Hydroxychloroquine hoarding versus toilet paper hoarding.

This post is not to argue for or against the off-label use of hydroxychloroquine for COVID-19 since there are already some good thoughts from the CDC on it. The main thing people should take away is that the CDC mentions “hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID-19. ”

What is more concerning to me is how there are rumblings from the pharmacy community of doctors prescribing large amounts of tablets for themselves and/or for their family members. This large amount is assumed to be an attempt to stockpile the medication for use as prevention/treatment of COVID-19. I guess toiler paper isn’t the only thing we are stockpiling. This is frequent enough that Washington’s Medical Commission sent out a statement asking “pharmacists to act with their best discretion to ensure patients continue to receive appropriate treatment in time of shortages.” The appropriate treatment of hydroxychloroquine would be lupus, rheumatoid arthritis, and malaria and NOT for prophylaxis of COVID-19. We are potentially creating a drug shortage for people who actually need it, ie people with approved indications for it.

Again, I want to emphasize that I am not against the use of hydroxychloroquine for clinical studies. I also feel at this point (3/25/2020), there are probably good reasons for physicians to prescribe off-label use of hydroxychloroquine for COVID-19 patients who are critically ill. So the hoarding hydroxychloroqine would, to me, be purposely slowing down clinical studies and hurting critically ill COVID-19 patients.

In short, hoarding of toilet paper might leave someone in “deep shit,” pun intended, but hoarding of hydroxychloroquine will leave someone in deep shit health wise.

Stay safe everybody!

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Diabetes and “the virus”

Hello everyone,

I hope everyone is keeping their hopes up and their pillboxes full. As always, it’s prudent to keep a good supply of your medications in case you cannot leave your house, but you might want to be more vigilant with stocking up on other things if you have diabetes. In 2018, potentially 10.5% of the US population had diabetes so we know how important it is to keep diabetics safe during these difficult times. We all know high blood glucose (sugar) is not a good thing but don’t forget low blood sugar (hypoglycemia) is not safe either especially when you are a diabetic.

It scares me to hear when a patient say, “my blood sugar was so low that it woke me up and I had to go downstairs to get juice.” Please consider keeping a good supply of juice (or your glucagon kit) in easily accessible areas throughout the house so you do not have to walk up or down the stairs while you are dizzy and shaking from hypoglycemia.

Also, don’t forget to refill all your test strips and lancets to keep monitoring your blood sugar if that is what your doctor recommends. You might not be as active if you are stuck in the house so good monitoring of your blood sugars is especially important during these times.

Hope everyone is doing well and is staying safe. Please note my *disclaimer* at the bottom of this blog. Thank you.

Out of Hand Sanitizer? Ask your compounding pharmacist.

Hello friends,

Are you frantically searching for hand sanitizers but they are nowhere to be found? Well, you technically can find them but it’s going to cost you an arm and leg for just a bottle of hand sanitizer.

Worry no more! The FDA released some good news that allows temporary compounding of certain alcohol-based Hand Sanitizer products by pharmacists in State-licensed pharmacies or Federal facilities and registered outsourcing facilities.

These “State-licensed pharmacies” refers to compounding pharmacies so if you are already using a compounding pharmacy to make your other medications, you can ask the compounding pharmacist if they are able to make a nice batch of Hand Sanitizer. This is not a perfect solution but would be a lot better than trying to make your own Hand Sanitizer (which I know some people have been doing).

Word of warning though, when I called my local compounding pharmacy, they said the cost was $6 for a small 2 ounce bottle!

Stay safe and well-informed, friends!

Coronovirus preventing medication fills? Talk to your local pharmacist!

For those living in the state of Washington, there are some recent news that might help cure some of your coronavirus woes. If you are having problems filling your prescriptions because of the following, try asking your friendly local pharmacist to help:

1. The Insurance Commissioner issued an emergency order to Washington state health insurers to allow a one-time early refill for prescription drugs. But before you call your local pharmacy, make sure to check with your health plan whether or not your prescriptions (and drug plan) is included in this emergency order.
2. It was recently announced by the Pharmacy Quality Assurance Commission that rule WAC 246-869-105 is in effect which allows a pharmacist to provide an emergency refill of an expired prescription for a 3 day supply for non-maintenance medications and a thirty-day supply for a maintenance medication if the pharmacist is unable to obtain refill authorization from the prescriber.

In general, there might be some lag time between these announcements and and the participation of your local pharmacy, so it is always good to work collaboratively with your pharmacy and insurance to figure things out. Hope this helps someone and don’t forget to wash your hands!

Keep your phone clean, don’t get sick!

Serious question and let’s be honest with each other — how often do you clean your phone?

Most people don’t give a second thought to using their cellphone everywhere, from the second they get out of bed until they are tucked in bed. But research shows that cell phones are far dirtier than most people think, and the more germs they collect, the more germs you touch. Americans check their phones about 47 times per day, according to a survey by Deloitte, which affords plenty of opportunities for microorganisms to move from your fingers to your phone.

