you just ahead on being well it's asked the pharmacist our guest this week are Renee klingler and Nicole drinker from Prairie medical pharmacy at Sarah Bush Lincoln will be covering a wide range of common questions about prescription and over-the-counter medications as well as vaccinations stay tuned being well starts now production of being well is made possible in part by Sarah Bush Lincoln Health System supporting healthy lifestyles eating a heart healthy diet staying active managing stress and regular check-ups are ways of reducing your health risks proper health is important to all at Sarah Bush Lincoln Health System information available at sarahbush.org alphacare specializing in adult care services that range from those recovering from recent hospitalizations to someone attempting to remain independent while coping with a disability chronic illness or age-related infirmity alphacare compassionate professional home care additional funding by Jazzercise of Charleston today show is called ask the pharmacist and I have two talented and educated ladies here talk all about our pharmacy questions first of all talk about the kind of schooling and education that a pharmacist today needs to have depends on which route you want to take there's a couple different options you could go directly into a six-year seven-year programme or you could complete a pre pharmacy or a bachelor's degree and then go into a four-year program to receive your doctorate so and you guys both have your doctorate in its pharmacology is that what it is in pharmacy pharmacology is one specific aspect what we study in pharmacy okay so what kinds of questions should people be asking you that we often don't what kind of scope of knowledge do you have in the area of pharmacy we're able to tell patients how to take their medication how to store their medication side effects to watch out for drug interactions that can occur with over-the-counter medications or with their other prescription medications and pharmacy has kind of changed it's a faster-paced we live in a faster paced world lots of drive-throughs which is convenient but are you seeing that that faster pace is taking away from some of that interaction that you have with people definitely yeah I would say yes so what is the most common question that you often get on a daily basis for people how much the medication costs and if their insurance covers it or not was their most common well I mean cost is important yes and you see generic and name-brand can you explain what's the difference between names name branded generic other than cost and why some drugs are not generic when a particular medication comes out brand new um the manufacturer has a patent on it that patent is usually good from anywhere from 10 to possibly 20 years depending on the medication and if they extend the patent while the patent is there the generic medication cannot be made only the brain medication is able to be distributed so that's why those medications cost a lot more they're trying to recoup all the money made in research and paying their scientists and all their funding advertising yeah it's expensive yes to create new drugs alright so we've all gotten probably a prescription that has those labels all on the bottle things we shouldn't do so we're going to go through some of them first one is why do some medications need to be taken at night certain medications have been proven to be more effective in the evening one of your most common ones as a cholesterol medication called a statin and the reason you take that in the evening is it best helps the way our body produces our cholesterol which is mostly in the evening and overnight so if you forget to take it at night is there any danger in taking it in the morning or the afternoon no not at all it just may not be as effective it is if you take an evening okay so let's switch to those medications that say take it in the morning first thing an example one of those would be like your thyroid medication it's very stimulating so that's why we recommend taking it in the morning and then you also need to be sure to take that one on an empty stomach other ways certain foods or other medications can interfere with the absorption of that one alright so the brought up foods one of the things we often see is this interaction with dairy it'll say don't take it with dairy products why is that the issue is the calcium in the dairy which some people don't realize also can be in a multi vitamin fortified orange juice anything containing calcium at all an antacid in essence it is because the calcium itself binds the drug molecules in your stomach so your body doesn't get to absorb it as well and it most commonly happens with antibiotics okay so what you had mentioned full stomach empty stomach why are some drugs better on an empty stomach some on a full it all depends on how they're absorbed okay so some medications require not to go into a lot of chemistry acid and bases it depends on what crosses the membrane most easily whenever you eat your stomach produces acid so therefore some of those medications will be absorbed easier in a more acidic environment okay so and then the last one we often see is don't take with alcohol what class of drug I mean it's pretty obvious but what kinds of drugs should you not take alcohol pain medications is a really big one many of our narcotic pain medications some medications that treat depression and anxiety in particular the class called benzodiazepines all of these cause a lot of sedation and so taking them with alcohol can be very dangerous everybody's a little bit different some people are more sensitive to those effects and therefore they would have more sedation and may develop complications from taking them together okay so read those labels precautions and take them it's an effectiveness thing and also a safety thing yes alright so let's switch gears war will probably get back to 202 prescriptions but over-the-counter medications there are so many are there things we should be aware of in mixing over the counters with our prescriptions yes and certain pain medications contain tylenol in them so you never want to add additional time and on top of that there is a maximum recommended daily allowance to town on because it can harm your liver so that's really important and it also can be found in combination