Pharmacist Corner

What is the relationship of chickenpox and shingles? Is there a vaccine for shingles?

  • Both chickenpox and shingles are caused by the same virus, varicella-zoster. Once a person has had chickenpox, the virus remains in the body permanently, but silently. As the person gets older, the chances of the virus getting reactivated to cause herpes zoster, or shingles, increases. Shingles causes painful rash with blisters, that may accompany with burning sensation, fatigue, and itching. Pain from the rash may persist even after the rash is gone, this is called postherpetic neuralgia. 
  • There are two shingles vaccines approved:
    • Zostavax -- 1 dose for anyone 60 years and older
    • Shingrix (newer vaccine) -- 2 doses, separated by 2 to 6 months, for anyone 50 years and older

The Key to Staying on Schedule with Your Daily Medications

If you take a medication (or more than one) every single day, is it really such a big deal if you miss a day now and then?  Will your health be harmed if you skip a pill on occasion, either by accident or by purpose?

The answer is yes!

If you have a chronic health condition, such as high blood pressure or high cholesterol as just two common examples, you have that condition every single day.  It doesn’t come and go like a common cold, and unfortunately, it’s not likely to get better on its own (although for many conditions, proper diet and exercise can help maintain your health and manage chronic disease).

Because your health condition doesn’t go away, adherence to therapy – which means taking your medication exactly as prescribed every single day – is critically important.   Adherence to therapy helps to effectively manage your illness to prevent the disease from progressing.  It also reduces the number of times you have to see your doctor, and reduces the risk of visits to the ER and longer-term hospitalization.  And, staying healthy saves you money, which is certainly a nice additional benefit! Also, if you are taking a long term medication and see that your symptoms (high blood pressure, high cholesterol, ….) are better, that doesn't mean you can stop taking the medication.  This means the medication is working.  So keep it up!

There are several factors that can lead to poor adherence to medication schedules.  Here’s a list of a few factors, and what you can do to “stay on schedule” no matter what:

  1. Patient factors. This includes lack of understanding of your prescriptions, what they do, or how often you should take them.  The solution to this is quite simply to ask!  Whenever you are given a new prescription, ask the doctor or the pharmacist to explain it to you, including exactly when you should take it, and any side effects or interactions with other drugs, vitamins, foods/drinks you should be aware of.
  2. Doctor considerations. Patients often see multiple doctors, and each visit with a doctor can be short and sometimes confusing.  This can lead to potentially harmful drug interactions, as well as lack of understanding of how and when a medication should be taken.  As stated above, the solution is to ask questions.  Have a list of all your medications with you, to review with each doctor you see.  Whenever you are given a new medication, review the entire list, and ask your doctor questions until you fully understand what you are taking, how often, and why.  And if you have questions after you leave the doctor’s office, don’t hesitate to ask the pharmacist. 
  3. Health care system issues. The U.S. health care system is fragmented, and various providers, and routine/urgent care centers, don’t always communicate effectively with each other.  For this reason, it is important for the patient, or a friend or family member, to help coordinate care.  This means reviewing your medication list with each provider you see (carry the list with you at all times).  If you provide your list of medications to your pharmacist as well, he or she can help you manage your prescriptions and avoid interactions.

In summary, the more you know about your medications and the more you talk with your health care providers and pharmacists, the better your health will be.

Why do we not hear about chickenpox anymore?

  • Chickenpox is caused by the varicella-zoster virus. The most common symptom of chickenpox is a rash that usually forms itchy blisters. Because it is very easy to catch chickenpox from an infected person, almost every adult in the U.S. has been infected.
  • The chickenpox (Varicella) vaccine (Varivax) was licensed and available in the U.S. in 1995. Since then, the chickenpox cases have dropped more than 95%. Two doses of the vaccine is recommended for all children 12 months through 12 years of age, first dose at 12 months of age, and second dose at 4-6 years of age (at least 3 months after the first dose). Everyone age 13 years and older who has never had chickenpox, and did not get the vaccine when they were younger, should also get two doses at least 28 days apart. 

