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Family Health FAQ
Community Pharmacist FAQ
Understanding the Labels on Supplements
Food & Medication Relationship
Diabetes Medications
Hypertension Medications
Athlete's Foot Medications
Family Planning Pills
Cough & Cough Medications
Athritis Medications
Asthma Medications
Antibiotics
This FAQ provides general information only and does not replace specific information given to you by your pharmacist, doctor, or other health care provider. Be sure to consult one of them if you have questions. |
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Community Pharmacy FAQ
Q : What is the difference of Pharmacist with Pharmist, Chemist and Druggist ?
A : Pharmacist is defined as a person professionally qualified to prepare medicine. And, there is no such word as Pharmist actually. Druggist is a tradesman who sells drugs, who may not be a pharmacist, eg we have Chinese Medical Hall Druggist. Chemist is an expert in chemistry who may or may not be a pharmacist as well. A pharmacist is sometimes being addressed as Chemist or Druggist, but not the other way round.
Q : What is the role of the pharmacist, particular community pharmacist in the healthcare services ?
A : The pharmacist is an adviser to the public on everyday health care and is a key figure in the supply and delivery of medicines to the consumer. He is a partner of the manufacturer of non-prescription medicines. Both share the common goals of service of high quality for the patient and encouragement of the rational use of medicines. The pharmacist in his professional capacity and in direct contact with patients is competent to provide sound advice on the medicines he supplies. With this definition, community pharmacists not only oversee the dispensing and storage of all medicines given to patients, but also provide a variety of patient counselling services including asthma care or diabetes care.
Q : What is the qualification required for a community pharmacist to practice in the community setting ?
A : Your community pharmacists has met the following standards before receiving their license to practice:
- At least three to four years of university-level pharmacy education
- Trained and qualified in all aspects of handling medications, including dispensing prescription and non-prescription medications, drug therapy and understanding drug interactions and side-effects
- Trained in the principles of good pharmaceutical care including patient counselling and care
- Aware of all health care and pharmacy laws governing pharmaceuticals, pharmacists roles and pharmacy operations
- Successfully completed provincial and national examinations on pharmacy practice and applicable pharmacy laws and standards
Q : Do you think I should have a community pharmacy to be my Family Pharmacy just like the way we have the Family Doctor ?
A : Yes, you should. Your community pharmacist is always there to help you decide what is best for you and your family. This is why it is important to stay with one pharmacist or pharmacy to be your Family Pharmacy. Staying with one pharmacy allows the pharmacist to maintain your health record and to provide you with the best advice whenever you have questions about current or new prescriptions, over-the-counter medications or herbal products.
Francis Lau, B. Pharm., is a practising community pharmacist at Constant Pharmacy. He can be reached at francis@constant.com.my |
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Understanding the Labels on Supplements
Q : When I read the labels on certain supplements, I get confused of the measurement units that they are using, such as IU, RE, MG, MCG. What do they actually mean ?
A : Fat-soluble vitamins like A, D, E and K are usually measured in IU, International Units. But for Vitamin A, World Health Organization had decided to change to RE, Retinol Equivalents, the equivalent weight of retinol actually absorbed and converted. 1 RE = 5 IU over here. While 1 IU Vitamin A = 0.3 mcg Retinol and 1 IU Beta-carotene = 0.1 mcg Retinol.
Other vitamins and minerals are usually measured in MG, milligrams and MCG, micrograms. 1 MG = 1,000 MCG.
For vitamin E, 1 IU is the same as 1 MG.
Some herbs preparation like Ginkgo Biloba used to be measured with the ratio 50:1 of raw material to the extract, this means 2000mg of Gingko Biloba leaves with have 40mg of the extract.
Q : Some labels of the supplements come with the percentage comparison of RDA and USRDA, why they give different standard and what are they actually mean ?
A : RDA and USRDA are not the same thing. RDA (Recommended Dietary Allowances) was introduced in 1941 to safeguard public health. The RDA are not formulated to cover the needs of those who are ill, which means they are meant strictly for healthy individual. They are estimates of nutritional needs necessary to ensure satisfactory growth of children and the prevention of nutrient depletion in adults. USRDA (U.S. Recommended Daily Allowances) were formulated by FDA as the legal standards for food labeling in regard to nutrient content.
Just because a product claims to provide 100% RDA or USRDA for a nutrient, doesn’t necessary mean that it is a sufficient amount for your individual needs.
Q : Does this explain why no doubt the RDA for Vitamin C is only 60mg for adult, when we could find many Vitamin C supplements come with 250mg to 1,500mg ?
A : Right. Stress and illness, past or present, affects everyone’s nutritional requirements differently. For example, if you are a smoker, each cigarette will destroy 25 – 100mg of vitamin C. Even if we do not smoke, we can’t escape from passive smoking and the polluted environment.
Q : Is 300 Kilocalories equal to 300,000 Calories energy ?
A : No. There are no different between this two units. 300 Kilocalories is the same as 300 Calories energy produced by the nutrients. In countries where the metric system is used, energy value is measured in Joules. A joule is slightly less than one quarter of Calories.
