Why do we eat when taking tablets

We've all been advised to take our medication with food. Since childhood, it's a common thing to hear. Although most drugs don't actually require food, here's a couple of reasons why:

1. Disguise taste : many drugs have unpleasant tastes. By taking them with food, their foul tastes can be masked and avoided altogether. 

2. Reduce side effects (nausea and vomiting): drugs that have known and pronounced nausea and vomiting side effect profiles can be improved by advising patients to take them with food in an attempt to attenuate these reactions. Penicillins can cause nausea and by taking them with food, tolerance in most patients is improved. 

3. Metabolism: in some cases, food can delay, speed up or improve the absorption of certain drugs. In the case of some oral anti fungals for example, fatty food promotes absorption of acidic drugs. 

4. Sensitivities: the gastrointestinal tract is lined with soft delicate epithelial cells and these can often become sensitive in some patients; having food with drugs ensure that no direct contact with these cells and potentially abrasive drugs occur. In this case food acts as a protective lining to reduce irritations. 

It's important to note that, needing to take your medicine with food is not a call to gluttony. I'm most cases a piece of fruit or snack is enough. No need to fill up your plates and overindulge under pretext of medicine. 

Another point to note is that certain foods like grapefruit shouldn't be taken with medicine as it may induce metabolism 

And reduce drug efficacy. 

For these reasons and more, it is a rule of thumb to take medicine with food; Unless specifically indicated to be taken on an empty stomach. 

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Pharmacist Or Superhero? The extraordinary Lengths

We can all pull a list of some of the lawful, common duties that are required to be performed by a pharmacist in a retail setting, but what about those extra miles that go unnoticed, unspoken of and unwritten?

Here's a break down of just 6:

*They are babysitters: Mostly to certain identified less than careful GPs (some interns and/or weirdos) who often let a lot of basic mistakes slide in their prescriptions. Imagine phoning for dosages, directions or dates?! The validity of a script is one thing, but some errors are more fatal than others of course... thankfully your pharmacist is their to double check those discrepancies and save your life! They have to call, email, follow up, adjusting doses and rectifying drug mistakes or drug interactions. If you ever have a treatment concern or a question your pharmacist is the first person to ask.

*They are health care "bouncers": To ensure safety for patients, pharmacists monitor use of all medication. They are often shouted for refusing to refill expired prescriptions, early refills or excessive OTC purchases, but it's for patients' own good. Codeine abuse for example can only be curved by strict one item per patient enforcing rules. Let them responsibly safeguard your drug intake.

*They are life coaches: When patients have difficulties (even personal) they usually rant and ramble at the counter. Fortunately there's a pharmacist with a listening ear ready to indulge and advise that patient as best they can (esp when time allows). Both in a professional but empathetic manner. They get stopped at the grocery store, at the bank and pretty much anywhere in their community to answer pertinent personal questions and give guidance. When you have no one else to go to, pour out your heart to your pharmacist, they really care.

*They are multipurpose jugglers: Whether its your specialist, your medical aid, your GP or your dentist, pharmacists plat a key role in co ordinations with other health care practitioners. Between phone calls, prescriptions, compounding, emails, and  counselling; their juggling game is strong. They also know about unusual things not necessarily pertaining to the pharmacy. They sometimes go the extra mile to book appointments and make sure you are on track with your next check up.

*They are your advocate & supporter: They really care for your treatment adherence and outcomes. So much so that they often break the rules to help their patients obtain medicine or treatment promptly. They borrow, lend, and outsource all sorts of medication to ensure patients have their supply. Sometimes procedure will take days to be approved, but trust your pharmacist to make miracles happen. They are also known to supporting your wallet by saving you some coins on your medicines bills. They know what's on special, which generics to substitute and how to make your Rands go further. Some have even made personal home deliveries outside of work hours.

*Some are even magicians: The most unforeseen circumstances may occur where medicine is unavailable but your trusted pharmacist will make it appear in your dispensary ready for you to take home. They will mix, extract, compound and manipulate drugs in order to achieve the desired outcome but if the drug isn't even registered in the country, they are known to pull strings, obtain favours and deliveries from suppliers at the drop of a hat. When your medical aid refuses to pay for certain medicine under certain conditions, they have a few tricks up their sleeves that could work too. Marvel at their prowess.

There's a lot more that goes on behind the counter all for the sake of PATIENTS well being and there s nothing (almost) a pharmacist wouldn't do for their patient. Appreciate all the effort because most of it is definitely out of their scope.

