This information on managing your disease states and staying in good health was compiled by University of Hawaii at Hilo College of Pharmacy Interns (SN, JZ, DH, EM, SE, BC) 2010. Please refer to links for more detailed information and talk to your doctor about your specific case.
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Type 1 Diabetes: The body does not make insulin. Insulin helps the body use glucose from food for energy. People with type 1 need to take insulin every day.
Type 2 Diabetes: The body does not make or use insulin well. People with type 2 often need to take pills or insulin. Type 2 is the most common form of diabetes.
Gestational Diabetes: May occur when a woman is pregnant. It raises her risk of getting another type of diabetes, mostly type 2, for the rest of her life. It also raises her child’s risk of being overweight and getting diabetes.
Some exercise ideas could include:
| After Meal | <180 mg/dl |
|
Before Meal
|
70–130 mg/dl |
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Cholesterol is a fat-like substance that can be found in your blood. There are three main types of cholesterol that make up your Total Cholesterol.
Maintaining a healthy cholesterol level in your blood is important to avoid heart attack and stroke. Your doctor can order blood test to tell you what your cholesterol levels are. High cholesterol leads to a condition called atherosclerosis (the hardening of your arteries). Your arteries should be like a garden hose, flexible and smooth. Your arteries carry blood with oxygen and nutrients to all parts of your body. With atherosclerosis your arteries start to develop a layer of fat (plaque) along the inside. With plaque build up your arteries are no longer flexible and smooth. That layer of plaque makes it hard for blood to travel through your arteries.
| Total Cholesterol: | < 200 mg/dL |
| LDL | < 100 mg/dL HDL > 60 mg/dL |
| TG | < 150 mg/dL |
If you have high cholesterol or 2 or more of the listed risk factors, you need to make changes to improve your health. Having high cholesterol or risk factors for high cholesterol may mean you are at risk for Coronary Artery Disease (CAD). CAD is the single largest killer and cause of disability in men and women in the U.S.
http://www.nhlbi.nih.gov/guidelines/cholesterol/atglance.pdf http://www.aace.com/pub/pdf/guidelines/lipids.pdf
Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. There are two types allergic and non-allergic asthma. The cause of asthma is unknown but it is linked to a combination of genetics, environment and biology.
Sports with short bursts of energy like baseball or football generally create less problems whereas ongoing activity can make it worse
There are many things that can trigger an asthma attack. The most common include:
Medications used to CONTROL Asthma
Medications used to TREAT an ATTACK
There are two basic types that deliver medication directly into the lungs to treat asthma: Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI). A DPI is different from a MDI because you must inhale forcefully since there is no propellant. General instructions for an MDI such as your rescue inhaler:
1.Remove cap and shake inhaler.
2. Tilt head back and breathe out.
3. Hold inhaler two finger- widths away from open mouth, compress and inhale.
4.Breathe in slowly for 3-5 seconds.
5. Hold breath for 10 seconds.
6.Wait at least one minute and continue as directed.
* When using a corticosteroid, remember to rinse out your mouth, gargle and spit after using.
Green Zone = doing well (no cough, wheezing etc.)
Yellow Zone = asthma is getting worse (cough, wheezing, shortness of breath, chest tightness)
Red Zone = medical alert! (very short of breath, medicines are not working etc.)
Having too much uric acid in your body causes gout. Your body may make too much uric acid, or have a hard time getting rid of uric acid. If to much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed. A common place for this to happen is on your big toe.
Gout may not be preventable, but you can help by avoiding things that trigger your symptoms such as:
SBP, or Systolic Blood Pressure (number on top) is the pressure of your heart while the ventricles are contracting and forcing blood to the body. DBP, or Diastolic Blood Pressure (number on bottom) is when your heart is relaxing and the ventricles are filling up with blood.
1. Nerve Damage: High blood glucose can cause nerve damage in your legs and feet. As the result you may not be able to feel pain and other sensations like heat and cold. You may have a cut or a wound on your feet or legs and not even know that it’s there. If there’s no sensation the cut or wound may get worse and possibly get infected. This lack of sensation is called diabetic neuropathy.
2. Poor Blood Flow: High blood glucose can also cause poor blood flow to your legs and feet. Decreased blood flow makes it harder for wounds or sores to heal.
