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Boggio Family of Pharmacies

Boggios: A healthy choice for your whole life

Age-related Macular Degeneration (AMD) is the most common cause of vision loss in Canadians, especially after the age of 65. There are two types of AMD: wet and dry, with the latter being much more common. Dry AMD typically presents as a slow, painless loss of vision. Usually, the centre of the visual field blurs while the edges of your sight stay the same. In wet AMD however, vision loss is much more rapid.

The cause of AMD is still mostly unknown, but we do know that there is damage to parts of your eye that help send images to your brain. Development of AMD has been linked to genetics, smoking, blood pressure, heart health and diet.

How can you reduce your risk of developing AMD?

  • Stop smoking. Smoking is associated with up to 4 times higher risk of developing AMD. Speak to your pharmacist for help in quitting
  • Eat a balanced diet
  • Keep your blood pressure under control
  • Take your cholesterol and heart medications
  • Speak to your pharmacist for tools to monitor your vision. There are special, easy-to-use visual scales that you can use at home to detect if you are developing AMD.

What about vitamins and minerals?

You might have heard that certain supplements might be good to reduce the risk of getting AMD. At the moment, the best data suggest that supplements only help patients with at least intermediate-severity AMD – so if you don’t have a diagnosis of AMD or if your AMD is very minimal, taking a vitamin might not be the best choice. Talk to your pharmacist to see if a supplement is for you.

If you have been diagnosed with AMD with at least some moderate vision loss or more, a supplement might be a good idea. There are many formulations out there marketed for vision loss but not all of them are supported by best evidence. Your pharmacist can help you choose the best supplement for preserving your vision.

What about wet/severe AMD?

If you have been diagnosed with wet AMD, you will need to start prescription medication for AMD. These medications are usually injections that are administered to the eye by your eye specialist. Many of them work well not only to keep your AMD from progressing, but they can also help to restore vision that has been lost.

Many of these injectable medications can be quite expensive but they may be covered by your drug plan. Some of the drug companies that make these medications also offer assistance for patients in paying for these injections. Talk to your pharmacy team for more information regarding the most cost-effective way to purchase these medications and to save you money.

The most common side effects of these medications are minor eye pain and red spots on the eye near the injection site. These are normal side effects and they typically resolve a few days after administration. Very rarely, these medications may cause an infection in the eye called endophthalmitis which can cause permanent vision loss. Therefore, if you notice severe eye pain or vision loss after the injection, see a doctor immediately.

The most effective way of protecting yourself from the flu is by getting the flu shot each year. A new vaccine is developed annually based on the three strains of influenza which are predicted to be the most prevalent that year. The vaccine works by introducing a small amount of inactivated influenza virus into our body allowing our immune system to build an army of antibodies to the virus. If we are then exposed to the live virus, our immune system sends the antibodies to “attack” the foreign invader, preventing an infection from developing.
Unfortunately, sometimes the unexpected happens, as was the case this flu season. The influenza strain that ended up being the most widespread this year was not one of the three strains contained in the vaccine, so there were many cases of people getting sick – even those who did get vaccinated. Naturally, people are concerned about the effectiveness of the flu shot and have doubts about whether they should get the vaccine again.

Here are some points to consider when making your decision to get immunized next flu season:

1. Extensive research is done each year to make the decision about which three strains will be included in the vaccine. Generally, the predictions are very accurate and the vaccine prevents many thousands of people from becoming ill each year. However, we need to remember that the annual flu vaccine does not protect against all strains of the influenza virus, so there is a chance that someone could become infected with another strain.

2. We need to understand that what happened this year was unusual. This season, the virus essentially ‘outsmarted’ us. It was determined that the main viral strain mutated, leaving the vaccine less effective than expected. This mutation meant that the virus changed in such a way that the antibodies our immune system had developed after receiving the vaccine, were not able to mount a very effective response to infection by the live virus.

3. The flu vaccine CANNOT give you the flu. The components of the vaccine are inactivated influenza viral particles – meaning only pieces of the killed virus are present and are not able to cause infection.

4. Immunity from the flu shot is not immediate. It takes about 14 days for our immune system to develop antibodies to the strains contained in the vaccine. During this lag period, it is possible to develop an infection if contact with the virus occurs during the first two weeks after vaccination.