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The "Generic" Myth Finally Debunked!

To substitute or not to substitute! That is the question!

It's not as clear-cut as we'd like it to be. Many drugs on the market are generics to originator (branded) drugs. Do they differ? Can they be substituted? To simplify it, the answer is two fold.

Yes, because they are (bio) equivalent but no because sometimes they are metabolized differently and therefore the experience is that: they're not the "same"?!

Some pharmacists will tell you 'it's the same'! And quite rightly so, often when addressing patient fears, uncertainties and issues of treatment accuracy. It's a quick answer to calm the patient down. A generic drug contains the same active ingredient, at the same dose than it's original counterpart. Therefore in this light, they ARE the same!

However, when it comes to efficacy and side effect profile, generic drugs might differ. This is because formulations (processes of manufacturing the drug and excipients or other additives) can differ.
Potency may also differ, as drug concentrations, release rates and absorption into plasma rates also differ. The regulated ranges for plasma concentrations (AUC) usually fluctuate between 85-110% match. Meaning a generic drug can be less or more potent than the original drug even at the same dose. Generic drug bio-equivalence have to be the same by law, but bio-equivalence doesn't necessarily mean tolerance equivalence either.
Patients may often complain that one generic doesn't work for them, or that the generic "feels" different. Besides a strong possibility of them just being picky or playing mind games, there is a real rationale behind it. It might actually be that they metabolize the generic differently and hence experience (effect and side-effect of) the generic drug more or less than with the originator.

The other common patient phobia is with pricing. Many patients feel cheated if a drug is too cheap. They actually want to pay more as they think it will "work better". Again it often is a mind game associated with perceived value. But the truth is, big price difference are  because of research setbacks.

The originator drug took time (including clinical trials) and lots money to develop, and so once it reaches the market for the first time, it benefits from patent exclusivity in sales. Usually 15-20 years. This is to recuperate the heavy research costs incurred and make profit for that manufacturing company.
After this period, the originator drug patent expires and is then made available to other manufacturers who can simply "copy" the 'recipe' for much less monetary investment and no research time. They therefore can slash the prices radically - hence cheaper generics.

At the end of the day, a generic drug will act in the same way as an original drug in effecting it's desired pharmacological effect. It may however feel different to a patient  who experiences it differently due to a difference in overall metabolism.

Next time a patient asks you if "they're the same", what will you say?


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10 Baby Pharmacy Hacks

So here are 10  helpful baby health tips for you when it comes to easing your baby routine!

Skip the queue: most facilities will agree to let a parent with a baby receive priority assistance especially if the child is in distress or crying. Kindly ask your pharmacist for prompt assistance.

Sooth Teething : with a clean finger, apply drops of the medicated solution dose to the gums and rub gently every 1-2hours. By dividing the dose into smaller intakes, pain threshold (local) coverage is better  experienced by baby. This is a great alternative to giving a full oral dose 4-6 times daily.
You get better symptomatic relief at the site and you can apply more frequently for soothing and control.

No spill: never use a spoon to give baby their medication. Rather use a syringe. It is better calibrated hence accurate and it also doesn't spill if they knock it with their hands or heads. Always dilute medicine in a bit of milk, or juice rather than the whole feed. This helps to mask the taste. If they don't finish the feed at least the full dose is taken.

Nappy rash: you will never have a nappy rash again if you apply an oil to baby's bum after each change. Unlike water based creams, oils don't completely absorb and therefore they form a good protective (anti-rash) layer on top of baby's skin.

Home made re-hydration: if baby has lost a lot of fluids, they easily become dehydrated especially if they've been vomiting or had diarrhea. This could quickly become dangerous and send you to the ER. However with one tbsp of sugar, half a tbsp of salt and a tall glass of pure/boiled/ filtered water, electrolytes can be replenished and resolve the situation. Administer in small intervals until diaper trends return to normal.

Baby change bag: when packing for baby, the usual diapers, wipes and bottles should be included but don't forget to add a change of clothes for the parent too! If baby throws up or squirts you during a change, your clothes may be embarrassingly messing afterward.

Baby medicine:  when giving an antibiotic or other liquid medicine to baby, to keep track of administered doses, draw a chart with all required doses on the side of the bottle with a permanent marker and tick as you go along. It can get quite confusing and losing track is easy.

Nail clipping: when baby has just falling asleep, wait 20 minutes and proceed to clipping their nails. This ensures no fussing and crying during this mandatory task.

