Tuesday, November 27, 2007

How Do Drug Work - NEW Non Sedating Antihistamine

Hello Everyone,

On a previous post I wrote about Zyrtec (cetirizine) now being available over the counter (OTC).
There is now another non sedating antihistamine on the market.

YXZLAR (levocetirizine) was approved by the Food and Drug Administration (FDA) as a once-daily prescription antihistamine. It is classified as a non sedating antihistamine and indicated for the the relief of symptoms associated with seasonal or perennial allergic symptoms. It is also indicated for non complicated skin allergies. When a drug is INDICATED for a certain condition, that means that the FDA has approved that drug for that specific use.

The most common side effects of Xyzlar in adults were drowsiness, fatigue and dry mouth.

Here is an interesting medication phenomenon. See if you can see any similarities here.



Are they the same drug? No, not exactly. On a molecular level, in the world on medicinal chemistry, levocetirizine is an ENANTIOMER of cetirizine. More specifically, it is the active R-enantiomer. Think of your left hand as being an enatiomer of your right hand. They are the same, but reversed. Being the active enantiomer means that it is the levocetirizine molecule that actually provides the antihistmine effects.If anyone would like more information on the specifics of stereo-chemistry, please email me.

Anyway, I got carried away there.

So, if your allergy symptoms are being well controlled by Zyrtec (cetirizine) and since it is now over the counter (OTC), you may want to look for a prescription product. XYZLAR may be a good candidate to ask your physician about.

Thanks for your interest,

Dr. Paul

General Health Information - Non Sedating Antihistamines

Hello Everyone,

On a previous post I talked about non sedating antihistamines. In that article, I referenced Zyrtec (cetirizine) as one of the prescription products available.

I just read that on 11/22, the Food and Drug Administration (FDA) approved Zyrtec tablets, chewable tablets and syrup for nonprescription, over the counter (OTC) use. It is approved for temporary relief of symptoms due to hay fever or other respiratory allergy symptoms.

Andrea Leonard-Segal, M.D., director, Division of Nonprescription Clinical Evaluation in the FDA's Center for Drug Evaluation and Research stated "The approval of Zyrtec for nonprescription use offers an additional treatment option for children and adults. As for all nonprescription drugs, consumers and caregivers should read and carefully follow all directions on the labeling."

What does this mean for you?

For many of you, to obtain this medication, you will not longer to need to visit your physician to get a prescription for Zyrtec. That's the good news.

For many more with prescription drug coverage, since Zyrtec is now OTC, the medication will no longer be covered. If you were paying a $10 co-pay for your Zyrtec, you will now be paying much more. That's the bad news.

I tried to research the prices of OTC Zyrtec but I was unable to find a current price. As soon as I find a price I will let you know.

Please consult with your Pharmacist or Physician for alternatives to Zyrtec if you would like to switch to a prescription product.

I will be posting some updated information on an alternative.


Dr. Paul

Saturday, November 24, 2007

How Do Drugs Work - Nasal Steroid Sprays

Hello Everyone,

The folks with allergies are still out there and in South Texas allergy season doesn't end anytime soon. So far, we have talked about antihistamines and decongestants that are used to treat allergy symptoms. There is another class of medications to use in your fight against seasonal allergies and these are the nasal corticosteroids.

Nasal corticosteroids, also know as Inhaled Nasal Steroids, reduce swelling and secretions by decreasing histamine and prostaglandins along with other substances in the nose. Nasal corticosteroids have been shown to improve symptoms of sneezing, itching of the nose, runny nose, and congestion.

According to the Joint Council of Allergy, Asthma and Immunology (JCAAI), nasally inhaled corticosteroids are the most effective medication class for controlling symptoms of allergic rhinitis. They also recommend that the inhaled nasal corticosteroids should be used as first line therapy for the treatment of allergy symptoms. The American Academy of Allergy, Asthma and Immunology (AAAAI) also recommend nasal corticosteroids for the initial management of allergy symptoms.1

Drugs in this Class

Beclomethasone Nasal Inhalation (Beconase AQ) 2x/day
Budesonide Nasal Inhaler (Rhinocort Aqua) 1x/day
Flunisolide Nasal Inhalation (Nasarel) 2 - 3x/day Generic available
Fluticasone Nasal Inhalation (Flonase) 1x/day Generic Available
Fluticasone Nasal Inhalation (Veramyst) 1x/day
Mometasone Nasal Spray (Nasonex) 1x/day
Triamcinolone Nasal Inhalation (Nasacort HFA) 1x/day
Triamcinolone Nasal Spray (Nasacort AQ) 1x/day

These medications are only available with a prescription. Therefore, you must schedule a visit to your doctor's office to get a prescription.

