Naloxone Saves Lives

Naloxone can quickly restore normal breathing and save the life of a person who is overdosing on opioids. In 2015, over 33,000 people died from an overdose on opioid drugs, including prescription pain relievers, heroin, and fentanyl.  Naloxone is a safe medication that is widely used by emergency medical personnel and other first responders to prevent opioid overdose deaths.

Naloxone is now available at pharmacies and covered by OHIP for use by patients.  Should you or someone you know be at risk for opiate overdose, please speak to your pharmacist for more information on how you can obtain a kit.  Training will be given and you will learn how to safely and properly administer naloxone in case of emergency.

Source.


Jennifer Heipel has approximately 12 years of experience working as a hepatology nurse/clinical research coordinator for several gastroenterologists, hepatologists, infectious diseases and addiction specialists. She is trained in the treatment of Hepatitis B and C therapies as well as general hepatology and pre/post liver transplant follow up. Jennifer serves as Charlton Health’s full time Hepatology Nurse and manages the Hepatology Program. She has worked and continues to work with Dr. Puglia at McMaster University and other area Gastroenterologists to develop a comprehensive, in-house Hepatology program and Hepatitis C program here at Charlton Health.

 

Posted in The Charlton Centre | Leave a comment

Changes in Provincial Coverage for Injectable Methotrexate

Methotrexate can be used as a disease modifying agent for many conditions, from inflammatory arthritis to psoriasis to inflammatory bowel disease.  In our past blogs, we have written about many strategies for managing its adverse effects.  Injectable methotrexate is preferred over tablets as it is better absorbed and has less nausea, yet government coverage for the injectable form has been for the 25mg/ml vials. Drawing up a dose out of a vial can be difficult for arthritic hands.

A pre-filled syringe is now being covered by government sponsored plans (ODB, Trillium, ODSP) which is a higher concentration than the methotrexate supplied in vials. This means that the same dose is now provided in half the volume (i.e. 20 mg is in 0.4ml of liquid vs 0.8ml in the vial format) and the pre-filled syringe is much easier to administer. Syringes are available in 17.5mg, 20mg, 22.5mg and 25mg strengths.  We are happy to answer your questions about this dosage form of methotrexate.


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.

Posted in The Charlton Centre | Leave a comment

Fatty Liver Disease: Part 2

This is the second half of the blog we started last week on Fatty Liver Disease. To see Part One, click here.

How is fatty liver treated?

There isn’t a medication or surgery to treat fatty liver. Instead, your doctor will offer recommendations to reduce your risk factors. These recommendations include:

limiting or avoiding alcoholic beverages

managing your cholesterol and reducing your intake of sugar and saturated fatty acids

losing weight

controlling your blood sugar

If you have fatty liver because of obesity or unhealthy eating habits, your doctor may also suggest that you increase physical activity and eliminate certain types of food from your diet. Reducing the number of calories you eat each day can help you lose weight and heal your liver.

You can also reverse fatty liver disease by reducing or eliminating fatty foods and foods high in sugar from your diet. Choose healthier foods such as fresh fruits, vegetables, and whole grains. Replace red meats with lean animal proteins such as chicken and fish.

What is the long-term outlook for fatty liver?

Many cases of fatty liver don’t develop into liver disease. The liver can repair itself, so if you take the necessary steps to treat high cholesterol, diabetes, or obesity, you can reverse your fatty liver. If you’re a heavy drinker, stopping drinking or limiting your alcohol intake to 1-2 beverages a day may heal your liver completely. A liver biopsy can help your doctor identify permanent liver damage, as well as determine the severity of damage and the best way to treat it.

If fatty liver persists and is not reversed, it can progress into liver disease and cirrhosis. The progression to cirrhosis is dependent on the cause. In alcoholic fatty liver, continuing to drink alcohol in excess can lead to rapid development of cirrhosis and subsequent liver failure.

The progression of nonalcoholic fatty liver disease varies, but in most people it does not lead to liver scarring and cirrhosis. However, if you are diagnosed with steatohepatitis, you have a higher chance of developing scarring and liver disease. Twenty-five percent of people with steatohepatitis will develop cirrhosis within a decade.

If a fatty liver has progressed to cirrhosis, the risk of liver failure and death rises significantly.

How do I prevent fatty liver disease?

Protecting your liver is one of the best ways to prevent fatty liver and its complications. This includes drinking alcoholic beverages in moderation. According to the Centers for Disease Control and Prevention (CDC), “moderate alcohol consumption is defined as having up to one drink per day for women and up to two drinks per day for men.”

