Shingrix is a shingles vaccine that will offer greater protection against shingles than our current vaccine, Zostavax.  One of its advantages is that it is extremely effective regardless of the age it is administered, offering over 90% protection in those over age 70. Effectiveness of our current vaccine, Zostavax, decreases significantly when given to adults over age 70.

Shingrix will require two injections given 2 months apart.  Unlike the live vaccine, Zostavax, Shingrix isn’t a live vaccine and therefore can be given to patients who are taking immunosuppressant treatment. However, recipients may experience more redness and and skin irritation from Shingrix as it is a very immunogenic vaccine.  Therefore we are uncertain if could cause a flare in people with an auto-immune disease.

We will keep you informed of all information once this vaccine is released.  We are not yet sure of how the provincial government will respond in offering coverage of this vaccine. Currently Zostavax is provided through public health to those between 65-70 years of age.

For more information on this vaccine or any other medications, please speak to your healthcare provider.

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.

The lining of the nose needs  to be kept moist to prevent “cracking” of the lining of the nasal passages which can lead to discomfort and bleeding. This problem is more prevalent in our dry winter months.  Some patients who autoimmune conditions can be prone to both dry eyes and dry nose, however either can occur in many people.  Having a humidifier especially in the winter months can be helpful.  Over the counter prescription nasal gels can help and newer nasal sprays containing sesame oil can offer great long lasting protection which may be less irritating.  Some patients have found applying coconut oil to be the most effective while others prefer squeezing the contents of a vitamin E oil capsule and applying this to the lining of the nose.  Once to twice daily application is suggested to prevent nasal irritation.

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.

Dry eyes can be caused by many things: from too much “screen time” being on your computer or tablet, to auto-immune conditions. There is a 30% incidence in dry eye in people over age 50. There are three layers to the eye tears that protect our eyes; water, oil and mucous. In conditions where tears evaporate too quickly, this is often due to a lack of the oil layer. The water layer being deficient occurs in about 80% of people with dry eyes. There are now artificial tears which include an oil layer. Prescription eye drops can also offer great benefit especially when there is an autoimmune cause for the dry eye. The eye drop chosen depends on the reason for the dry eye and this can be properly assessed by an optometrist or ophthalmologist.

A helpful website to assess your dry eye is: www.dryeyedisease.ca. The Canadian Dry Eye Assessment Tool is included on this site.

Stay tuned for our next blog where we will discuss patients who suffer from dry nose and treatment options.

It is well known that even 1/2 a grapefruit or one glass of juice can reduce an enzyme called cytochrome P450 (CYP 450) by 50% for up to 24 hours.  This is important because some medications such as atorvastatin, amlodipine, carbamazepine and one of our newest medications for rheumatoid arthritis, tofacitinib (Xeljanz) need this enzyme to be eliminated from the body.  If grapefruit juice is combined with these medications, they could accumulate in the body increasing the potential for adverse effects. Therefore, it is recommended that grapefruit not be ingested with medications requiring this enzyme for processing.

Not all fruits contain furanocoumarin derivatives which seem to the culprit in affecting this enzyme. However, lab studies indicate that pomegranate, pomelo, black mulberry juice, wild grape juice, and black raspberry juice also interfere with CYP3A4. Pomegranate is now known to have as significant an impact as grapefruit.

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.

Last Thursday, the first dose in Canada of a new biologic treatment for psoriasis was injected at Charlton Health.  Guselkumab is marketed under the name of Tremfya and is approved by Health Canada for moderate to severe plaque  psoriasis.  It is given by injection using a pre-filled syringe on day 1 of treatment, followed by an injection on day 28 and a maintenance of every 8 weeks.  Guselkumab works by removing an inflammatory cytokine called interleukin 23, which is produced in excess in the skin cells of patients with psoriasis.  We are very excited to be offering this new and effective treatment at Charlton Health.