Most scientific studies state that the effectiveness between all nasal corticosteroids are similar. Since individual responses may vary, you may have to try several different brands to see which drug is the most effective for you.

These medications do not provide the immediate relief that other types of medication can. It is recommended that these corticosteroid nasal sprays be started before symptoms occur. So if you know that cedar season is coming, you should plan ahead and start your therapy. Remember, corticosteroid nasal sprays are not intended to relieve acute symptoms so they need to be used on a regular (daily) basis. Once control has been achieved the dosage should be reduced to the minimum dose to control your symptoms.

Side effects are generally minimal with nasal irritation (burning/stinging sensation) and taste disturbances (dysgeusia) being the most common.

As always, follow the prescribing directions. If you have any questions, please talk with your Pharmacist or Physician or email me.

Thanks for your support,

Dr. Paul

1. American Academy of Allergy, Asthma and Immunology. Practice parameters for diagnosis and management of rhinitis. Available at: http://www.acaai.org/NR/rdonlyres/C39594CA-ABDF-4DBA-93EC-1CFB3429D305/0/rhinitis.PDF. Accessed November 23 2007.

Wednesday, November 21, 2007

How Do Drugs Work - Non-Sedating Antihistamines

Hello Everyone,

I'm sure it's been a very busy week for everyone and with all the holiday preparations, who has time to be sick. Or, who has time to feel drowsy or stay in bed because they are taking antihistamines for their allergies?

Good News. There are now medications that are called Non-sedating Antihistamines.

Claritin - Loratadine (OTC)
Clarinex - Desloratadine
Zyrtec - Cetirizine
Allegra - Fexofenadine

These are 2nd generation antihistamines that claim to be less sedating than their 1st generation counterparts such as Benadryl - diphenhydramine.

Studies have indicated that these non-sedating antihistamines are as effective as diphenhydramine.

Is there some wordplay going on here?

Are they NON-sedating or are they LESS sedating than their 1st generation counterparts.

Researchers looked at 18 different studies where researchers compared the effects and side effects of the 2nd generation antihistamines and diphendydramine against a non-active ingredient (placebo). When researchers go back and look at studies that have been completed and then summarize the findings of those studies is called a meta-analysis.

In those 18 studies, both the 2nd generation antihistamines and diphenhydramine caused significantly more sedation and psychomotor impairment compared to placebo. However, the diphendydramine caused significantly more sedation and psychomotor impairment than the 2nd generation antihistamines. There were a few exceptions to this trend.

Those studies support the conclusion that the 2nd generation antihistamines are LESS sedating than diphenhydramine. However, they are more sedating than placebo. Therefore, one could conclude that the 2nd generation antihistamines are LESS sedating but they are not NON-sedating.

What does all that mean?

What is really important is HOW DO THEY MAKE YOU FEEL?

CONSIDER - If both diphenhydramine and the 2nd generation antihistamines can control your allergies... does one cause you to doze off and with the other you feel fine?

If that is the case, take the one that works for you. Remember, of the 2nd generation antihistamines, only Claritin in available without a prescription. The 2nd generation antihistamines are also more expensive. Consult with your Pharmacist or Physician for more information.

The 2nd generation antihistamine products are also available in combination with a decongestant, usually pseudoephedrine.

If you have any specific questions regarding your medications, please do not hesitate to email me.

Have a very happy Thanksgiving.

Dr. Paul

Saturday, November 17, 2007

General Health Topics - What I Recommend for Allergies

Hello Everyone,

It's allergy season. People are suffering....me included.

We have talked about using antihistamines and decongestants to combat allergy symptoms. Several readers have asked what is better and how should they take them.

This is what I recommend for Over the Counter (OTC) allergy treatment.

