Medicines Improve your Understanding and your Health Lung Health Patient Education Day 2015 Marina Lyne Pharmacist, Launceston General Hospital
What we will discuss Medicines how they work Potential interactions food, herbs and over the counter medications Respiratory medications Optimising therapy
Routes of administration Oral Inhaled Topical Transdermal Rectally Vaginally Injected
Medications: how they work Optimal efficacy with minimal toxicity Administration of a drug depends on: Absorption substance entering the blood stream Distribution - the dispersion of substances throughout the fluids and tissues of the body. Metabolism - breakdown of the medication into active components or waste products. Excretion - the removal of the substances from the body
Chronic conditions and compliance Adherence, Concordance and Persistence > 10% prescription medicines dispensed are never used Poor compliance with 30-60% prescription medicines after six months Up to 90% asthma/copd patients show incorrect inhaler technique Up to 25% patients never get adequate instruction
Understand your medicines Know what your medicine is for Know what effects and possible side effects to expect Understand the severity of your condition Know your options for administration of medications Ask your pharmacist questions and get a CMI (Consumer Medicines Information leaflet)
Can I take it with food? Generally: food slows absorption delays time to reach optimum blood levels reduces likelihood of gastric side effects Always check with your pharmacist if you are unsure as food can affect absorption of some medications more than others.
What else can affect your medications? Grapefruit: chemicals in grapefruit juice and grapefruit pulp interfere with the enzymes that break down (metabolise) various drugs in the digestive system Alcohol: It s not always a problem, but caution necessary - especially with sedatives, antidepressants, some antimicrobials and some medications for diabetes
Herbal medications are they safe? If they work, they can have side effects and interactions with your regular medications: Echinacea St John s wort Black cohosh Chamomile Bee pollen products Glucosamine Speak with your pharmacist if you start any new medications
Respiratory medications - Inhalers Relievers: Fast acting medications that give quick relief of asthma symptoms Possible side effects include: increased heart rate, sometimes felt as palpitations muscle tremor (shaking, especially in the hands), and/or slight feelings of anxiety or nervousness
Respiratory medications - Inhalers Preventer: Make the airways less sensitive, reduce redness and swelling and help to dry up mucus Need to be used regularly to reduce shortness of breath, may take a few weeks to have full affect. Possible side effects include: sore throat hoarse voice and/or oral thrush
Inhaler technique Up to 25% of asthma and COPD patients do not get adequate instruction Up to 90% of patients demonstrate incorrect technique Studies show underuse of preventers and overuse of relievers
Why should I use a spacer? 70% more medication gets into your lungs than if you use a puffer on its own. They reduce the local side effects of inhaled steroids in preventer medications, because less of the medication sticks in your mouth and throat You don t need to coordinate pressing your puffer and breathing in at the same time
How to use a spacer 1. Remove puffer cap, shake puffer well, then attach puffer to end of spacer 2. Press down on the puffer to activate dose 3. Breathe out gently 4. Seal your lips around the mouthpiece (or put the mask over your child s mouth and nose) 5. take a long, slow, deep breath in 6. hold your breath for at least 5 seconds, or as long as is comfortable 7. breathe out 8. repeat if you need more puffs of medication.
New Inhalers Symbicort is now available in: rapihaler (metered dose inhaler) and turbuhaler (dry powder inhalation) Rapihaler: can be used with spacer as with other MDIs Turbuhaler: requires breath activation, do not need to hold breath after dose A lot of the new inhalers have an expiry of 90 days after opening foil packaging, please be aware of this when opening new inhalers
Devices NEBULISER: A nebuliser pushes compressed air through liquid medication, which makes it a mist. inhaled through either a face mask or a mouthpiece. A standard dose of medication takes 5-10 minutes to be inhaled.
What to avoid Smoking: Smoking and exposure to smoke (passive smoking) can damage your lungs, and stop them from working properly 1) Increases mucus - more mucus-producing cells and glands grow in the airway walls - damages and reduces parts of the airways that help to clear mucus 2) Damages the airways - chemicals in cigarette smoke destroy lung tissue and also make the airways less elastic and therefore more narrow - causes inflammation in the airways
Trust your pharmacist! Questions?
Acknowledgements National Asthma Council Australia http://www.nationalasthma.org.au/ Asthma Foundation Australia http://asthmaaustralia.org.au/ Lung Foundation Australia http://lungfoundation.com.au/ John Bell Pharmaceutical Society of Australia