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Patients & Consumers

You probably know the name of your doctors. You may even know where they went to medical school, why they chose their specialty and how long they have been in practice. But do you know as much about your pharmacist?

If you take any kind of medication for any reason, you should choose your pharmacist as carefully as you choose your physician.  Today, medications have become our most important and cost effective tool for treating illness and disease.  With the number of prescription medications and over-the-counter medicines available to consumers today, the role of the pharmacist becomes important to help one manage their overall health care. 

About Pharmacists

Pharmacists are medication experts. They do much more than simply counting tablets and pouring liquids. For each prescription, a pharmacist must:

• Check to see if the information provided by the prescriber is complete;
• Ensure that the new medication will not interact with other medications you are taking;
• Determine whether the medication and dosage are appropriate for your health condition; and,
• And make sure you understand the proper way to store and take the medication.

Each of these steps is critical to your well-being. For this reason, the Doctor of Pharmacy degree requires at least two years of pre-professional (undergraduate) study followed by four academic years of professional study. During these six years, a student pharmacist becomes the most knowledgeable health care professional when it comes to medicines and their uses.

Pharmacy is practiced in a wide range of settings:

• Community pharmacies
• Hospitals
• Long term care facilities
• The pharmaceutical industry
• Mail service
• Managed care
• Government (Department of Defense, Department of Veterans Affairs, Indian Health Service, Public Health Service)

The pharmacist is a key health care professional in helping people achieve the best results from their medications. Consumers should choose a pharmacist they trust and build a partnership for good health.

How Your Pharmacist Helps You

If you’re like most people, you will see your pharmacist three times as often as you see your physician annually.  Your pharmacist is the most accessible member of your health care team. By getting to know your pharmacist, you can gain a valuable ally – one who will help you get the full value of both your prescriptions and over-the-counter medications.

Pharmacists are trained professionals who understand the composition of drugs, including their chemical, biological, and physical properties. Because they have studied a drug’s manufacture and use, pharmacists are able to ensure its purity and strength. They can inform you about:

• The name of the medicine and what is it supposed to do;
• When and how to take the medicine;
• Possible drug interactions or allergies;
• Possible side effects;
• Safety during pregnancy or breastfeeding;
• A less expensive version (generic) of the medicine;
• Insurance coverage;
• What foods, drinks, or activities to avoid while on the medication;
• When to take the medication;
• How to store the medication; and,
• What to do if you miss a dose.

Pharmacists work closely with your doctor to make sure your medicine is working correctly.  Tell your pharmacist if you are having problems with side effects or if your medical problem is not getting better.  He or she can contact your doctor and help choose another medicine that may work better for you. You, your doctor and your pharmacist are a powerful team, working together to make sure you get the best results from your treatment plan.

Find a Pharmacist

The first step is to find a pharmacist you feel comfortable speaking candidly with. After introducing yourself, you should provide as much background as possible – including which medications (prescription, over-the-counter, and herbal remedies) you currently take. Share any conditions (such as allergies or pregnancy) that may affect your response to a medication and keep this information up-to-date. Finally, ask questions each time you get a new medication. Despite the best efforts of your physician and pharmacist, it is up to you to effectively manage your health.

Managing Your Health

According to the Centers for Disease Control (2004 report), 44% of Americans are taking at least one prescription medication and nearly 17% are taking three or more. Americans spend billions of dollars each year on prescription and over-the-counter medications.  These dollars are wasted if the medications are used incorrectly. You may even end up spending more if you fail to get better and end up in the hospital. According to a March 2001 study in The Journal of the American Pharmaceutical Association, Americans pay $177.4 billion a year in avoidable health care costs.

By working closely with your pharmacist, you can decrease the money you spend on your health care while improving your health. 

Better Health by the Numbers

If you have been diagnosed with a chronic condition, take the time to learn a few key numbers that will help you feel better and live longer.

Diabetes

Research shows that keeping your blood glucose (blood sugar) close to normal reduces your chances of having eye, kidney, and nerve problems. To control your diabetes, you need to know your blood glucose numbers and your target goals.

You and your health care team should discuss the A1C goal that is right for you. For most people with diabetes, the A1C goal is less than 7.  An A1C higher than 7 puts you at risk for complications.  Lowering your A1C—by any amount— can improve your chances of staying healthy.

When self-monitoring blood glucose, aim for Plasma Values of 90-130 before meals, less than 180 one to two hours after meals.  Your Whole Blood Values should be 80-120 before meals, less than 170 one to two hours after meals.

People with diabetes are at high risk for heart attack and stroke. That is why people with diabetes need to control their blood pressure and cholesterol levels as well as their blood glucose levels. Be smart about your heart and take control of the ABCs of diabetes: A1C, Blood pressure, and Cholesterol.

