Pharmacy News Online: Chemicals in some air fresheners may affect breathing

The People’s Pharmacy: Chemicals in some air fresheners may affect breathing

For years, I had woken up in the middle of the night unable to breathe through my nose. This disrupted a good night’s sleep, as I would have to get up and sit for 20 to 30 minutes waiting for my sinuses to drain.

I blamed it on lack of humidity, since it never happened while I was vacationing at the beach twice a year.
I recently read that home air fresheners contain formaldehyde and petroleum distillates, aerosol propellants and p-dichlorobenzene (PDB) that can irritate nasal passages. I immediately unplugged all my air fresheners, and after one day, I was amazed with the results.

I have now slept straight through the night for about two solid weeks. Who would imagine that plug-ins could cause such sinus misery?

Air fresheners contain a variety of chemicals that may irritate the respiratory tract. PDB, found in mothballs as well as air fresheners, could result in reduced pulmonary function (Environmental Health Perspectives, August 2006).

Other compounds found in air fresheners include phthalates. These often are used to carry fragrance in consumer products. Phthalates also are used to make plastic products pliable. These chemicals are controversial because they are hormone disruptors and potential carcinogens.

I have had thinning hair since I started on blood pressure meds. I had to switch to a short haircut. Since then, I have been put on atenolol, Norvasc, Diovan and enalapril. I suspect the beta blocker is responsible for the fact that you can see more scalp than hair.

Even with the shortest, punkiest cut, you see scalp, and it is embarrassing.

I now own a myriad of wigs, but I can’t seem to get used to them.

When women lose hair due to chemo, it is met with empathy. Saying it’s my blood pressure pills doesn’t provoke the same reaction. I am now 62, so this has been going on for years, but it has become much worse since I started atenolol.

Hair loss is frequently an underappreciated side effect of medications. Prescribers may not mention this complication.

You are right that atenolol, like other beta blockers, can cause hair loss. Diovan, amlodipine (Norvasc) and enalapril are somewhat less likely to trigger this reaction.

Finding the best blood pressure treatment that doesn’t cause hair loss will require some sleuthing by your doctor.

To help you with this discussion, we are sending our “Guide to Hair and Nail Care” with a list of medications that cause hair loss. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to Graedons’ People’s Pharmacy.

Whatever happened to Pepcid? I have not been able to find it in stores, especially Pepcid Complete. What product would you recommend as a replacement?

Pepcid Complete is an over-the-counter product for heartburn. It contains an acid-suppressing drug called famotidine plus a fast-acting antacid combination of calcium carbonate and magnesium hydroxide.

The company (Johnson & Johnson) has had its share of manufacturing and packaging difficulties during the past year, with recalls of products such as Tylenol, Benadryl and Sudafed, as well as Pepcid. A spokesperson assures us, however, that Pepcid Complete should be back on pharmacy shelves within a few weeks.

When I met the woman I married, she had bad breath, obviously from deep inside. I ignored it, as I could think of no solution.

After 15 years of marriage, I realized it was worse after she ate ice cream. Lactaid solved the problem. The bad breath was her only symptom.

You are the second person to report that the inability to digest milk sugar (lactose intolerance) resulted in bad breath.

Although we could find no scientific evidence to confirm this observation, using a lactase enzyme pill (Lactaid) seems like a straightforward solution.

You recently replied to a person who has weak fingernails. You mentioned some treatments, but did not point out that this could be a symptom of hypothyroidism.

Often little things like brittle nails and dry skin are overlooked and never mentioned to the doctor because of their seeming insignificance. Some of these apparently unrelated problems could be a hallmark of a more serious health concern, especially when they occur in a constellation of symptoms. With hypothyroidism, brittle nails, dry skin, hair loss, poor memory, trouble with concentration, weight gain and depression are all indicators.

Any condition that does not improve as it should might be signaling an underlying problem. It is better to find and treat the cause, not just the symptom.

You have described many symptoms of an underactive thyroid gland. Other signs include constipation, fatigue, cold intolerance, reduced sex drive, high cholesterol and slow pulse. Because such complaints are so common, they are sometimes overlooked or dismissed.

Walgreens Vice President of Clinical Affairs Examines Impact of Growing Specialty Pharmacy Industry at Pinsonault Associates Managed Markets Summit

Vice President of Clinical Affairs Dr. David Lorber discussed key trends in specialty pharmacy today at the Pinsonault Associates Managed Markets Summit in Miami. The session, titled “Employer Issues in Specialty Pharmacy,” examined the impact for payers, including the role of adherence in cost management and containment, benefit and coverage decisions, formulary and medical policy, pipeline management, provider network and member satisfaction and disruption.

“As more people rely on specialty pharmacy medications, the health care industry needs to place an emphasis on cost control, appropriateness of care, adherence and waste management.”

Specialty medications include complex treatment regimens and medications that require special delivery, storage and handling. Depending on the condition and prescribed therapy, these medications may be taken orally, intravenously or self-injected. There is also enhanced clinical management to monitor medication adherence, side effects and dosage changes. Specialty prescriptions typically cost about $2,000 for a 30-day supply, which is 28 times the traditional retail prescription. Approximately 3-5 percent of the population takes a specialty medication, and that number is increasing.

“Specialty pharmacy is one of the most rapidly growing segments of total drug spending, which brings both concern as well as opportunity for enhanced efficiencies,” said Dr. Lorber. “As more people rely on specialty pharmacy medications, the health care industry needs to place an emphasis on cost control, appropriateness of care, adherence and waste management.”

