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If CPR (cardiopulmonary resuscitation) is performed in the first few minutes of cardiac arrest, a person’s chance of survival can double or even triple. Troy Wiedenbeck, MD, cardiologist with the Renown Institute for Heart & Vascular Health, explains how you can be ready to perform it in case of an emergency. According to the American Heart Association, over 350,000 out-of-hospital cardiac arrests occur in the U.S. This highlights the importance of CPR to everyone, not just medical personnel. Most people do not have heart trouble at a hospital or fire station, they have it going about their everyday lives. And when someone has a heart attack outside of a hospital, their survival often depends on receiving help from a bystander. Signs of Heart Trouble First, how do you know when someone is experiencing cardiac arrest? The signs and symptoms of cardiac arrest are immediate and drastic, including: Sudden collapse No pulse Not breathing Loss of consciousness And sometimes, patients can experience symptoms beforehand, such as fatigue, fainting, blackouts, dizziness, chest pain, shortness of breath or vomiting. CPR Change Many of us know CPR as both mouth-to-mouth and pumps to the chest, but the rule now is hands-only. Can you explain the change? Hands-only CPR is exactly what the name says -- it's CPR without mouth-to-mouth. The American Heart Association recommends using only your hands. So if you see someone suddenly collapse, it’s recommended to call 9-1-1 and push hard and fast in the center of their chest. Doing this will get blood flowing back to the brain, lungs and other organs for someone having heart problems. Performing CPR on Adults vs. Children Hands-only CPR is just as effective as mouth-to-mouth and chest compressions for teens and adults who may have gone into cardiac arrest. Remember, it’s important to act fast. First, call 9-1-1 and then start chest compressions right away. If you perform CPR on someone within the first few minutes, it can double or triple their chance of survival. Keep in mind, for infants and children younger than 12 years old, regular CPR with mouth-to-mouth, as well as chest compressions, is still recommended. Two Steps to Save a Life If you see a teen or adult suddenly collapse follow these two steps: Call 911 so care providers can begin to respond. When calling 911, be specific about your location, especially if you are calling from a cell phone. Knowing the street address, building, floor and closest entry point can save precious time for first responders. Answering the dispatcher’s questions will make sure help arrives fast, and at the correct location. Push hard and fast in the center of the chest. The goal during CPR is 100 to 120 compressions per minute, about the same tempo as the song “Stayin’ Alive,” or “Thriller.”  For hand placement, it’s also important to put the heel of your hand on the center of their chest and place the other hand on top. Push down on their chest at least two inches. It may seem severe at the time, but pushing this hard can truly save a life. Continue performing compressions as long as possible. If you tire, have someone take over compressions, if possible, and take turns until medical help arrives. For information on a CPR course in Reno, please contact REMSA at 775-858-5700.

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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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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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