In April of 2017 a new form of hormone therapy was approved by Health Canada for women with an intact uterus.  It has already been in the United States for over a year. When giving systemic doses of estrogen for the treatment of hot flashes and other symptoms of menopause, progesterone is commonly given to block estrogen stimulating the lining of the uterus.  As some women cannot tolerate progesterone, this new product offers the benefits of estrogen with a different agent to block stiumulation to the uterus.  The additional benefit is that it also blocks estrogen stimulus to the breast.  This product is referred to as a tissue selective estrogen complex (TSEC).  It is a combination of oral conjugated estrogen and a selective estrogen receptor modulator called Bazedoxifene.  It is sold under the name of Duavive.  This offers women who are appropriate candidates for hormone therapy another option.

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

Normal changes in memory occur with aging, but it is important to recognize changes that require further assessment. Alzheimer’s Disease changes may include: poor judgement and decision making, new problems with words in speaking or writing, changes in mood and personality with increased irritability, inability to manage a budget, losing track of the date or season, difficulty having a conversation, misplacing things and being unable to retrace them.  There are conditions, which if left untreated can mimic Alzheimers Disease and these need to be investigated and managed.  Certain prescription medications, drug interactions, low vitamin B12,  an under-active thyroid gland, a tumour, urinary tract infection and untreated depression are all possible causes of a change in cognitive function as well. Women seem to have an increase in vulnerability for cognitive decline with a lower estrogen levels after menopause being one of the contributors.

One of the biggest preventative strategies for memory loss is exercise. Being outside, maintaining movement and socialization are key!

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

HDL (high density lipoproteins)  have always been known as the good cholesterol as they can pull “bad cholesterol” away from the blood vessel wall. At the 2017 North American Menopause Society Meeting held last month in Philadelphia, research was presented that shed a new light on HDL.

After menopause a rise in HDL may not be so beneficial.  It appears that higher levels are due to HDL becoming dysfunctional and picking up more cholesterol which is subsequently redeposited in blood vessels.  This phenomenon also exists with inflammatory diseases where elevated HDL is associated with high inflammation and actually leads to greater cardiovascular risk.  Stay tuned as we learn more about different facets of HDL and it’s different types of particle sizes and effects.

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

Dr. Neil Binkley is part of the Osteoporosis Clinical Research Program at the University of Wisconsin. He was very passionate about preventing fractures as the consequences of breaking a weakened bone are significant and greatly affect a person’s ability to live independently.  It is now the opinion that anyone who has a fracture over the age of 50 should be investigated for future fracture risk.  Many factors contribute to fracture risk; one of the biggest being the risk of falling. Poor balance, instability in walking, neuropathy and impaired vision all increase falls.  Maintaining strong muscles is also vital to stability and preventing falls.  Not enough importance is placed on muscle strength and preventing fracture. The greatest risk of breaking a bone is having low bone density and low muscle mass.  It is a myth that excess fat acts as a cushion and prevents fracture.  In fact, obesity increases the risk of fracture especially ankle and upper leg fractures.  Beyond our current great treatments for osteoporosis which strengthen bone, new therapies are being investigated to improve muscle mass.

Our pharmacist Carolyn Whiskin is not only a specialist in the field of biologic medication but is also a certified menopause practitioner with the North American Menopause Society (NAMS).  She recently returned from the annual NAMS meeting in Philadelphia. Over the next several weeks we will be sharing some of the key learnings from this meeting. Be sure to follow our weekly blog and Facebook page for this information.

This week, we’re pleased to be bringing you information on an upcoming FREE forum that our pharmacist, Carolyn Whiskin, will be speaking at. The Ontario Pain Foundation regularly hosts these sorts of forums on a wide range of topics surrounding pain management.

Carolyn Whiskin will be speaking on “Integrating Natural and Traditional Medicine for Treating Pain.”

Please see the attached flyer for more information.

“Pain and the Opioid Crisis… Toward the conquest of pain…”

Location: Burlington Seniors’ Centre, 2285 New Street (in Central Park), Burlington

Time: 2:00 – 6:00 p.m.

Date: Sunday,  5 November, 2017