Primatene Mist: Over-the Counter Asthma Symptom Relief

Written by Kyle Farina

Asthma is a disease which affects the lungs and makes it more difficult to breath. The lung tissue constricts and spasms and makes getting adequate oxygen more difficult, requiring the patient to breathe more frequently and feel like they are short of breath. Currently, the two types of medication which are used to treat Asthma are inhalers, which are broken down into rescue inhalers and controller inhalers. Control inhalers, such as Advair, are used daily to help delay the progression of Asthma, whereas rescue inhalers are used only when you are experiencing shortness of breath. Both rescue and control inhalers are only available by prescriptions; however, the FDA has recently considered re-approving and over-the-counter rescue inhaler option for patients.

Primatene Mist® was an over-the-counter inhaler that was available for patients to buy and use as a rescue inhaler. It was taken off the market in 2011 because it had chlorofluorocarbon. This compound was found to deplete the ozone layer and the FDA removed it from the market for this reason. Primatene Mist® contains epinephrine, which is similar to albuterol in that it works to stimulate receptors in your lungs and cause your lungs to relax and not spasm. Many patients, especially those with mild Asthma symptoms, objected to the product being removed, as they were using the inhaler successfully and it was readily available for them.

Although we live in a world of convenience now and an over-the-counter option for rescue inhalers sounds appealing, there are some downsides to re-releasing these products. One concern is that an over-the-counter product makes it seem as though Asthma is not a serious disease and is a “do-it-yourself” management job.

This is not the case whatsoever!

Asthma is a very serious disease and should be managed by a healthcare provider. The second concern is that patients who do not have Asthma will still use the medication for inappropriate reasons, such as to increase heart rate to help with workouts or potentially abuse the epinephrine to try and lose weight. This medication is not approved to be used in anyone other than an Asthma patient, and it should never be used to lose weight or to increase performance.

As a healthcare professional, it is important that we give our patients the most up-to-date information and recommendations for these new products. Primatene Mist® is going to be released on the market soon and it’s important for patients to be aware of the product and its usefulness, while also understanding its downsides. Primatene Mist® works similar to albuterol inhalers and should only be used as a rescue inhaler while experiencing shortness of breath. The medication is currently not recommended in the GINA guidelines (clinical guidelines to managing Asthma), and this medication should not replace you visiting your healthcare provider.

As always, feel free to reach out to us or stop in if you have any questions. We look forward to helping you get the best quality care!

Allergic Reaction vs. Intolerance: An Important Difference

Written by Kyle Farina

It is not uncommon to have side effects to certain medications. Some of the common side effects we hear about on a day-to-day basis are stomach upset, nausea, dizziness, and headache. However, there are times when medications do not cause side effects, but rather, the patient is allergic to the medication. These allergic reactions are more severe in nature and present differently than side effects, and it is important for patients to be able to tell the difference.

What is an allergic reaction? An allergic reaction is the process by which your body recognizes something foreign as a threat, and it sends the immune system to try and destroy the foreign object. This is our body’s natural defense and helps us fight off infection. The body will recognize a foreign substance – in this case, bacteria – and it will send immune cells to destroy the bacteria. During this time, patient’s usually present with a fever, potentially have some inflammation, and feel a little run down. This is okay; it means that the body’s defense system is working! However, there are times when our body’s recognize common substances and our immune system will try to get rid of it. When our body sends the immune system to attack some commonplace items, such as peanuts, tree pollens, and potentially medications, we experience the same inflammatory response as when we are fighting an infection.

There is no way to prevent an allergic reaction from happening and no way to predict whether someone will be allergic to one substance or another. It is important to recognize the signs of an allergic reaction. The two most common presentations of true allergic reaction are hives/rash and anaphylaxis. Hives/rash is pretty easy to identify for most patients. The skin becomes irritated, red, itchy or painful, and also sometimes has bumps on it, which are called hives. The second type of reaction, anaphylaxis, is more dangerous and needs to be treated as soon as possible. With anaphylaxis, the patient’s lips and throat will swell and breathing becomes more difficult. Both of these reactions are considered to be true allergies, and patients should be advised to avoid whatever items cause these flareups.