Your doctor can help you take care of your feet
If your blood glucose is high, your body loses fluid. With less fluid in your body, your skin can get dry. Dry skin can be itchy, causing you to scratch and make it sore. Also, dry skin can crack. Cracks allow germs to enter and cause infection. If your blood glucose is high, it feeds germs and makes infections worse. You may get dry skin on your legs, feet, elbows, and other places on your body.
Nerve damage can decrease the amount you sweat. Sweating helps keep your skin soft and moist. Decreased sweating in your feet and legs can cause dry skin.
http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/feet.pdf
The kidneys are two structures inside your body, along each side of your lower back, approximately the size of your fist. They are very complex organs with many functions. You might not notice them unless something is the matter, and even then, you may not realize something’s wrong until serious damage is done.
Remove Wastes: Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, ready to be eliminated through the bladder.
Make Hormones: The body has many chemicals floating in the blood called hormones which are responsible for maintaining normal body functions. The kidneys make three important hormones involved in everything from your blood pressure and creation of new blood cells, to the amount of calcium your body can use.
Drink Water: Staying hydrated is essential! Though everybody is different in his or her needs, you can aim for 8 to 10 glasses of water per day. Soda and juice count too, though plain water is often the best choice for your body.
Control Your Blood Pressure: Your body pumps blood through your kidneys every day in order to filter out wastes. If the pressure through those tiny, delicate blood vessels of the kidneys is too high, they can become damaged. Have your blood pressure checked regularly. If you’re on a blood pressure medication, keep taking it. Even if you feel fine, your blood vessels are being damaged by the high pressure.
Cut Down or Cut Out Caffeine: This stimulant is found in coffee, tea, soft drinks, and energy supplements. You probably know it keeps you awake, but you may not know that caffeine is a “diuretic,” or an actual drug that makes your body lose water by urinating more. This makes your kidneys work more to keep up with this outflow of water, and you may become dehydrated!
Control Your Blood Sugar: A healthy body naturally takes sugars from food and move it through the body as needed. However, people with diabetes have difficulty dealing with sugars in the blood. The kidneys are just two of the many organs of your body that can be hurt by poorly controlled diabetes. Check your blood sugar often and learn how to use your prescription medications and lifestyle changes (like exercise and diet) to manage your blood sugar levels to protect your kidneys. Diabetics can improve their kidney health, too.
Most times, decreased kidney function will go undetected. You can’t see your kidneys, and it often doesn’t hurt when they slow down.
GFR, or Glomerular Filtration Rate, is how efficiently your kidneys filter out wastes from your blood. It’s determined by a blood test. Blood testing is a reliable way to know how your kidneys are functioning. A urine sample will test for proteins in your urine. Healthy kidneys filter out proteins while a damaged kidney lets them flow into the urine.
Changes in Urination: Foamy, dark, or bloody urine are not normal. More frequent urination, difficulty urinating, or large volume of urine may be signs of a problem.
Swelling: Failing kidneys don’t remove excess fluid as well as normal. Swelling in hands or feet may be a symptom of various health problems.
Fatigue: Anemia is associated with failing kidneys, which means oxygen isn’t delivered to the tissues as efficiently (less red blood cells).
Skin Rash and Itching: Wastes that the kidneys normally filter may build up in skin causing itch.
Nausea and Decreased Appetite: Build up of wastes in the body can cause these and/or bad breath and metallic taste in the mouth.
Shortness of Breath: Excess fluid in the body may accumulate in the lungs. Anemia may also cause this as oxygen isn’t transported well.
Dizziness or Trouble Concentrating: Anemia means the brain is not getting enough oxygen.
Flank Pain: The kidneys are in the lower back, if you feel pain there, contact your doctor.
Healthy kidneys function perfectly, or 100%. As we age, and as diseases and health conditions affect us, our kidney function decreases. Small decreases don’t cause any problems at first, but may be forewarning of problems to come.
Kidney disease is a progressive, steady decline in kidney function. Your doctor can work together with you to slow that decline, and plan for the time that your kidneys can no longer function. Kidney failure is when your kidneys function at 15% or less of normal. You will need dialysis or a kidney transplant if this is you.
Hemodialysis is a procedure to substitute for healthy kidneys. It uses a machine to eliminate wastes from your blood that your kidneys cannot. You and your doctor should make necessary arrangements before your kidneys can no longer support your body. It is often done three times per week at a hospital or clinic and lasts several hours.