AM Dosing - 2 psuedoephedrine tablets or 1- (12 hour) psuedoephedrine tablet

AM Dosing - 1 spray in each nostril of Afrin 12 hour formula (oxymetazoline) nasal spray.

PM Dosing - 1 spray in each nostril of Afrin 12 hour formula (oxymetazoline) nasal spray.

PM Dosing - 25mg (1 tab) - 50mg (2 tabs) of diphenhydramine before going to bed.


If you have high blood pressure, heart condition, diabetes, currently taking and MAO Inhibitor drug, glaucoma or prostate swelling you should not take the decongestant.

Diphenhydramine can cause drowsiness. Take appropriate precautions when using this medication

Overuse (> 4-5 days) of decongestant nasal sprays can cause rebound congestion. Do not overuse.

When sleeping, if stuffiness or post nasal drip keeps you from sleeping comfortably, prop yourself up on a couple of pillows.

Hopefully this can help you feel better. Please read all medication labels carefully.

Have a nice weekend,

Dr. Paul

Wednesday, November 14, 2007

How Do Drugs Work - Decongestants

Hello Everyone,

As "Cedar Fever" gets worse in South Texas, more and more patients are reaching for over the counter (OTC) remedies to help them cope with the runny noses, itchy eyes and increased sinus, head or nasal congestion. An earlier article covered antihistamines which works well for the runny nose and itching.

Today we are going to discuss medications that patients take to fight that congested feeling. There are usually two types of congestion that patients experience. Chest congestion or nasal congestion. Most of the medications that we are going to discuss today are for nasal, head or sinus congestion.

Congestion problems? What medications can you take to fight that congestion. DECONGESTANTS! Be careful.... they are not for everyone.

Decongestants belong to a class of medications called sympathomimetics. That is... they mimic the action of the chemical in the body (neurotransmitter) that controls the sympathetic nervous system. The chemical in the body is norepinephrine, commonly called "adrenaline".

Adrenaline is the chemical in the body that controls the "Fight or Flight Response" in the body. You know the feeling..... something scares you and all of a sudden, your heart is beating faster, you are breathing faster, your blood pressure goes up and you feel anxious.

It speeds up the heart by stimulating the receptors in the heart causing it to beat faster.
It increases blood pressure by causing a the blood vessels to constrict (get smaller)
It stimulates breathing and opens your airways because if you are going to fight or run you need more oxygen.
It can give you more energy reserves by causing the liver to convert stored sugar to glucose that your cells can readily use for energy.
It can keep you awake.

It SPEEDS things up. SPEED! You have heard that term referring to illicit drugs. Well, speed belongs to the same family of drugs. In fact, there are many medications that belong to that same class of medication. Sympathomimetics have many medicinal uses... Attention Deficit Hyper Activity Disorders, Appetite Control, Weight Loss, Low Blood Pressure, Asthma Control, Nasal Decongestants.

So, Nasal Decongestants, How Do They Work? Medications like psuedoephedrine, phenylephrine, ephedrine and topical decongestants like oxymetazoline work by stimulating the receptors on the blood vessels in the sinuses causing them to constrict and relieving that stuffy feeling. That simple.

Recently the sale of psuedoephedrine was restricted. This medication is now kept behind the counter with the Pharmacist in an effort to control large sales of psuedoephedrine. Why is this? Psuedoephedrine is used in the manufacture of the illicit substance - methamphetamine.

Above I mentioned that nasal decongestants are not for everyone. This is why....

It speeds up the heart by stimulating the receptors in the heart causing it to beat faster.
If you have a heart condition, the increase in heart rate can cause problems.

It increases blood pressure by causing a the blood vessels to constrict (get smaller).
If you have high blood pressure, the increase in blood pressure can cause problems.

It can give you more energy reserves by causing the liver to convert stores sugar to glucose that your cells can readily use for energy.

If you have diabetes, the increase in blood sugar can cause problems.

It can keep you awake.
If you take decongestants late at night, it can cause restlessness and inability to sleep.

Decongestants should not be taken with other medical conditions. If you have any chronic illness, please check with your Pharmacist or Physician to see if these medications are safe for you.