Q : Sometimes we come across the words Chelated, Hydrolyed, Predigested and Cold Pressed, on the labels, what are they actually mean ?
A : Minerals Chelated with amino acid are 3-5 times better assimilated than the ordinary form, thus better absorption. Hydrolyzed protein is water dispersible and already in assimilated form. Predigested protein has already been broken down and can straight go to the bloodstream. The oil capsules that the oil is extracted by Cold Pressed, remain polyunsaturated and haven’t been destroyed by heat.
Q : I noticed some vitamin supplements come with the word Time Release. What does this actually mean ?
A : Time Release, Sustained Release or Slow Release is popular among medicines. Now this technology has been introduced as well for vitamin preparation. It is a process by which vitamins are enrobed in tiny time pills and then combined into a special base for their release in a pattern that assures 3 to 6 hour absorption. This is particular important for water soluble vitamins that without time release, are quickly absorbed into bloodstream and excreted in the urine in less than 3 hours.
LL Choo, B. Pharm., is a practising community pharmacist at Constant Pharmacy. She can be reached at choo@constant.com.my
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Food & Medication Relationship
Q : : I know of drugs interaction, is there also food-drug interaction ?
A : Yes, certain drugs and food do not mix well. When taken during the same period of time, some foods and drugs can interfere with the body’s ability to ultilize a particular food or drug, which explain why some drugs are prescribed “with food” or “on empty stomach”.
Q : We often hear that we shouldn’t take our medication with coffee, tea or alcohol. Why is it so ?
A : Coffee, tea and alcohol can increase the effect of certain drugs. Hypnotics, antidepressants, and antianxiety drugs are greatly affected by alcohol, resulting in enhanced central nervous system side effects. Taking with antihypertensive drugs like beta blockers may cause a drastic decrease in blood pressure. When taken with antidiabetic drugs, alcohol can alter blood sugar levels. Caffeine in coffee or tea can interact with antibiotic, ciprofloxacin and antiasthmatic, theophylline, to produce increased stimulant effects.
Q : I used to get different opinion on whether I should take antibiotics like ampicilin after food or with empty stomach. How should I decide ?
A : Certain antibiotics such as class of Penicillins, are no doubt best absorbed on an empty stomach, but may be taken with food to reduce stomach upset. Thus, the decision should be based on individual conditions. However, they should not be taken with acidic food, fruit juices, cola or other acidic beverages, as increased stomach acid can interfere with their absorption.
Q : I used to take a glass of grapefruit juice during breakfast. I read somewhere that it is harmful to those on high blood pressure pills like me. How true is it ?
A : Grapefruit juice do interact with many drugs because it inhibits the oxidative metabolism by cytochrome P450 isoenzymes in the gut wall or liver. This causes higher levels of drug in the body and consequently an increase in side effects or toxicity. The following drugs should not be taken with grapefruit juice:
- Calcium Channel Blocker eg amlodipine, felodipine and nifeipine.
- Cyclosporine
- Midazolam
- Buspirone
- Triazolam
- Carbamazepine
- Cilotazol
- Cholesterol Lowering Statins eg lovastatin, fluvastatin and atorvastatin. But alright with pravastatin.
SF Chan, B. Pharm., is a practising community pharmacist at Constant Pharmacy. She can be reached at chan@constant.com.my |
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Diabetes Medications
Q : How is diabetes treated ?
A : The goal in treating diabetes mellitus is controlling elevated blood sugars without causing abnormally low levels of blood sugar. Type 1 diabetes mellitus is treated with insulin, exercise, and a diabetic diet. Type 2 diabetes mellitus is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugars, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Q : I am a diabetic and was prescribed two types of medications. According to the dispensary, one is to be taken before meal and the other after meal. For formal, can I take the medication just before I start taking my meal ?
A : It is quite straightforward when we mention after meal. But for before meal or with empty stomach, the medication should be taken 1 hour before food or 2 hours after food.
Q : My father has been diagnosed to have type 2 diabetes mellitus, and was prescribed some oral medications. May I know how this medications help in treating his diabetes ?
A : Based on what is known, medications for type 2 diabetes are designed to:
-Increase the insulin output by the pancreas
-Decrease the amount of glucose from the liver
-Increase the sensitivity or response of cells to insulin
-Decrease the absorption of carbohydrates from the intestine
Q : My mother who is a diabetic, non-smoker, is having a simple cough and cold, without any other serious symptoms. She would like to know what precaution she need to take while looking for cough and cold remedies in pharmacy ?
A : Sugar content in the cough and cold remedies. It is best to consult your pharmacist as there are cough and cold medications that are without sugar and as well as alcohol.
PK Ng, B. Pharm., is a practising community pharmacist at Constant Pharmacy. She can be reached at ngpk@constant.com.my
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Hypertension Medications
Q : I got my blood pressure checked by my doctor in clinic and the result was 150/95, but I used to get the result of somewhere 130/85 while monitoring myself at home. Does this shows my home blood pressure monitoring kit is not accurate ?
A : May be but not necessary true. To rule out, first you should bring your home blood pressure monitoring kit to your pharmacy for calibration, the pharmacist should be able to assist you on this. Then, you should consider whether you are having the “white coat hypertension” where many may feel tense up while visiting their doctor.