National Kidney Disease Education Program
Hypothyroidism is a condition when your thyroid gland doesn't produce enough hormones. It interferes with the normal chemical balance in your body. If left untreated, it can lead to many health problems which include obesity, joint pain, heart disease and infertility. It may even lead to an enlarged thyroid (goiter).
Accurate thyroid function tests are available to diagnose hypothyroidism, and treatment with medications is simple, safe and effective.
Signs and symptoms of hypothyroidism vary widely and depend on the severity of your hormone deficiency. They develop slowly over a number of years.
Autoimmune disease
Treatment for HYPERthyroidism Radiation therapy
Thyroid surgery
Medications
Anyone can develop hypothyroidism, but you are at an increased risk if you:
Certain medications, foods, and supplements may affect the absorption of Levothyroxine or your thyroid hormone. Talk to your doctor or pharmacist if you eat large amounts of soy products or a high-fiber diet or take:
Thyroid hormones are available by prescription only. You should not purchase products that have thyroid hormone from natural food stores because their potency and purity is not guaranteed and could be harmful to your body.
Keep taking your medications even if you feel better
Insomnia is defined as trouble with sleep, either falling asleep or staying asleep. You may not be wide awake all night, but have inadequate or poor quality of sleep. It may be short term or long term, and there are a variety of causes.
Transient Insomnia: Lasting less than seven days. It may be due to acute stress, like an argument or a morning meeting. It could also be due to environmental disturbance such as an unfamiliar place, lights, weather, noises, or a large meal before bed.
Short Term Insomnia: Lasting seven days to three weeks. It may be due to more severe stressors such as loss of a job, illness, death in the family, getting married, or financial problems.
Long Term Insomnia: Lasting more than three weeks. This may be caused by an existing medical problem such as pain, frequent urination, sleep apnea, Parkinson’s disease, restless leg syndrome, or a variety of psychological conditions.
“Learned Insomnia”: This is a behavioral condition, often where anxiety is experienced at bedtime. The bedroom is associated with a lack of sleep, but sleeping may be achieved elsewhere such as the couch or at a desk.
Up to 85% of people with insomnia have never talked to their doctor about it. Symptoms of insomnia Difficulty falling asleep: It may take a long time to fall asleep after lying down in bed. Waking up frequently: You may be up multiple times during the night, and have trouble falling back asleep each time. Waking up too early: You may wake up earlier than expected or desired and not be able to fall back asleep afterwards. Unrefreshed sleep: You may sleep all night without interruption but still feel tired the next day. How much sleep is enough? There is no magic number. You need only as much sleep as it takes to feel rested and refreshed in the morning!
There’s a strong correlation between age and insomnia. Most complaints of insomnia are in the elderly. This is partially caused by increased number of health conditions, increased number of medications, and changes in circadian rhythm.
Before the age of 40, men and women are equally likely to experience insomnia. After age 40, women are more likely than men.
Establish a regular sleep-wake cycle: Get in the habit of going to bed at the same time every day, and waking up at the same time every day. This means sticking to it even on the weekends. It will train your body that bedtime means sleep time!
Wind down before bed: Spend some time before bedtime doing something non-stimulating like watching television, reading a book, or listening to quiet music.
No exercising within four hours of sleep: Exercise is best done in the mornings, when it can boost your energy all day long. Four hours should be given at least after exercise before you expect your body to relax enough for sleep.
Use the bedroom only for sleep: Don’t watch television or eat in bed. Move all of your activities to a different room so your mind associates only sleeping with the bedroom.
Minimize extreme temperatures and lights: Set your thermostat to keep your bedroom at a steady, comfortable temperature. Too hot or too cold of a room can decrease quality of sleep.
Drown out sounds with “white noise”: If you have noisy neighbors or live near traffic sounds, you can try drowning them out. Use a constant background noise like a fan or the air conditioner.
Cut out the caffeine: Try to phase out caffeine from your diet. It might help perk you up short term if you’re sleep deprived, but it will make a vicious cycle when it keeps you awake the next night. Look for it in tea, coffee, soda, and medicines.
Alcohol is a bad choice for insomniacs. It will make you drowsy and fall asleep more quickly, but you’ll soon be up again because it leads to poor quality sleep with frequent waking, in addition to increased urination at night.