Many of the combination cough and cold remedies have decongestants in them. Please take time to read the ingredient list before you make a purchase. If needed, please ask your Pharmacist for assistance. Remember, if the package says it is a non-drowsy formula, chances are it has a decongestant in it.

I am trying to keep these explanations easy to understand. If they are not clear or you would like more information, please let me know.

Thank you for your support.

Dr. Paul

Tuesday, November 13, 2007

General Health Topic - Medicare Fall Open Enrollment - November 15 - December 31 2007

Hello Everyone.

Again, it is that time of year. This time it is for Medicare's fall enrollment period which starts in a couple of days on November 15 and runs through December 31, 2007.

For my readers that are eligible, now is the time to review your health care and prescription drug coverage and make changes if needed. If you are not enrolled in a plan, now is the time to enroll.

For my other readers that aren't eligible, I'm sure you know someone that is eligible, your parents, grandparents, neighbor, coworker. A friendly reminder for them would be appreciated.

I'll admit that I am no expert on Medicare health plans. However, there are many people that are and I have included many links for you to get as much information as you need. There are many plans and options available. If you have parents or grandparents that are eligible, please take time to help them decipher the many plans that are available.

As outlined in the Health and Human Services (HHS) website the three important steps to follow are:
1. Prepare - Gather information on the available plans looking at does your doctor participate in the plan, do the plans cover the medications you are taking, and all associated costs of the plans.
2. Compare - will the plans meet your needs, costs and customer service.
3. Decide - enroll in the plan that will work for you.

Here are a government links to gather more information:

Open enrollment Information - http://www.cms.hhs.gov/center/openenrollment.asp

State drug Plan Information - http://www.cms.hhs.gov/Partnerships/STDrugPlanInfo/list.asp

Official Medicare Site - http://www.medicare.gov/

Comparing plans - http://www.medicare.gov/Publications/Pubs/pdf/11163.pdf

The following links are provided by private business, insurance companies and different organizations. I do not endorse one product over the other. I am simply providing information to help you make your best decision. for more choices go to www.google.com and do a search on Medicare Plan providers in your area.

AARP Medicare Plan Information - https://www.aarpmedicarerx.com/

A good place to get started - http://www.medicareinteractive.org/page2.php?topic=counselor

Aetna - www.aetna.com/members/individuals/medicare/medicare_resources

Humana - http://www.humana-medicare.com/

This site compares plans in Texas - http://www.planprescriber.com/medicare/client/156904/web/index.jsp?group=156904&adwords=y&gclid=CNut_6uW2o8CFUV0OAodDQfH8w

There are many more avenues to gain the information you need to make your best decision.

Good luck.

Dr. Paul

Saturday, November 10, 2007

General Health Topic - Gross Hotel Glasses

Hello Everyone,

The other day I wrote an article about hand washing and using antibacterial wipes in groceries stores, hotels and other locations to try to prevent the spread of colds, flu, etc.

Yesterday I read an article in USA Today about the glasses in hotel rooms that I thought I would pass along.

Here is the article:

Gross hotel drinking glasses

Think the glasses in your hotel room are sanitized?

Unless they're plastic and wrapped, think again.

A reader alerted me to a report this week by the investigative team at Atlanta Fox 5 TV. They checked into a half-dozen area hotels and put a hidden camera in the bathrooms. What they found everywhere -- from budget to luxury hotels -- was disgusting: Housekeepers rinsing glasses in the bathroom sink. In one case, glasses were swooshed out after a housekeeper had been cleaning the toilet; in another, glasses were sprayed with what looked like a toxic mirror-cleaning product before being rinsed and dried.

Hotels typically say glasses are put through the dishwasher, but I have observed housekeepers swishing them out in the sink to save time near the end of a shift. Health experts interviewed by Fox 5 said the practice was a violation of rules and that dirty glasses could spread disease


(Note: this article was cut and pasted from the enclosed link. I did not write it.)

I will try to pass along these tidbits when I find them in an effort to stay Healthy.

Have a nice weekend.

Dr. Paul

Thursday, November 8, 2007

How Do Drugs Work - Antihistamines

Hello Everyone,

Tis the Season.

Well, Thanksgiving and Christmas are coming but that is not the season I am talking about.

I am referring to ALLERGY SEASON.

