Castletown Chemist Health Information

Preparing for a cold change

Most of Australia is still trying to cope with the hot, humid conditions of summer; but with the inevitable cooler temperatures accompanying the arrival of autumn and winter, we’ll soon be thinking more about coughs and colds and how to best treat them.

This year, along with the change in the weather, there’s a regulatory change in the way some popular cold remedies can be purchased.

Over the last few decades there has been a world-wide trend towards the “self care” model where each of us individually takes greater responsibility for our own health and well being. The move to this model has been made easier by having potent, safe and effective medicines more freely available.

Many medicines, previously available only on prescription, are now available directly from pharmacies. This list includes medicines for hair loss, heartburn and haemorrhoids; preparations to treat migraine and mouth ulcers; and treatments for dandruff, thrush and other fungal infections. In this context it might seem strange that certain medicines, quite commonly used for the relief of the symptoms of coughs and colds, will be somewhat more difficult to obtain.

As from 1 January this year, all medicines containing the decongestant pseudoephedrine have to be provided personally by the pharmacist – self selection of these products will not be permitted. And from 1 April some of these medicines will revert to prescription-only status. Why is this so? Well, it’s certainly not because pseudoephedrine is dangerous, toxic or somehow unsafe. Whilst pseudoephedrine is not suitable for everyone, particularly if you are taking other prescription medicines, for most people it is very safe and effective. It can be taken alone or in conjunction with antihistamines, pain relievers and cough suppressants for the relief of nasal congestion associated with hayfever or the common cold.

In fact the problem is not with pseudoephedrine itself, but rather with what it can be made into. For many years Australian law enforcement agencies have been concerned about the purchase of medicines containing pseudoephedrine for the purpose of manufacturing methylamphetamine – one of the central nervous system stimulant drugs of abuse.

Despite some controls over the sale of pseudoephedrine products which were put in place in 2002, there has been an increase in the use of methylamphetamine and the number of “backyard” laboratories making the drug (generally from pseudoephedrine as a raw material).

Amphetamine was first manufactured in the late 19th century and by the 1930s was used medically to treat a number of conditions such as alcoholism and schizophrenia. Later amphetamines were used in the treatment of asthma, depression and obesity.

Methylamphetamine, developed originally in Japan in 1919, was first of all used for the emergency treatment of sedative overdose. Subsequently the drug was given to military personnel during World War II to increase performance and endurance, but addiction become widespread. By the 1960s and 70s it was well recognised that any therapeutic benefits which amphetamine provided were short lived and serious adverse effects were apparent with long term use. Problems include physical and psychological dependence, sleep disorders and mental disturbance. Controls on manufacture and supply were then introduced.

These new restrictions on the sale of some cough and cold treatments, therefore, aim to make diversion for illicit use more difficult whilst still maintaining availability of effective medicines for genuine consumers. Some of the popular cough/cold medicines will be reformulated; most will remain available in their original form, but you will need to ask your pharmacist for them. In most States, your name and address will be required.

So your purchase may take a little longer but you can be sure your pharmacist can offer you the best product to suit your individual symptoms.

Pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information can give you more advice. Call 1300 369 772 for the nearest location.

Hatching up a treatment for head lice

With school now back in full swing, children will be meeting old friends and making some new friends too. Probably, “sleep-overs” will again become part of the school-year landscape. But, beware, you could be entertaining some uninvited guests as well.

According to statistics from the NSW Health Department, more than 20% of primary school students are likely to have head lice; and it’s unlikely these statistics would vary too much from state to state.

Given the number of enquiries in pharmacies, it seems quite possible that eradication of head lice is one of the most frustrating problems encountered by parents.

The fact is anyone with a head can catch head lice – regardless of age, sex, background or how clean your hair is. Head lice spread anywhere that people work, play and live together. Most often children get them at school – often at the start of school. Indeed, it takes only one infested head to infest a whole classroom full of heads; then our children so unselfishly pass the infestation on to the rest of the family.

