My latest Medcast: a discussion of the association between Proton Pump Inhibitors and infectious diarrhea. 

Nice informational video about statin medications. 

Hello,

Please note my terms of use prior to interpreting the information below.

Stimulants (like Adderall) are the most effective treatment for ADD/ADHD. If you tolerated it ok, and did not experience any significant side effects, that is still probably the best way to go. 

Alternative non-stimulant drugs include Strattera as you mentioned, as well as guanfacine. Neither are as effective as stimulants, but they do have the advantage of not carrying as much abuse potential or sleep disturbance. Guanfacine can be quite sedating though, which may be a drawback. Another option is the antidepressant drug bupropion, although it has problems of its own (such as a risk of seizures) and it doesn’t have much data for effectiveness in adults.

Let me know if you would like further clarification.

-Aaron Emmel, Pharm.D., BCNSP, BCPS

RxEconsult interviews Dr. Aaron Emmel about his medication therapy management business, SmarterMeds.

Good afternoon to you.

The terms of this blog apply to this post.

Well, I am not sure what kind of pain medications you are referring to. Regardless though, it really doesn’t matter as there shouldn’t be any drug interaction between nicotine and either narcotic pain medications, acetaminophen, or NSAIDs. The only concern I can think of would be with certain migraine medications (the “triptans” and Migranal), as nicotine may enhance their cardiovascular toxicity. 

So the fact that you are on a nicotine patch really wouldn’t effect the safety of the pain pills otherwise. 

Good luck!

-Aaron

Thank you!

I have never been involved in the admissions process, so I couldn’t give you a concrete answer. But I imagine, that all other things being equal, the person with the certification will look better since the college knows that person has a true interest in pharmacy. If it doesn’t interfere with your schoolwork or delay your application, you may want to consider it. 

US News did a ranking of pharmacy colleges several years ago, based on survey data from those in the academic field. 

http://grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-health-schools/pharmacy-rankings

I would apply to as many as possible, in whichever locations you’d be willing to go to. Pharmacy school has become very competitive, so you’ll have a better chance of getting in the more you apply. 

The school that you go to doesn’t make as much of a difference in your education as your own personal attitude towards the process. Just remember that the more you learn and the more proficient you become, the better off your patients will be. 

Good luck!

-Aaron

Perhaps outside the scope of my pharmacist blog, but I will tackle this question since I maintain board certification in nutrition support:

Honestly, I am not familiar with this strategy. I did a quick search on “cleansing” diets, and I have to say they appear to be nothing short of ridiculous. Also, a pubmed search of the terms “colon cleanse”, “cleansing diets”, “detox diet”, etc. turns up only information pertaining to evacuating the colon prior to colonoscopy. None of the websites I browsed that promote the diets cite any reliable scientific evidence of safety or benefit. 

It would not be healthy at all if sustained for any significant period. The body needs protein to avoid catabolism, and sufficient protein intake is unlikely to occur from a diet restricted to fruits and vegetables. Additionally, the body needs certain fatty acids to sustain life. Once again, unless a significant quantity of avacados were consumed, this is not likely to occur from that type of diet. 

A healthy diet will contain a various foods choices from all of the food groups. Studies have suggested that diets plentiful in fruits and vegetables may reduce the risk for certain cancers and cardiovascular disease, so they are an extremely important component of a healthy diet. But eliminating all other food groups is not a good idea. 

I think it is safe to state that there is no evidence to support any health benefit or sustained weight loss from the use of a cleansing diet. Looks to me like another case of some clowns trying to make money utilizing a “snake oil” approach to promoting health. 

Hope this helps!

Aaron Emmel, Pharm.D., BCNSP, BCPS

I know I’m a little late on this one…sorry! I didn’t really address the issue with iron, but I will say that most are probably best getting one w/out unless you have either been diagnosed with an iron deficiency or are a premenopausal woman. That is, if you are going to take a multivitamin at all (watch the video!).

First, let me preface that it has been years since I have worked in retail pharmacy. The initial figure you threw out is probably fairly close. Most structure their pharmacists as salaried employees, with additional shifts categorized as overtime (with or without an added premium). Given how tight the current job market is, however, I doubt there is much overtime available at all. Some chain retail pharmacies in some areas are only offering sub 40 hour/week contracts to new grads. 

I also believe that we are not going to continue to see the same types of salary increases we have been seeing for years. The market has been flooded with pharmacists, so the demand isn’t as high as it has historically been. Also, payment to health care providers is changing in general towards a pay-for-performance model. This has the opportunity to benefit us in the long run, so long as enough pharmacists are willing to step up to the plate to prove our value as providers of clinically and economically valuable services. Otherwise, I would not be surprised to see our average salaries plateau or even decline (as it did with physical therapists). 

A bit of advice:

Do not focus on the salary! You will earn a decent living as a pharmacist no matter what environment you work in. Find what you like to do, and do it. When you are talking about around 6 figures in yearly salary, $10,000 to $20,000 does not make a big difference as far as lifestyle goes. However, once you have established a certain financial lifestyle (through commitments to housing and vehicles, etc.), that $10,000 to $20,000 becomes a big deal and makes it very tough to change directions in the future. Job satisfaction will lend much more towards personal happiness than a 10% difference in salary. Trust me.

I committed myself to a chain drugstore, took scholarship assistance, bought a house, etc. When I faced the grim reality of hating my job, and having an opportunity to do something that would make me much happier (and pay me a good bit less), it was an extremely difficult move to make. Fortunately, I made the right decision…but I can’t imagine many in a similar situation would have to stomach to do it. 

This is not a knock on any particular field of pharmacy practice, but a general issue that I see pharmacy students make time and time again. Given my personal experience with the same, I always try to pass on what I have learned. 

Anyway, best of luck and thanks for checking out the blog. 

-Aaron

Talk to your doctor. While that is a reported side effect of minocycline, it is important to be evaluate for a potential bacterial or fungal infection (which you are at increased risk for while taking an antibiotic such as minocycline). 

Regardless, this sounds like reason enough to talk to your doctor about changing to a different treatment for your acne. There are a plethora of options, so I won’t go into specifics (since it really depends on the particular patient). Unfortunately, this is something that can persist from weeks to months after stopping minocycline.