Pharmacogenomics: Glipizide

NewSpring Pharmacy PharmacogenomicsGlipizide is the most commonly prescribed diabetes medication. Last year, about 24 million Glipizide prescriptions were filled by pharmacies in the U.S. Unfortunately, this very helpful medication causes a number of side effects for some people, including nausea, vomiting, diarrhea, abdominal pain, hypoglycemia (low blood glucose concentration), flatulence, indigestion, and rash.

Pharmacogenomic testing identifies variations within genes which may affect how a person’s body metabolizes various drugs, including Glipizide. These test results can help the doctor choose the safest and most effective drug and dose for your diabetes management. In some cases, when gastrointestinal side effects are unbearable, the physician can prescribe transdermal Metformin as an alternative and NewSpring Pharmacy can make the Metformin topical cream for you. This helps manage diabetes while avoiding GI side effects (see article above).

Recently, one of our patients who had struggled for a while with gastrointestinal side effects from Glipizide called the pharmacy after reading about topical Metformin on our website. We consulted with his doctor and made the topical Metformin cream for the patient, which solved the long-standing stomach side-effects, to his great relief.

YOU First: What a diabetes support program can do for you

NewSpring diabetes support program

Dealing with diabetes on your own can be overwhelming. Besides taking your meds, there are major lifestyle changes to be made, as well as concerns about complications to deal with. Doing it all on your own can be so daunting, which is why NewSpring Pharmacy has launched YOU First, a support program for people with type 2 diabetes.  The program will empower participants by giving them tools and encouragement to control diabetes and prevent or delay complications.  Here are some examples:

Nutrition: Coming up with a really good meal plan that works for you and sticking with it can be easier with some support.

Exercise: Getting about 30 minutes of exercise daily is an enormous help for diabetes management. Figuring out what kind of exercise to do, and how much, is the first step. You want to pick an activity that you enjoy and that fits well with your daily schedule and fitness level. We will help customize the type and level of activity that will get you moving.

Taking your meds: You may have questions about how to get the best possible outcome from your medications. Who better than your pharmacy to advise you on this. We are here, ready to support you.

Taking charge:  Do you feel confident about checking your own sugar levels and blood pressure? Do you know which complications to watch out for, and how? The YOU First program will equip you with the knowledge and encouragement you need to confidently take charge.

The YOU First program is now open for enrollment. If you would like to join or need more information, please call 623-932-9800.

HEAD TO TOE: Four diabetes complications and tips to manage them…

November is an important month. It’s National Diabetes Month; a time to learn more about how to avoid diabetes if you are at risk, how to live well if you have been diagnosed, and how to support our loved ones through it all. Did you know that one in 11 Americans has diabetes. Keeping your blood sugar levels under control by taking your meds, eating right, and exercising makes a huge difference. Over time, diabetes can cause us many health problems, from head to toe! But the good news is, you can prevent, delay, or manage these complications. Read on for some of the complications to look out for and some tips on how to deal with them…

Brain
Our brains are our most complex organs, and the command center of our lives. Our slightest movement, the simplest thought, the deepest emotion, depends on our brains. And the health of your brain depends on the health of the blood vessels that feed it. High blood sugar levels can, over time, damage both large and small blood vessels and interfere with blood flow to the brain, which affects the white matter. The white matter is the area where nerves from different parts of the brain connect. When this connectivity is disrupted, our mental function is disturbed. When this happens, over time, one may have trouble with performing regular daily activities. It can also cause memory loss, and even dementia. Research has also found that people who have diabetes by middle age have an increased risk of Alzheimer’s.

Tip: A combination of physical and mental exercise helps brain health. Mental exercise can be in the form of social engagement such as socializing and working with other people, or reading and learning new skills, for instance.

NewSpring Pharmacy diabetes complications Eyes
If you have diabetes you’re at risk of getting certain eye conditions that can affect your vision, or even cause blindness Diabetic retinopathy, the most common eye condition among people with diabetes, causes blood vessels in your eyes to bleed or leak fluid. This fluid can also cause Diabetic macular edema (DME), which is swelling in the part of your eyes called the macula.

Diabetes can cause too much glucose in the lens, leading to Cataract, a condition where your eye’s lens becomes cloudy. The cloudiness prevents light from being reflected to the retina, and so affects your vision. Another condition to look out for is Glaucoma, which happens when pressure builds up in your eye. For people with diabetes, this may happen because the fluid that should be moving around in your eye gets blocked.