Head lice are wingless insects that make their home in the hair. Their favourite hiding places are behind the ears and at the back of the neck. Female lice lay their eggs (known as nits) close to the scalp, where they remain firmly stuck to the base of the hair shaft until they hatch in about a week’s time.

Head lice actually survive by feeding on blood they suck from the scalp – in a similar way to a mosquito. Unlike mosquitos, it appears head lice do not carry disease.

However, they can cause severe itching and this can lead to scratching and skin infections.

The good news is that if you or your children have head lice, there are simple, safe and effective ways to manage the problem. Various shampoos, lotions, cream rinses and conditioners are available. Your pharmacist can advise you about which is best for you. Head lice can become resistant, and if you have used treatments before it may be desirable to change to one with a different active ingredient.

Head lice are apparently on the increase. No wonder, then, as we search for information about an effective treatment, the Pharmacy Self Care fact card on head lice has become one of the most sought after.

The recently revised Head Lice fact card explains the various treatment options and how to get the best effect from the treatment you choose. The card is one in the series available from all pharmacies providing the Pharmaceutical Society’s health information.

Another good source of information is the Nitbusters website. Nitbusters is a joint project in NSW between the Health Department, the Department of Education and Training and the Federation of Parents & Citizens Associations. Nitbusters is aimed not so much at eradicating head lice, because there is no evidence that any one treatment will kill all lice and eggs, but more realistically at identifying and managing head lice.

Remember whatever head lice treatment you choose, a fine toothcomb is essential to get the nits out and a good hair conditioner will get rid of the knots.

If you find dead lice, the product has worked; but you will need to retreat in 7-10 days to catch the lice that have since emerged from newly hatched eggs. For persistent cases, discuss with your pharmacist whether you need to change the treatment to another with a different active ingredient; and consider a “Nitbuster” program at your school.

In any event, for the best advice about busting nits, call into a Self Care Pharmacy and pick up the Head Lice fact card.

Save your own skin

The need for adequate intake of vitamins by way of regular diet has been well established for over 100 years. There is no doubt vitamins play an important role in maintaining health and in the prevention of disease.

The use of vitamin supplements, particularly as therapeutic agents – that is agents acting as medicines to treat specific diseases – is somewhat more controversial. What dose, how often, and for how long, are questions the answers to which, in many cases, are not all that clear.

Most often recently, it’s been the so-called antioxidant vitamins – A, C and E – which have received the most publicity. Now, it seems, it’s the turn of Vitamin D.

An article in this month’s edition of the American Journal of Public Health suggests that daily supplementation with 1000 international units (about 25 micrograms) of Vitamin D3 has the protective effect with regard to certain cancers. A reduction in the incidence of colon, breast, prostate and ovarian cancers might be expected, according to researchers at the Moores Cancer Centre, University of California, San Diego.

The study claims that some 18 cancers occur more frequently in the northern states of the US than in the sunnier south. This is explained by the fact that most Vitamin D is manufactured in the body by exposure to sunlight.

In just about everywhere in Australia 10-15 minutes in the sun each day will be sufficient to generate more than the required amount of Vitamin D. However, following release of the report in the UK, some doctors there were recommending either supplements or sunbaking.

Of course, sunbaking in Australia is overkill in the worst possible sense of the word. Sunshine may be hard to come by in Britain and northern Europe and even in the most northerly parts of the USA, but too much Australian sunlight can be very counter productive.

In Australia nearly 400,000 people are treated each year for skin cancer, more than 1300 die; mostly from melanoma – the deadliest form.

Currently the Cancer Council is promoting commonsense for sun lovers with the distribution through pharmacies of the leaflet called “Melanoma: the facts at your fingertips”.

For instance, did you know that more than five sunburns in a lifetime can double your risk of melanoma. Even one severe sunburn, especially in childhood, is a risk factor; and repeated sun exposure has a cumulative adverse effect – the reason why six out of 10 melanomas occur in people over the age of 55.

The good news is 95% of melanomas can be cured; but early diagnosis is essential. So check your skin regularly. Look for a spot, a mole or a freckle that appears different – or maybe a new spot that wasn’t there before. Get to know your skin well. Use mirrors strategically placed to view these hard-to-get-at places, or you might be able to ask your partner to help with a routine inspection.