You go to bed one evening and you wake up in the morning with nose dripping, red eyes, scratchy throat, wheezing, sneezing, hives, and maybe throat tightness.

That is your body's immune response to a substance that is causing irritation in your nose and throat. The mast cells in your body are producing histamines. The histamines and the other chemicals that they stimulate are responsible for your runny nose and itchy eyes. Histamines can cause allergic reactions in other parts of your body...like if you are allergic to peanuts or some prescription drugs.

To treat those symptoms, you need something to block the action of histamine. Something that works against the histamine, something that is "ANTI-histamine"

"Anti-Histamine" - Does that sound familiar?

Antihistamines are a class of medication that are used to counteract the action of histamines in the body. Specifically, they block histamine-1 receptors in the respiratory tract, GI tract and blood vessels. By blocking the receptors, the histamine is prevented from adhering or interacting with the receptors. The histamine can not then trigger the chemical cascade that then causes the symptoms that make you miserable.

Examples of antihistamines include chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), clemastine (Tavist),fexofenadine (Allegra), loratadine (Claritin) and cetirizine (Zyrtec). The less-sedating antihistamines (Allegra, Claritin, Zyrtec) are available either by prescription or over the counter.

Side effects commonly include drowsiness and dry mouth. Because they can cause drowsiness, many people can not take antihistamines early in the day and you should not take them before driving or performing any other hazardous activities. I usually recommend to my patients to take antihistamines at night before going to sleep. In fact, many people take diphenhydramine so they can sleep! Antihistamines can cause difficulty urinating, confusion, and an increased risk for falls or injury especially in older adults.

Antihistamines are also useful for treating hives. There are antihistamine creams, lotions and gels that can be applied topically to treat itching on the skin.

There are other types of antihistamines. However, they are not usually known by that name. Remember, there are histamine receptors in the stomach. When those receptors are stimulated, it causes the acid producing cells in the stomach to produce acid. Histamine-2 blockers (H2 blockers) are used as an anti-acid treatment for treating heartburn. Examples of H2 blocker medication include ranitidine (Zantac) or cimetidine (Tagamet).

Please stay tuned to future posts concerning other medications to treat allergy symptoms such as decongestants. There are many patients that should not take decongestants because of their other medical conditions. Please be careful because there are many combination allergy treatments that contain both antihistamines and decongestants. Please read the label carefully or ask your pharmacist for advice. If the package says "Non-Drowsy Formula" - WATCH OUT. That usually means that it has a decongestant in it. We will go over that information soon.

Hope you stay healthy.

Dr. Paul

Wednesday, November 7, 2007

An Ounce of Prevention

Hello Everyone,

The saying goes... "An Ounce of Prevention is Worth a Pound of Cure".

In pharmacy, we spend most of our time providing medications to our patients that focus on curing or making health conditions better.

What we should really focus on is PREVENTION!

We should try to prevent the condition in the first place. Preventative measures are the key. That is going to be one of the focal points of this blog. Many of the diseases and conditions that we face are preventable. Getting proper exercise, eating right, stop smoking, getting immunized, regular health Check-up and Dr. visits, visiting the dentist regularly, age appropriate health screenings and tests (mammograms, colonoscopy), knowing our cholesterol level, wearing our seat belts, etc. are all things that we should do that will contribute greatly to our overall health.

Cough, Cold and Flu season is here. In an earlier post, we talked about flu vaccines and how they can prevent catching the flu. However, one of the easiest ways to prevent catching colds and flu is proper hand washing and personal hygiene.

How should you wash your hands and when should you wash them? Here are some hints and guidelines:

For effective hand washing:

Wet your hands under warm running water.
Apply a small amount of liquid soap.
Cover all surfaces of your hands with soap and water, rubbing vigorously.
Rinse with clean running water.
Dry hands thoroughly, using paper towels or a clean towel.

When should we wash our hands?

