Ask the Pharmacist

To follow-up on my new kick to stop being sick, let’s talk about drugs.

Have you ever wondered what questions you are supposed to ask the pharmacist? Well I have, so I decided to get it straightened out once and for all. Here’s my Q&A with a fellow Gen Yer/my good friend/pharmacist, Joshua Lorenz, who kindly answered my questions:

Y-rd: A lot of young people—especially these days when unemployment is high—are scared to spend the money to go to the doctor. A lot of people probably don't even know that they can ask their pharmacist some common questions. Can you tell us what some easy questions are that you should really ask your pharmacist instead of the doctor?

Joshua: Before I answer this question, I just want to clarify that a pharmacist is not trained or educated to diagnose most complicated disease states. Pharmacists are drug experts; however, we still have enough knowledge to help a patient with their decision to go see a doctor or head to the emergency room. Here are some great questions/topics you can ask your pharmacist about at your local pharmacy:

• Any and all questions regarding any medication, whether it is prescription or over-the-counter (OTC). This includes herbal supplements and 'natural' remedies.
• I always recommend people spend at least a little time speaking with your pharmacist whenever you start a new medication. I find the amount of time that patients spend with their doctors discussing their medications varies widely, from nothing to five minutes.
• 'Can I drink any alcohol while I taking this medication?' Pharmacists are perfectly suited to tell you if what you are taking interacts with any other substances, lab tests or medical conditions. Keep in mind that common drugs such as caffeine and alcohol can significantly interact with certain prescription and OTC medications available over the counter. And herbal supplements, including diet and weight loss pills, can also significantly interact with other pills you may be popping during the day.

On the flip side, what is the most annoying thing people could ask the pharmacist?

Where is the kitty litter? Why does it take you so long to fill my prescription if you just need to put pills in the bottle? I could go on, but I highly recommend the blog post about "why your prescription takes so damn long to fill" from the blog Your Pharmacist May Hate You. It does an excellent job at explaining the average day of a community pharmacist and why your prescription can often take so long to fill.

Can you think of any common (legal) drug mistakes or misconceptions?

There are a few simple ways you can avoid being on the receiving end of a drug error. As you may expect, a large percentage of errors result from the illegibility of a doctor's handwriting. This is decreasing due to advances in technology, but it still occurs due to software issues. Although pharmacists are legally required to call the physician if it is illegible, many pharmacists, like nurses, are hesitant to contact a doctor if the doctor has a difficult personality. You can help protect yourself by having someone at the doctor's office repeat back to you the name, strength, and frequency of the medication you should be taking. Write this information down and check it against the prescription you eventually purchase.

Another common misconception is that ‘natural’ remedies or herbal supplements are more safe than other prescription or OTC drugs. This simply is not true. These herbal supplements and natural remedies are not regulated by the FDA and are not held to the same safety and effectiveness standards. And pharmacists do learn about these substances. While there are some that can provide relief, the vast majority are overpriced and shown to be ineffective. A classic and popular example of this is the remedy Airborne, available at most pharmacies.

Do you have any tips about easy ways to save on drug costs? Are generic drugs just as good as the original?

I always recommend generic products to patients. Both prescription and OTC generic drugs are required to contain a comparable amount of drug. They also must work the same way and the same amount of time as the brand-name version. The only difference allowed is in the inactive ingredients used to manufacture the medication. If you are allergic to multiple substances, it is always recommended that you check the label.

Of course I have come across people that swear whatever version of the medication they are currently taking is better than the brand or generic. In these circumstances I usually recommend that the person continue on the same medication if it is working for them.

Another way to save on drug costs is to actually make sure you need a drug to help alleviate your symptoms. For example, some cough and cold products available over-the-counter have marginal to no benefit for some people. Believe it or not, pharmacists are actually educated to decrease the number of medications a person is taking, not increase. A quick visit to the pharmacist can help with these decisions.

Just for fun (because I'm fair-skinned): Does Aspirin really work for sunburn?

Aspirin and other medications included in the class NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve), can be used to relieve the pain and inflammation associated with sunburn. I recommend this especially within the first 24 hours of sunburn as this is when they will be most effective in relieving pain. If your sunburn is itching, then taking a non-drowsy antihistamine such as Claritin in the morning and Benadryl at night can help. Aspirin and the other drugs listed above do NOT prevent sunburn from occurring. The best practice is prevention with sunscreen and minimizing sun exposure. Your pharmacist can give you additional information about other practices and remedies to try depending upon your age, skin type and other medications you may be taking. There are also additional medications you may consider if your sunburn is severely blistering. And if you are having a fever, feeling confused or having increased weakness, then you should go to the ER immediately.

Is there any other advice you'd like to share with fellow young people about staying healthy and taking the right drugs?

If anything has been learned from the recently celebrity deaths, then I hope it is that you should keep a closer eye on all the medications you take and the interactions that can occur. Even common products like acetaminophen (Tylenol) can have devastating effects in high doses and are included in many prescription pain medications. As a pharmacist I discourage the use of illegal substances, but I still encourage all people to tell me everything they are using for the sake of avoiding potentially deadly interactions. When a pharmacist counsels you at the pharmacy, you have a right for that consultation to be private. Please use that right to ask the questions you want and receive the information you need.

Joshua Lorenz, PharmD, MBA, is a pharmacy practice resident in Columbus, Ohio. You can contact him with any questions at joshua.lorenz@gmail.com.

On that note, Y-rd is headed to the beach armed with SPF 50 sunscreen.