From the scalp, neck and ears; right down to the feet – the soles, toes and nailbed; the whole body needs not so much a makeover as a thorough going over.

You can get more information at the Cancer Council website or call in to your local Self Care pharmacy to pick up a copy of the fact card titled “Sense in the Sun”. Phone 1300 369 772 for the nearest location.

And if you just never, ever see the light of day; perhaps you’re in hospital or a nursing home, or your religious or cultural traditions mean you’re covered up most of the time; then talk to your doctor or pharmacist about the possible benefits of a Vitamin D supplement.

Minimise the cost of your medicines

Concerned about the cost of prescriptions? Well, who isn’t? However, there are ways you can actually save money on your medicines – this despite the fact that the price of pharmaceutical benefit (PBS) prescriptions has taken quite a jump recently.

Each year, on January 1, there is an increase in cost of PBS prescriptions, that is those subsidised by the Australian Government. Generally this increase is in line with CPI (consumer price index).

The so-called patient “co-payment” for each prescription is now $29.50. However, this is the maximum price you should need to pay. Many medicines may cost less than this; and if you have a concession card issued by Centrelink (Department of Social Security) or the Department of Veterans Affairs, the maximum amount payable is $4.70 per prescription item.

Even at nearly $30 per item, the Pharmaceutical Benefits Scheme still offers us pretty good value for money. Some medicines actually cost many hundreds (occasionally even thousands) of dollars more than the co-payment. The full cost of PBS medicines is now printed on the dispensed label, so an indication of the real cost of each medicine is there for us all to see.

It is now well known that some brands of medicines cost more than others and the government subsidises up to the cost of only the lowest-priced brand. If you choose a more expensive brand, then you will have to pay the difference. A doctor or pharmacist can give more advice about this brand price premium and how to avoid any extra charge. At your request the pharmacist can often substitute a less expensive brand.

Remember all medicines in Australia are required to meet the Therapeutic Goods Administration’s high standards of quality, safety and effectiveness. The standards are exactly the same for the less expensive and the more expensive brands.

In any event, another way of curbing the cost of prescription medicines is for you to keep a record of spending on PBS prescriptions on a Prescription Record Form (PRF). If you have all or most of your prescriptions dispensed at the same pharmacy, the pharmacist will be able to keep a computer record of these transactions. You can use the PRF to keep a record of items occasionally dispensed elsewhere. The regular pharmacist can then add items to the computer list.

When you have a record of spending $960.10 on PBS medicines for yourself and your dependents in a calendar year, the cost of all subsequent items during the year comes back to $4.70 each. This is called the PBS Safety Net. It gives reasonable financial protection for patients and their families if they require a large number of medicines.

For concession card holders, the Safety Net threshold is $253.80 – equivalent to 54 items at $4.70 each – after which there is no charge for any PBS item, provided one of the lowest-priced brands is dispensed.

This year the Government has introduced a modification to the Safety Net procedures. It’s called the “20 day rule”. This means that, for certain medicines, if you need a repeat dispensing within 20 days of the previous supply, the cost may not count towards your Safety Net contributions. And if you’ve already reached your Safety Net level, you may have to pay the pre-Safety Net co-payment amount.

The aim of this new regulation is to reduce medicine wastage as a result of hoarding or inappropriate use. Your pharmacist can provide you with a brochure with more information about the new 20 day rule.

PBS medicines are available not only to all Australian residents but also visitors from countries with which Australia has special health care agreements (United Kingdom, New Zealand, Malta, Italy, The Netherlands, Finland, Sweden and the Republic of Ireland).

If you want some more advice about the savings you can make with the PBS Safety Net and by choosing the less expensive brands of PBS medicines, ask for the Help with Medicine Costs fact card at your local Self Care Pharmacy. Call 1300 369 772 for the nearest location.

Don’t cut down, just quit!

Along with the fun and festivities generally associated with this time of year, we often set aside a little time to reflect on what’s happened during the previous 12 months and make plans for the next.