Dr. Lorber discussed a case study that showed consistent patient adherence can result in savings. Walgreens multiple sclerosis patients adherent to medications, when compared to less adherent patients, resulted in savings of about $1.1 million for a large national insurance payer for the 801 patients over the two-year period. The same case study also showed higher adherence reduced costs related to multiple sclerosis emergency room visits, inpatient stays and use of durable medical equipment.

“Improving the health and well-being of patients can be accomplished by providing convenient access to drugs and ensuring there is a consistent and coordinated care management programs,” said Dr. Lorber. “Patient counseling and education by trained pharmacists and nurses, like those at Walgreens and Take Care Health Systems, translates into fewer office visits as a result of improved adherence. Proactive patient monitoring also drives early recognition of, and response to, adverse drug reactions and side effects, resulting in improved outcomes.”

Walgreens specialty pharmacy offers patient assistance coordination, multiple distribution channels, strong manufacturer relationships, advanced clinical programs, cost management programs and access to limited distribution drugs.

Dr. Lorber joined Walgreens as the vice president of clinical affairs in November 2010 and is responsible for clinical oversight and consistency of Walgreens clinical programs. Previously, he was vice president of medical affairs for CVS Caremark. Prior to joining CVS Caremark, Dr. Lorber was medical director at Blue Cross Blue Shield of New Mexico in Albuquerque and a private practitioner in pulmonary, critical care and internal medicine. He has held numerous positions in community leadership and professional organizations including president of the New Mexico Chapter of the American Thoracic Society and faculty appointments as assistant clinical professor of medicine with the University Of New Mexico School Of Medicine, and as assistant professor with the University of Arizona Medical Center in Tucson and the Tucson VA Hospital.

About Walgreens

Walgreens is the nation’s largest drugstore chain with fiscal 2010 sales of $67 billion. The company operates 7,697 drugstores in all 50 states, the District of Columbia and Puerto Rico. Each day, Walgreens provides nearly 6 million customers the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice in communities across America. Walgreens scope of pharmacy services includes retail, specialty, infusion, medical facility and mail service, along with respiratory services. These services improve health outcomes and lower costs for payers including employers, managed care organizations, health systems, pharmacy benefit managers and the public sector. Take Care Health Systems is a Walgreens subsidiary that is the largest and most comprehensive manager of worksite health centers and in-store convenient care clinics, with more than 700 locations throughout the country.

Statements in this release that are not historical are forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are not guarantees of future performance and involve risks, assumptions and uncertainties, including, but not limited to, those described in Item 1A (Risk Factors) of our most recent Annual Report on Form 10-K and Quarterly Report on Form 10-Q, each of which is incorporated herein by reference, and in other documents that we file or furnish with the Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those indicated or anticipated by such forward-looking statements. Accordingly, you are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date they are made. Except to the extent required by law, Walgreens undertakes no obligation to update publicly any forward-looking statement after the distribution of this release, whether as a result of new information, future events, changes in assumptions or otherwise.

ONLINE EXTRA: Wichita pair arrested for false prescriptions

Two people were arrested Saturday by the Arkansas City Police Department after allegedly attempting to purchase prescription drugs with a false prescription, according to a press release.

The incident occurred prior to 2:12 p.m. at K’ and D’ Pharmacy, 224 S. Summit St.

Shelley Renae Leitzell, 27, of Wichita, was arrested on charges of obstructing the legal process, battery of a law enforcement officer, possession of a controlled substance (heroin) and possession of drug paraphernalia.

She also was charged with three counts of forgery, two counts of theft, and three counts of unlawfully obtaining and distributing a prescription-only drug.

Leitzell was transported to the Cowley County Jail, where she remained Monday morning on a $23,000 bond, according to a jail official.

Also arrested was Thomas Graham Reynolds, 28, of Wichita, on charges of forgery, theft, possession of a controlled substance (heroin), possession of drug paraphernalia, and two counts of unlawfully obtaining and distributing a prescription-only drug.

He also remained at the county jail Monday morning, on a $10,000 bond.

Also detained were two young children, who later were released to relatives.

The ACPD officer who responded initially at the pharmacy received false information from Leitzell when he made contact with her, according to the release.

She then fled the store on foot. The officer and an off-duty trooper who happened to be nearby gave chase.

They apprehended her as she began to fight with the officer, the release said.

Additional officers responded to the area as the chase came to an end.

Meanwhile, Reynolds was detained in the vehicle in which Leitzell attempted to flee.

During interviews of the apprehended pair, officers located a small, zippered purse contained several used syringes, heroin and other drug paraphernalia.

Also discovered were several other false prescriptions, each filled out with identical information, but in different names, the release said.

A flash drive also was located that contained Microsoft Word documents used to print off the fraudulent prescriptions.

Further investigation at the police department determined that the pair also visited Ark City on March 28, when they visited three local stores and obtained three false prescriptions before returning to Wichita.

The investigation is continuing, police said. The couple had a long list of area pharmacies and maps of other cities in their possession.

UPDATE (11:30 p.m. Monday): Documents found inside the vehicle already have helped area law enforcement agencies clear other cases that still were open, Police Chief Sean Wallace said in a follow-up release, including:

Three cases cleared by the Augusta Department of Public Safety;
One incident discovered by the El Dorado Police Department, with a report in the process of being made when the release was sent;
10 incidents identified by the Hutchinson Police Department, all tied to the pair;
Two incidents discovered by the Wellington Police Department that hadn’t yet been logged;
Three cases cleared by the Winfield Police Department.

Reports were filed in those cases and additional charges were pending against the two suspects, the release said. The pair’s information was forwarded to the other agencies so they also could file charges.

A total of 23 cases, both locally and in nearby jurisdictions, had been connected to Leitzell and Reynolds as of Monday morning, the release concluded.