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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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Most prescriptions meds are available in generic form. Find out the similarities and differences between the two and how to determine whether a generic is right for you. Approximately 80 percent of prescriptions sold today are generics. If you’re taking a prescription medication, chances are it’s a generic form of the brand-name drug. But are you getting the same quality in a generic medication? Do generics measure up? The answer in most cases is yes — generics, just like branded products, are regulated by the Food and Drug Administration. “To have a generic product approved by the FDA, the generic manufacturer must prove that its product is bioequivalent to the branded product,” explains Adam Porath, PharmD, BCPS AQ-Cardiology, BCACP and Vice President of Pharmacy Services. Basically, it has to function the same. “Generic products are extremely well tolerated and will provide the same results as using a branded product,” Porath says. Here’s how generics are the same as name-brand prescriptions: Generic products contain the same active ingredients. They produce the same desired clinical effect and accompanying side effects. Generics come in the same form as their branded counterparts: pill, liquid or inhaler, for example. Release into the bloodstream matches the name brand in timing and strength. Here’s how they differ: Generics generally cost less. Federal law requires generics have different names and look different: shape, size, markings and color. Generics contain different inactive ingredients, like binders, fillers and artificial colors. Different side effects with generics can usually be attributed to these additions. Why do generics cost less? When pharmaceutical companies develop a new drug, they are paying for research, development, clinical studies, marketing — in some cases it can cost more than $800 million and take 10 to 15 years to develop a new drug. “The manufacturers of branded medication products have to recoup their research and development costs,” Porath says. So companies are granted a limited patent to sell their drug without the competition of generic counterparts. “When patent exclusivity ends, the market is open for any generic manufacturer to make a competing product with FDA approval.” Without the same startup costs, companies can sell generics at 80 to 85 percent less. And because more than one company can produce the same generics, competition drives prices even lower.

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February is American Heart Month. While cardiac care is crucial every time of year – especially as heart disease stays the number one killer in the United States – American Heart Month serves as a great reminder to stay on top of your heart health. We spoke with Malina Ruiz, a cardiology nurse practitioner at Renown Health, on three key ways to embrace heart-healthy living and how genetic screening can help inform you of certain genetic risks that can play a role on the cardiac life stage.  1.  Invest in a heart-healthy diet. Eating a diet that is rich in fruits, vegetables, whole grains and healthy fats (including monounsaturated fats such as avocados and polyunsaturated fats such as sunflower oil) is a key defense in protecting your cardiac health, according to Malina. While you are filling your plate with these nutritious foods, remember to keep an eye on your saturated and trans-fat intake, and try limiting foods that are high in those fats.   “No matter what age we are, maintaining a heart-healthy diet will always be important,” said Malina.    Need help finding cardiac-friendly meals? The National Heart, Lung and Blood Institute makes it easy with heart-healthy recipes and tips from experts.  2.  Do an exercise audit. “Keeping an active lifestyle during our younger years is one of the most important factors that affect heart health in future years,” said Malina. Maintaining a regular exercise regimen that allows you to raise your heart rate and break a sweat can help prevent future cardiac events.     A good rule of thumb is to aim for 150 minutes a week of moderate-intensity exercise, which averages out to 30 minutes a day on 5 days out of the week.    It’s never too late to start a regular exercise routine! Exercise doesn’t have to be something you dread – leverage American Heart Month to find activities that you enjoy. The American Heart Association can help you discover new ways to move your body. At the end of the day, as Malina emphasizes, “any movement is better than nothing!”  3. Don't skip those check-ups. Regular preventative visits with your primary care provider can help you identify possible risk factors for heart conditions before they start actively affecting your life. “Check-ups become even more important as we age, along with being aware of the signs and symptoms of heart disease, heart attack and stroke,” added Malina.     There’s no time better than the present – call our expert scheduling team today at 775-982-5000 to request a preventative check-up with your primary care provider.

