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Use Caution: Mixing Over-the-Counter Medications Can Be Harmful
When you’re too sick to go to work but not sick enough for a doctor’s visit, over-the-counter medicines are a welcome relief to help alleviate that fever, runny nose or allergies. But because those medicines aren’t signed off on or managed by your doctor and pharmacist, you must be especially mindful of what you put into your body. Whenever you pop a pill, you want to ensure you’re taking the correct dosage, waiting the right amount of time before taking another dose and not mixing certain medicines. Too Much Tylenol/Acetaminophen Tylenol — or acetaminophen — is a popular pain reliever for many, but too much can be bad for your liver. “Our bodies have a finite ability to metabolize Tylenol,” says Andy Wright, clinical pharmacist at Renown Rehabilitation Hospital. “When too much builds up in the liver, it becomes toxic. In patients with medical conditions like cirrhosis of the liver or hepatitis, this could be disastrous.” Remember, acetaminophen is in more than just Tylenol and generic pain relievers. You may also see acetaminophen in flu, cold and cough medicines, like Nyquil, and some prescription medications including Norco and Percocet. Keep a list of the medications you take, and limit daily acetaminophen use to 3,000 mg per day. When you’re scanning medicine bottle contents, remember acetaminophen is also referred to as APAP, AC, acetam or paracetamol. Mixing Painkillers When you’re dealing with pain and not getting any relief, taking a different medication may seem like the easy solution. Maybe you take some Aleve — a form of naproxen — for a headache, but it isn’t working, so you switch to Motrin, an over-the-counter form of ibuprofen. Not a smart idea. Ibuprofen and naproxen along with aspirin are known as nonsteroidal anti-inflammatory drugs (NSAIDS). Because these medicines work in similar ways, they should never be combined or used in larger doses or more frequently than directed. Otherwise your risk of side effects can increase, which range from mild nausea to severe gastrointestinal bleeding. It’s also important to consider your family history when taking NSAIDs because, “recent studies have shown NSAIDs may have greater cardiovascular risks for people taking blood thinners or those with hypertension,” explains Andy. “A good example is ibuprofen: It has a relatively low gastrointestinal bleed risk while it has a moderate to high cardiovascular risk. The opposite is true for naproxen.” Rather than experimenting with multiple medicines, figure out which drug works best for you. You may find muscle soreness improves with aspirin, whereas when a headache hits, naproxen is best. Keep in mind that these medications aren’t always best for everyone in the family. “Aspirin in children and teens is not recommended unless under the supervision of a doctor,” Andy says. And pregnant and lactating women should generally avoid NSAIDS due to risk of birth defects and bleeding. “In both of these cases, acetaminophen or Tylenol are preferred but only if approved by an OB/GYN.” Fighting Allergies Over-the-counter antihistamines like Claritin, Zyrtec and Allegra have made fighting itchy eyes and runny noses a little easier. But these daily medicines — when taken inappropriately or in the wrong combinations — can also have an adverse effect. Similar to acetaminophen, you need to watch for antihistamines in other products. Sleep aids — like Tylenol PM and Unisom — commonly use an antihistamine known as diphenhydramine, which may increase your risk of overdose. “Combining antihistamines, or overdosing, can cause many adverse effects including dry mouth, blurred vision — even arrhythmias,” Andy says. “Only take these medications on their own.” If you’re still struggling with symptoms, you can talk to your doctor about adding an over-the-counter nasal steroid. Andy confirms the importance of closely following the directions listed on antihistamine (and all medicine) bottles. He has seen extended release nasal decongestants cause significant arrhythmias requiring medical care after a patient took the medicine with warm fluids. “The decongestant in question is designed to slowly release, but it can dissolve suddenly in the presence of warm liquids like coffee,” Andy explains. “This can cause the pill to deliver 12 to 24 hours of medication all at once.” Taking an Antidiarrheal with Calcium Calcium supplements and antidiarrheal medicines are another harmful combination. Calcium firms up your stool, but if taken with an antidiarrheal, can cause severe constipation. If you need to take an antidiarrheal, take a break from your calcium for a few days until you’re back to normal. Another consideration when taking calcium supplements or calcium-based antacids is gas. “I’ve had several patients report cases of excessive gas using Tums or calcium carbonate-based supplements.” Andy suggests instead “trying Maalox or Mylanta for indigestion and Citracal as a supplement.” Talk with Your Doctor or Pharmacist About Your Medications If over-the-counter drugs aren’t providing the relief you need, it’s time to see your doctor. And remember, for your safety it is important to keep your doctor and pharmacist up-to-date with any medications — prescribed or over-the-counter — that you are taking.