High Blood Pressure

Blood pressure is usually measured in millimeters of mercury (mmHg) and is recorded as two numbers—systolic pressure (as the heart beats) “over” diastolic pressure (as the heart relaxes between beats)—for example, 130/80 mmHg. Ask your doctor to write down for your blood pressure numbers as well as your blood pressure goal so that you can monitor your blood pressure at home between visits.

Both numbers in a blood pressure test are important, but for people who are age 50 or older, systolic pressure (the top number) gives the most accurate diagnosis of high blood pressure. It is high if it is 140 mmHg or above.

About two-thirds of people over age 65 have high blood pressure. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension. This means that you don’t have high blood pressure now, but are likely to develop it in the future unless you adopt the healthy lifestyle changes, including:

Maintain a healthy weight. Check with your health care provider to see if you need to lose weight. If you do, lose weight slowly using a healthy eating plan with fewer calories and reduced serving sizes.
Be physically active. Engage in physical activity for a total of 30 minutes on most days of the week. Combine everyday chores with moderate-level sporting activities, such as walking, to achieve your physical activity goals.
Follow a healthy eating plan. Set up a healthy eating plan with foods low in saturated fat, total fat, and cholesterol, and high in fruits, vegetables, and lowfat dairy foods such as the DASH eating plan. Write down everything that you eat and drink in a food diary. Note areas that are successful or need improvement. Reduce sodium in your diet. Choose foods that are low in salt and other forms of sodium. Use spices, garlic, and onions to add flavor to your meals without adding more sodium.
Drink alcohol only in moderation. In addition to raising blood pressure, too much alcohol can add unneeded calories to your diet. If you drink alcoholic beverages, have only a moderate amount—one drink a day for women, two drinks a day for men.
Take prescribed drugs as directed. If you need drugs to help lower your blood pressure, you still must follow the lifestyle changes mentioned above. Use notes and other reminders to help you remember to take your drugs.

Cholesterol

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes “hardening of the arteries” so that arteries become narrowed and blood flow to the heart is slowed down or blocked. High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack.

Everyone age 20 and older should have his/her cholesterol measured at least once every 5 years. It is best to have a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and provides four categories of information.

• Total cholesterol numbers should be less than 200 mg/dL. Numbers in the 200-239 range are considered borderline high and numbers above 240 are considered high.
• LDL (bad) cholesterol is the main source of cholesterol buildup and blockage in the arteries. Ideally, your LDL number should be less than 100 mg/dL. Numbers in the 100-129 range are considered above optimal, in the 130-159 range are considered borderline high, in the 160-189 range are considered high, and above 190 are considered very high.
• HDL (good) cholesterol protects against heart disease by keeping cholesterol from building up in the arteries. In this category, higher is better.  A level less than 40 mg/dL is too low and increases your risk for developing heart disease. HDL levels of 60 mg/dL or more are preferable.
• Triglycerides, another form of fat in your blood, can raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.
  If you have been diagnosed with high blood cholesterol, you will need to begin with some Therapeutic Lifestyle Changes (TLC) including a healthier diet, weight management, and increased physical activity.

There are also several types of drugs available for cholesterol. Your doctor can help decide which type of drug is best for you. The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL.  Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels.  Cholesterol absorption inhibitors lower LDL and can be used alone or in combination with statin drugs.

Obesity

Two key measures are used to determine if someone is overweight or obese. These are body mass index, or BMI, and waist circumference. BMI is a measure of your weight relative to your height. It gives an approximation of total body fat—and that’s what increases the risk of diseases that are related to being overweight. Overweight is defined as a BMI of 25 to 29.9; obesity is defined as a BMI equal to or greater than 30.

But BMI alone does not determine risk. For example, in someone who is very muscular or who has swelling from fluid retention (called edema), BMI may overestimate body fat. BMI may underestimate body fat in older persons or those losing muscle. That’s why waist measurement is often checked as well. Another reason is that too much body fat in the stomach area also increases disease risk. A waist measurement of more than 35 inches in women and more than 40 inches in men is considered high. 

If you need to lose weight, it’s important to do so slowly. Lose no more than 1/2 pound to 2 pounds a week. Begin with a goal of losing 10 percent of your current weight. This is the healthiest way to lose weight and offers the best chance of long-term success.

There’s no magic formula for weight loss. You have to eat fewer calories than you use up in daily activities. Just how many calories you burn daily depends on factors such as your body size and how physically active you are. One pound equals 3,500 calories. So, to lose 1 pound a week, you need to eat 500 calories a day less or burn 500 calories a day more than you usually do. It’s best to work out some combination of both eating less and being more physically active.

For more information on any of these conditions, speak with your health care team. You can count on your community pharmacist for the medications and supplies you need to take control of your health.