Before eating or preparing food
Immediately after handling raw foods, such as poultry
After going to the bathroom or changing a diaper
After contact with blood or body fluids (e.g., after sneezing, coughing, wiping your nose)
After touching animals or their toys and leashes
After touching contaminated or dirty items such as trash cans, cleaning cloths, drains.
Before dressing a wound, giving medicines, or inserting contact lenses
Whenever hands look dirty

Soap and water and proper hand washing facilities are not always available. Carry a small bottle of an alcohol based hand sanitizing gel such as Purell to use as needed. The following link has an interesting article that shows that using sanitizing gels can reduce the spread of stomach illness. http://www.medicalnewstoday.com/articles/30267.php

Carry a small package of antiseptic wipes (Purell Hand Wipes) for wiping off items that you come in contact with at the grocery store (shopping cart handles), hotels (Phones, remote controls), airports, parks, shopping malls, public restrooms and other public places.

Here are some additional links with information from the Center for Disease Control (CDC)


and from Lysol.


The CDC also publishes some good brochures and wall charts on hand washing. Here are those links:



Please note: These publications are available for download only as *.pdf files. These files require Adobe Acrobat Reader in order to be viewed. Please review the information on downloading and using Acrobat Reader software.

If you have any suggestions for topics of discussion, please let me know.

Thank you for your time,

Dr. Paul

Tuesday, November 6, 2007

How Do Drugs Work - Laxatives

Hello Everyone,

Since the name of this blog is How Do Drugs Work, it is time to start talking about....... How drugs work! The medical term for how drugs work is their "Mechanism of Action (MOA)"

Today we'll talk about.......

LAXATIVES - medications that promote bowel movements. most of these products are sold Over the Counter (OTC).

To maintain good bowel health, remember to get exercise, eat fiber rich foods and drink plenty of fluids. If that doesn't help you stay "regular" you may need to take a laxative to get you back on track.

Saline cathartics -magnesium citrate, magnesium hydroxide (milk of magnesia, MOM), magnesium sulfate (Epsom salts), sodium biphosphate, sodium phosphate (Phospo-Soda).
MOA - Saline laxatives act by attracting water in the intestine and produce a watery stool.

Stimulant and irritant laxatives - Senna (Sennacot) and bisadocyl (Dulcolax) Sennosides (Ex-Lax Laxative) and Castor oil (Purge).
MAO - increase the peristaltic movement of the intestine which forces the stool out.

Bulk forming laxatives - Psyillium (Metamucil, Konsil), methylcellulose (Citrucel) and polycarbophil (FiberCon).
MOA - increase the bulk and volume of the stool, soften the stool and stimulate intestinal motility. This class of laxative is most effective when used daily and consumed with plenty of fluids.

Stool Softener - Docusate (Colace)
MOA - holds water within the stool, providing a larger, softer stool.

Lubricant laxative - Mineral Oil, Glycerin and Magnesium Hydroxide
MOA - Coats and softens the stool by slowing intestinal absorption of fecal water.

Hyperosmotic laxatives - Glycerin and lactulose.
MOA - holds water within the intestine.

Common side effects of laxatives - Laxatives can cause cramping, gas, bloating, nausea or diarrhea. Most likely to cause side effects are the stimulants. The side effects can include abdominal discomfort, faintness and cramps. The bulk-forming laxatives can cause bloating, gas or cramping at first. These symptoms should go away in a few weeks or less.

Interaction with medications - Your current medical condition and other medications you are taking are important things to consider when selecting laxatives. Laxatives can interact with many different drugs such as Coumadin (warfarin). Ask your pharmacist or doctor if you are not sure what type of laxative is right for you.

Laxative Abuse - Some people will abuse laxatives to rush food through their bodies before the calories can be absorbed as a weight loss scheme. This practice is not safe and can cause short and long term damage to the intestines and overall health. Abusing stimulant laxatives can cause the intestines to react only to the stimulant and will stop working without them. If you feel you may have a laxative abuse problem, please contact your healthcare provider.

Here are a few links with more information on Laxatives and how they work.



Thanks for your time,

Dr. Paul

Sunday, November 4, 2007

Flu Shot Reminder

Hello Everyone,

Flu season is here. Now is the time to get your annual flu shot.

The following folks are the ones who really need to get vaccinated:

  • Over age 50
  • Any age if you have chronic medical conditions such as high blood pressure, irregular heartbeat, history of stroke or heart attack, diabetes, compromised immune system, anemia, asthma or other breathing problems
  • If you live in a nursing home
  • If you live in a house with people listed above
  • Health care workers

Check with your local pharmacy, Dr's offices, County Health Departments etc. concerning locations to get your flu shots. Many locations give the shots at low or reduced cost. Many locations will bill Medicare on your behalf if you are a qualified recipient.

