This week on our blog, we are continuing our theme of looking back at some of our more popular posts from the last few years. Today, we bring you a very popular one, “Raynauds Phenomenon is more than cold hands and feet.”

Here is the original text:

In our cold winter weather, many people complain of cold hands and feet with reduced circulation to these areas.  Often the skin will be whiter than normal and quickly normalizes once warmed.  Raynaud’s Phenomenon is a level beyond this whereby blood vessels constrict to a greater extent than normal as a result of cold temperatures or stress. There are three phases to the colour change of the skin. Initially, the restricted blood flood causes the skin surface to feel cold and the skin has a white colour, then the skin turns to a purple-blue colour, followed by a pink or red colour as the blood flow eventually returns.

There are prescription medications which can swallowed to promote blood flow that often cause a lowering of blood pressure.  A variety of prescription ingredients can also be prepared in a prescription cream and applied to the affected areas.  Feel free to ask our pharmacists about these options.  Raynaud’s can exist on its own or happen as a result of a pre-existing autoimmune condition.  Be sure to speak to your physician if you are experiencing the symptoms outlined above.  If severe and not treated, lack of blood flow can result and ulceration and the skin and serious consequences.

Keep tuning in to our blog for more of our favourite blogs. If you have a burning question, get in touch with us!

We often get questions as to why medications have such long complicated names and people wonder if the names have meaning.

In actual fact, the naming of prescription medications is based on international nomenclature regulations. When a new category of medications is introduced, certain groups of letters will be assigned to represent an aspect of how the medication works. Any other medication that is introduced in that category will have to incorporate that same group of letters within their name. For example, medications ending in “olol,” such as atenolol, bisoprolol and propranolol are all referred to as beta blockers and slow the heart rate. Medications ending in ‘zole” such as omeprazole and pantoprazole are acid lowering medications.

In the family of biologic medications which mimic proteins in the human body, several letter combinations have been assigned to indicate how the biologic works and what type of biologic it is. For example…

• “Mab” at the end of the name means it mimics a monoclonal antibody, such as adalimumab (Humira)
• If there is an “xi” included in the name, it means the cell used to produce the biologic is chimeric or mouse based such as; Infliximab or Rituximab
• When the antibody being mimicked by the biological treatment is humanized in origin then “zu” is included, such as tocilizumab.
• When a biologic is treating a tumour, “tu” is in the name. Such as tratuzamab.
• Biologics used to treat bones have “os” such as denosumab (Prolia).

There are many more examples of this. The next time you look at a medication’s name, you’ll realize there is a lot of meaning behind those letters.

This blog post was written by Charlton Health specialist pharmacists Vishnu Dyal and Carolyn Whiskin.

For many of us September feels like the start of a new year, even though we are still in 2019. As we reflect back over the last 2 1/2 years we have been writing our Wise Words Wednesdays blog, there are posts that generated great interest that are still quite applicable today. In our next few weeks we will highlight some of the top viewed posts and encourage you to use the search bar on the charltonhealthcare.com website to find answers to many of the common questions we receive from our patients.
As an example, I was recently asked about magnesium supplementation from a patient who is on an acid lowering medication. I knew I had written on the topic. We searched “magnesium” in the search bar on our website’s homepage and voila, here is the post that was displayed. It is still great information and I have added a little more…

#WiseWordsWednesday: Do medications affect nutrition?

See the original blog here.

Every day we get questions in our infusion clinics. Today’s blog features one of those questions…

Rituximab (Rituxan) is a biologic therapy that depletes a specific type of B cell in the immune system. This B cell is responsible for generating antibodies that will promote long term protection against the virus or bacteria the person is being vaccinated for. When available, any needed vaccines should be given two weeks before receiving rituximab as this is the time needed for a vaccine to be effective. Alternatively, you must wait until 5-6 months after the dose for vaccination, as it can take this long for a person to replace their B cells after a Rituxan infusion.

If you are just getting an infusion now and the flu vaccine for this season is not yet available, then you will need to wait until the New Year (5-6 months from now). This will leave you more vulnerable to the flu until that time. Therefore, ensuring your family members and close contacts receive their flu vaccine is very important. Hand washing is one of our best protections from the spread of infection.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

• Ensure you have eaten a full meal prior to your infusion.
• Drink plenty of water to be well hydrated. This should begin the night before your infusion.
• Always bring a current list of medications to each infusion. New medications or a change in your health status must always be reported to your infusion nurse.
• If you are unwell and are unsure if you should come for your infusion, please call ahead.
• Wear a loose-fitting shirt. This allows the nurse to easily and properly monitor your vital signs.
• Bring a blanket and/or sweater.
• Bring something to help pass time (book, laptop, tablet, handiwork). Ensure you have earphones if listening to music/movie so you can be mindful of others in the clinic.
• Please refrain from wearing perfume or other fragranced products.
• If you receive Benadryl or Gravol as a pre-medication, it is the policy of the clinic that you do not drive yourself. Please arrange transportation in advance.
• Kindly inform us of any allergies.