Spit up or vomit stains: whether on the couch, catpet or your clothes, use a paste made with sodium bicarbonate (baking soda) and water. Apply generous amount to stain and let dry over night. Vacuum or wash in the morning!



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Employees Before Customers!

In 2018 every employer needs to realize change, recognize trends, and readjust their strategies. Employees are no longer secondary citizens but they are in fact your primary customers!

Think of it this way; If no one wants to work for you, you won't have very many customers in any case. Additionally, if those working for you feel unappreciated and uncared for, they won't go out of their way to serve your customers who too will in turn feel uncared for. Thus unravelling the 'satisfaction' meter and ultimately dropping profitability.

Company culture is a fool proof way to check how employers value their employees.

30 years ago Richard Branson said: customers don't come first, employees come first. Look after your employees and they will look after your customers.

This is truer today than ever. Employee engagement is likely the most important thing after customer care to a profitable business. However, the best care will only be given to customers by employees who are most engaged in their work. This comes through value demonstrated, and value experienced by employees.

A study done at Harvard business school found that millennials aren't as focused on pay scales as the previous generation used to be. Although it still matters, recognition and a sense of achievement are primordial to remaining engaged.

It therefore makes all the sense to factor this in any company's culture in order to increase  competitiveness, profitability and desirability.

If you're a company owner or in senior management, let this grab your attention. Little changes in your company culture may prove to be tremendously beneficial both in the short term experience and it's overall ranking by employees.


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Top 5 Medical Aids In SA 2018

Like many other things in life, the more options you have the more confusing it becomes to choose.
In SA, the five most popular medical aids are as follows:

1.Discovery
2.Bonitas
3.Medihelp
4.Momentum
5.Gems

According to the SAcsi (South African consumer satisfaction index), these top 5 providers have an above average quota for patient satisfaction.

However, many still complain about low value for money, unexpected high co-payments, increasing premiums far above inflation rates, complex rules and exclusions.

Medical aids are reluctantly paid as the most costly monthly expenses in many homes.

So how does one choose a medical aid?

Discovery has 15 different plans to chose from ranging from R792 for a main member in Keycare core earning from R0-R8550 and R4,398 per main member in the classic deltas comprehensive plan.

Bonitas has 4 plans ranging from R1604 for BonEssential plan to R3265 for Standard plan per main member monthly contribution.

Medihelp has 4 plans ranging from dimension prime 1 with a monthly main member contribution of R1725 to dimension prime 3 with a R2940 contribution.

Momentum has 7 plans, with options ranging from R759 per main member earning between R0-R6,300 in the Network Ingwe Option plan to
R5113 per month per main member in the Extender option 2 plan.

Gems has 6 plans with the lowest Sapphire plan of R383.50 monthly contribution per main member and the Onyx plan of R 6450 per main member per month.

Most medical aids will cover the standard 27 chronic illness list and some will add a few other conditions depending on your chosen plan.
M
The choice remains yours but to help you a little bit more here are a few comparative sites:

http://www.medicalaidcomparisons.co.za and
 https://www.hippo.co.za/medical-aid-quote/

that can tailor your need and match them to a suitable provider.


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10 Things Outstanding Pharmacists Do Differently

Here are ten ways (in no particular order) to identify someone who does an outstanding job and provides the best possible service to patients:

1. They do their homework: Continuous education is key in keeping up to date with treatment guidelines and procedures. An excellent pharmacist reads up and stays afloat on the newest trends ideas and regimens. They read up and are clued up. "I don't know" is rarely on their tongues.

2. They ask insightful questions: this requires deeper understanding of the problems patients can pose and it is strategically set out to reach an optimal desirable therapeutic end. Patient history to gain basic insight is crucial for diagnosis and treatment selection (basics) but building patient trust with thought provoking, meaningful specifics & information (deeper) is essential to adherence and ultimately therapy outcomes. Insightful questions reveal experience, knowledge and flexibility in tailoring treatments.

3. They are empathetic: They put themselves in the patients shoes to understand challenges arising. When you tell a patient to take medication six times a day, practically what does it entail? Have they tried it for themselves? Having to wake up at night to take a dose? An excellent pharmacist would add tips on how to achieve the task at hand. Setting alarms on your phone, asking a relative to remind you, and keeping a small pill container in your purse or pocket are a few examples.

4. They are open to dialogue: this might seem obvious, however when routine kicks in and pharmacists develop a comfortable road map to executing a counselling task for example, the dialogue tends to go one way and is more of a lecture to the patient. However to include them in treatment regimen, dialogue must flow in both directions. Questions and answers from both parties reveal a mutual, cooperative partnership and intentionally engages commitment To achieve therapy goals.