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Addressing Health Equity for Communities of Color
Area Church Pastors, the City of Reno, the City of Sparks, the Washoe County School District, REMSA and Renown will be available to discuss the impact of COVID-19 on communities of color, and how they have joined together to provide free COVID-19 testing to area residents. WHAT Media is invited to interview community leaders to learn how we are coming together to address health disparities and promote equity in healthcare access and delivery. The first project to support our community and address health equity is to partner with area pastors to provide free COVID-19 nasal swab testing for adults and children of faith-based organizations, churches and school children. The first drive-through/walk-up test site will be hosted on Saturday, September 26 from 1-4 p.m., at Ministerio Palabra de Vida by Pastor Cesar Minera. Testing will be offered for members of Ministerio Palabra de Vida (Word of Life Ministries) and A.M.E.N. (Asociacion de Ministros Evangelicos de Nevada), a network of over 15 churches in the Reno, Sparks and Carson City area, as well as WCSD students and families living in that area. REMSA staff will conduct the nasal swab testing and Renown Health will process the tests. Having symptoms of COVID-19 is not required to get tested. WHEN Thursday, September 24 at 1:45 p.m. WHERE Ministerio Palabra de Vida 2375 S Virginia St, Reno, NV 89502 VISUAL & INTERVIEW OPPORTUNITIES Pastor Cesar Minera A member of the church congregation Representatives from the City of Reno (Vice Mayor Reese), City of Sparks, WCSD, REMSA and Renown Health WHY According to the American Hospital Association, the COVID-19 pandemic is disproportionately affecting our Black, Indigenous and people of color communities. Black and Latino Americans are three times more likely than white people to contract COVID-19. The Centers for Disease Control and Prevention reports the COVID-19 hospitalization rate for Black and Latino persons also face similar grim hospitalization rates, 4.7 and 4.6 times higher, respectively, compared to white persons. Black people are dying at a rate nearly two times higher (24%) than their share of the population (13%), and, in 42 states, including Nevada, Latino people make up a greater share of confirmed cases than their share of the population, according to the COVID Data Tracking Project at The Atlantic. In support of Governor Sisolak’s proclamation of Racism as a Public Health Crisis, a partnership of faithbased organizations, churches and Pastors, along with community leaders recognize that it is critical to change the culture of medicine by addressing racism and implicit biases that contribute to health disparities. The group of northern Nevada community leaders includes; Reno Mayor Hillary Schieve; Sparks City Counselman Kristopher Dahir, Chaplain for the Northern Nevada Veterans Home, and Board President of Excel Christian School; Angela D. Taylor, Ph.D. of Washoe County School District's Board of Trustees, an ordained minister and assistant Pastor at Greater Light Christian Center; Senior Pastor Cesar Minera of Ministerio Palabra de Vida (Word of Life Ministries) and President of A.M.E.N. (Asociacion de Ministros Evangelicos de Nevada), a network of over 15 churches in the Reno, Sparks and Carson City area; Pastor Nathan DuPree of Living Stones Church and executive director of 360 Blueprint, a collaboration of the local law enforcement agencies, the Washoe County School District and local community leaders, and co-chairman of the African American Clergy Council of Northern Nevada (AACCoNN), faith-based organizations, churches and Pastors uniting to support our community focusing on families, health, education, job development, and crime prevention; Norris DuPree, Jr., Ph.D. and President of Transformations Therapy and Behavioral Consultation; Pastor DeSean Horne of Second Baptist Church, Dean Dow, MBA, CMTE, President & CEO of REMSA and Anthony Slonim, MD, DrPH, President & CEO of Renown. The first project to support our community to address health equity is to partner with area pastors to provide free COVID-19 nasal swab testing for adults and children of faith-based organizations, churches and school children of the WCSD. There is no cost to be tested. Those with insurance will be asked to provide an insurance card, all others will be tested free, with thanks to the Renown Community Benefits fund. About Renown Health Renown Health is Reno’s only locally owned, charitable, not-for-profit integrated health network. Being not-for-profit means that all income stays in the community— and is reinvested in programs, people and equipment to improve the health of the community. Renown directly contributes to the community’s overall well-being with a Community Benefit mission to reduce health disparities, promote community wellness and improve access to care for vulnerable populations. This includes offering free and discounted care to those unable to afford healthcare, and partnerships with others to address health and well-being. In partnership with many community-based organizations, area schools, human and social service agencies, and government and business leaders, Renown supports many educational, public health outreach, and community development initiatives throughout Nevada. In FY19, Renown Health, a locally-governed, not-for-profit community health network invested more than $158 Million for health education, community initiatives and non-reimbursed healthcare services. In FY20, CEO, Dr. Tony Slonim provided $150,000 in funding to 60 local agencies to support Diversity & Inclusion efforts and Social Determinants of Health.
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Generic Drugs – What You Need to Know About Them
Without a doubt, taking medications can not only be expensive, but also confusing. In the United States, generic prescriptions are widely used, with 9 out of 10 people choosing them over a name brand. Pharmacists are a great resource to help us understand the benefits and side effects of any medication. We asked Adam Porath, PharmD, Vice President of Pharmacy at Renown Health, to answer some common questions about generic drugs. What is a generic drug? A generic drug has the same active ingredients of brand-name drugs. Brand-name drugs have a patent (special license) protecting them from competition to help the drug company recover research and development costs. When the patent expires other manufacturers are able to seek approval for a generic drug. However, the color, shape and inactive elements may be different. Per the U.S. Food & Drug Administration (FDA), a generic medicine works in the same way and provides the same clinical benefit as its brand-name version. Why do they cost less? Generic drug makers do not have the expense of costly development, research, animal and human clinical trials, marketing and advertising. This savings is passed on to the public. Also after a patent expires, several companies will compete on a generic version of a drug, further driving down prices.