5. It is recommended that everyone over the age of 6 months be immunized each year. Not only can it protect you from becoming very sick, but it can help to protect those around you, by reducing the spread of the virus. Furthermore, if you do come down with the flu after receiving the vaccination, the infection will likely be less severe and may not last as long.

6. Vaccines – including the flu vaccine – do NOT cause developmental disorders like autism. People have become very concerned with the idea that thimerosal (a preservative used in some vaccines) is linked to the development of autism in children, but there is no evidence of this being true. However, there are flu vaccines available that do not contain thimerosal if you still have concerns.

6. It is beneficial to get the flu shot at any point during flu season; not only at the beginning. Also, it is a good idea to get vaccinated even if you have already had the flu that season as the infection may have been caused by a different strain.

Although the flu vaccine is the most important form of protection from the flu virus, people must remember that hand hygiene is also a key component to preventing the spread of infection. Washing hands thoroughly and often, using hand sanitizer when washing is not possible, and staying home if you have flu-like symptoms to avoid spreading the virus to others.
Influenza can be a serious illness for many people, especially children, the elderly and those who are immunocompromised, but the flu vaccine is important for everyone. It helps to protect yourself and those around you from potentially becoming very ill. If you have more questions about the flu vaccine, please talk to your pharmacist.

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What are the measles?

According to the World Health Organization, measles is a highly contagious, serious disease caused by a virus. It is characterized by a red blotchy rash, commonly causes diarrhea and pneumonia and in more severe cases can even cause brain swelling or death. Measles is an airborne disease that spreads easily through the coughs or sneezes of an infected person. It may also be spread through contact with saliva or nasal secretions of an infected individual. People can be contagious for as many as 4 days before the rash and for up to 4 days after the start of the rash.

Why has there been so much talk about measles lately?

In the past several years there have been multiple measles outbreaks. Currently we are dealing with a number of cases throughout the Niagara Region. Over the last year you may have also heard about the much larger multi-state outbreak that has occurred in the United States. This larger outbreak has been linked to some of the cases in Canada while other cases have been linked to travel to countries where measles is endemic.

What are the symptoms?
• Fever
• Runny nose
• Drowsiness
• Irritability
• Red eyes or sensitivity to sunlight
• Small white spots on the inside of the mouth and throat
• Red blotchy rash that starts on the face and spreads to the rest of the body within 3 to 7 days after the start of symptoms

How can I prevent myself or my family from contracting measles?

The most important measure you can take to prevent the measles is to get vaccination with two doses of a measles-containing vaccine. The first dose of measles vaccine is typically administered at 12 months of age with a second dose administered prior to a child’s fifth birthday. All adults and children are advised to ensure that their vaccinations are up to date. For more information on whether your vaccinations are up to date, contact your health care provider or the Niagara Region public health department.

What to do if you suspect you have the measles:

• Before visiting your health care provider, be sure to contact them first and describe your symptoms over the phone so that they can take appropriate precautions before assisting you, or direct you to the most appropriate health provider.
• Contact your health care provider or Niagara Region public health at 905-688-8248, ext. 7330.

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Although we are in the midst of another flu season here in Canada, it has been the Ebola virus recently dominating headlines and causing fears around the globe. The World Health Organization (WHO) reports more than 14,400 confirmed or suspected Ebola cases as of Nov. 11, 2014, mainly in the African countries of Guinea, Liberia, and Sierra Leone, thus making it the largest Ebola outbreak ever recorded. The current epidemic has led to over 5,100 deaths and the lack of any vaccine continues to cause fears of a global spread of Ebola. However, a closer look at the details regarding these events should ease nerves and help shift focus back to the greater threat of year’s influenza strain.

In the early stages of infection, it is difficult to differentiate Ebola from the flu as both cause non-specific symptoms such as sudden onset of fever, fatigue, headaches and a sore throat. However, Ebola patients will begin to develop vomiting and diarrhea after 3-6 days and approximately half will also experience hemorrhagic events such as nosebleeds, bloody diarrhea, and bruising typically occurring between 2 to 21 days after initial symptoms appearIt is also important to note that unlike the flu, Ebola is not an airborne virus. Furthermore, Ebola can only be transmitted once symptoms appear while flu patients can spread the virus before and during their illness.

