Technorati Tags: pharmacist, pharmacy

Source: Excerpts from Mayo Clinic Article

Definition of SAD

Like many people, you may develop cabin fever during the winter months. Or you may find yourself eating more or sleeping more when the temperature drops and darkness falls earlier. While those are common and normal reactions to the changing seasons, people with seasonal affective disorder (SAD) experience a much more serious reaction when summer shifts to fall and on to winter.

With seasonal affective disorder, fall’s short days and long nights may trigger feelings of depression, lethargy, fatigue and other problems. Don’t brush this off as simply a case of the “winter blues” that you have to tough out on your own.

Seasonal affective disorder is a type of depression, and it can severely impair your daily life. That said, treatment — which may include light box therapy — can help you successfully manage seasonal affective disorder. You don’t have to dread the dawning of each fall or winter.

Symptoms

Seasonal affective disorder is a cyclic, seasonal condition. This means that signs and symptoms usually come back and go away at the same times every year. Usually, seasonal affective disorder symptoms appear during late fall or early winter and go away during the warmer, sunnier days of spring and summer. But some people have the opposite pattern, developing seasonal affective disorder with the onset of spring or summer. In either case, problems may start out mild and become more severe as the season progresses.

Fall and winter SAD (winter depression)
Symptoms of winter-onset seasonal affective disorder include:

Depression

Hopelessness

Anxiety

Loss of energy

Social withdrawal

Oversleeping

Loss of interest in activities you once enjoyed

Appetite changes, especially a craving for foods high in carbohydrates

Weight gain

Difficulty concentrating and processing information

Spring and summer SAD (summer depression)
Symptoms of summer-onset seasonal affective disorder include:

Anxiety

Insomnia

Irritability

Agitation

Weight loss

Poor appetite

Increased sex drive

Reverse SAD

In rare cases, people with seasonal affective disorder don’t have depression-like symptoms. Instead, they have symptoms of mania or hypomania, a less intense form of mania, during the summer. This is sometimes called reverse SAD.

Symptoms of reverse SAD include:

Persistently elevated mood

Increased social activity

Hyperactivity

Unbridled enthusiasm out of proportion to the situation

Causes

The specific cause of seasonal affective disorder remains unknown. It’s likely, as with many mental health conditions, that genetics, age and perhaps most importantly, your body’s natural chemical makeup all play a role in developing seasonal affective disorder.

Specifically, the culprits may include:

Your circadian rhythm. Some researchers suspect that the reduced level of sunlight in fall and winter may disrupt the circadian rhythm in certain people. The circadian rhythm is a physiological process that helps regulate your body’s internal clock — letting you know when to sleep or wake. Disruption of this natural body clock may cause depression.

Melatonin. Some researchers theorize that seasonal affective disorder may be tied to melatonin, a sleep-related hormone that, in turn, has been linked to depression. The body’s production of melatonin usually increases during the long nights of winter.

Serotonin. Still other research suggests that a lack of serotonin, a natural brain chemical (neurotransmitter) that affects mood, may play a role. Reduced sunlight can cause a drop in serotonin, perhaps leading to depression.

When to seek medical advice

Most people experience some days when they feel down. But if you feel down for days at a time and you can’t seem to get motivated to do activities you normally enjoy, see your doctor. This is particularly important if you notice that your sleep patterns and appetite have changed — and certainly if you feel hopeless, think about suicide, or find yourself turning to alcohol for comfort or relaxation.

Medications

Some people with seasonal affective disorder benefit from treatment with antidepressants or other psychiatric medications, especially if symptoms are severe. The Food and Drug Administration has approved bupropion extended release tablets (Wellbutrin XL) for the prevention of depressive episodes in people with a history of seasonal affective disorder. Other antidepressants commonly used to treat seasonal affective disorder include paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor).

Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take antidepressant medication beyond the time your symptoms normally go away. This strategy can help prevent worsening of symptoms.

Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try several different medications before you find one that works well and has the fewest side effects. Like other medications, all antidepressants pose the risk of side effects and some have health precautions that you and your doctor must discuss.