cold products which a lot of people don't think to read the back of the box to see that what they're taking already has tunnel and they may take more on top of it those combination products can be very dangerous because people start taking multiple cold medications and if you don't read the labels you may be taking more of something than you should be so is tylenols and named brent is acetaminophen is that this generic name for acetaminophen so you're taking something a prescription with acetaminophen and don't be taking an over-the-counter with it correct okay what about for people that I've seen ads for this on TV cold medicines and its effect on people with high blood pressure there is a particular line of blood pressure medications called coricidin HB they make specific medications that don't have a decongestant in it okay the decongestant is dangerous for people with high blood pressure because it can increase their blood pressure okay so you gotta watch for that sort of stuff are there just because something is over the counter does it mean that we can just take as much as we want they all have limits ok so like which ones should we be we should probably aware of all of them but what are some we should really be concerned about for over-the-counter watching how much we're taking tylenol is a big one okay especially with so many different things that contain tylenol in them what is the main issue that comes about when you take too much acetaminophen it causes liver toxicity okay so what is that quiz e do you know what their what is the recommended dose maximum per day is four grams and adults and sometimes greater than 65 they've actually started recommending three grams okay I feel like it's a little safer so like four we don't we're not thinking about graves don't know how many pills is that a day it depends on the strength of tylenol that you buy because it comes as a 325 325 milligrams uh-huh 500 milligrams or 650 milligrams okay so it'd be like eight of the five and downloads a day can you mix like acetaminophen with some of the other I can't think of the generic but like a leave and ibuprofen which are the now I'm not the pharmacist what's the other class of incense incense HR the anti-inflammatories can you mix those and be okay you can alternate them but it also depends if you're taking some other medications there are certain ones you can't take while you're on insides in particular blood thinners and since then your blood so we worry about you having a bleed okay so you really need to tell your doctor tell your pharmacist about the other things you're taking as well education is important it is that something you think people fail to think about sometimes I think they think oh it's tylenol it's harmless or it to leave it's harmless mm-hmm just because it's over the counter doesn't mean it's not important okay so what about vitamins and supplements important as well they're like Nicole mentioned the blood thinners they can interact with a lot of our herbal supplements so making sure your doctors aware of everything that you're taking okay let's talk about you know when it's cold and flu season you go into the pharmacy and you get all these there's lots of choices mm-hmm I always have a hard time picking I don't know what to choose I mean I just get some that covers everything or D gets what do you do we were just talking about this saturday as pharmacists we actually both do the same thing we we treat our symptoms i buy individual products and I pick and choose what I need to take based on our symptoms but I also understand people that are already taking a lot of medications you don't want to take a lot more so the combination products may be better suited for them but it would be important to go ask the pharmacist go get them have them help you pick something out that would be most appropriate for you okay so you shouldn't if you don't have a cough don't get something that treats cough is out with sure you don't really need it so just be taking extra medication okay let's talk about treating Colts they kind of hang on for a while I mean what do you if you give us some advices so someone's starting to feel those cold symptoms when should they start taking something right away right away and then what's the typical duration of a cold can last up to like three weeks okay depending on the virus yes so what about for flu is there anything out there that we can take for the flu if you have a true like respiratory flu there are some prescription medications available if you go see your doctor depending on your specific situation over the counter you're really just going to treat your symptoms okay now I want to talk to you guys about and we see it in the news a lot about this antibiotic business and we've had several people on this show talking about antibiotics although this is your platform to talk about antibiotics and you know kind of some of the dangers that can come if we're taking them one really not supposed to UM antibiotics do not treat viruses they only treat bacterial okay so having an antibiotic prescribed to you or kind of requesting one when you don't need it doesn't do you any good the only thing it does is bacteria are kind of smart and they figure out how to become resistant they figure out how to beat the antibiotics or get around them so the more we take antibiotics we don't need we're creating bacteria that is smarter than the antibiotics that we have kind of see what kind of illnesses are bacterial vs viral because I always get that next up but it depends pneumonia typically bacterial ear infections typically bacterial sinusitis typically bacterial but viruses can cause some of them okay so it's important to see your position they can help with the diagnosing of whether they think it's bacterial or viral depending on your symptoms so the flu and the cold are generally viral yes you just gotta sort of deal with the symptoms um let's stay on antibiotics what are some things that can cause some interactions with antibiotics and some issues when you're taking one thing and it lessens the effectiveness of maybe something else the biggest thing is birth control okay I talked about like how food can affect the effectiveness of the antibiotic but the antibiotic can make birth control not as effective okay I get an antibiotic for a bacterial infection and I