Scientists believe that the first Ebola patient contracted the virus after handling an infected animal, possibly a fruit bat or monkey. Unlike humans, these animals are able to ‘host’ the virus without becoming severely ill. Once a human becomes infected, transmission to other people may occur only through direct contact with blood, secretions or other bodily fluids from an Ebola-infected person. In West Africa, this direct contact occurs during traditional West African funerals that involve washing and touching the deceased as part of the mourning process. This practice is not commonly followed in Canada and would limit the rate of transmission if the virus somehow found its way to North America.

You may have heard speculation that mortality rates for the current Ebola outbreak are as high as 90 percent. Keep in mind that these inflated rates are based on patient care settings that are not as sophisticated as the resources available in Canadian facilities. Insufficient medical care, shortage of supplies and a lack of funding are undoubtedly contributing to the epidemic. Although there is no specific treatment or vaccine currently available for Ebola, our hospitals are able to provide high-quality supportive care which can help boost the patient’s own immune system enough to overcome the virus on its’ own.

Therefore, at least within Canada, there is no reason to fear those with a fever or upset stomach. However, reasonable precautions should be followed if we encounter people with Ebola-like symptoms who have also travelled to West Africa within the past 3 weeks. These patients should seek immediate treatment to ensure they receive the best available treatment as quickly as possible. And, of course, getting a flu shot is an easy, effective way to prevent ‘the other virus’ from spoiling your Holiday season!

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An ostomy can have profound effects on an individuals daily activities, diet and even medication regimen. An individual dealing with an ostomy (an ostomate) must be very careful with their use of over the counter and prescription medications in order to ensure effectiveness of that medication as well as to prevent complications/ side effects.

There are three main types of ostomies:

•ileostomy – a portion of the small intestine is rerouted/ removed
•colostomy – a portion of the large intestine/ colon is removed or rerouted
•urostomy – a portion of the urinary tract is removed or rerouted

Generally, individuals with an ileostomy must be much more cautious when it comes to their medications compared to individuals with a colostomy or urostomy. As a result this article will focus mainly on medications and how they affect and are affected by an ileostomy.

In an ileostomy an ostomate has had a portion of their small intestine removed or rerouted. The small intestine is responsible for the greatest absorption of nutrients and medications. You can imagine that by removing this important organ it will have a huge effect on the absorption and therefore effectiveness of certain medications. In particular many coated or delayed/ controlled release drugs may pass through the shortened small intestine without actually being absorbed. Individuals with an ileostomy may notice that these controlled release drugs will actually pass through their digestive system and appear unchanged in their ostomy pouch.

In order for a medication to be absorbed it must first be broken down into a liquid/ gel form. If this does not happen before passing out of the body it will not be absorbed and will not produce its desired effects on the body. There are certain instances where this process can be sped up in an ostomate by crushing the medication and preparing it in a liquid suspension. This compounded suspension is ready for absorption immediately once it hits the digestive tract improving the likelihood that the medication will be absorbed and do its job. However, it is extremely important that you do not crush, split or alter any medication without first checking with your pharmacist or doctor. There 3 reasons why certain medications must not be crushed or split:

•Certain medications come in higher doses that are intended to be released very slowly over a long period. If these medications are crushed that large dose is released all at once resulting in potential toxicity/ overdose.
•Other medications have a coating on them that help prevent the medication from irritating the stomach. When this coating is removed the medication inside comes into contact with the stomach lining causing unnecessary irritation and stomach upset.
•Lastly, Some medications have a coating that protect the medication from being destroyed by the stomach acid. If this coating is broken the medication will be easily broken down in the stomach and will not work.

Laxatives and other medications that can cause diarrhea are usually avoided in individuals with an ostomy unless otherwise directed by your physician. Laxatives can speed the rate at which the medication is cleared from the digestive system, therefore reducing its absorption. Laxatives may also cause fluctuations in an ostomates vital fluids and electrolytes.

In general immediate release formulations of medications such as suspensions, liquids, gel capsules and uncoated tablets are the best route of administration for any ostomate. As a general rule of thumb, if a tablet is placed into a glass of water and begins to dissolve within 30mins there is a good chance that this medication will be absorbed and produce its desired effects even in an individual with an ileostomy.