While cold turkey is what many of us might be consuming for quite a few days along with the other leftovers from Christmas dinner, for some people it’s the strategy used to fulfil one of the more common New Year’s resolutions – that is to quit smoking.

As with all lifestyle and behaviour changes such as exercising more, drinking in moderation and modifying our diet, being able to stop smoking can be really difficult at the best of times. Around December/January when parties or paying bills (or both) make life especially stressful, these kinds of resolutions can be really hard to keep.

Nevertheless, when it comes to smoking, any time is a good time to quit; and it’s never too late. Recent studies have shown that for smokers who quit at age 50 the risk of a tobacco-related death is reduced by about two thirds; and for those who stop before middle age the risk is little more than for non-smokers.

However, becoming and staying a non-smoker doesn’t happen by accident. Smokers who plan before they quit are significantly more successful than those who don’t; and planning can be done quickly and easily. The decision to quit must be yours and yours alone, but to help you plan for long term success you should enlist the support of family and friends. Your pharmacist can also offer you valuable support.

Pharmacists throughout Australia providing the Pharmaceutical Society’s Self Care health information have a series of fact cards offering the best advice on how to quit for good.

If your attempts to quit have so far been unsuccessful, don’t give up; it’s certainly worth what can sometimes seem a bit of a struggle.

Nicotine replacement therapy (NRT) could be an option worth considering. These nicotine substitutes help to treat the withdrawal symptoms and cravings which can make it so difficult to quit.

If you are concerned about the adverse health consequences of smoking, transferring your addiction to the so-called light, mild or low-tar variety of cigarettes is not a good option. Research shows that with these cigarettes smokers change their smoking style to somehow obtain the same amount of tar and nicotine – a message delivered in the current anti-smoking advertising campaign which Australia’s “consumer watchdog” (the ACCC) has forced tobacco companies to fund.

When you do stop smoking, your body will most likely still have a need for nicotine – the addictive component of cigarettes – and this is what creates the urge to smoke again. By taking nicotine in a “clean form” – that is without the dangerous carbon monoxide and tar ingredients – the physical withdrawal symptoms are reduced, allowing you to focus your energies on breaking the smoking habit.

Thus NRT lessens the likelihood of experiencing irritability, tenseness, drowsiness and lack of concentration. Four NRT products are currently available in Australia: patches, gum, inhaler and lozenges.

All these medications are now available from pharmacies without prescription; and a prescription-only product known as bupropion may also be useful for some smokers who want to become committed quitters.

To help you quit, your pharmacist can help you choose the most appropriate product.

Spring clean your medicine cabinet

Recycling is on the rise. This is one of the messages to come from a report released at the time of National Recycling Week, established just 10 years ago by Planet Ark.

Remarkably, the recycling industry now processes more than 11 million tonnes of material each year and to undertake this process the industry employs around 5,000 Australians.

So far that’s all good news; but there is a less attractive side to the story. Apparently we are still quite a wasteful nation. In fact, compared with a selection of a dozen so-called OECD countries, in 2004 Australia was the second most wasteful country surveyed. Statistics indicated that we produced 690kg of waste for every man, woman and child – more than any other country but one, the United States of America.

There are several things that should never end up in the rubbish dump; and amongst these are medicines. Nor should medicines be recycled. Keeping old medicines can be a health risk, and disposing of unwanted medicines inappropriately can also pose a risk to the environment.

We Australians are certainly a nation of hoarders. That may be great for some things – items of furniture perhaps, that might gain in antique status – bottles of wine that mature with age – and there are those unique collectible items such as stamps and coins that appreciate in value as time goes by.

There’s no financial benefit, however, in collecting medicines. In fact, there are some significant problems associated with having old or unwanted medicines lying around the house.

It seems obvious that if your medicine cabinet is ‘choc-a-block’ with medicines there’s a chance of confusion and misadventure – even more so if those medicines are not stored correctly. They must be out of sight, out of mind and out of reach of kids and grandkids.

And while children may be at special risk by swallowing a little (or a lot) of this and that – just out of curiosity, it is also easy enough for us adults to get confused with a cupboard full of alternatives.