start to feel better and I decided I'm done I kind of sometimes antibiotics make you feel kind of issue anyway what's your recommendation for antibiotic taking it you need to finish the full course of therapy and why is that by stopping early you're probably not killing all the bacteria we were trying to treat and therefore like Nicole said they're going to become smart they're going to become more resistant to those medications and it's going to make it harder down the road for the doctors to treat infections that you're getting okay so take all of it even if you're feeling better is that sometimes what happens to people they don't take it and then they get it again and then they need something stronger is that sort of starting that cycle yep enough nice darn it okay so be careful about the ANA bags I don't why do they make you they make me kind of nauseous why do antibiotics seem to create that nausea feeling for some people it's just certain classes and the way the structure is and it's just it can be very hard on the stomach okay yeah anything you can do to lessen the effect some of them specifically can't really distinguish between good bacteria and bacteria so it kills the good bacteria that's found normally in our stomach in our intestines so one of the recommendations is to take like a probiotic yogurt that can reintroduce the good bacteria into your stomach it helps with the classes that cause in the diarrhea and things like that so are there some some side effects from taking animatics because it's getting rid of all the good bacteria to diarrhea is a big one okay some women experience yeast infections when they get them okay but they're necessary sometimes all right so another area that you guys deal with his vaccines let's talk about this 2014 2015 flu vaccine let's talk about how the vaccine you know is developed early in the season how that whole process works basically they look at what strands of the flu were most prominent the flu season before so it would have been in the 2013-2014 flu season based on the most prominent ones that's how they determine which ones to put in the vaccine so it's it's a guess I mean it's not going to always be a hundred percent match so now we're we're hearing or we've heard that maybe this flu vaccine is maybe not they didn't quite guest just right what's what's going on it's different just different strains of the virus seem to be occurring so people that they give the vaccine may not have coverage against that specific strain so therefore they are getting sick so are they going to come out with it is there another vaccine to treat the flu that's out there that's more prevalent are we just going to have to hope for the best we'll just have to hope for the best and prevention is the main thing means still getting the flu shot you could be one of those people that gets one of the strains that the flu shot does cover you just never know so getting the flu shot is good hand washing those are really the most preventive methods okay so what do you say to people say when I got a flu shot I got the flu right away I felt terrible what what's going on are they really getting the flu no no what's good good um so when we get the flu vaccine it introduces inactivated parts of that virus into our body that lets our immune system produce a memory of how to fight it so when your immune system kind of gets ramped up you feel certain things you might feel like you have a mild fever you might have things like that feel tired yes those are all symptoms of your immune system being activated not necessarily the illness but people associate it with the illness because the same thing happens when you get sick and some people's bodies just need to create more of a response than others and so some people have a hard time after getting the flu vaccine okay let's talk about tip I'm kind of on this flu thing right now people how do you distinguish between whether you get a cold or flu what's kind of is there something telltale that's as this is really the flu this is not just a cold I want to say fever is one of the big ones you start developing a fever and kind of the all-over body aches just feeling like you're is completely kind of got hit by a truck or just hurt all over yeah it's a cold can be really bad I think the worst part about cold is it just drags on for like two weeks it just takes forever to get over so fever is kind of the biggest indicator of the of the flu all right so let's talk a little bit about other vaccines that people can get at their pharmacy what are some other common ones that that you guys do pneumonia is a big one shingles vaccine meningitis hepatitis tetanus and diphtheria that would be like your whooping cough vaccine so pretty much the main ones yeah I was the same I'm missing a new who do you recommend gets a pneumonia vaccine is that an annual thing that people should be getting no no typically if you are it depends if you have any of the disease states that put you at more risk for pneumonia so a big one would be if you have COPD you typically can get your vaccine earlier on and then the CDC doesn't recommend getting revaccinated until after you turn 65 okay so possibly two in your lifetime okay what about the shingles vaccine because I had shingles at 40 and I would love to get that shot because I don't ever want to have I didn't have a bad case of it but I don't want it again can I get it the vaccine it's actually only indicated for patients who are 50 years or older okay if you are 65 and older you can go to your pharmacy without a prescription if you are 50 to 64 you have to get a prescription from your doctor okay so why D is why can't I mean I'm 44 lb 45 why can't I get it now what to wait to like 50 it's not indicated for that age range typically those are the healthy people you don't develop it's not as common for people to get shingles in that age range so we're more concerned with the people who are older have a more weakened immune system okay so if you get that vaccine are you guaranteed that you will never get shingles no no especially with the shingles um there's different reports on how effective it is but it's not as effective as the pneumonia vaccine but what you can you know hold on to is that if you do get it it should be a shorter duration with a less severe case okay so even though you may get it shouldn't