription medication. The fact is that antibiotics, among other drugs, do not “go” with alcohol. For instance, alcohol can interfere with the absorption of erythromycin or the efficacy of doxycycline. Moreover, taking even a sip of alcohol with antibiotics or antifungal medications such as cefoperazone (Cefobid), ketoconazole (Nizoral), metronidazole (Flagyl), and tinidazole (Tindamax) can lead to flushing, nausea, abdominal cramps, low blood pressure, rapid heartbeat, and shortness of breath. These unpleasant symptoms, which are collectively known as the “disulfiram-like reaction,” are named for the drug prescribed to help problem drinkers resist alcohol. So, check the label of all drugs for an alcohol warning.     

HINT: Avoid alcohol for three days after finishing a course of antibiotics so they can clear the body.

            While most people afflicted with osteoarthritis pain continue to focus on pain relievers in pill form, they may be helped just as well by medicated creams and patches. These topical NSAID (non-steroidal anti-inflammatory drugs) pain relievers, which are quite popular in other countries, were recently found by experts at the Agency for Healthcare Research and Quality to be just as effective as pills at relieving the pain of osteoarthritis. In some cases, these topical treatments may cause skin reactions, but they help avoid the adverse reactions associated with NSAID pill use. Over-the-counter creams include Aspercreme and Myoflex. If a stronger medication is needed, a consultation with a doctor can result in the prescription of Voltaren gel or the Flector patch.

HINT: The Voltaren gel and the Flector patch both contain diclofenac, a non-steroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body.

            While drug manufacturers recoup research-and-development costs by selling the drugs they bring to market in large quantities, some medications will never be popular enough to be profitable because they are only suited to a very limited group of users. In order that individuals with rare diseases have the opportunity to be treated with new medications, the federal government instituted the Orphan Drug Act in 1983 with the intention of stimulating research, development, and approval of products to treat rare diseases. Medicines that treat fewer than 200,000 individuals are designated as “orphan drugs.” Orphan drugs, like other medications, still have to be proven to be safe and effective through research and clinical trials before the FDA will approve them for marketing.

HINT: “Orphan drugs” enjoy seven-year marketing exclusivity in the United States.

            Patients who take injections or pill forms of the class of anti-osteoporosis drugs known as bisphosphonates should be aware that the drugs might trigger jawbone decay after certain dental procedures. According to recent research, oral treatment with alendronate (Fosamax) for as little as a year was found to increase the risk for jawbone disease after a tooth extraction or with denture-related ulcers or other dental problems. Analysis of the medical records of patients who had taken alendronate pills showed that four percent displayed active jawbone decay, or osteonecrosis. All the affected patients were women ranging in age from 63 to 80 who had taken 70 milligrams of alendronate once per week for 12 to 120 months.

P.S. Bisphosphonates are used to reduce the risk of bone fracture and to increase bone mass in people with osteoporosis.

         Home healthcare is often the first choice of families dealing with loved ones who are facing Alzheimer’s issues. Recognizing the necessity for outside assistance such as a companion or nursing assistant can make this a viable option. Home healthcare allows the individual to remain in familiar surroundings with less disruption in routines, resulting in reduced confusion. It also helps alleviate the stress associated with the demands of caregiving. The key is allowing the home healthcare provider to relieve the caregiver of some of the responsibilities of attending to a loved one with Alzheimer’s. Caring for someone with Alzheimer’s is an extremely challenging experience for families. Home healthcare may be the best option.

P.S. Planning ahead by exploring care options for a loved one with Alzheimer’s is critical when it comes time to make the right decision.

        When considering the services of a geriatric care manager (GCM), first determine whether you have the time, inclination, or skills to manage the challenges of geriatric care. If you are not sure, you may wish to enlist the help of a GCM. A GCM determines an individualized plan to care for your loved one. Consider if the problems that you or your loved ones are facing are becoming larger and more complex than you can comfortably manage. Are there other demands and responsibilities that render you unable to provide the desired level of supervision and attention to your loved one’s challenges?  Home healthcare providers work with GCMs to ensure that the best home care arrangements are provided.

P.S. As a professional, the GCM can address issues before they become problems, and get them resolved.