Over the Counter Medicine for Insomnia
Diphenhydramine: Brand names Sominex, Benadryl. It’s also added to “PM” formulations of Tylenol and cold medications. This is an antihistamine used for allergies or cold symptoms, but has a side effect of drowsiness, and so we use it for a sleep aid too. 25mg or 50mg are appropriate doses for sleep. Any more is not proven to help more, but will give you more side effects. These adverse effects include dizziness or confusion, dry mouth, dry eyes, constipation, and urine retention. These may be more pronounced in the elderly. Take it 30 to 60 minutes before bedtime for best effect. It will keep working for 4 to 6 hours, so most people won’t wake up drowsy.
Doxylamine: Brand name Unisom. This is similar to diphenhydramine, though it may be better tolerated. Take 1 tablet 30 minutes before bedtime. Melatonin: This is a hormone our body uses to regulate our sleep and wake cycles. Appropriate doses for sleep are 0.3mg and 0.5mg given 1 to 2 hours before bed. There is not a lot of information for long term safety and efficacy, so only use it short term and check with your doctor.
With all sleep aid medications, don’t drive or do anything that requires your concentration while you’re taking them.
Over the counter products are only for short term relief. Ask your doctor about prescription medications if you’re still having trouble sleeping.
Gastroesophageal reflux disease, or GERD, is a condition where the contents of your stomach or upper intestines come back up into your esophagus (throat). It may also be called heart burn or acid reflux, though GERD is a disease that is persistent over time, while heart burn might just be a passing episode once in a while.
The esophagus isn’t meant to have acid inside of it, it’s only the tube that brings food into the stomach from the mouth. There is a muscle at the bottom that’s supposed to open only when you swallow, but in people with GERD, there’s a problem where it may open from time to time and let acid out of the stomach.
The cause of GERD may be either too much acid in the stomach, poor muscle control between the stomach and esophagus, or a combination of both.
In addition to pain you feel when acid comes back up towards your throat, it is damaging that delicate tissue. Long exposure of your esophagus to stomach acid can cause serious problems such as esophagitis, ulcers, or bleeding of your esophagus.
If you have infrequent, mild symptoms like these, you may try over the counter medication first. If symptoms aren’t relieved or persist, see your doctor.
If you notice any of these severe symptoms, see a doctor immediately.
Don’t eat problem foods: There are certain foods known to aggravate GERD and cause episodes of acid reflux. High fat foods, chocolate, spicy foods, onions, garlic, mint, and tomato sauce are some examples.
Don’t drink problem drinks: Caffeine is found in tea, soda, coffee, and some medications or supplements. It is a known irritant to the stomach and can cause reflux. Highly acidic drinks can also trigger heart burn, such as tomato juice, orange juice, or carbonated sodas.
Change how you eat: Large meals create a physical problem when the stomach is stretched out to hold the food. Try eating smaller meals through the day, and don’t eat before bedtime. Lying down after eating gives the contents of the stomach even more help coming back up into the esophagus.
Stop smoking: This piece of advice is likely the toughest one to accept, but it will lower risks for a wide variety of diseases including GERD. Betel nut can also cause stomach issues including heart burn, try and stop that, as well.
Manage your body weight: Obesity is linked to GERD and acid reflux. Start small, aim for a reasonable goal like losing 5% of your weight over time. A simple change, like drinking ice water instead of soft drinks, can make a big difference over time. Wearing loser clothes cause less pressure on the stomach and may help as well.
Elevate the head of your bed: Remember gravity! In people who suffer from heart burn or GERD, it helps to incline the bed to keep stomach contents where they belong. Extra pillows aren’t enough, try putting something solid between the mattress and the box spring.
Avoid Alcohol: Alcohol is a known irritant to the stomach, and can make a bad problem worse. There is also a link between alcoholism and GERD.
Antacids: These are things like Tums, Maalox, Mylanta, Rolaids, Gaviscon, Milk of Magnesia, and more. They work by neutralizing the acid in your stomach by adding a basic substance like calcium or magnesium. They are useful if you only have symptoms once in a while, because they are taken for the symptoms, and not to prevent the flare ups. Don’t take these with other drugs, they have a tendency to stick to the drug and prevent your body from absorbing it (check with your pharmacist for your specific situation).
H2 Blockers: This class of medications includes things like Zantac (ranitidine), Pepsid (famotidine), Axid (nizatidine), and Tagamet (cimetidine). These are taken once or twice a day and decrease production of acid in the stomach. They can be taken short term to manage an episode of heart burn over several days. Check with your pharmacist or doctor before picking this off the shelf, they can have interactions with many prescription drugs you may be taking.