5. They know their value: most pharmacists add tremendous value to their patients therapies and health care in general. However an outstanding pharmacist will let it transpire. A lot goes unnoticed behind the counter and an unsuspecting patient won't know half of it. With effective communication (verbal and nonverbal) an outstanding pharmacist will demonstrate the value they add. This may be in the form of gestures/ postures and mannerisms, or statements, suggestions and questions, confirming and reassuring patients; all wrapped up into a pleasant, & superior experience.

6. They follow up: after a while working at a pharmacy, pharmacist will recognize patients on a name basis.  They develop a relationship and know more and more about their patients. Outstanding pharmacists follow up on even the non prescription items they had suggested or opted for their patients' ailments not long ago. This contributes to building patient confidence and trust as they feel valued and of importance. They are noticing the intentional care and appreciate the follow ups. Outstanding pharmacists give a phone call or write an email response.

7. They are confident: they do not need anyone to validate their skill. They are not out to please or be liked but to do an excellent job. Sometimes that requires saying no and being firm. Patients, practitioners, or nurses who push their luck and abuse favours will be reprimanded and kindly turned down by outstanding pharmacists who hold their ground. They know their scope, limits and boundaries for better and for worse. They aren't afraid to keep them.

8. They are team conscious: working in health care is NOT an individualistic or selfish job destination. You must and will form part of various teams. Outstanding pharmacists are inclusive. They know to include nurses, specialists and GPs on their wagons and do not self-limit their processes. If a patient requires additional assistance, they refer, call, ask and inquire from their team. Taking decisions alone can be detrimental to patient therapy and they know it.

9. They are resourceful: being part of a team is one thing but being in contact and having the correct resources to refer or inquire about anything is crucial to outstanding pharmacists. Poison control, emergency numbers, specialist practises and the promotional discounts/ cost cutting strategies are things that an outstanding pharmacist should know!

10. They love their job: passion is inextinguishable. When they do what they love and love what they do, it shows. It's appreciated and the positivity of it all is communicable and transferable To others. Patients will feel the energy, see the love and experience superior service emanating from passion. Outstanding pharmacists intuitively bring a 'come back to me' feeling to their patients every time.

There it is. Ten of the things that make this special breed seldom utter the phrase: "I don't know". 

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Sore Throat? Stop it Quickly!

At the first sign of a sore throat especially during the cold and flu season, this should be your first and hopefully only step if done correctly & on time!

Gargle with salt water!

Sounds simple enough, but shockingly this inexpensive, efficacious, easy to make & use home remedy often gets overlooked and undervalued when it should be the first line.

This capitalistic world pushes adverts that teach us to run to the pharmacy for everything (sprays, lozenges and syrups) but actually you don't have to.

Save yourself a trip. Be wise, a sore throat is usually a sign that the bacteria balance in your throat is offset. Streptococci are the common culprits. Sugar at this point is your worse enemy but salt is your best friend.

To bust these intruders, do not wait. Grab a tablespoon of salt and a cup of water. Stir together and gargle as frequently through out the day as possible. Even up to 10x.
Remember, bacteria grow quickly so if you gargle once in the morning (@ 8h), by lunch time (@ 13h)  it's already too late. Especially if you've eaten or had sugar in between, make sure to set your phone on a 2 hourly or 3 hourly frequency to gargle through out. The first day is most critical. By the next, it either will have subsided and resolved or fully developed and proliferated into a full blown throat infection.

The convenient thing to do is to prepare a salt water bottle to take with you for the day. Whether at work or at school, take a 2 mins gargle trip to the bathroom every 2-3 hours.

It's safe for everyone,  But Do not swallow. Gargle and spit. If you swallow, your ingesting an unhealthy amount of salt and bacteria dislodged from your throat are able to continue their trouble in your gut.


That's the good pharmacists

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Pharmacy Hacks Everyone Should Know!

Here are ten genius tricks for every one to know; once you've read them share to your friends so they can also make use of them.

1. Swallowing tablets: did you know that to easily swallow a tablet you need take a generous sip of water, insert the tablet in your mouth and tilt head backward.  This prevents bitter taste from settling in your tongue if you place the tablet first before taking water. For capsules, tilt head forward. This allows the capsule to float to the back and helps your process.