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UNR Med and Renown Health Recognize Transgender Day of Remembrance
Medical Students Recognize Transgender Lives Lost to Violence, Address Inequities in Health The month of November includes Transgender Awareness Week, which concludes with Transgender Day of Remembrance (TDOR), on Sunday, November 20, a day for people to come together to recognize the many transgender lives lost to violence over the last year. Transgender people remain one of the most underserved groups of people across several domains, including health care. The Transgender Day of Remembrance and Resilience memorializes people who have passed due to transphobic violence. The Transgender community is an umbrella term used by people who do not identify with the gender associated with the sex they were assigned at birth. Not everyone identifies with the term transgender, and there are many self-identifier terms for people who do not identify with their assigned sex at birth (e.g., woman, man, trans, non-binary, gender nonconforming, gender fluid, gender queer, and more). Transgender Day of Remembrance is held in November to honor Rita Hester, whose murder on Nov. 28, 1998, launched the “Remembering Our Dead” web project and a San Francisco vigil the following year. The event provides a forum for transgender communities and allies to raise awareness of the threat of violence faced by gender variant people and the persistence of prejudice felt by the transgender community. Communities organize events and activities including town hall style "teach-ins," photography and poetry exhibits and candlelit vigils. These activities make anti-transgender violence visible to stakeholders like police, the media, and elected officials. In 2010, TDoR was observed in over 185 cities throughout more than 20 countries. Here in Reno, the University of Nevada, Reno School of Medicine (UNR Med) hosts Diversity Dialogues, a series hosted by the Office of Diversity and Inclusion. This month, the Medical Student Pride Alliance of UNR Med honored transgender people whose lives were lost in acts of anti-transgender violence, that included a medical student-led discussion regarding ways to help raise visibility and awareness for transgender people and the issues faced by the community. Diversity Dialogues is an open discussion of diversity and inclusion issues and the diversity initiatives at UNR Med. The UNR Med Diversity Dialogues included a reading of the names of those who died from October 1st of the former year to September 30th of the current year, and education on transgender and gender non-conforming people. Medical students recommend ways that healthcare providers can help support the community including: Being open to feedback, criticism, and new information Contributing to a LGBTQ+ safe space by using pronoun pins, flags, inclusive language Registering your practice on Nevada Gender Affirming Healthcare Project (NGAHP), GLMA: Health Professionals Advancing LGBTQ Equality, Outcare Health, & other provider lists Reading new research in academic journals and stay up to date with guidelines including World Professional Association for Transgender Health (WPATH) Version 8 and attending CME courses on LGBTQ+ Care. The general public can support the community by: Standing up for trans people in your life, in the media, and amongst your peers, and be an active, proud ally to the community Respecting people’s identities and fluidity and learn to use different pronouns Consuming trans-friendly and LGBTQ+ friendly media (tv shows, movies, music, podcasts) Following trans people on social media, specifically activists/educators, to learn from them This month, the Human Rights Campaign (HRC) Foundation, the educational arm of the Human Rights Campaign, the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ+) civil rights organization, released “An Epidemic of Violence: Fatal Violence Against Transgender and Gender Non-Conforming People in the United States in 2022” a report honoring the lives of at least 32 transgender and gender non-conforming people killed in 2022 and shining a light on data that HRC has continued to collect on the epidemic of violence. HRC has officially recorded at least 300 violent deaths of transgender and gender non-conforming people, including 32 in 2022 alone, since the organization began tracking this violence ten years ago. Overall, transgender and gender non-conforming victims of violence are overwhelmingly Black, under 35, and killed with a firearm. The highest known single-year total of fatal deaths of transgender and gender non-conforming people was in 2021, when at least 57 trans & gender non-conforming people were violently killed. Worse, these disturbing numbers likely underreport the deadly violence targeting transgender and gender non-confirming people, who may not be properly identified as transgender or gender non-conforming by police, media or other sources. In 2022, the Human Rights Campaign Foundation recognized Renown Regional Medical Center in Reno, Nev. as the first and only hospital in Nevada at the highest level of support as “LGBTQ+ Healthcare Equality Leader.” The Healthcare Equality Index (HEI) is the nation’s foremost benchmarking survey of healthcare facilities on policies and practices dedicated to the equitable treatment and inclusion of LGBTQ+ patients, visitors and employees. For more on LBGTQ+ care and providers at Renown, visit renown.org/diversity/lgbtq-at-renown/. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Since 1969, UNR Med has trained more than 3,900 students, residents and fellows. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu. Renown Health is Nevada's largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children's hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health.
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