13 Things You Should Know About Your Pharmacist

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.”

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

9 More Things About Your Pharmacist

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 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.

Flu shots: Important if You Have Heart Disease

Flu shots are recommended for anyone with heart disease. Find out why.

If you have heart disease, flu season can be a dangerous time. Death from influenza (flu) is more common among people with heart disease than among people with any other chronic condition. Fortunately, getting a flu shot can reduce your risk of catching the flu or developing complications from the flu.

Doctors have long recommended that older adults and other high-risk groups get flu shots, but now emphasize the importance of flu shots for those with heart disease, as well. The flu shot could prevent thousands of flu-related complications and deaths every year in people who have heart disease.

Why are flu shots important for those with heart disease?

According to the Centers for Disease Control and Prevention (CDC), the flu is estimated to cause more than 36,000 deaths annually in the United States. In addition, it sends about 200,000 people to the hospital. The rate of flu-related complications is even higher for people with heart disease.

If you have heart disease, you’re at increased risk of complications from the flu — including pneumonia, respiratory failure, heart attack and death. Having the flu can also cause dehydration and worsen pre-existing conditions such as heart failure, diabetes or asthma.

Even if you get the flu despite having a flu shot, you’ll probably have a less severe case of the flu. Getting a flu shot might even lower your risk of a heart attack if you have heart disease.

Is it safe to get a flu shot if I have heart disease?

Flu shots are safe for most people who have heart disease. Get your flu vaccine injected by needle, which is usually done in the arm. Some people develop mild arm soreness at the injection site, a low-grade fever (about 99 F to 100 F, or 37 C to 38 C) or muscle aches. These side effects usually go away within a day or two.

The flu vaccine that is given by nasal spray (FluMist) isn’t recommended for people with heart disease because it’s made with live virus that can trigger flu symptoms in people with heart disease.

You shouldn’t get a flu shot if you’re allergic to eggs, or if you’ve had a serious allergic reaction to the flu vaccine in the past. If you’re sick with a fever at the time you plan to get a flu shot, your doctor may recommend waiting until you feel better to get your flu shot.

When should I get a flu shot?

If you have heart disease, get the flu shot each fall when it becomes available, usually late September through November. However, if flu shots are still available and you haven’t yet received a vaccination, you’d still benefit from getting a flu shot in January or later. That’s because the flu season doesn’t typically peak until January, February or March.

Do I have to get a flu shot from my cardiologist?

You don’t have to get your flu shot from your cardiologist. However, the American Heart Association recommends that cardiologists have the flu shot available at their clinics. The flu shot is also available through primary care doctors, some specialists and cardiology clinics, public health departments, and some pharmacies. It’s best to call ahead to determine if vaccine is available and when. Some places may require an appointment.

FDA Issues Interim Safety and Risk Assessment of Melamine and Melamine-related Compounds in Food

FDA News

October 3, 2008
Media Inquiries: 
Stephanie Kwisnek, 301-827-0955
Consumer Inquiries: 

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.

Welcome to MayoClinic.com’s New Genetics blog!

With Mayo Clinic genetic counselorCarrie A. Zabel, M.S., C.G.C.

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October 3, 2008 10:22 a.m.
Welcome to the genetics blog
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By Carrie A. Zabel, M.S., C.G.C.

Welcome to MayoClinic.com’s new Genetics blog! I am excited to be able to facilitate this online discussion.

I can recall many professional lectures I attended which indicated that “genetics knowledge was coming at us like a freight train.” Well, if that’s true, then the freight train is moving faster than ever. Within the past week or so, I have read three popular press articles about DNA, individualized medicine and genetic testing — without even seeking them out. These were things that I randomly came across as I was reading the morning newspaper and while sitting in my local hair salon. The excitement about genetics is certainly surrounding us.

My training in genetics has focused on a traditional approach of single-gene inheritance, single genes which are passed on in families and either increase a person’s susceptibility to disease or cause disease directly. However, these things only affect a minority of people. For example, although approximately 10 percent of individuals with cancer have an underlying strong genetic susceptibility to the disease, the majority of it occurs due to a combination of mild-to-moderate genetic susceptibility and environmental factors; we call this multifactorial inheritance.

Genetics today is taking a much broader look at disease and realizing that we need to identify these milder genetic factors to help you better understand your risk for common conditions (heart disease, diabetes, cancer) so that you may get appropriate screening, preventative treatment and be encouraged to lead a lifestyle that deters disease.

There are many genetic tests now available through genetics professionals, and even online, that offer an ability to help predict your risk of disease. I want to hear your thoughts on this. In my mind, this possibility is littered with challenging issues about how we will adapt as a society to “individualized medicine.” Do you want to know your future risks? Will this knowledge encourage a healthier lifestyle? Will it increase health care costs? And, because the technology is so new, are the predictions even valid?

Again, I am truly excited to be navigating this discussion with you. My hope is that our discussions will not only benefit you, but also the medical community. I look forward to hearing from you.