Q : Why there are two numbers in a blood pressure reading ?
A : Blood pressure is the force of the blood pushing against the walls of blood vessels. The pressure is greatest when the heart contracts or beats. This is called “systolic pressure”. While the heart is filling up, the pressure falls, which is called the “diastolic pressure”. The top number is systolic and the bottom number is diastolic.
Q : I have been on the blood pressure pills for two years, and have my blood pressure checked regularly. According to my doctor, my pressure reading is under control, since I am feeling fine now, can I just stop taking the pills ?
A : Never stop taking your hypertension medication without first consult your doctor. Antihypertensive medications will not cure high blood pressure, but will help control the condition. The objective of treatment is to achieve a good quality of life living with hypertension, such as to avoid the serious health problems that hypertension can cause eg. heart attack, kidney failure, stroke and enlargement of the heart.
Q : I have the family history of high blood pressure. How do I avoid developing it ?
A : Maintain a healthy lifestyle which includes regular exercise, eating foods low in salt or sodium and control your body weight.
YK Lai, B. Pharm., is a practising community pharmacist at Constant Pharmacy. She can be reached at lai@constant.com.my |
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Athlete’s Foot Medication
Q : What is Athlete’s Foot and is it only happened to the athletes ?
A : Athlete’s foot is a common, contagious fungus infection of the skin, which usually occurs on the feet, especially the soles and skin between the toes. It is not only confined to the athletes but may affects anyone in any age group.
Q : How did I get this fungal infection ?
A : The fungus, which grows in warm, moist environments, likes to live in the outer layers of your skin. They commonly attack the feet because shoes create a warm, dark and humid environment, which encourages fungus growth.
Q : Is there any medication I can use to treat the Athlete’s Foot ?
A : The initial treatment for a simple case of athlete’s foot is usually a tropical antifungal cream, which may come in as fungistatic or fungicidal alone or combined with steroids for symptoms like itch, rashes and inflammation. Consult your pharmacist to get the right regimen for your case.
There are also antifungal medication to be taken orally, which you need the doctor’s advice before using them. This oral medications may have fatal drug interactions with certain painkillers, antibiotics, cough and cold remedies, non-sedative antihistamines and asthmatic medications. Thus you must let your doctor and pharmacist knows what other medicines you are taking currently.
Q : Now that the Athlete’s Foot is gone, how do I keep it away ?
A : Help tips for prevention include:
- wear sandals or shoes when walking on moist or wet floors
- don’t share shoes or personal care items such as towels
- wear socks made of absorbent materials such as cotton or wool
- choose footwear that allows for air circulation
- keep floors in shared facilities clean and dry
- keep your feet clean and dry
MY Chan, B. Pharm., is a practising community pharmacist at Constant Pharmacy. She can be reached at munyee@constant.com.my |
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Family Planning Pills
Q : I wish to take pills to prevent unwanted pregnancy, how would I know if the pill is suitable for me ?
A : You should discuss whether it is right for you with your doctor and your pharmacist can provide important information. Family planning pills or Oral Contraceptives are not for every women. It you have any of the following conditions, the pill might not be right for you:
- history of heart attack or stroke
- blood clots in the legs, lung or eyes
- chest pain
- cancer of breast, uterus, cervix or vagina
- vaginal bleeding with no cause
- liver problem during pregnancy or during prior use of the pill
- suspected or known pregnancy.
Q : What are the common side effects of the pill ?
A : Some women may experience irregular vaginal bleeding. This is quite normal and usually goes away within the first few months. If the bleeding is heavy or if you also have pain, contact your doctor. Other common side effects includes nausea, vomiting, changes in appetite, fluid retention, spotty darkening of the skin, headache are usually temporary and some of them can be minimized by taking the pill at night before resting.
Q : Since I also take some other medications and supplements, I wonder if they do interact with the pill ?
A : A number of drugs, such as antibiotics, St John’s wort, drugs that prevent seizures and vitamin E may make the pill not work as well as it should. This could lead to pregnancy or menstrual irregularities. It can be helpful to talk to your pharmacist about these other medications.
Q : What if I missed taking my pill ?
A : Most packages of oral contraceptives have step-by-step instructions on how to handle missed pills. In most cases, if you missed only 1 pill, you should take the missed pill as soon as you remember, and take the next 1 at the regular time. If you missed more than 1 pill, instructions usually vary with the type of pill used. The pharmacist can tell you what to do. As a precaution, use backup methods of contraception for the rest of your menstrual cycle.
Q : How long should I wait after stopping the pill before trying to become pregnant ?
A : In most cases, a waiting period of 2 to 6 months is suggested, but you should consult with your doctor regarding individual plan.
Q : Can I get sexually transmitted disease while taking the pill ?
A : Oral Contraceptives cannot protect you against sexually transmitted diseases, such as AIDS, herpes and gonorrhea.
LC Chua, B.Pharm., is a practising community pharmacist at Constant Pharmacy. She can be reached at chua@constant.com.my
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Family Health FAQ