Prevention

There’s no known way to prevent the development of seasonal affective disorder. However, if you take steps early on to manage symptoms, you may be able to prevent them from getting worse over time. Some people find it helpful to start treatment before symptoms would normally start in the fall or winter, and then continue treatment past the time symptoms would normally go away. If you can get control of your symptoms before they begin, you may be able to head off serious changes in mood, appetite and behavior that can disrupt your daily life.

Sad Bear picture is from mahnamahna.net/blog

Technorati Tags: depression, sad, seasonal affective disorder

Medarex Receives Milestone Payment for Investigational Antibody Targeting Integrin Receptors 2008-11-05, Source: Medarex, Inc. DRUGS cnto-95 COMPANIES: medarex inc centocor inc Medarex, Inc. today announced that it has received a milestone payment of an undisclosed amount from its licensing partner, Centocor R and D Inc., for the completion of a Phase 2 trial of CNTO 95, a fully human antibody targeting the integrin receptors that are implicated in tumor-induced angiogenesis. The CNTO 95 human antibody was generated using Medarex’s UltiMAb(R) technology. Medarex may receive future milestone payments and royalties should this product candidate progress to commercialization and achieve commercial sales.

Technorati Tags: cancer drugs, CNTO 95, oncology

by Bob Diamond R.Ph

CA-MRSA Staph Infection

Methycillin-resistant staphylococcus aureus (MRSA) is a well-known public health problem.

I just read a new study in the September 2008 issue of the North Carolina Medical Journal The study was about Community Acquired - Methycillin Resistant Staphylococcus Aureus, better known as a CA-MRSA infection, in children under 18 years old.

This is different than the MRSA (pronounced mersa) skin infection that has been acquired in a hospital setting. If a staph infection was acquired in the hospital, it is called HA-MRSA.

The Wake Forest University School of Medicine conducted the study.

This study was designed to look at children who reported to an emergency room with a skin abscess (skin infection with puss) that looked like it might be MRSA. If the child had not been admitted to a hospital within the last 30 days, and they had MRSA, it was determined to be community acquired. The study covered an 18-month period. 88 children were evaluated. They ranged in age from 2 weeks to 17 years.

After the CA-MRSA infection was identified by the doctor, each individual infection was tested by a laboratory to determine which antibiotics were the most effective against it.

The study concluded that community acquired-MRSA was responsible for almost 90 percent of the skin abscesses that were seen in the emergency department during that time.

The most interesting fact that came out of this study was that if an abscess was less than two inches (five centimeters) across, the wound would usually heal, if the doctor cleaned and debrided (removed dead or diseased tissue) the wound thoroughly, whether he administered antibiotics of not.

If the wound was larger than two inches, then the patient would only be healed if they were admitted to the hospital, and given aggressive antibiotic treatment.

One thing this study demonstrated is that CA-MRSA is not normally life threatening if it is taken care of while the size of the abscess is less than two inches. If you wait too long to treat it, then it can become life threatening.

If you see an infection on a child’s skin that has puss in it you need to treat it is as soon as possible, before it becomes a serious problem.

Click here for the North Carolina Medical Journal

Bob Diamond R.Ph

www.BobthePharmacist.com

DiamondRN@gmail.com

Technorati Tags: CA-MRSA, MRSA, staph infection

  Caregivers’ Support is Critical  

Article Source:  Chemotherapy.com

A diagnosis of cancer can be overwhelming, stressful and frightening. Many people with cancer turn to spouses, family members and friends for support. The role of the caregiver can range from providing emotional support to researching treatment options to helping your loved one stay on their treatment plan. 

A survey of 150 cancer patients, conducted in May 2002, showed that virtually all (99 percent) patients said their support network of people was extremely or very important in helping them get through chemotherapy. The same amount agreed strongly or somewhat strongly that having people who care about them made them more motivated to get through chemotherapy and 95 percent said their support network was instrumental in helping them get through the serious side effects of chemotherapy.1 

If you are reading this, it is likely that someone you care deeply about has been diagnosed with cancer. You might be trying to determine your appropriate role. This information is intended to provide insight into some of the feelings, needs, questions and worries you might have as you move forward in your role as a caregiver in your loved one’s fight against cancer. 