PPIs (Proton Pump Inhibitors): These are the newest class of medications for GERD and the most effective, though different in several ways. Prilosec (omeprazole) is the only one available on the shelf now. The medication is taken once a day for 14 days. It doesn’t work immediately, it is used more to prevent trouble than fix an episode of heart burn you may be having now. This class of medication is the best at decreasing stomach acid, but you must plan ahead.
National Institute of Health - GERD
People who have a high amount of body fat when compared to their height are considered overweight or obese. When you eat a lot of fatty foods, don’t exercise, and/or have family members that are overweight, you are more likely to be overweight. Being overweight increases your chances of developing diseases like heart disease, diabetes, cancer, and arthritis. This can lead to heart attack, stroke, and even death. Losing even a small amount of weight (5-10%) can reduce your risk for developing these diseases.
In some cases, underlying medical conditions such as hormone disorders or medications can cause weight gain. These can also make it difficult to lose weight. Ask your doctor or pharmacist for more information about disorders and medications that can cause weight gain.
Doctors use a measurement called BMI (Body Mass Index) to estimate your body fat and determine if you need to loose weight. Your BMI is calculated using your height and weight. You can use the following table to calculate your BMI.
BMI less than 18.5 = Underweight
BMI 18.5 to 24.9 = Normal
BMI 25.0 to 29.9 = Overweight
BMI over 29.9 = Obese
In addition to being overweight, the following items can increase your risk of developing heart disease and other complications like diabetes.
*Ask your local PHI Pharmacy about free blood pressure and blood sugar testing.
The best way to lose weight is to eat less and get more physical activity. The amount of calories you eat needs to be less than the amount of calories your body uses. In general, reducing your calorie intake by 500 to 1,000 calories per day can result in losing 1-2 pounds per week. Try to eat healthy foods like fruits, vegetables, grains, poultry, fish, beans, and lean meats. Avoid foods high in saturated fats, trans fat, cholesterol, salt, and sugar.
Seasonal allergies are often referred to as hay fever, or allergic rhinitus. They occur when your immune system overreacts to particles in the environment that are generally harmless. These particles are called allergens. Allergens include grass, dust, mold, animal dander, cockroaches, and pollen. Allergens enter your body through inhalation or direct contact with the nose or eyes. In response, your body produces types of white blood cells called antibodies that work to get rid of the allergen. This is referred to as an “allergy attack” and is what causes the symptoms you experience when exposed to the allergen.
Different people respond to different allergens. Some allergens are present only during specific seasons (for example, the rainy season) and may not affect you during the rest of the year. It is important to identify the allergens that are causing your symptoms so that you can anticipate and prevent allergy attacks.
During an allergy attack, your immune system reacts to allergens by producing inflammation in the nose, and sometimes the eyes, in order to clear your body of the allergen. This response can produce some or all of the following symptoms:
The symptoms of seasonal allergies can appear quickly as allergens become present in the air. For example, when trees release their pollen in response to their flowering cycle, allergens become present in couple of days that were not present before. Due to the similar nature of the symptoms, people often think they are experiencing a cold or sinus infection when it is really just seasonal allergies. It is important to be able to tell the difference so you can know how to treat your symptoms and when to see a doctor.
|
Cold |
Allergies |
|
|
Duration |
5-7 days |
Weeks-Months |
|
Cough |
Common |
Sometimes |
|
Body aches |
Sometimes |
Never |
|
Itchy eyes |
Rare |
Common |
|
Sneezing |
Common |
Common |
|
Sore throat |
Common |
Sometimes |
|
Runny nose |
Common |
Common |
|
Fever |
Sometimes |
Neve |
There are several methods for treating seasonal allergies that do not require a prescription from the doctor. Be sure to ask your pharmacist when choosing a medicine for your allergies to avoid interactions with other medications and side affects.
Non-drug Remedies:
Over-the-counter Drugs:
The best way to prevent attacks is to avoid the allergens that cause your allergies. If you are allergic to pollen, avoid outdoors when the pollen season is present. If you are allergic to mold or dust, clean your house at least two times a week, avoid carpet, and use anti-allergen pillowcases and bedding.
When avoidance isn’t possible, use antihistamines. Antihistamines work by blocking the receptors in the body that cause your allergy symptoms. In order to work best, they need to be used daily so that there is a constant amount of medicine in your body. They also work best when used before an attack happens. This is why it is important to anticipate environments that contain allergens and take antihistamines before you are exposed to the allergen.
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