Taking an accurate blood pressure reading

Taking an accurate blood pressure reading

In 2019 the American Heart Association published an article giving tips on checking blood pressure correctly.

 

Taking the reading

Before checking it is preferable to sit resting in a chair for 3-5 minutes to obtain an accurate resting reading.

Blood pressure can vary in each arm so it is recommended that it be checked in both arms and whichever arm gives the higher reading is the arm that should be used to check blood pressure each time.

It’s important to NOT cross your legs when your blood pressure is being checked as this can lead to a higher reading.

Sitting on a chair or bed without back support can lead to a higher reading.

Readings should preferably be taken on bare skin however they can be taken over clothing as long as the clothing is not rolled up as this can constrict the area and elevate the reading.

There should be NO talking while a measurement is being taken.

Make sure the cuff is large enough.  If a cuff is used that is too small it can give a higher reading.

 

White coat hypertension

Sometimes it is found that patients’ blood pressure readings are higher when checked by a Doctor (who traditionally wore a white coat) as opposed to being checked elsewhere.  It is for this reason that Doctor’s sometimes suggest that someone have their blood pressure checked in a pharmacy to see if the reading is similar.

 

Measuring blood pressure yourself

For most people it is not necessary to check your own blood pressure and this usually leads to unnecessary worrying.  There are some situations where your Doctor might ask you to check it for a period of time and record the readings to show them.

 

Telehealth prescriptions

Telehealth prescriptions

How do I receive my prescription medicine after a Telehealth appointment?

 A lot of GP appointments are now being held via Telehealth ie appointments are taking place over the phone or other electronic means in preference to visiting your GP in person.  This seems to be working well however there is some confusion, for Pharmacists and GP’s also, about what happens with your prescription that is issued during this consultation.

Electronic prescribing was due to occur in Australia this year even before COVID-19 was around.  This is now being fast tracked so that it will hopefully be available in the next few months.  In the mean time the government has introduced telehealth prescriptions which are one way prescriptions can be received and dispensed up until 30th September 2020.

 

What it a Telehealth prescription?

In all Australian states, except Queensland, prescriptions are able to be faxed or emailed to a pharmacy for most medicines and supplied to patients.  If there are repeats ordered on these prescriptions the repeats must stay at the pharmacy and so all further repeats must be obtained from that pharmacy.

 

Prescriptions from Telehealth consultations may not be Telehealth prescriptions!

If the GP decides to post the prescription to the pharmacy after faxing/emailing then a valid repeat may be available to be collected by or posted to the patient.  This means it is no longer a Telehealth prescription.

Yes. It’s confusing for us Pharmacists too as we are not sure which way the GP will go.

 

Some medicines can not be obtained on Telehealth prescriptions

There are certain medicines that GP’s must send the prescription to the pharmacy for.  Medicines that are classed as schedule 8 or schedule s4d fall into this group.  If you are not sure if you take medicines in these schedules just ask your Pharmacist.

 

Reclassification of some medicines

Some medicines that were not previously in schedule s4d were placed into this schedule on 17th April.  What does this mean?  Medicines such as pregabalin (Lyrica), tramadol, (Tramal), quetiapine (Seroquel), zolpidem (Stilnox) and zopiclone (Imovane) now have a prescription expiry of 6 months when they previously lasted 12 months.  This means that if you have a prescription for any of these items that was written more than 6 months ago your prescription is now out of date!  This is going to be a problem for many unsuspecting patients.  Please talk to your GP as soon as you can if you are in this situation.

Gout

Gout

What is gout?

Gout is a type of arthritis.  Attacks can occur rapidly and are very painful.  Gout usually affects the big toe though it can occur in the rest of the feet, ankles, knees, hands, wrists, elbows and even ears.

 

What causes gout?

Gout occurs when there is too much uric acid in the blood stream and instead of this uric acid leaving the body through our kidneys it turns into uric acid crystals in joints.

Causes of increased uric acid include;

  • Too much alcohol especially beer
  • Eating foods high in purines such as red meat, seafood
  • Taking diuretics
  • Having certain medical conditions; diabetes, kidney disease, high blood pressure, high cholesterol
  • Being overweight

Males and those with a family history of gout are also more likely to suffer with it.