If you are employed, ask your employer if they will be sponsoring a flu vaccine clinic. Or, organize a health fair at your office and make arrangements to have flu shots given at that time. Contact me if you need more information on how to set up a health fair. Many employers will provide flu shots at no cost because it may result in fewer sick days taken by the employees.

I have included some links for more information.





1. Read Dr. Paul's notes

2. Go Grocery Shopping


4. Pay Bills

Please let me know if you are finding this information helpful. If you have any suggestions for future topics, let me know.

Thanks for your time,

Dr. Paul

Thursday, November 1, 2007

Prescription Medication and Traveling

Hello Everyone,

It's November 1st and the holidays are rapidly approaching. If you are currently taking prescription medication and you are planning travel to visit friends, relatives or to take a vacation, here are some helpful hints:


Travel with medications in their original prescription bottles that contain your name, medication name and directions for use. Do not place them in a pill box. They will be easier to identify and easier to show that the drugs are actually prescribed for your health. You don't want to have to explain to that customs official that those narcotics in that plastic baggy are actually prescribed for you.

If your medications include narcotics, controlled substances or needles, have your doctor write a short letter of explanation to verify that the items are needed. Get a letter from your Doctor if you have a pacemaker, implanted defibrillator, implanted pain pump, using an ambulatory pump for intravenous medications or an insulin pump.

Take along more of your prescription medication than you think you will need. It would be a shame not to be able to extend your visit just because you are running out of your blood pressure medication.

Going back to a previous topic, make sure to wear your medical alert bracelet to let people know if you have certain medical conditions. Also make sure you have a copy of your medication list in your purse or wallet if needed.

Try to bring along a copy of your prescription that has both the brand name and generic name of your medication. If you are abroad, it may help you find the right medication that you need.


Make sure to put medications in your carry-on bags. Do not place in your checked baggage. That way, if your bags are delayed or lost, you will have your medications with you.

Medications that are liquids, aerosols or gels need to meet the carry-on requirements of the Transportation Security Administration (TSA). I have included the link for you at the bottom of the page.

If you are diabetic, make sure you have your GLUCOMETER with plenty of testing strips, and lancets to check your blood sugar often. Traveling can be stressful and may cause your blood sugar to increase. Make sure you have snacks as well. If your plane is delayed or you have to sit on the tarmac for an extended period and you don't get a chance to eat, you don't want your blood sugar to go too low. Have some candy, some glucose tablets, some glutose or a box of juice.

If you have a heart condition, be aware that most airports have AUTOMATIC EXTERNAL DEFIBRILLATORS (AED). Make a mental note where they are located and make sure that your travel companions note their location as well. The AEDs can save your life. We will talk about those in a later post.

A long flight can really cramp your legs. They can also cause a condition called Deep Venous Thrombosis. (DVT) If you are prone to that condition, try to get up, stretch and walk around the cabin if you can. Keep that blood pumping.

Stay well hydrated.

CRUISES - Sea Travel

While on those ships, the food is fantastic. If you are diabetic, again, make sure you have your trusty GLUCOMETER with plenty of testing strips, and lancets to check your blood sugar often. Those yummy desserts can make your blood sugar go crazy. Don't let it get out of control.

If you are taking Coumadin (warfarin), make sure you don't drastically alter your diet. Try to maintain your current consumption of Vitamin K containing foods. If you don't know what those items are, drop me a line and we'll go over them.

If you are prone to sea sickness, talk with your Doctor or Pharmacist to see what remedies are most appropriate for you. Plan ahead. If you need a prescription, waiting to the last minute will add to your stress.


Motor coach travel is cool in that you are in your home away from home. As you pull into your favorite RV Resort, find out what access they have to Emergency Medical Services (EMS), do they have AEDs available in the park, what other first aid facilities are close by. Is there a local pharmacy that will deliver to the park if a prescription is needed.

Carry a first aid kit in the coach.

Here are the links for more information:



While you are traveling there is one very important thing to remember as it is very vital to your health....

HAVE FUN ! ! ! ! !

Talk with you later,

Dr. Paul