be as bad yeah i mean we're starting to see lots of ads on TV for shingles you just never even really heard of it before and now it's become so mainstream i means if you've had it it's not a fun thing to have it could be very dangerous all right so talk about some other advice that you think people need to know maybe here's a question what should people have in their medicine cabinet not that we really have some people have the traditional medicine cabinet but what do you recommend as pharmacists we were talking about this yesterday also we both have benadryl at the same time a little late benadryl allergic reactions can happen any time you may develop an allergy that you don't know about so benadryl is the quickest and best thing to treat it especially if you're needing to tide yourself over to you can get to an ER okay so benadryl what else pain medication I mean everybody's different on what they think works best for them or what they should be on based on their other medications so whatever preference of pain medication that you want we were also talking about where you keep your med cabinet that's very important a lot of people keep their medications in the bathroom that is not a good place to keep your medications okay moisture can degrade those medications so whenever you're taking a shower taking a bath all that moisture gets into the air it can be very harmful for your medications so best place to keep them innocent dry captain mm-hmm alright so this always happens to me with cold medications I take get some don't take it all and then I get a cold two years later and I look at that expiration and like well it's still good hoffa do you recommend cleaning out that medicine cabinet if it's expired I would not I'm taking it okay what am I going to die if I take expired you know cold pills or what happens to that any kind of medication after it's expired Louis medication just becomes less effective okay some medication can be dangerous if you take it after it's been expired and tetracyclines is one of those medications so if you have that and it's expired get rid of it okay what I mean like what happens to it or what is it just changes chemical it's very it does yeah it's very harmful to your body okay i zoom in after it's been degraded um which I should ask this what if um you know your child gets sick and you don't have like a children's strength of like tylenol or something can you give them a smaller dose of an adult size or what about for children taking adult medications over the counters you technically could it's the same medication the biggest thing with the difference between the children and an adult is the concentration of each okay so you would have to be very very careful and I would say consult a doctor consult someone with exactly how much you should give because it will be a much smaller amount so maybe harder those are usually pill forms and you know our kids don't take well to pill forms the liquid is a lot easier for them yeah and it's kind of hard to cut pills in half and liking it exactly yeah half exactly um what what do you recommend if people do see this and like I should clean out my medicine cabinet what's the safest way to get rid of meds we actually take them back at the Prairie medical pharmacy it's oh gosh we do take expired meds back and they recommend diluting the water and pouring them over kitty litter and coffee grounds that helps absorb it and you can just throw it out you have any they also usually do yearly take back events through the police department especially if you're controlled substances that's a good way to get rid of a lot of those so maybe doing like a yearly med clean out in your cabinet maybe close to one of those events and just take all your meds there and you can get rid of them okay but most pharmacies will take you guys only a lot of fun a lot of them don't okay I you know we've seen reports where it's not good to put them down the garbage disposer the toilet because it infiltrates the water supply that's why it's nice to put it if you put in the kitty litter or something like that occurs to helps absorb that out of it and it makes it less appealing for anything to get into it that's true I mean some pills look like candy yes one else in children and and you know we need to just be aware of you know also you know other people invading the medicine cabinet this prescription drug abuse has become a problem yes so any last we just got like a minute left any last little bit of advice you want to give to people on medications or maybe pharmacists feel free to ask us questions were available anytime you can always call your pharmacy or don't be afraid to stop a pharmacist and ask them even if they seem busy always having an up-to-date med list with us that is very important if you go to the hospital it's good to be able to show them what you're on over-the-counter and prescription and going to your pharmacy if you're asking about that coughing cold medication if you can pull out your list and say this is what I take what is not going to interfere with this all right did you have something else well I'm back on the vaccines a lot of people don't realize with the tetanus one you are supposed to get boosters uh-huh so then whenever they have an accident or cut or fall and they come to the ER they're not up to date so then they have to get the shot and the pertussis or whooping cough also helps protect the elderly and especially little babies oh that's a good one to stay up-to-date on too well thank you ladies for stopping by our show and giving us great information so this was ask a pharmacist so they encourage you to ask your pharmacist if you've got questions thanks for watching production of being well is made possible in part by Sarah Bush Lincoln Health System supporting healthy lifestyles eating a heart healthy diet staying active managing stress and regular check-ups are ways of reducing your health risks proper health is important to all at sarah bush lincoln health system information available at sarahbush.org alphacare specializing in adult care services that range from those recovering from recent hospitalizations to someone attempting to remain in too while coping with a disability chronic illness or age-related infirmity alphacare compassionate professional home care additional funding by Jazzercise of Charleston you