Tick Repellent

Wearing a tick repellent while outside is a key component of prevention. Follow these steps for proper application:

  • Read the label to determine how much you need to apply.
  • Use only on exposed skin or clothing and do not apply under clothes.
  • Avoid the eyes and mouth.
  • Use only small amounts around the ears.
  • Avoid applying to damaged skin.
  • Put sunscreen on first, if needed, and repellent second.
  • Do not breathe in spray products.
  • Do not use around food and drinks or pets.
  • Keep out of children’s reach.
  • Wash product off your skin and clothes when you return indoors.

Other Measures

In addition to repellent, there are several other recommended measures to avoid tick bites:

  • Wear long sleeves and pants. Tuck your pants into your socks.
  • Check for ticks daily. Be sure to also check your pets for ticks.
  • Walk in the center of trails and avoid tall grass and brush.
  • Shower soon after returning indoors.
  • If you see ticks on your clothes, wash them in hot water and tumble dry on high heat for 10 minutes.

What to Do When You Find a Tick

Should you find a tick on your skin, the goal is to remove it as soon as possible. Follow these tips for safe tick removal:

  • Use fine-tipped tweezers to firmly hold the tick as close to the skin as possible.
  • Pull straight up without twisting, jerking or crushing the tick.
  • If mouth-parts remain, let the skin heal. The parts will be expelled on their own. Avoid causing excessive skin damage.
  • Clean the area with soap and water or rubbing alcohol after tick removal.
  • Discard the tick by placing it in alcohol, sealing it in a bag, wrapping it in tape or flushing it down the toilet.

If you follow these tips for preventing and handling tick bites, your chance of contracting Lyme disease may decrease. Still, be on the lookout for flu-like symptoms or a rash resembling a bullseye. These symptoms may indicate Lyme disease.

Whether or not you recall getting a tick bite, if you experience any of the symptoms of Lyme disease, see your health care provider right away.

Do You Drink Enough Water?

Are you drinking enough water? Sometimes, it can be hard to tell whether you're getting enough water to stay healthy.  People tend to forget the health benefits of water, but it's important to remember that water benefits your body in many ways.

Drinking water gets rid of waste through urination, sweating and bowel movements. Water protects joints and keeps the body’s temperature normal. It also protects the spinal cord and other sensitive tissues in the body.

Drinking too little water can lead to dehydration. Dehydration symptoms include the following:

  • Dizziness
  • Nausea or vomiting
  • Muscle cramps
  • Dry mouth
  • Fast heartbeat

Dehydration can become severe. If you experience the following symptoms of severe dehydration, seek emergency medical attention immediately:

  • Confusion
  • Weakness
  • Loss of consciousness

If your body is dehydrated and can’t cool itself properly, you can experience heat illness. This involves three stages: heat cramps, heat exhaustion and heat stroke. Read more on heat-related illnesses here.

On average, the recommended daily fluid intake for men is about 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) for women.

However, the recommended daily water intake is different for everyone — water consumption is not one size fits all. Factors like how hot and humid it is outside, how much you exercise, your sweat rate, how active you are and pregnancy will determine how much water you should drink.

That's why it's important to speak with your health care provider about the amount of water you should drink every day.

When you're determining how much water to drink every day, remember that fluids can come from sources other than water. An estimated 20 percent of daily fluid intake actually comes from the foods you eat. In fact, some foods can provide a significant amount of fluid. Some vegetables and fruits, such as watermelon, are almost 100 percent water by weight.

Even if you don't like the taste of water, there are many ways to get your recommended daily fluid intake. Here are some ideas to increase your intake:

  • Add lemon or cucumber slices to water to make the taste more appealing.
  • Add electrolyte drink mixes to water.
  • Drink flavored sparkling water.
  • Drink low-fat milk, teas or low-sugar juices.

icon test

  • Eat fruits and vegetables that contain a lot of water, such as watermelon, spinach and celery.