If you or a loved one is living with an ostomy always make sure that your physician and pharmacist are aware. If they are aware of your situation they will be able to select a better medication regimen specifically for you. Talk to a Boggio Family of Pharmacies pharmacist today to make sure your medications are safe and effective for your unique situation.

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Mobility scooters offer the ability to travel great distances that are not usually within walking distance. They can help you move around your home, neighbourhood and inside stores. However they can be dangerous if not used safely.
Follow these tips before you head out so you can get safely from home to your destination.

Read the instruction manual upon purchase so you know the safety features and controls on your new scooter. Read the tips that are given for navigating bumps, curves and uneven ground. Some heavy duty scooters are designed for rough terrain. Learning to drive your scooter in a safe area such as a parking lot or driveway is always recommended to learn how your scooter manoeuvers in all weather. Having confidence will make it a safer experience for you and others around you.

Some basic scooter tips include:
• Use sidewalks whenever possible. If no sidewalks exist, travel on the far left side of the road facing traffic.
• Cross at pedestrian crosswalks. Check for traffic before crossing.
• Make “eye contact “with motorists or pedestrians before crossing to make sure they are stopping.
• Obey all traffic control signs and devices.
• Slow down when travelling around pedestrians and avoid travelling too closely.
• Keep to the right on sidewalks and avoid honking your horn.
• Drive your scooter straight at a ramp. Most scooters have anti tip wheels to keep them from tipping when doing angled manoeuvres.
• Your scooter should have a safety flag, reflectors and lights in the front and back so you can be seen at all times.
• Wearing a reflective safety vest is also a good idea and is essential if you have to travel at night.
• Carry a cell phone and have your emergency contact information taped onto your scooter so it is easy to find.

For more information on scooters please visit or call one of our four Boggio Family of Pharmacies Home Health Care locations. Our dedicated and knowledgeable staff will be happy to help you with any questions you might have in purchasing your new scooter this season.

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There are many common issues that pharmacy staff run into when trying to fill prescriptions that may delay your trip to the pharmacy, or even force you to come back for a second trip. At the Boggio Family of Pharmacies, we want to make your trip as quick and simple as possible. Here is a list of tips and tricks!

 

  1. Keep the pharmacy updated on all of your personal information. Often times a prescription that has been sent to us from a doctors office cannot be filled because we are missing information. For example, if we receive a prescription for “John Doe” we may have several patients with that name on file and if your patient record is not up to date, we may not be able to fill the prescription until you come into the store. All personal information is kept completely confidential and will never be shared. Some important pieces of information to keep up to date at the pharmacy include:

◦      Phone numbers, including mobile or work numbers that are appropriate to contact you at

◦      Address, especially when items are requested to be delivered

◦      Allergies and medical conditions. This will ensure that the pharmacists can properly evaluate the appropriateness of any new or existing medications.

◦      Drug coverage information. Did you receive a new insurance card from your employer? Confirming that this information is up to date can save yourself time when you come to pick up your medications.

  1. Always check if your prescription has repeats before you completely run out of medication. It may take us several days to hear back from doctors offices for repeats, especially if the office is closed, or if you come in on a weekend. Knowing how many repeats you have on a medication, and ensuring that the pharmacy has additional repeats on file before you run out can save you time and frustration. Under the pharmacists discretion certain chronic medications can be extended for short durations, but they must still attempt to contact the doctor for a prescription before they can do this. Narcotics, controlled substances and targeted substances cannot be extended under any circumstance due to the nature of this medication. For these medications, it is extremely important to be aware of how many repeats you have on file.
  2. Know if your medication has a dispensing interval. Some medications (not limited to but often narcotics and controlled substances fit into this category) are prescribed by the doctor with an interval between the dates that the medication can be filled. For example, if the doctor asks for the medication to be filled with a 30 day interval, the pharmacy has an obligation to dispense that medication every 30 days. You can save yourself a lot of headache by knowing what day your prescription is ok to be filled. Some private and government drug plans have intervals as well. Each plan can be a little bit different so ask one of our dispensary team members how this may affect you.

 

By using these tips and tricks, we feel that you should experience a much smoother trip to the pharmacy. As always, if you have any questions or concerns feel free to call or stop by one of our four Boggio Family of Pharmacies locations today!