Follow your doctor’s instructions, and take medications for diabetes or high cholesterol as directed. Additionally, aim for at least 30 minutes of exercise most days of the week to maintain a healthy weight.

Source


Jennifer Heipel has approximately 12 years of experience working as a hepatology nurse/clinical research coordinator for several gastroenterologists, hepatologists, infectious diseases and addiction specialists. She is trained in the treatment of Hepatitis B and C therapies as well as general hepatology and pre/post liver transplant follow up. Jennifer serves as Charlton Health’s full time Hepatology Nurse and manages the Hepatology Program. She has worked and continues to work with Dr. Puglia at McMaster University and other area Gastroenterologists to develop a comprehensive, in-house Hepatology program and Hepatitis C program here at Charlton Health.

Posted in The Charlton Centre | Leave a comment

Fatty Liver Disease: Part 1

The liver is the second largest organ in the body. Its function is to process everything we eat or drink and filter any harmful substances from the blood. This process is interrupted if too much fat is in the liver. Fatty liver is when fat accounts for more than 5 to 10 percent of your liver’s weight.

What are the causes of fatty liver?

The most common cause of fatty liver is alcoholism and heavy drinking. In many cases, doctors don’t know what causes fatty liver in people who don’t drink much alcohol.

Fatty liver develops when the body creates too much fat or cannot metabolize fat fast enough. The excess fat is stored in liver cells where it accumulates to form fatty liver disease. Eating a high-fat, high-sugar diet may not directly result in fatty liver, but it can contribute to it.

Besides alcoholism, other common causes of fatty liver include:

  • obesity
  • hyperlipidemia, or high levels of fats in the blood
  • diabetes
  • genetic inheritance
  • rapid weight loss
  • side effect of certain medications, including aspirin, steroids, tamoxifen (Nolvadex), and tetracycline (Panmycin)
  • high Blood pressure

What are the types of fatty liver?

There are two basic types of fatty liver: nonalcoholic and alcoholic.

Your doctor may use an ultrasound to detect fat in your liver. The fat will show up as a white area on the ultrasound image. Other imaging studies may also be done, such as CT or MRI.


 

 

Jennifer Heipel has approximately 12 years of experience working as a hepatology nurse/clinical research coordinator for several gastroenterologists, hepatologists, infectious diseases and addiction specialists. She is trained in the treatment of Hepatitis B and C therapies as well as general hepatology and pre/post liver transplant follow up. Jennifer serves as Charlton Health’s full time Hepatology Nurse and manages the Hepatology Program. She has worked and continues to work with Dr. Puglia at McMaster University and other area Gastroenterologists to develop a comprehensive, in-house Hepatology program and Hepatitis C program here at Charlton Health.

Posted in The Charlton Centre | Leave a comment

March is Pharmacy Awareness Month

Pharmacy Awareness Month is the perfect time to celebrate pharmacists’ expertise and the important role they play in delivering quality care to patients! Many people are unaware of the many places where pharmacists make a difference in the health care of Canadians.   Pharmacists are the most accessible health professionals and are  counted on for advice on their prescription, non-prescription and herbal treatments. Understanding how medications work, adverse effects to watch for, and interactions between medications are some of the areas where pharmacists educate patients.  In addition, pharmacists advise on vaccinations as well administering them and provide consultation services in helping people quit smoking.

What many people don’t know is the areas of specialization that some pharmacists have developed, such as diabetes education, women’s health, geriatric specialization, oncology, auto-immune diseases, and more.  Pharmacists work in hospitals, family health teams, the pharmaceutical industry and in academia doing research and educating students.  As health professionals, pharmacists are dedicated to being life long learners.  As part of their licence to practice pharmacy, each pharmacist must maintain a learning portfolio of all their educational activities and establish annual learning goals. Most pharmacists graduating today, have had 7-8 years of university education along with a year of internship prior to writing their licensing exams.

The pharmacists at Charlton Health are proud to service our patients and welcome your questions.
Posted in The Charlton Centre | Leave a comment

FREE Inflammatory Arthritis Info Sessions

This week on our #WiseWordsWednesday blog, we’re excited to bring you some information on some upcoming patient seminars that we think will be useful to you.

Inflammatory Arthritis Info Sessions are held regularly by Registered Allied Health Care Professionals with Rheumatology experience. These FREE sessions are right for you if you suffer from Rheumatoid Arthritis, Psoriatic Arthritis, or Ankylosing Spondylitis. The next sessions are:
Screen Shot 2018-02-28 at 11.36.59 AM
Part 1: March 22nd, 3-5PM
Part 2: March 27th, 3-5PM

Ankylosing Spondylitis
May 22nd, 6:30-8:30PM

For more information and to reserve your FREE spot, contact Dianne Freeman at dianne.o.t@gmail.com or 416-523-2995.