 

Symptoms of gout

Joints affected by gout are red, swollen and painful.  They can also look shiny.  Gout can be so painful that the sufferer can not bear anything touching the joint.

 

Treatment of gout

Anti-inflammatories are the first level of treatment for gout and some of these can be obtained over the counter from your Pharmacist.  There are also medications available from your Doctor to treat an attack if anti-inflammatories aren’t appropriate.

If someone suffers with recurrent attacks then a medication may be prescribed by your Doctor to prevent gout attacks from occurring.  These preventative medicines need to be taken every day even if an attack occurs.  In this instance treatment medicine can be used in addition.

COVID-19 myths

COVID-19 myths

Can the pneumonia or flu vaccinations prevent me from getting COVID-19?

No they can’t because they are different.  However if you are vaccinated against other illnesses you will have better overall health and will be less likely to catch COVID-19 or get as sick if you do.  Scientists in several countries are working on a vaccine for COVID-19 but it will take many months at the minimum for it to be available.

 

Can you take ibuprofen if you have COVID-19?

Despite reports in the media that it might be unsafe to take ibuprofen if you have or may have COVID-19 there is no evidence that this is the case.  WHO initially warned against this but have now said that there is no evidence of a problem.  Having said that there are many people who should not take ibuprofen such as those taking certain blood pressure medicines, diabetics etc.  Paracetamol is best to use if you have a temperature or general pain.

 

Are older people more likely to catch COVID-19?

No, however they are more likely to become seriously ill if they do contract it.

 

Will wearing a face mask stop me from catching COVID-19?

No.  The only people who should wear a face mask are those who are sick so that they don’t transmit their germs to anyone else.

Wise supply and use of medicines

Wise supply and use of medicines

In order to avoid a “toilet paper scenario” Pharmacists have commenced policing of medicine sales like never before.  Part of our role as a Pharmacist is to ensure that the right people are obtaining the right medicines in a suitable quantity.  There have always been instances where someone might require several months’ worth of medicines usually to cover overseas holidays.  There are no holidays happening any time soon and as such new rules are now being enforced for medicine sales.

Pharmaceutical companies have advised the TGA that they do not anticipate shortages in medicines due to COVID-19 however if people try to stockpile there will be a problem just as there is with toilet paper.

Pharmacists are now to limit prescription medicine dispensing to one months supply.

This means that you can only get one box/bottle of each of your medicines at a time.  Most medicines come in a one month supply.  If you get more than one month in yours then you will get your usual supply.  Trying to go to different pharmacies won’t work as we can tell when you have had your prescriptions dispensed.

Customers can now only buy one Ventolin or Asmol inahaler over the counter

(you can still get two on a prescription if that’s what your prescription states).  These can only be sold to people who have been initially commenced on these by a Doctor.  If you used an asthma reliever five years ago for two weeks it is not a reason to try and buy one now just in case.  If too many people try and do this there will become a shortage.

Other items that people have been panic buying are paracetamol for adults and children.

Children’s paracetamol products will now be kept behind the counter with the aim of reducing people buying it just in case and saving it for those who need it.

The same rule applies here in that you can only buy one product.

Stockpiling of medicines has always been discouraged for reasons such as that the product may go out of date before you need it or the Doctor may change your medicine.  These reasons apply now more than ever.  If we use medicines sensibly and don’t harass the pharmacy staff to allow you to obtain more than you need for one month there will be no medication shortage.

On another note healthcare workers (along with many other workers ) are very stressed right now.  We are normally very busy at work however we are currently answering more phone calls, more questions from people coming in to the pharmacy and dispensing (or chatting about why we can’t dispense) more prescriptions than usual.  While this is happening we are trying to work with pharmacy sticky labels while wearing gloves as well as talking on the phone and in person with masks on.  Delivery numbers are increasing and cleaning and sanitising are occurring at least every hour and as needed.  Please adhere to the social distancing rules of keeping 1.5 metres away from the next person and avoid touching and handling items unnecessarily.  Prescriptions no longer need to be signed.  Please wash your hands well and often.  We endeavour to do our best to serve you while we are worried about your health, our health and safety and that of our families.

 

Tomorrow I will bust some COVID-19 myths.