Tip: Early detection and treatment of diabetic retinopathy can reduce the risk of blindness by 95 percent. If you have diabetes, get a comprehensive dilated eye exam at least once a year, or more often if recommended by your eye doctor.

Kidneys
Our kidneys are our blood filters. They retain the useful nutrients and remove waste from our body. But too much sugar in the blood damages the kidneys’ filters by clogging and damaging their tiny blood vessels. Besides, people with high blood sugar are more likely to develop high blood pressure, which also damages the delicate nerves of the kidney. Diabetes is the leading cause of kidney disease, which can lead to kidney failure.

Additionally, excess blood sugar can damage the nerves that communicate between the brain and the bladder to let us know when the bladder is full. A bladder that is always full can be damaged by the pressure over time. When urine which has a lot of sugar due to diabetes remains in the bladder for a long time, the risk of bacterial infection is high. The infection starts in the bladder but can eventually spread to the kidneys and damage them.

Tip: In the early stages of kidney disease, often there are no warning symptoms. If you have diabetes, get annual blood and urine tests to monitor your kidney health. Early diagnosis and treatment can prevent kidney failure.

NewSpring Pharmacy diabetes complicationsFeet
If you have diabetes, monitoring the health of your feet and caring for them is extra important. Experts advise people with diabetes to have annual foot exams to check for peripheral neuropathy. Peripheral neuropathy causes pain or loss of feeling in the toes, feet, legs, hands, and arms; and for most people with diabetes, it is their feet that take the brunt of this condition. Doctors estimate that nearly half of the amputations caused by neuropathy and poor circulation could have been prevented by careful foot care.

The tell-tale signs of peripheral neuropathy are pain, tingling, numbness and loss of feeling in the arms, hands, legs or feet. Some people have nerve damage with no symptoms at all, while others suffer excruciating pain. Prescription pain creams such as those customized at NewSpring Pharmacy can help manage pain caused by nerve damage.

The danger of lost sensation lies in not noticing sores or injuries in the feet. Unnoticed, these injuries may become ulcerated or infected.

Tip: Wash your feet in warm water (not hot), dry them well. Inspect your feet and toenails for any injuries, wounds or infections. The Center for Disease Control recommends you see your doctor if such wounds do not heal after one day. Apply lotion on the tops and bottoms of your feet, but not between the toes.

A Very Diabetes-friendly Thanksgiving to You!

NewSpring Pharmacy diabetes Thanksgiving

What is Thanksgiving without the stuffed turkey, the cranberry sauce, and the pie! If you’ve recently been diagnosed with diabetes and you’re wondering whether to cancel Thanksgiving dinner altogether, you need not worry. You and your family can enjoy a delicious meal without having to suffer a blood sugar spike. You can tweak a few things, create some new traditions, and have lots of fun with it. Here are some tips.

Breakfast matters
What’s the most important meal of the day? Yes, it’s breakfast, even on Thanksgiving. Some people will skip breakfast to ‘make room’ for a hearty Thanksgiving dinner. A better strategy for managing diabetes is to spread your eating through the day. Have a light breakfast, then snack on veggies and delicious healthy dips between breakfast and your main meal. If you’re not starving, you’ll have more control when it’s time for the main meal.

Carb choices
A traditional Thanksgiving dinner is high in carbs, but you can make a few creative changes. Here are some tips:
Make your own stuffing without bread crumbs. Can this be done? Yes, there are many delicious recipes for stuffing with ingredients such as brown or wild rice, quinoa, sausage, mushroom, or cauliflower.

Get creative with your pie. How about a crust-less pumpkin pudding topped with a bit of whipped cream or dark chocolate?
Replace one traditional carb dish with a veggie dish – just be sure it’s a delicious one. Think colorful. How about a beautiful dish of roasted veggies: cauliflower, colorful bell peppers, carrots, broccoli, eggplant…the possibilities are endless.

Old traditions, new traditions
What traditions make Thanksgiving special in your family? What are your family’s must-have foods? Is it the turkey, the mashed potatoes, the cranberry sauce? You can make changes that keep your important traditions going with a few tweaks so that those who are insulin-challenged can also enjoy them. For instance, for you mashed potatoes, instead of milk and butter, mash with chicken or vegetable stock and olive or avocado oil. By using healthier ingredients and keeping your portions of high-calorie foods small, you can enjoy a traditional Thanksgiving dinner.

