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Ask the Pharmacist Frequently Asked Questions
Osteoporosis
Posted 1/26/2010
Question: How effective is Evista to Treat Osetoporosis?
After having my last bone density scan, I was told I had loss 50% of the bone in your spine due to Osteoporosis. I'm taking Evista for it, I can't take the others because it causes stomach problems, how effective is it?? I would like for it to fix it, but if it will maintain it as it is that would be better that nothing, I guess. Besides the spine, I have loss 25% in my hips.I have broken my waist, several ribs, my hand, and toes when I hit them on something. I need surgery on some more of them, but my doctor said my bones were too bad. I take 90 mg. morphine every 12 hours, percocet 10/325 mg, and I use flector patches on my neck because of pain.
PharmD Response
The treatment of osteoporosis for someone with your condition and degree of bone of loss is generally the use of calcium + Vitamin D + a prescription medication. The drug Evista works by decreasing the rate of bone loss and promoting an increase in bone mineral density. This increased bone density will subsequently decrease the incidence of bone fractures. Evista is very effective for the treatment of osteoporosis. Studies have shown that over the course of a year or so you should begin to see an increase in your bone mineral density.
H1N1
The information on this website related to the H1N1 virus is provided to adults, parents and caregivers for information and educational purposes only. The information provided on this section of the website is current as of October 2009. As more ill persons are identified and more is learned about the virus, new information will become available. For the most up-to-date information visit either of the two CDC (Centers for Disease Control and Prevention) websites: 1) H1N1 (Swine Flu): Resources for Parents and Caregivers (http://www.cdc.gov/h1n1flu/parents/) or the 2) 2009 H1N1 Flu (Swine Flu) website (http://www.cdc.gov/h1n1flu/). Note: Much of the information contained within this topic was derived from both of these websites and/or links contained within these websites.
Note: Only your physician can definitively determine if you or a member of your family has become infected. Furthermore, only your physician can prescribe the medications needed to treat (or prevent against) the H1N1 viral infection. For more information (beyond the scope of this pamphlet) consult your physician or visit the CDC website at: http://www.cdc.gov/h1n1flu/.
How is the H1N1 virus transmitted?
Posted 12/14/2009
It is believed that the novel H1N1 virus spreads from person to person (transmission) in the following ways:
Large-particle, close contact (<6 feet) respiratory (lung) droplet transmission (e.g., coughing and sneezing).
NOTE: The transmission from lung secretions (airborne infection) can be prevented by wearing a surgical mask.
Individual contact with contaminated surfaces (e.g., shopping carts and door handles) is believed to be another source of transmission via ‘droplet infection’.
It is believed that the novel H1N1 virus will survive on a contaminated surface and infect a person for up to 8 hours after being deposited on that surface (coughing, sneezing, other body secretions).
NOTE: The transmission from infected public surfaces can be prevented with the use of microbial-resistant gloves (i.e. latex gloves) along with regular hand sanitization (with soap or alcohol-based sanitizers).
In summary, all respiratory (lung) secretions (mucus, cough droplets, saliva) and other bodily fluids (e.g. diarrhea) of H1N1 infected individuals should be considered potentially infectious and should be avoided by all non-infected individuals whenever possible.
What are the types and severity of the H1N1 virus symptoms?
Posted 12/14/2009
Symptoms of novel H1N1 viral infection may include a combination of any of the following: fever, cough, sore throat, runny nose, nasal congestion, body aches, headache, chills and fatigue. Diarrhea and vomiting may also be found in many infected individuals.
Symptoms of the H1N1 flu can be severe enough that hospitalization may be necessary.
Deaths related to the H1N1 virus have been reported in United States throughout 2009.
For the treatment of headaches, body aches as well as other cold and flu symptoms, what medications should be administered to children and adults?
CAUTION!
Do NOT Administer aspirin (acetylsalicylic acid) to children or teenagers (under the age of 18) who have the flu. When administered to these individuals, aspirin can cause the development of a rare but serious illness called Reye’s syndrome. For more information see: http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm
Do NOT Administer aspirin (acetylsalicylic acid) or over-the-counter (OTC) NSAIDS (Non-Steroidal Antiinflammatory Drugs), such as ibuprofen and naproxen to patients with decreased kidney functioning, gastrointestinal disease and/or decreased liver function without first consulting your/their physician due to an increased risk of worsening each of these conditions
Check ingredient labels on over-the-counter cold and flu medications to see if they contain aspirin or NSAIDs and follow the recommendations of “Caution Statements” listed above.
Children 5 years of age and older and teenagers with the flu can take medicines without aspirin, such as acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, Nuprin®), to relieve symptoms.
Children younger than 4 years of age should NOT be given over-the-counter cold medications without first speaking with a health care provider.
The safest care for flu symptoms in children younger than 2 years of age is using a cool-mist humidifier and a suction bulb to help clear away mucus.
Fevers and aches can be treated with acetaminophen (Tylenol®) or ibuprofen (Advil®, Motrin®, Nuprin®) or nonsteroidal anti-inflammatory drugs (NSAIDS).