Summer Full of Bites and Stings

Summer means spending lots of time outdoors, whether you are on the river, playing in the yard, or just relaxing on the porch.  It also means lots of opportunities for bites and stings from bugs and wildlife.  We've compiled some tips to prevent and treat all sorts of bites and stings that you may encounter during these hot summer days.

How to treat bug bites:

The best ways to prevent bug bites are to apply insect repellents that contain at least 20 to 30 percent DEET, cover exposed skin with long sleeves and pants and wear close-toed shoes.

If you've been bitten, you can treat the bite as follows:

  1. 1.Use water and soap to wash the bite.
  2. 2. Apply over-the-counter creams, such as calamine or hydrocortisone, to stop the itch.
  3. 3. If it still itches, consider taking an oral antihistamine, such as diphenhydramine
  4. 4. Avoid scratching!
  5. 5. Use an ice pack to reduce the swelling.
  6. 6. If you start experiencing symptoms like fever, rash or body aches, tell your health care provider right away.

How to treat bee stings:

  1. 1. Remove the stinger by scraping it with your fingernail or some gauze. Do not use tweezers. Tweezers can release the venom from the stinger.
  2. 2. Wash the area with water and soap.
  3. 3. Use an ice pack to reduce the swelling.
  4. 4. If the sting hurts, consider taking ibuprofen (Advil) or acetaminophen (Tylenol) to treat the pain.
  5. 5.If you start experiencing signs of an allergic reaction, such as swelling in other parts of the body, nausea, hives or difficulty breathing, go to the emergency room right away.

Back-to-School Health Tips for Kids

Another school year has started.  How should you prepare your kids for school?  Here are some important health issues to be aware of as you get your children school-ready.

Head Lice

These parasitic insects are mostly found among human hairs. They feed on blood from the scalp. They are highly contagious and spread through head-to-head contact. Classic symptoms include constant scratching of the head that does not subside, small red bumps and a rash. If you notice any of these symptoms, inspect the scalp for any tiny yellow or brown lice eggs or for grayish-white, sesame seed-sized lice.

Talk to your health care provider to come up with a plan to best treat your child and household. Treatment can vary, depending on your child’s age and what you have previously tried.

Before school starts, tell your child to avoid head-to-head contact, not to share personal items that touch the hair, and not to lie on things or places used by someone with lice. Finally, check the school’s return policy, which in most cases only requires one topical treatment before returning to school.

Back Problems

Even with lockers at school, increasing school loads are forcing children to carry heavier bags. If your children’s bags look too heavy, there may be cause for concern.

When carrying heavy shoulder bags, there is uneven weight on the shoulders. While the short-term effects of soreness may be nothing unusual, in the long term, a heavy shoulder bag can contribute to the spine curving sideways, a condition known as scoliosis.

On the other hand, backpacks pull you backward instead of sideways. This can contribute to a condition called kyphosis, also known as a hunchback, due to the effort to hunch forward while carrying the backpack.

Bags should be less than 10 percent of the carrier's body weight. If a heavier bag is unavoidable, try using larger straps or carrying shoulder bags closer to the body and alternating sides.

Vision Problems

Vision change happens frequently in children and can lead to problems with behavior and attention in the classroom. Because simple vision screenings at school cannot detect the actual health of the eyes, you may want to have your kids take a complete eye exam before school starts.

For sports and outdoor activities, make sure your child wears proper, well-fitting eye protection. Also, teach your child to follow the 20-20-20 rule when using digital devices. This means taking 20-second breaks every 20 minutes and looking at something 20 feet away during the breaks.

Most health insurance policies cover pediatric eye exams. If you notice any vision problems in your child, such as squinting, headaches, holding books close to the face or a short attention span, schedule an appointment with an optometrist.

We need your help!! We are starting a “Pharmacist Corner” on our website/ facebook page. Questions will be answered by one of our pharmacists and posted. Don’t worry we won’t share who ask question on post. What do you want to ask or know more about? Please send questions via PM here or email to Feel free to share with your friends and invite them to like our facebook page.

Last Updated: 9/13/2018