Thanksgiving doesn’t have to be just about the food. It’s only one meal in a 24 hour day! How about creating some new Thanksgiving family traditions, such as a 5K walk or bike ride, a volleyball game, or simply putting on some irresistible music and inviting everyone to dance.

Thanks but no thanks
Someone trying to pile your plate for you? “It’s only one day,” they say with a determined smile and a heaped serving spoon hovering over your plate. Decide ahead of the day that there are some things you just won’t have, no matter what; like soda, sugary drinks, fruit juice, pies baked with white flour, and deep fried foods. Take charge of the dinner conversation (recruit an understanding family member if need be) so that the focus is not so much on the food as on lively conversation. Think of a couple of intriguing topics ahead of time. Someone might be so taken in with the conversation they may just forget about heaping your plate with food.

Beet Dip Recipe
NewSpring Pharmacy healthy Thanksgiving1 cup beetroot, cubed and steamed

Plain non-fat Greek yogurt

Crushed garlic, to taste

1 tbs Olive oil. Salt and spice to taste
Blend all ingredients in blender or food processor and enjoy!

Exercise matters in the fight against diabetes

NewSpring Pharmacy diabetes exerciseWhen you eat carbohydrates, your body breaks them down into glucose (sugar). This glucose in your blood will provide energy for your body, but first, it needs to be absorbed from the blood into your body cells. That’s where insulin comes into the picture.

Insulin is a hormone produced by your pancreas. Insulin tells the cells that there is glucose in the blood to be taken up. But if there is always too much glucose in the blood, the cells learns to ignore the messages from the insulin. When this happens, you end up with too much glucose in your blood. This is type 2 diabetes.

How does exercise help?
Exercise can reduce the glucose in your blood. When you exercise, your muscles can use glucose without insulin. So even if your body has learned to ignore the insulin, when you exercise your muscles get the glucose they need when they contract. As a result, your blood glucose level goes down. The muscles can continue to take in glucose in this way for a few hours after you exercise. As a bonus, if your body has learned how to ignore your insulin, that is, if you are insulin resistant, exercising reduces your insulin resistance. This means that your body improves its ability to understand the message from your insulin and use the glucose in your blood more effectively.

Exercise Tip: Consider 3 short but intense bursts of exercise daily. Research showed that type 2 diabetes patients who did short bursts of high-intensity exercise for 10 minute three times daily improved their cholesterol, blood glucose and weight more than those who did 30 minutes of sustained, lower-intensity exercise daily.

Personalizing your diabetes meds

NewSpring Pharmacy unique servicesCustomizing your medication is an excellent solution to meet individual needs. Here are some of the ways meds can be customized to meet the needs of people with diabetes.

Pain cream
Peripheral neuropathy, a complication of diabetes, affects the nerves and can cause pain in the toes, feet, legs, hands, and arms. Many people take pain medication to relieve this excruciating pain. But pain that persists over a long period of time often means continued use of strong oral pain medications. These can cause side effects such as stomach irritation. We work with your health care provider to customize a prescription that avoids such side effects. For instance, instead of a capsule or tablet, a patient could perhaps get their medication in the form of a topical cream or spray. This direct application of pain meds to the site not only avoids side effects, it relieves pain faster and more efficiently.

Topical Metformin as an Option
Metformin (Glucophage®, Glumetza®, Fortamet® Riomet®), which traditionally comes in tablet form, is commonly used for treating type 2 diabetes. However, some patients cannot tolerate the oral dose due to nausea, vomiting, gas, bloating, diarrhea and loss of appetite, which are common side effects of oral Metformin. Many have oral Metformin therapy discontinued due to the severity of their side effects. NewSpring Pharmacy can formulate Metformin into a gel or cream to be applied on the skin. Topical application of Metformin bypasses the gastrointestinal system, solving the problem of gastrointestinal side-effects from oral Metformin.