Today we bring you another update from the European rheumatology conference (EULAR). 

Sarcopenia is a condition that increases naturally with aging. It occurs when there is a muscle mass decline accompanied by muscle weakness and in the most severe cases, affects physical function such as walking speed. Walking speed has been a determinant in longevity. The incidence of this in people over 65 is 7-11%, in rheumatoid arthritis is 15-32%, in psoriatic arthritis and ankylosing spondylitis is 20-34% and in osteoarthritis is 22-30%. 

In fact, joint damage only accounts for 21% of the cause of reduced walking speed in rheumatoid arthritis; whereas muscle wastage plays a large part. The worst outcomes occur when there is excess body fat along with low muscle mass. This altered body composition has great detriment to overall health and is more common in people with rheumatoid arthritis than just having low muscle mass alone. 

Protein helps build muscle mass, yet with aging and increased inflammation, the ability to generate muscle building from protein can be altered. The type of protein in food that is chosen can make a difference on the ability to build muscle. 

The research presented at this conference suggested fast digested whey proteins and leucine rich proteins are best at providing muscle building. Muscle mass is also promoted by having vitamin D supplementation. Research has also shown that omega-3 fish oil is helpful in promoting muscle mass and helped to improve walking speed. The addition of omega-3 has also shown to enhance rates of remission in people taking disease modifying therapies for rheumatoid arthritis. Further benefits were seen with regular exercise, which is suggested at 150 minutes per week. On average, only 17% of patients with rheumatoid arthritis achieve this goal. 

The main messages from this presentation were to prevent muscle wastage and excess fat storage consider the following: 

• reduce inflammation, 
• adjust the diet to include fast absorbing proteins, 
• add omega-3,and vitamin D supplementation 
• regular exercise

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

An update from the European rheumatology conference in Madrid (EULAR) as reported by our pharmacist Carolyn Whiskin.  

A review of 56,000 patients from the Mayo Clinic databank was reviewed to determine what common disease states people had prior to their diagnosis of rheumatoid arthritis and which ones they were more likely to develop as a result of having the condition.

The findings of this data assessment showed that prior to the diagnosis of rheumatoid arthritis the following diseases are more likely to be present then in the normal population: inflammatory bowel disease, Type 1 diabetes, epilepsy, osteoarthritis, and thyroid disease. Once a diagnosis of rheumatoid arthritis has been made, conditions that are more likely to develop then in the general population include: cardiovascular disease, congestive heart failure, deep vein thrombosis, obstructive sleep apnea, and lymphoma. The risk of developing these other conditions often is increased when disease activity is higher and the person has carried the burden of inflammation for a long period of time. The risk of plaque formation in blood vessels is greater in those who also have high blood pressure and diabetes.

This shows the importance of good screening for other conditions that may have a greater likelihood in people with high levels of inflammation. It also underscores the importance of disease control and being on treatments that will lower the burden of inflammation as soon as the condition is diagnosed. 

Autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis are much more involved than what is happening in the joints or on the skin. 

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

This week we bring you another update from the European rheumatology conference held in Madrid (EULAR) which was attended by our pharmacist Carolyn Whiskin. 

When a person carries excess weight, there is an increase in the production of inflammatory substances referred to as cytokines. In addition, excess weight on joints leads to a bio-mechanical stress resulting in micro damage to the joints. In one study where patients had a BMI (body mass index) of 33 or greater, they were put on a restricted diet for 12-16 weeks. More food was slowly re-introduced thereafter. At the end of six months the average BMI dropped to 30 and measures of fatigue, inflammation disease activity and quality-of-life all significantly improved. In addition, blood pressure, lipids and blood sugar levels all improved with weight loss. It is well known that higher BMI leads to greater tender and swollen joints and increased levels of inflammation measured in the blood. Higher BMI equates to higher disease activity including skin involvement in psoriasis and psoriatic arthritis. Treatments such as anti-TNF biologic therapies do not work as well in obese patients. This speaks to the importance of weight-loss being part of a treatment regimen for all types of inflammatory arthritis.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.