In regard to medications though, why is it important for patients to know the difference between allergic reaction and medication side effects? Allergy information is a critical piece of patient history and will guide therapies prescribed by your provider. For example, sometimes patients will say they have an allergy to an antibiotic – let’s say amoxicillin – and you forget to tell us that the allergy was upset stomach (which is a common side effect of most antibiotics).

Now that we have this allergy listed in our system, we will be unable to dispense amoxicillin to you because you said you have an allergy to it. But that’s not all – because this medication is a penicillin based antibiotic, we are going to be unable to dispense penicillin-based antibiotics and may even be weary of dispensing cephalosporin antibiotics, such as Keflex, because they are similar molecules. Now, the provider and pharmacist have to work to come up with a different antibiotic to use for your infection which may not be the best to treat your infection or it may have worse potential side effects.

It is important to remember that there is a huge difference between medication side effects and being allergic to a medication. If you have questions regarding allergies and whether or not you may be experiencing and allergic reaction or side effect, feel free to give the pharmacy a call! We are more than happy to help you and ensure you get the best available healthcare available!

The Life of a Prescription and How You Can Help

Written by Kyle Farina

As we continue to develop new technologies and innovations, we – as people – are becoming used to having whatever we want at the tip of our fingers and we are able to get it fast. As a result, we tend to want things done as soon as possible for our convenience. One of the common things we hear everyday at pharmacies all over the country is, “why does it take so long to fill my medication?” and “you just move one the pills from one bottle to the other, right?” It is completely understandable that patients want their medications readily available at all times; however, the life of a prescription is not necessarily as simple as moving pills from one bottle to the next.

First, your prescription starts at your providers office. In New York State, your provider is required to send an electronic prescription to a pharmacy of the patient’s choosing. So, as you’re getting ready to leave the office, your provider informs you of a new medication he will be starting you on and you he will send the script right away. Great! You can run to the pharmacy now and pick-up said medication, right? Not quite…

In an ideal world, the prescription will be sent to the pharmacy right away; however, there are a couple obstacles in the way. For example, some providers will write all of their prescriptions for the day and save them, then “release” them to all the pharmacies at a specific point in the day. All providers are different and there is no way to determine whether the provider placed your prescription in with the later batch or sent it right away. Also, there are the hiccups associated with needing electronic prescriptions. Power outages, connection issues, mis-clicking, etc. are all possible errors that may delay your prescription from arriving to the pharmacy. At this point, the prescription which was sent to the pharmacy while you were leaving may not have even left the provider’s office.

Once the prescription arrives to our pharmacy electronically, we enter the data into our system and – uh oh! – we found an error in the prescription! Something does not add up on the prescription and we need to clarify the order with your doctor. I am more than happy to call the office for you, but this takes time, as I now have to get into contact with your provider or nurse and they are also busy seeing patients. Unfortunately, this process takes time, as we do not want to make guesses as to what the prescription should be and hurt the patient.

Once the prescription was clarified and we are good to go, we can start counting out your prescription and getting it labeled and ready to be verified. However, when we went to grab your medication from our shelf, we found out that we don’t have enough to fill the prescription and have to order more. We can supply you with a couple days’ worth, but we will not be able to give you the full prescription until we receive the new order, which may take up to 2 days depending on shipping, weather, etc.

While these are some common issues we encounter on a day-to-day basis, it is important to know that this does not happen all the time. Not every prescription will come be sent at the end of the day. Not every prescription will have something mismatched or interact with another medication that you are taking. Most common medications are also readily available and in-stock at your pharmacy. Unfortunately, there is no way for us to predict whether or not your prescription may encounter these hiccups – and we wish there were so we could inform you – and your prescription may not be ready for pick-up immediately after leaving the doctor’s office.

There are things you can do to help! Calling your pharmacy beforehand is a great way to get started and see if the prescription has reached the pharmacy yet and to make sure that we have the medication in stock. Talking with a member of our staff is also a great way to check if the medication interacts or if we are working to resolve an issue with your prescription.  The pharmacy is also working on a lot of other prescriptions as well, and we can give you a better idea of when your prescription is going to be ready for pick-up! This does not just benefit the pharmacy; we want to make sure that you are also benefitting and not wasting a trip only for us to tell you that we do not have medication.

As always, feel free to call us or talk with a member of our staff if you have any questions. We are more than happy to help you!