Click on the two links below to learn more helpful information about cancer and caregivers and their needs.

Dealing with the Diagnosis

Connecting with Others

Technorati Tags: cancer care, cancer caregivers

Article from Readers Digest

What to bear in mind the next time you visit the pharmacy counter.

1. Don’t try to get anything past us. Prescriptions for painkillers or sleeping aids always get extra scrutiny.

2. We’re not serving fries in here. I’d think twice about using a drive-through pharmacy. Working there distracts us-not a good thing when it comes to pharmaceuticals.

3. We’re human … and we make mistakes (about two million a year). Ask if we use a bar-code system to help keep us from pulling the wrong drug off the shelf or giving the wrong strength of the right drug.

4. Sometimes we can’t read the doctor’s handwriting either. E-prescribing can help, but as of 2006, fewer than 20 percent of prescriptions were being electronically transmitted.

5. I hate your insurance company as much as you do. “Even if something’s working for you, the insurance company may insist you switch to something else,” says pharmacy owner Stuart Feldman.”I’m stuck in the middle trying to explain this to customers.”

6. We can give flu shots in most states.

7. A less-qualified pharmacy technician may have actually filled your prescription. Currently, there is no national standard for their training and responsibilities.

8. Generics are a close match for most brand names. But I’d be careful with blood thinners and thyroid drugs, since small differences can have big effects.

9. I can give you a generic refill that’s different from the one you started with. When in doubt, ask. Online resources like cvs.com let you double-check your pill.

10. We’re not mind readers, and there’s not some big computer database that tracks your drugs and flags interactions for pharmacists everywhere. Use one pharmacy. If you start using a new one, make sure we know what you’re taking.

11. Avoid the lines. It gets busy Monday and Tuesday evenings, since many new prescriptions and refills come in after the weekend.

12. Look into the $4 generics offered by chains like Target, Kroger, and Wal-Mart. And it can’t hurt to ask your pharmacy if it will match the price.

13. Yelling at me won’t help. If I can’t reach your doctor and/or insurance company to approve a refill, there’s nothing I can do about it. “It’s frustrating,” says pharmacist Daniel Zlott, “but I’d be breaking the law in some states if I gave it to you.”

Sources:
Dr. Daniel Zlott, oncology pharmacist, National Institutes of Health; Cindy Coffey, PharmD; Greg Collins, pharmacy supervisor, CVS/pharmacy, California; Stuart Feldman, owner, Cross River Pharmacy, New York

Technorati Tags: pharmacist, pharmacy

Article from Readers Digest

More secrets from behind the drug counter.

1. Don’t put up with the silent treatment. Pharmacists are required by law in most states to counsel patients and answer their questions. If your pharmacist seems too busy to do talk with you, take your business someplace else.

2. An over-the-counter version might do the trick. You may just need to take more pills and forgo insurance reimbursement. But always talk to your pharmacist, and do the math. Half the prescriptions taken in the U.S. each year are used improperly, and most patients nationwide don’t ask how to use their medications.

3. Ask about over-the-counter drugs. “People assume that if it’s over-the-counter, it’s safe,” says Daniel Zlott, a pharmacist at the National Institutes of Health. “I’ve seen serious complications.”

4. Go ahead and call me doctor (I’m just not that kind of doctor). Since mid-2004, pharmacy students must pursue a doctorate in pharmacy (Pharm.D) in order to be licensed. Pharmacists licensed before then must have at least a Bachelor of Pharmacy and pass a series of exams. Either way, your pharmacist has spent more time studying drugs than even your doctor has.

5. Open up a little. “The better I know you as a patient—your health history, your family, and how busy your life is—the better I can tailor medications to fit your lifestyle,” says Zlott. “You may not want to take a drug three times a day, for example, and I’ll know that if I know you.”