So what do we do to ensure our homes are safe from medication misadventure? Well, what we don’t do is flush our unwanted medicines down the toilet or the kitchen sink; nor do we dispose of them in the household garbage.

We should not assume that sewage treatment plants can effectively treat all substances contained in medicines and we don’t want fish and other aquatic life suffering the side effects of medicines we no longer want.

The only safe method of disposal is to return your unwanted medicines to your local pharmacy. Medicine collection bins funded by the Commonwealth Government have been placed in every pharmacy in Australia. Once full, they are removed and the contents safely destroyed. It’s all part of the RUM (Return Unwanted Medicines) campaign.

Each month the RUM program helps to prevent about 30 tonnes of medicines from potentially harming our environment or possibly harming us as well.

Why not give your medicine chest a bit of a spring clean? For more information about RUM or simply to get some advice on how to sort your medicines and manage them better, call into your local Self Care Pharmacy. Phone the Pharmaceutical Society on 1 300 369 772 for the nearest location.

The rights and thongs of healthy feet

Depending on where you live in the world, the word thong can describe quite different articles of clothing. In Australia, it generally applies to that very casual flip-floppy type of footwear.

Comfortable? Perhaps; but possibly a health hazard. This was one of the messages to come from the recent National Foot Health Week.

Maybe a walk in thongs down to the beach or around the pool at weekends is reasonable, however the Australian Podiatry Association has warned against constant daily wear. According to spokesperson for the Association, Victorian podiatrist Matthew Dilnot, “There is no support in the thong; there are a lot of people who struggle with them and they end up doing long-term damage. As a regular daily thing you are better off wearing sandals.”

The theme for “foot week” was “walking is the best medicine for feet”; and for most of us walking is a pleasant and reasonably easy way to maintain overall physical fitness.

You won’t quite manage to get around the world in 80 days by walking; but, over a lifetime, even the average walker will chalk up about 130,000 km – that’s a circumnavigation of the earth three times! Ideally, each and every one of us should take about 10,000 steps every day.

With this immense responsibility for travel, it’s no wonder that the feet can be described as fairly complicated pieces of machinery. Fifty-two bones, a quarter of all the body’s bones, are in the feet; and on a nice summer’s day the feet produce around 500ml of perspiration by way of the 250,000 sweat glands.

Of course all that perspiration can produce a few problems of its own. The warm, moist environment enclosed within either our joggers or business shoes can lead to some nasty fungal infections – infections that will become more visible now the increase in temperature means the wearing of sandals and open-toed shoes. Athlete’s foot is certainly not exclusive to athletes’ feet. We are all potential sufferers.

Tinea pedis, as athletes foot is more correctly called, can be itchy and irritating. In the more severe cases, pain sometimes becomes a symptom, too.

Fortunately, effective treatments for tinea are now available. But the secret of success is persistence and perseverance. Products such as Clonea, Daktarin, Resolve or Lamisil – available in various forms: creams, gels, sprays and lotions – need to be used appropriately to get best results and to prevent recurrence of infection.

Fungal infection of the nail, particularly the toe nail, can be somewhat more difficult to eradicate. Onychomycosis is the medical term to describe this condition, but the more colourful description of “nail rot” is sometimes used. If your nails are yellow, cracked or crumbling, then you may be one of the 800,000 or so Australians with a fungal nail infection.

There are a couple of ways to get rid of nail rot; but it does require a commitment. Severe infections may require the prescription-only tablets containing terbinafine, while moderately infected nails usually respond well to topical treatments. Of these, the convenient, once-a-week treatment with Loceryl nail lacquer seems to offer the best results.

If you want to indulge in some carefree and comfortable walking this summer, free from the itch, irritation and ugliness of fungal infections, you can get some good advice from your local Self Care Pharmacy. Call the Pharmaceutical Society on 1300 369 772 for the nearest location.

For more detail on fixing fungal nail infections for good, check out the web site www.nailtherot.com.au And, if you want to make sure your feet are fit for walking, or simply want to make a fashion statement, remember thongs of any size, shape or form should rarely be seen.