Posted in The Charlton Centre | Leave a comment

How Rituximab (Rituxan) Works

As a pharmacist working in the field of biologics, patients often comment on how they appreciate  the way I describe how each medication works in the body.  Recently,  I was asked to put in writing what I had verbally explained about the medication rituximab (Rituxan).

I am sharing that with you in the blog today and will continue to write a series on different medications used in auto-immune diseases.  Feel free to put in requests for medication you would like explained as I have done below.  Stay tuned…


How Rituximab (Rituxan) Works

Rituximab works by destroying a specific type of B cell which is in the “head office” of the immune system. We feel that these B Cells are directing the production of excess inflammation in Rheumatoid Arthritis.

When Rituxan is given and the B cells in the circulation are destroyed, these cells will release inflammatory chemicals from inside themselves. This could make a person very uncomfortable during an infusion. For this reason, pre-medications are always given before the infusion. Acetaminophen, an antihistamine called Benadryl and a steroid called Solucortef are all part of the pre-medications. As the steroid can significantly reduce inflammation, people can often feel quite a bit better for a couple of days after an infusion. This is not the Rituxan working yet.

Once the first dose of Rituxan is given, the B cells that are produced in the bone marrow, will be released into the circulation to replace the ones Rituxan has destroyed. Therefore, a second dose of Rituxan is given 2 weeks later, to destroy the new B Cells just released. After this second dose, it usually takes 6 months for the B Cells to be produced back to the same level they were initially.

Therefore, the Rituxan is given again 6 months later.

If someone is making B Cells quicker than the 6 months their condition may begin to flare earlier. If this is happening discuss this with your rheumatologist.


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.

Posted in The Charlton Centre | Leave a comment

The Ontario Government Extends Coverage of Prolia to Men

Prolia (denosumab) is approved in Canada for the treatment of osteoporosis in men and postmenopausal females. it is given as an injection every 6 months and significantly reduces fracture risk.

Until now, the  government coverage through plans such as Trillium  or for seniors aged 65 and over, only provided Prolia for women based on specific criteria.  As of January 31st,  this coverage has been extended to men who are at high risk for a fracture and who have either had adverse effects or lack of efficacy  to swallowed osteoporosis medications such as  Fosamax or Actonel.

The criteria for coverage for women has also been changed, with the age restriction of being over 75 being removed.

If you have osteoporosis, be sure to discuss this new coverage with your physician to see how it might effect you.


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.

Posted in The Charlton Centre | Leave a comment

MedsCheck

The MedsCheck program is a one-on-one interview between the pharmacist and the patient to review the patient’s prescription and non-prescription medications. The MedsCheck medication review will encourage patients to better understand their medication therapy and help to ensure their medications are taken as prescribed and that patients are getting the most benefit from their medications.1
When you come to visit us at Charlton Health, you will find that we like to incorporate the MedsCheck service.  This allows us to take a broader view of your overall health and to integrate your new medication into your current profile.

1. Taken from http://www.health.gov.on.ca/en/pro/programs/drugs/medscheck/medscheck_original.aspx

Posted in The Charlton Centre | Leave a comment

Bell “Let’s Talk” Day

Today is  Bell ‘Let’s Talk’ Day.  You have probably seen this event advertised on social media, radio, and television.  This is a day to open  the dialogue on mental illness.  One of the concerns we address at Charlton Health is the issue of mental health with relation to chronic pain.  When we are in conversation with our patients this issue often arises.  It is a well-known fact that living with chronic pain predisposes a person to depression.  We recognize this and want to open the discussion.

Bell Let’s Talk Day donations are fully funded by Bell directly based on engagement by Canadians in the cause. Bell donates 5 cents to Canadian mental health programs for each of these interactions on Bell Let’s Talk Day at no extra charge to participants:

  • Every text message, mobile and long distance call made by Bell Canada and Bell Aliant customers.
  • Twitter: Every tweet using #BellLetsTalk and @Healthy_Minds
  • Facebook: Every view of the Bell Let’s Talk Day video.
  • Instagram: Every post using #BellLetsTalk and tagged @HealthyMindsCanada
  • Snapchat: Every use of the Bell Let’s Talk Snapchat geofilter

So please consider getting involved  today – raise awareness and financial support!

Learn more here.

Posted in The Charlton Centre | Leave a comment