NORTH CAROLINA TRIANGLE’S PREMIER HEALTH PUBLICATION • WITH 70,000+ HEALTH-CONSCIOUS READERS BIMONTHLY

CENTRAL PHARMACY AND CENTRAL COMPOUNDING CENTER

pdf of this article

For more information about these community pharmacy/education/wellness centers, contact:
 

Jennifer Burch, PharmD
Sejjal Patel, PharmD
Michael Verble, PharmD
Ziyad Jabar, PharmD

Chad Clay, PharmD
Jhuvon Francis, PharmD


CENTRAL PHARMACY

2609 North Duke Street, #103
Durham, NC 27704
Telephone: (919) 220-5121
Fax: (919) 220-6307
www.centralpharmacy.com


CENTRAL COMPOUNDING CENTER

6224 Fayetteville Rd, #104
Durham, NC 27713
Telephone: (919) 484-7600
www.centralcompounding.com

Call to schedule a consultation with our pharmacists.

Pharmacists: A Hidden Health Care Resource

“Pharmacists are the most over-educated and underutilized health care professionals in America,” asserts pharmacist Jennifer Burch, of Central Pharmacy and Central Compounding Center in Durham. “And—especially during the current health crisis—this is regrettable, because they could be an invaluable resource.”

Dr. Burch

Pharmacists, she points out, are ideally suited to serve as the knowledgeable “bridge” between trying at-home or over-the-counter (OTC) options and seeking medical care. “In today’s digital world,” she notes, “many patients bypass their doctor and the pharmacist altogether to seek information on-line. But anyone can make a website, and the key is distinguishing good information from bad.

“For one thing, much of the standardized information on the Internet can be very general. The ‘medical advisors’ don’t know you, the patient, or your set of circumstances right now. And mixed in with general advice is an enormous amount of advertising designed to convince you that you need a given medicine or supplement. That’s a major disadvantage of getting your medical advice from the Internet.”

Another serious drawback of on-line self-diagnosis, notes Dr. Burch, “is that ‘Dr. Google’ tends to ignore the fact that OTC products—or any medicines, for that matter—do not work in isolation. They’re affected by, and may have an effect on, other medicines you’re taking, supplements you’re taking—even your diet.

“And this is where building a relationship with your pharmacist can be so helpful,” explains Dr. Burch. “Pharmacy care can be so much more than just putting pills in bottles. Pharmacists are the best trained health care professionals in drug therapy management out there—and are perfectly positioned to help patients with questions or problems related to OTC drugs—either alone, or in combination with other medications.

“So, I would urge everyone to consult their pharmacist about which OTC products to choose—because your pharmacist knows what other medicines you may be taking and is certainly better informed about the contents of the OTC products they have available.”

Finding a “pharmacy home,” advises Dr. Burch, could be one of the most beneficial things you can do for your own health care. “If don’t already have a relationship with your pharmacist,” she says, “make a point of getting acquainted. They need to know the basics of your health condition if they are going to be helpful to you.”

Changing Product Landscape

Today, the front of the pharmacy contains a wealth of OTC options; but navigating those options requires a very high level of knowledge. “Familiar brand names,” says Dr. Burch, “have evolved over time, changing ingredients and extending product lines. And it’s certainly hard to know what you’re getting just from the brand name. For one example, there are shelves of products labeled ‘cold medication’—many of them branded as Sudafed or Tylenol, or other combination products with similar ingredients. But even Sudafed doesn’t necessarily contain its namesake ingredient, pseudoephedrine.

“So if you have a cold or congestion and the doctor simply says, ‘Go take Sudafed,’ you can be left wondering which of many brands to take, or which variation—the one with pseudoephedrine or the one with phenylephrine? And that’s a good question!” says Dr. Burch. “OTC products are frequently reformulated; and if it’s hard for me, the pharmacist, to figure that out, it’s harder still for the consumer.”

Correctly determining which specific OTC medication to take is only one of the dangers of self-prescribing, notes Dr. Burch. The other risk can be choosing the wrong drug, period. “A good rule of thumb,” she advises, “is, if you’re treating yourself with OTC products for even a seemingly minor condition like a headache or a cold, you should expect to improve in about three days. If not, it’s time to check with the pharmacist about what to do next or whether it’s time to see the doctor.

“And that’s another important role: ideally, pharmacists are a key part of a health ‘triangle’—of patient, physician, and pharmacist,” she explains. “We’re often able to identify problems that the doctor is unaware of, or to advise patients on when to see their doctor.

“At Central Pharmacy and Central Compounding Center,” says Dr. Burch, “being accessible to clients for questions like these is the highest priority. And, given the challenges of the pandemic, we’ve done everything we can to expand that accessibility—consulting with clients by phone, via telemedicine, as well as in person.”

Over-the-Counter vs. Uh-Oh

Pharmacists also watch out for red flag combinations between certain prescription medications and OTC products. “This is another example of the value of developing a relationship with your pharmacist,” says Dr. Burch. “We understand, for instance, that blood thinners, along with diabetes and hypertension medications, pose the most frequent issues in combination with other medications. So, when we fill your prescription, we can have an educated conversation about what you should take for a cold or a cough or an ache or a pain that doesn’t interfere with your medication regimen.

“A person with poorly controlled hypertension, for example, might not do well with many decongestants, which can raise blood pressure,” she says. “But an alternative solution, like Afrin nasal spray instead of the oral version, will have less effect on blood pressure while still alleviating symptoms. Similarly, we can help diabetes patients find a cough syrup that’s lower in sugar, so that treating a cough doesn’t set back their diabetes control.”

And in some cases, even a simple OTC intervention can make a big difference, observes Dr. Burch. “One example that comes to mind, was when a patient’s wife came in looking for a product called MagOx on his doctor’s recommendation. However, we learned, through discussion with the wife, that her husband was having diarrhea and needed to rebalance his electrolytes and increase his magnesium level. That was a red flag. Because, although MagOx is a great laxative, it’s poorly absorbed outside the gastrointestinal tract—so it wouldn’t raise his magnesium levels, and would definitely exacerbate the diarrhea. Instead, we recommended a switch to a chelated magnesium that quickly resolved the patient’s Restless Leg Syndrome, which had been worsening.”

Another frequently encountered challenge is working with patients who are taking 15 or 20 different prescription drugs. “Amazingly,” notes Dr. Burch, “that kind of a medication load is not uncommon. Figuring out what OTC medications such a patient can use becomes both complex and highly personal. And it takes a thorough understanding of how the medications interact—with each other and with additional supplements and OTC products.

“Whether you take one prescription medication or twenty, when it comes to taking OTC products into your body,” says Dr. Burch, “the very best practice is to first check with your pharmacist. We’re committed to finding the right product for every patient when it’s possible to do so.”