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According to a National Center for Health Statistics survey, about 8% of U.S. adults are not taking their medications because they can’t afford them. This means millions of adults aren’t taking their medication due to the high cost. Virtual Event with pharmacist, Adam Porath Thursday, July 23, 11 a.m. to Noon Attend Virtual Lecture 5 Ways to Cut Medication Costs Safely Cost might not be affecting your medication plan, but the following ways to save money on medication can help: 1. Questions to ask your prescribing provider Do I have to take this medication? This is particularly a good question when you’ve been taking a pill for some time and not sure if you should continue. Is there a way to combine my medications? A good example of this is for those who are taking blood pressure medications. Do I have to take this particular pill? Often there are generic choices in the same medication class. Can I get a larger supply? Basically, knowing the cost of a 30- vs 90-day supply is always a good idea. In other words, it could save you time and money. This generally works for medications you take long-term. Remember, asking questions can help you save money on medication, so communicate your concerns. 2. Research online Find the website for the medication and look to see if there are savings and support available through the drug company. 3. Consider a co-pay card Co–pay card programs offered by drug manufacturing companies are a direct way to lower out-of-pocket costs for prescription drugs for eligible patients. The cards can patients pay for the medications they, or their doctors, prefer. If you don’t qualify for a co-pay card, then you can look into patient assistance programs. 4. Consider patient assistance programs Drug companies sponsor these programs by income and they are often hard to find. The best way to find a patient assistance program is by asking your pharmacist. 5. If you’re on Medicare, consider updating your plan Medicare plans can change from year to year, which often times includes the medication they cover and the co-payments or deductible amounts. Annual Enrollment takes place October 15 – December 7, 2020. Most important, review the options and shop around for the best plan. Visit Senior Care Plus for information on Medicare Advantage Plans available to you. Want to ask a pharmacist more questions on how to save on medication? Join us for a Sterling Silver Club virtual event on Saving Money on Medication. To learn more about the Sterling Silver Club, visit our club website.

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Eating healthy is a daily challenge for many, but for those with cancer it is an even harder struggle. A cancer diagnosis not only impacts those diagnosed, but family members and friends too. One key area of concern is making sure your loved one stays well by eating healthy food every day. Here are some essential cancer nutrition tips from Renown Health registered dietitians Jessica Blauenstein and Amy Laster. Help to Prepare Meals and Snacks for Daily Cancer Nutrition Make it grab and go. Easy-to-make meals help reduce the burden of having to cook and prepare food. Having easy to grab snacks on the counter or in the fridge can help ensure your loved one has access to those nutrients when needed. Sit outside of the kitchen. This allows your loved one to avoid cooking smells which can make them feel sick as a side effect of cancer treatments. Also try serving them cold foods such as sandwiches, cheese and crackers, or shakes which have a mild scent. Try drinkable meals. Some people with cancer find it easier to sip their calories over the course of 30 minutes to an hour. Consider smoothies or supplemental shakes such as Ensure Enlive or Boost Plus as snacks not meal replacements. A great foundation for a smoothie is a protein source (Greek yogurt, protein powder, nut butters or milk) with a carbohydrate (fruits, juice or berries). Add other ingredients as desired, such as spinach, kale, and ground flaxseed or chia seeds to give it more vitamins, minerals, and fiber. Snack Ideas for Those Undergoing Cancer Treatment The following ideas are both quick and easy to make for your loved one. Chicken or tuna salad with whole grain crackers or as a sandwich on whole grain bread Greek yogurt mixed with cereal, fruit and/or nuts Cottage cheese with banana, cinnamon and/or peanut butter Favorite fruit with 100% natural peanut or almond butter spread - Try peanut butter with bananas, apples, or even celery Their favorite veggies dipped in a salad dressing of your choice - For example, carrots with hummus or ranch dressing Cheese and whole grain crackers - Add tomato slices with a dash of oregano on top for more flavor Eggs scrambled with cheese, vegetables and/or salsa Peanut butter and jelly sandwich on whole grain bread A baked sweet potato with some favorite toppings Hard boiled eggs and/or egg salad with whole grain crackers, or as a sandwich on whole grain bread Oatmeal or cream of wheat prepared with milk, fruit and/or nuts Sometimes your loved one may not feel like eating or refuse to eat. If treatment side effects are impacting your loved one’s ability to eat, please visit the websites below containing recipes tailored to treat side effects. Cook for Your Life ELLICSR Of course you may also consult a registered dietitian and/or the patients care team, if you have more cancer nutrition concerns. No Appetite? Assisting with Cancer Taste Changes Taste changes are common during cancer treatment. Patients experiencing these changes may not feel like eating, which can negatively impact their nutrition. Help your loved one overcome taste changes with these cancer nutrition strategies: Metallic or bitter taste in food - add something sweet such as maple syrup, honey or jelly. You may also try adding fat, such as a nut butter, avocado or regular butter. Pickles or vinegar could help with this too. A taste like cardboard - try adding salt and extra flavor to foods with seasonings and spices. Some examples are onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup, or mint. Lemon juice, citrus, vinegar, or pickles may also help with this as well Food tastes too sweet - try adding six drops of lemon or lime juice. Add small amounts until the sweetness is gone. Very salty taste - try adding ¼ teaspoon of lemon juice. Try plastic utensils instead of metal, especially if your loved one is struggling with foods tasting metallic. Dipping small bites of food into either lemon juice or vinegar can have a “palate cleansing” feel and may improve taste perception. This helps avoid getting tired of the flavor after a few bites. Try marinating food or meats in sweet fruit juices, salad dressings, or sweet-and-sour sauce. Other “palate cleansing” foods are lime juice, orange juice, mangos, lemongrass, parsley, cilantro, mint, ginger, basil, and pickled foods. Use aroma to make foods appealing, avoiding any smells that may cause nausea. In particular, cinnamon, nutmeg, cloves, coriander, cumin, ginger, and black pepper can add an aromatic flavor. Also include herbs such as oregano, rosemary and thyme. Think texture. Consider trying wafers, crunchy nut butters, carrots, celery, cucumbers, chips, rice crispies, corn flakes, crackers, panko crumbs, nuts, or seeds if you are able to chew and swallow them safely. Remember that patience with your loved one's changing appetite and tastes can be the strongest form of support you can provide. Nutrition Tips for Cancer Survivorship and Beyond If eating large meals is difficult for your loved one, encourage them to snack throughout the day. Aim for 4-6 snacks or small meals per day. Focus on consuming 2-3 protein-rich foods each day such as lean animal meats, fish, eggs, soy or a protein supplement with 20-30 grams of protein per serving. Eat a variety of brightly colored fruits and veggies. Aim to make half of each meal fruits and vegetables. Eat less than 18 oz. (cooked weight) of red meat per week. Limit cold cuts, bacon, sausage, and hot dogs. Avoid excess salt and saturated fats. Cut back on simple carbs. (i.e. desserts, candies, white bread/pastas, french fries, packaged foods, chips) Drink in moderation- if at all- one drink per day for women, two for men. Get enough vitamin D (through diet and/or supplement) Avoid tobacco of any kind. Keep a healthy weight and stay up on exercise. Other Ways to Help a Loved One with Cancer Assist with Chores Allow your loved one to relax as you help take care of chores around the house, such as cleaning, cooking and grocery shopping. This may reduce overall stress and can be helpful for those that get tired after their treatments. Physical activity can still be beneficial, so be sure to do an activity together that they enjoy and is approved by their doctor. Be Patient It can be very difficult to see a loved one go through cancer treatment. Remember to be patient with your loved one. There may be things we want them to do or eat that we know would be good for them, however, meet your loved one with grace and understanding. It is ultimately their decision on what to do, just be there to support and assist them as they go through this challenging time. Additionally, Renown hosts free “Eating Well After Cancer Treatment” nutrition classes for cancer survivors.  Our next cancer nutrition class series starts Thursday, June 3, 2021, and will be hosted virtually. It is open to anyone in the community. For more information or to register please click here.