Wound Care Compounding
Thanks to exciting technology advancements, the days of rubbing wounds to clean them may be on their way out. NewSpring Pharmacy compounds wound care meds that are less abrasive, that promote wound healing, reduce pain and avoid infection. To reduce the discomfort of wound care, we can make the meds easy to apply. For instance, we can make a compound that is liquid but turns to gel once in the wound, so that it’s easier and less painful to dress the wound. The wound care compounds can include: Misoprostol, which reduces inflammation and encourages elevation of collagen, an important part of wound healing; Phenytoin, which stimulates fibroblasts and has anti-bacterial activities; Pentoxifylline, which increases blood flow, therefore increasing oxygen supply and nutrients, both very necessary for healing; Aloe Vera, which stimulates faster tissue regrowth; Lidocaine and Morphine to reduce pain, and by extension reduce inflammation, allowing for healing. Antimicrobials such as Mupirocin, Ciprofloxacin, Gentamicin, and Clindamycin can also be incorporated into the compound.

For more information, please call NewSpring Pharmacy at 623-932-9800

Did you know your pharmacist could do this?…

NewSpring Pharmacy unique servicesA man walks into a pharmacy, picks up his prescription, grabs some over-the-counter pain meds, and he’s out in 5 minutes flat.

This may seem like the ideal scenario. No time wasted, he got his meds fast. Now he has time to go by the car wash, pick up some groceries, and catch the game on TV.

Hold on just a minute though. There’s something wrong with this scenario. If the only service this man got from his pharmacy was to dispense his prescription, then he’s missing out big. Read on about some of the services that NewSpring Pharmacy offers to optimize your wellness…

Compounding
At a restaurant, they have a delicious pepper steak on the menu; but it comes with fries and a small salad. You ask them to hold the fries and get you a bigger salad without croutons. Now that’s a meal suited to your dietary need, your culinary taste and your gluten sensitivity. Getting your meds compounded is something like that.

Your doctor prescribes a pain pill that works well for most people; but it hurts your stomach. Or your child gets a prescription for a suspension that’s too bitter for her to swallow. Maybe you get a medication that’s just fine except for one of the filler ingredients to which you’re allergic. These are some of the problems your compounding pharmacy can fix for you. For instance, we may change that pain pill into a different form such as a gel or cream; flavor the bitter suspension so your child can take it and begin to get well; or replace that filler ingredient with one that’s safe for you so you won’t have an allergic reaction. This is the compounding pharmacy’s recognition of and response to your unique differences.

Synchronization

If you watched the synchronized swimming Olympic event, you will never think of swimming as just jumping into a pool and front crawling to the other end as fast as you can. A synchronized swimming team works together so skillfully and gracefully they are a treat to the eye.

So what does synchronization have to do with pharmacies and medication? You or your loved one may have more than two prescription meds which were prescribed at different times or to manage different conditions. You want these prescriptions to work like a synchronized team. That means you’re not coming into the pharmacy two or three times a month to refill each prescription at different times. To make taking your meds easier, we can synchronize them to come due on the same day of the month. This makes it easier for you to comply with your prescriptions as you only have to visit the pharmacy once a month.

Medication Therapy Management

When you come in to get your prescriptions synchronized, what a great opportunity to have a Therapy Management meeting with your pharmacist. Is there anything about your meds you’ve been wanting to discuss. Perhaps a side effect that you just assumed there’s no solution to?

You may have a variety of prescriptions from different healthcare providers, and in addition you may be taking nutritional supplements and the occasional over-the-counter medication. Your pharmacist can identify any potential negative drug interactions, check if your different prescriptions may be doubling up on the same ingredients, and even advice on possible nutritional deficiencies caused by your meds.

Pharmacogenomics Testing

Have you ever had meds prescribed for you that made you feel absolutely terrible? Perhaps a return visit to the doctor resulted in a different prescription or an adjusted dose. This is the trial and error treatment method which is being overtaken by science. Pharmacogenomics is the study of how genes process and respond to medicines. Your genes determine what happens when you take a particular medicine. Not every drug works well for all of us. The same dose of the same medicine may cure one person and cause another severe side effects. Often a customized dose is necessary to get us feeling better. Genes provide the information we need through a simple DNA test that analyzes your genetic information against hundreds of commonly prescribed drugs. The report you get is a road map that will help your healthcare provider personalize your prescriptions for the most appropriate meds and dosage. Your results are useful for choosing over-the-counter meds as well. Your pharmacist can advise you on the best alternatives based on your test report.