6. “People take too many drugs, definitely,” says Stuart Feldman. Two out of every three patients who visit a doctor leave with at least one prescription for medication, according to the Institute for Safe Medication Practices. “Drugs are an easy solution,” says Feldman, “but there are other solutions.”

7. Talk to me—and check my work. Half the prescriptions taken in the U.S. each year are used improperly, and 96 percent of patients nationwide don’t ask questions about how to use their medications. When you pick up your prescription, at a minimum, ask, What is this drug? What does it do? Why am I taking it? What are possible side effects? and How should I take it? Not only does this help you to use the drug correctly; it’s also a good way to double-check that you’re getting the right drug.

8. We’ll save you money if we can. “A good part of a pharmacist’s time is spent dealing with patients and their incomes,” says pharmacist Cindy Coffey. Part of that is suggesting generic or OTC alternatives. Or if a doctor has prescribed a newer drug with no generic alternative available, says Zlott, “I might call the doctor to suggest an older drug that’s equally effective.”

9. “Some pharmacies are so volume-driven that the pharmacist can’t look up all day,” says pharmacist Cindy Coffey. There were a record 3.8 billion prescriptions filled in the U.S. in 2007—a 13 percent increase from 2003.

Technorati Tags: pharmacist, pharmacy

Technorati Tags: flu shots, heart disease

FDA News

The U.S. Food and Drug Administration (FDA) today issued the results of its interim safety and risk assessment of melamine and melamine-related compounds in food, including infant formula.

A safety/risk assessment is a scientifically based methodology used to estimate the risk to human health from exposure to specified compounds. It is based on available data and certain scientific assumptions in the absence of data. The purpose of the FDA interim safety/risk assessment was to identify the level of melamine and melamine-related compounds in food which would not raise public health concerns. The interim safety/risk assessment evaluated the melamine exposure in infant formula and in other foods.

The safety/risk assessment, prompted by reports of melamine contamination of milk-derived ingredients and finished food products containing milk manufactured in China, was conducted by scientists from FDA’s Center for Food Safety and Applied Nutrition and the Center for Veterinary Medicine. The FDA reviewed scientific literature on melamine toxicity. The FDA is in the process of identifying a group of experts that would be charged with the task of reviewing the risk assessment and providing guidance regarding the current gaps in scientific knowledge relating to the toxicity of melamine and its analogues.

Infant Formula

FDA is currently unable to establish any level of melamine and melamine-related compounds in infant formula that does not raise public health concerns. In large part, this is because of gaps in our scientific knowledge about the toxicity of melamine and its analogues in infants, including:

1. the consequences of the continuous use of infant formulas as the sole source of nutrition;
2. the uncertainties associated with the possible presence and co-ingestion of more than one melamine analogue; and
3. for premature infants with immature kidney function, the possibility that they may be fed these formulas as the sole source of nutrition and thus on a body weight basis experience greater levels of intake for a longer time than is experienced by term infants.

There is too much uncertainty to set a level in infant formula and rule out any public health concern. However, it is important to understand that this does not mean that any exposure to any detectable level of melamine and melamine–related compounds in formula will result in harm to infants.

Other Food Products

In food products other than infant formula, the FDA concludes that levels of melamine and melamine-related compounds below 2.5 parts per million (ppm) do not raise concerns.

This conclusion assumes a worst case exposure scenario in which 50% of the diet is contaminated at this level, and applies a 10-fold safety factor to the Tolerable Daily Intake (TDI) to account for any uncertainties. The TDI is an estimate of the maximum amount of an agent to which an individual could be exposed on a daily basis over the course of a lifetime without an appreciable health risk.

FDA continues to screen products, collaborate with foreign governments and their regulatory agencies, and monitor reports of contamination from international sources to help ensure that potentially contaminated products from foreign sources are examined if imported into the United States. If products are adulterated because they contain melamine and/or a melamine-related compound, the agency will take appropriate actions to prevent the products from entering commerce.

Technorati Tags: FDA, melamine, melamine contamination, melamine in infant formula

Back to posting index

Technorati Tags: Genetics