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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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When medical treatments no longer offer a cure, Hospice Care offers a special way to care for you and your family who are faced with a life-limiting illness. Serving Washoe, Lyon, Storey and Carson Counties, our team is available 24 hours a day, seven days a week.   Hospice staff receive special training to care for all types of physical and emotional symptoms that cause pain, discomfort and distress. When considering your options for end-of-life transition, our team is available to answer questions and discuss if Renown Hospice Care will meet your needs.  Your hospice care team includes Medical Director Registered Nurses Certified Nursing Aides Medical Social Workers Chaplains Registered Dietitians Trained Volunteers

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Compassionate Care Palliative and Supportive Care provides specialized medical care for serious illnesses and diseases, including advanced kidney failure or heart disease. Palliative Care helps to: Prevent and relieve suffering to help build the best possible quality of life. Add value to standard therapies by assisting with advanced illness planning and symptom management. Palliative & Supportive Care may be needed if: You've had multiple hospital admissions for severe illness. Severe pain, nausea, fatigue or other symptoms impacting quality of life and you are reconsidering treatment plans. Treatments are no longer working. You're feeling hapless or discouraged about the future due to your serious illness. Talk to your doctor to find out if palliative care is the right choice for you or your family member.   Your Care Team Your palliative care support team comprises doctors, nurses, chaplains, social workers and other specialists who work together with you to provide extra support. Your care team can help: Facilitate close communication between you and your physician team, as well as nurses and specialists. Offer medical assessments and symptom management to help reduce pain, nausea, fatigue, shortness of breath and anxiety. Improve the ability to tolerate medical treatments and fain the strength to live a productive daily life. Explain treatment options and the decision making process regarding care. Navigate the healthcare process. Lend emotional and spiritual support.

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Genetics helps individuals and families learn more about how conditions are inherited in families, what screenings and testing options are available, and what treatments may be available for some genetic conditions. Genomic medicine is the study of our genes (DNA) and their interactions with our health. Each person has a unique set of DNA, which is why Renown believes that we should use a person’s biological information to help personalize and improve care to achieve better health outcomes. The Importance of Genetic Research Genetic research helps us better understand medical conditions, the progression of disease, how people may metabolize medications, lead to future treatments, and more. It is also important to have representation from all ethnicities, genders, and backgrounds so the research encompasses a diverse population. This diversity helps ensure the research we do is reflective of everyone.

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