2. cutting tablets: Sometimes scored tablets are difficult to break. You may need to half your painkiller dose or just need a smaller strength then what you have; for this if you don't have a 'fancy' pill cutter at home you can clean and sterilize a nail clipper with alcohol /swabs or ask at the pharmacy for them to cut some tablets fir you in advance.

3. Paying less for tablets: Buying chronic medication can become very expensive in the long run. If your prescription drugs are available in a double strength, ask your pharmacist to dispense the double strength in half doses. That way you pay up to half the price of X 20mg for 15tablets instead of full priced X10mg for 30 tablets.

4. Ensuring quick & accurate services: before rushing into a pharmacy and becoming furious with impatience at the long lines you may find, phone your pharmacy before hand and let them prepare what you need. Many services are now available such as pre-ordering and are easily done through phoning or using apps. If your prescription is long or has particularly rare items on it, phoning ahead of time ensures that it it prepared, checked and that any outstanding item is ordered and delivered before you get there. If there are any co payments you can also prepare your payment before coming in to pick up. Ask that they phone you back to confirm pick up or if delivery services are possible. This saves time and reduces stress for both parties.

5. Never lose your info: walking in the pharmacy to grab something and suddenly realize you left your discount or loyalty cards at home? Worse your new medical aid card details? Well switch to digital! Email yourself a copy of all you pharmacy profile information so you'll have it anywhere!
Send a picture to yourself on social media and use that instead. Usually the serial / membership number is sufficient to store even as a contact.

6. Never forget a refill date: if you're forgetful or too busy to remember your life priorities, set a reminder on your phone! Nowadays everyone has a calendar on their phone. Set it to ring a day or two before you medication is due for a refill. Leaving it to the last day is risky if the pharmacy runs out or if a delivery gets delayed. There are also refill subscription services which send out automatic messages to members informing them of such important dates.

7. Be strategic: know your pharmacy and their various day to day operations such that you determine the best time to come in. Some pharmacies are swamped on a Wednesday morning after a staff meeting and have the longest lines then. Usually there is a first thing in the morning rush and an after work/ after school rush so knowing the busy times helps you come in when it's quieter. Also at lunch time there may be less staff as they relieve each other for lunch. The best time could be around 10-11am and 2-3pm. Ask your pharmacist when is the best time to be served in peace and quiet.

8.  Stay informed: your doctor is supposed to tell you what your diagnosis is and what the treatment entails. If they don't, ASK. Then quickly write it at the back of your script to make your pharmacist and your life simpler. This prevents misunderstandings, phoning to double check and hard to read scribbles that can delay dispensing time.

9. Be proactive: at the beginning of each year medical aid schemes usually modify their policies. The onus is on patients to make sure they understand these changes and are ready. Don't let your savings account surprise you half way through the year when you though it would cover you right through. Understand what you can and cannot buy and the frequency of these.

10. Be kind and friendly: usually behaviour is reciprocated. If you come in with attitude or anger, that energy is likely to be dished right back at you. Pharmacies are help centres where staff will go over and beyond the call of duty to attend to and help a friendly patient. Sometimes even breaking rules just to assist.  A polite request reasoned with a smile ( even when in pain or sick) can make a big difference to the counselling and outcome you may get form your prescription.

At the end of the day everyone is dealing with a lot. Use these 10 simple hacks during your next visit to the pharmacy and see if they help!

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Scarce Posts For Scarce Skills?!

Isn't it upsetting that so many scarce skilled jobs are equally scarce to come by? While populations sit on degrees, diplomas and certificates at home or resort to doing other forms of work from their actual qualifications, this situation is increasingly absurd and has to change.

But How???

Algorithms are not so hard to figure out and put together. Surely if we can forecast the number of posts for a particular profession every year, (government should have that information) then we could match up the number of available posts to those skilled & seeking them, and at least saturate the market to a reasonable point.

Another idea could be to provide incentives  for individuals to create private posts for these types of skills; or rather yet import post-creating internationals and multinationals to increase skilled jobs and get the quota right.

Perhaps these skills shouldn't be termed scarce if demand doesn't exceed the need. Institutions that provide them should maybe redirect students before they register and warn them of the scarcity of jobs in that field afterward? If that can deter some students and redirect them into more "job abundant" fields then employment rates could grow.

One way or another the problem is there and has to be solved. Pharmacy (pharmacists) in South Africa is an example of one of those scarce skilled fields. However, we all know nothing is ever simple in practice as it is in theory!

Have you experienced this problem? How would you solve this problem?

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