Diabetes education
Diabetes can be overwhelming to control, yet if it is not controlled well, there can be lifelong repercussions. Diabetes complications include nerve damage, vision loss, kidney disease and stroke. Your pharmacist can do more for you than just filling your diabetes prescriptions; he can support and empower you by giving you tools and encouragement to avoid or delay these side effects. NewSpring Pharmacy’s support program for diabetes patients begins in November 2017.

If you are interested in signing up for any of these services or you simply want to know more about them, please call NewSpring Pharmacy and talk to the pharmacist at 623 932-9800

 

Personalized Care: The future of medicine

NewSpring Pharmacy West Valley articleOffering personalized care to everyone who walks through the door of the pharmacy matters a great deal to one Avondale pharmacist. Our very own Lead Pharmacist, Dr. Nyabero, recently spoke to West Valley View writer Connor Dziawura about his passion for making a difference to the Avondale community, one customer at a time.

How does he accomplish this?

By talking to patients and their doctors, getting to know their individual needs for medication that is different from the commercial norm. The pharmacy then meets their personal needs, for instance by customizing dosages or dosage forms, or by changing filler ingredients which cause problems for individuals, such as gluten sensitivities. NewSpring Pharmacy also determine the patient’s best option through pharmacogenetic testing, a simple DNA test that helps determine what medications are best suited to an individual.

The article, ‘Compounding pharmacy makes treatment personal’ was published in West Valley View.

Medical Marijuana: Talk to your pharmacist about interactions with other meds

NewSpring Pharmacy medicine InteractionIn Arizona, more than 116,000 patients hold cards that allow them to use medicinal marijuana. Medicinal marijuana is most commonly prescribed for severe chronic pain, for relief from the side effects of chemotherapy, for cancer, for seizures, and for post-traumatic stress disorder, among other conditions. Patients who use medicinal marijuana are therefore likely to be using various other prescription medications at the same time. With the expanded use of medicinal marijuana, the issue of drug interaction arises. Since the marijuana is not obtained from a pharmacy, it is crucial that any doctor prescribing medication for a patient who is also using medicinal marijuana consult a pharmacist regarding possible interactions.

Marijuana can affect how the body breaks down medication and how it affects elimination of the other medications from the body. This can lead to either too much medication in the body, causing toxicity, or too little medication, resulting in ineffective treatment.

For instance, patients who take Clobazam, a medication commonly prescribed for seizures, need to be aware of its interaction with medicinal marijuana. Clobazam is broken down by the enzyme CYP450 (CYP3A4, CYP2C19), but marijuana inhibits the function of this enzyme. As a result, the concentration of Clobazam and its metabolites increase in the body and you end up with too much of the drugs in your system, which is toxic to the body.

Cancer patients being treated with chemotherapy need to be aware of the effect of medicinal marijuana on their treatment. Marijuana inhibits the enzymes that break down your chemotherapy meds as well, which can cause you to have toxic levels of the meds in your body.

Some other drugs that interact with cannabis are Fluconazole (for fungal infections), Fluvostatin (cholesterol), Ritonavir (HIV med), Diltiazem (cardiovascular disease), Carbamazepine (seizure med), Amiodarone (cardiac med), and St. John’s Wort (supplement).

If you use medicinal marijuana in combination with any other prescription, it is important to consult your pharmacist for information about interactions. Remember to have a comprehensive list of all the medications, herbs, supplements and over-the-counter medication you are taking. The completeness of this list will ensure a comprehensive analysis. If your pharmacist is uncomfortable feel free to call our pharmacist.

‘YOU First’ program set to inspire and empower diabetes patients

NewSpring Pharmacy diabetes support programDiabetes is a growing epidemic. In 2017, an estimated 30.3 million people have diabetes. Diabetes complications can be grave, including nerve damage, vision loss, kidney disease and stroke. It can be daunting trying to manage diabetes and prevent its complications on your own. NewSpring Pharmacy believes in empowering patients by giving them tools and encouragement to lead healthy lives, which is why we are launching the YOU First program for Diabetes patients in November 2017.

YOU First is an intensive program designed to support people with diabetes through proper diabetes education and follow-up on medication adherence. The program will emphasize the importance of exercise and nutrition in diabetes management. We believe that we can improve the outcomes of people with diabetes with this integrated program. Giving people the knowledge and encouragement they need to improve their health will help them in the long run to control and prevent complications.

If you would like to enroll or get more information about this program, call the pharmacy at 623-932-9800.