Recommendation Summary
Over-the-counter cold and flu medications should be used according to the package instructions may help lessen some symptoms such as cough and congestion.
NOTE: These medications will NOT lessen how infectious a person is to others.
Check the ingredients on the package label to see if the medication already contains acetaminophen or ibuprofen before taking additional doses of these medications—don’t double dose!
Patients with kidney disease or stomach problems should check with their health care provider before taking any NSAIDS.
What is the Incubation Period for the H1N1 Virus?
Posted 12/14/2009
The incubation period (or the time that occurs between H1N1 exposure and the appearance of disease symptoms) for the H1N1 virus is estimated to be 1-4 days and could range from 1-7 days.
What is the Infectious Period for the H1N1 Virus?
Posted 12/14/2009
The infectious period (or amount of time that the infected person can transmit the disease to another person) is believed to be from one day prior to illness onset until cessation of their symptoms.
What are the FDA Approved Treatment Options for Individuals Who Contract an H1N1 Viral Infection?
Posted 12/14/2009
There are currently two medications indicated for the treatment and/or prevention of the novel influenza (H1N1) virus (and only your doctor can prescribe these medications):
• Zanamivir
• Oseltamivir
Only your doctor can determine if it is necessary to prescribe these medications for the prevention or treatment of H1N1 viral infection. See your doctor for more information.
Additional treatment and prevention information can be found at the following websites:
Interim Guidance on Antiviral Recommendations for Patients with Novel Influenza A (H1N1) Virus Infection and Their Close Contacts (http://www.cdc.gov/h1n1flu/recommendations.htm)
H1N1 Flu (Swine Flu): Information for Specific Groups (http://www.cdc.gov/h1n1flu/groups.htm)
What is the FDA’s Recommendation for the Use of the Influenza A (H1N1) 2009 Monovalent Vaccine?
Posted 12/14/2009
Updated information will be published by CDC in MMWR or will be available at http://www.cdc.gov/flu.
Consult your physician to determine if they recommend that you (and/or your family members) receive the Influenza A (H1N1) 2009 monovalent vaccine and/or the seasonal flu vaccine.
NOTE: Seasonal influenza vaccines will NOT provide protection against the H1N1 virus. Hence, you need to receive two separate vaccines in order to be vaccinated against both the H1N1 and seasonal flu.
What are some general H1N1 "Healthy Living" Prevention Measures?
Posted 12/14/2009
1. Cover your nose and mouth with a tissue when you cough or sneeze.
2. Throw the tissue in the trash after you use it. Example: If you place your used tissue on a table in your house you could infect others who use the same table within up to 6 hours after you initially placed the tissue on that table.
3. Wash your hands often with soap and water or an alcohol-based sanitizer, especially after you cough or sneeze.
4. Use of alcohol-based hand sanitizers is also effective.
5. Use of barrier protection (microbial-resistant gloves, facial masks) is an effective way to prevent the virus from coming contact with your skin.
6. Avoid touching your eyes, nose or mouth after coming in contact with potentially contaminated surfaces (shopping carts, public restroom door handles, public tables, etc)
7. Washing hands after each time you come in contact with these surfaces will help to prevent contracting the H1N1virus (barrier protection will also help prevent viral transmission)
8. Try to avoid close contact with sick/infected people.
If you are a high-risk individual for contracting the H1N1 or other influenza strains, you should contact your physician (or obtain nursing advice) immediately if suspect that you have contracted the ‘flu’ virus.
What are Some Example Signs and Symptoms that may Necessitate Seeking Emergency Care?
Posted 12/14/2009
In children, emergency warning signs that need urgent medical attention include:
• Fast breathing or trouble breathing
• Bluish or gray skin color
• Not drinking enough fluids
• Severe or persistent vomiting
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
In adults, emergency warning signs that need urgent medical attention include:
• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting
• Flu-like symptoms improve but then return with fever and worse cough
What Groups are at Highest Risk for Developing H1N1 Flu Complications?
Posted 12/14/2009
Based on information obtained from worldwide cases of H1N1, disease-related complications range from mild respiratory (lung) illness, to lower respiratory tract illness (pneumonia) and/or severe dehydration. Deaths due to the H1N1 influenza viruses have occasionally occurred.
Groups at higher risk for seasonal influenza complications include:
• Children less than 5 years old
• Persons aged 65 years or older
• Children and adolescents (less than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection
• Pregnant women
• Adults and children who have chronic lung, cardiovascular, liver, hematological (blood), neurologic, muscular, or metabolic disorders
• Adults and children who have compromised immune systems (including cancer, certain medications and HIV)
• Residents of nursing homes and other chronic-care facilities
If you or a member of you family is included in this list (above), you should seek medical advice/care as soon as you (they) begin to feel ill. Furthermore, you should ensure that all appropriate precautions (proper sanitization, etc) are taken to prevent the onset of illness.
For more information on the impact and risk for complication for specific groups see: http://www.cdc.gov/h1n1flu/groups.htm