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Use Caution: Mixing Over-the-Counter Medications Can Be Harmful
With allergy season’s extended stay and cold and flu season having just begun, you may soon find yourself seeking relief through several different kinds of over-the-counter medications. Know what precautions you need to take when fighting multiple symptoms with multiple medications. When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, it’s crucial that you’re especially mindful of what you put into your body. Whenever you pop a pill, you want to make sure you’re taking the right dosage, waiting the right amount of time before taking another dose and not mixing certain medicines together. Recent stories like this one detail dangerous over-the-counter medicine combinations, and we’re following suit: Here is a quick go-to guide about potentially harmful over-the-counter combinations. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding. It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid. Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.
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Generic Drugs – What You Need to Know About Them
Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.
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Dr. Max Coppes to Lead William N. Pennington Institute
Max Coppes, M.D., Ph.D., MBA who has served as Nell J. Redfield Chair of Pediatrics at the University of Nevada School of Medicine (UNR Med) and pediatrician-in-chief at Renown Children’s Hospital for the last six years has announced he is stepping down to lead Renown’s Pennington Cancer Institute on a full-time basis. Dr. Coppes will continue to serve as Professor of Pediatrics and Internal Medicine at UNR Med. “Our goal is to improve the health of Nevadans and reduce the burden of cancer,” said Thomas Graf, CEO of Renown Health. “Having Dr. Coppes as our clinical leader for the William N. Pennington Cancer Institute on a full-time basis reflects Renown and UNR Med’s commitment to increase access to cancer care, foster a deeper partnership with UNR Med on clinical trials, collaborate on cancer research opportunities, and enhance medical education and post-graduate training. We are thrilled to have Dr. Max leading this important effort.” Today’s announcement comes two weeks after the William N. Pennington Foundation announced a $15.5 million gift to the Renown Health Foundation to help establish the William N. Pennington Cancer Institute at Renown. Dr. Coppes, a pediatric oncologist by training, has experience in leading large-scale, nationally recognized academic cancer center teams in both the U.S. and Canada. Dr. Coppes came to Reno in 2014 from the British Columbia Cancer Agency in Vancouver, where he served as president with responsibility for six regional cancer centers and two cancer research centers. He was an attending physician at BC Children's Hospital and a professor of Medicine and Pediatrics at the University of British Columbia. During his career, Coppes served as senior vice president at Children's National Medical Center in Washington, D.C. and held positions at several prestigious facilities in the U.S. and Canada including The Hospital for Sick Children (SickKids) in Toronto, Georgetown University, The National Cancer Institute, and the Cleveland Clinic. Since 2016, Dr. Coppes has served in the joint leadership role as the Nell J. Redfield Chair of Pediatrics at UNR Med and pediatrician-in-chief at Renown Children's Hospital, a position made possible through generous philanthropic support from the Nell J. Redfield Foundation along with investments by Renown Health and the School of Medicine. In 2016, the Pennington Foundation recognized the need for enhanced care and expertise for pediatrics and donated $7.5 million to Renown Children’s Hospital to establish the William N. Pennington Fund for Advanced Pediatric Care. “As the Nell J. Redfield Chair of Pediatrics at the University of Nevada, Reno School of Medicine and pediatrician-in-chief at Renown Children's Hospital, Dr. Coppes blazed the trail for the integration of academic and clinical missions at UNR Med and Renown. He demonstrated visionary leadership and undoubtedly will bring the same energy and vision as the clinical leader for the William N. Pennington Cancer Institute,” said Melissa Piasecki, Acting Dean of UNR Med and Chief Academic Officer for Renown Health. “Dr. Max Coppes is an extraordinary leader. In the last six years he has done much to elevate the standard of pediatric care available in our community,” said Sy Johnson, President and Chief of Staff of Renown. “Thanks to Dr. Coppes’ leadership, the generosity of the Pennington gift and other donors, 100,000 area children now have access to pediatric specialists and contemporary healthcare services at the region’s only children’s hospital. Now, less than 3% of all pediatric patients and their families need to leave the area for specialty care. That is an incredible accomplishment.” Significant achievements made under Dr. Coppes leadership include: Advancing Renown Children’s Hospital, the only dedicated children’s hospital in northern Nevada, offering programs and services for families from a 100,000 square mile area, from Sacramento, CA to Salt Lake City, Utah. Renown Children’s provides the area’s only Children’s Emergency Room, Pediatric ICU (PICU), children’s imaging center and the largest neonatal ICU (NICU), a level III intensive care unit. Under his leadership, the following service lines were established; adolescent medicine, pediatric hematology/oncology, pediatric nephrology, pediatric infectious diseases, pediatric ophthalmology, pediatric orthopedic surgery, pediatric cleft and craniofacial surgery, pediatric urology, pediatric dentistry, and pediatric emergency medicine. Hiring and supporting a team of over 40 pediatric physician specialists. These clinicians provide 30,000 patient visits annually, offering an exceptional level of care to help families. As a testimony to the community’s confidence in the care provided, market share for pediatric services at Renown Health is now close to 90%. Renown’s membership in the Children’s Oncology Group (COG), which gives local pediatric cancer patients access to the world’s largest organization devoted exclusively to childhood cancer and most leading-edge treatments. Application to establish a 3-year accredited (by the Accreditation Council for Graduate Medical Education (ACGME) pediatric residency program in Reno. If approved in September 2022, Renown Health and UNR Med will start training four new pediatricians each year starting in July 2023. Successful application to the Nevada Governor's Office of Science, Innovation & Technology to receive financial support to fund a new Graduate Medical Education program. Renown Children’s Hospital was awarded $ 870,433 for the new pediatric residency program. New construction of an expanded Neonatal Intensive Care Unit (NICU) with increased capacity to 49 bassinets, an expanded Pediatric Intensive Care Unit (PICU) with increased capacity to 16 private patient and family rooms, and a new Renown Children's Hospital in-patient floor with increased capacity for 38 private patient and family rooms for a total capacity of 58 pediatric beds on Level 4 of Renown Regional Medical Center. In 2021, Dr. Coppes was named the Healthcare Hero Community Partner by Northern Nevada Business Magazine.
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