While I’m sure everybody is washing their hands and disinfecting all surfaces, you may not think to give your phone a thorough cleaning. But you should, as it’s a device that you hold dearly in your hand all day and passionately put up to your face. Do you see the problem now?

Prior to the coronavirus outbreak, smartphone makers told consumers to avoid using disinfecting wipes or sprays on their devices to keep from damaging the coating on their touchscreen displays. But, realistically, how much cleaning can a microfiber cloth do to actually kill off germs?

We still do not have complete understanding of how long the coronavirus can survive on surfaces. The World Health Organization says the virus may last hours or even days outside of the body, so cleaning your phone is absolutely worthwhile!

WHOOSH! is a pretty popular phone cleaning product out there. However, this product does not contain any alcohol in it! This makes it pretty useless to me during the Coronavirus outbreak as it does not get rid of the germs on the phone’s surface.

What’s your favorite product/method to clean your phone? Any suggestions would be greatly appreciated.

How to keep yourself safe and ready to beat any virus?

It seems as though my entire blog has been dedicated to the topic of “virus” – but it’s important to discuss pressing issues that are happening around us right now.

No – I’m not a hypochondriac and quick to become stressed over every illnesses, like my lovely wife. But, the coronavirus has been on my mind quite often lately because well, we don’t know everything about this virus and do not have an immunity/vaccine available. So, how have I (a sensible pharmacist ;)) been preparing to weather this virus? Keep on reading below…

1. Water
2. Toilet paper
3. Frozen food
4. Canned food
5. Lots of vitamin C!
6. Fill up medicine cabinet (particularly acetaminophen to cure those fever)
7. Rubber bands….*curious why?* I’ll talk more about it in my upcoming post.

Ok, I must admit all the items listed above are every day necessities…so regardless of the outbreak or not, you should stock up! But, I’m concerned about a few things so I’m getting them now while supplies last!

1. Prices will start going up
2. People are rushing to get these items so there’s a chance they will be out of stock
3. Most important – It’s always a good idea to have the medicine cabinet stocked up in your home, especially those with prescribed medication. Last week the Food and Drug Administration announced that there is a shortage in the United States of one prescription drug due to the novel coronavirus outbreak. Here’s a link to the FDA’s shortage list if you’re curious. Many of the raw ingredients for pharmaceutical drugs (both prescription and OTC) are made in China (*holding face while screaming*) YES in CHINA, where many factories shut down due to COVID-19 outbreak. So please please encourage your family and friends to stock up on their prescription medications when possible.

What are your absolute must-haves to prepare for the Coronavirus?

Drinking bleach keeps the virus away?

There is a rumor circulating around that bleach can kill the Coronavirus!!!! Has anybody tried this? I sure hope not!

Hopefully this is not needed to be said, but please do not drink
bleach to try and prevent/treat COVID-19 (novel coronavirus).
Specifically the listed agents in the FDA “Miracle or Master Mineral
Solution, Miracle Mineral Supplement, MMS, Chlorine Dioxide (CD)
Protocol, Water Purification Solution (WPS).”

Aren’t you curious about how this myth came about? Part of it must come from
these Miracle Mineral Supplement (MMS) that the FDA mentioned; when
you mix these products with citric acid, they becomes chlorine dioxide
which is a powerful bleaching agent. These MMS are advertise as
remedies for treating multiple conditions with one of them being the
flu. Naturally, the idea of treating the flu transferred to treating
COVID-19. There are also some thoughts that conspiracy theorists came
up with this myth but I am not curious enough to dig deep into
conspiracy theories.

As always, please talk to your doctor before using medications
you read about online. If making a doctor’s appointment is a major
hassle, don’t forget you can always ask your friendly pharmacist at
your local drug store. Stay safe everyone.

https://www.fda.gov/news-events/press-announcements/fda-warns-consumers-about-dangerous-and-potentially-life-threatening-side-effects-miracle-mineral

Before you go, check out this awesome and informative video of the secret life of bleach, but don’t get any crazy ideas about drinking it!

What’s your favorite household disinfectants to kill of germs? My go-to product is hot water, yeah, splash that bad boy all over the house!

Freedom versus Coronavirus?

 Please do not mind me while I catastrophize for a brief second:

Chinese government: Everyone need to wear masks and stay home to
prevent the coronavirus.
Chinese population: Has no choice but to do whatever the government
says which might lead to stopping the spread of the virus.

American government: Everyone needs to stay home from work to prevent
the coronavirus.
American population: No way! You can’t infringed on my freedom! I’ll
do what’s best for me.

Of course, I love the freedom that being an American provides but I am
curious if a communistic/dictatorship type of government would be more
efficient when it comes to containing the spread of a virus. Even if
it was, I don’t think I would ever trade my freedom away just because
of the coronavirus. I do want to present a compromise though which
arose in my mind after I watch John Oliver’s thoughts on the
coronavirus. He mentioned how one of the ways Vietnam was containing
the virus was with a remix of a popular song (links below).

 Besides being entertaining, this video became very popular which help
brought a good sense of community and purpose to the Vietnamese
people. It helps move from the “people versus government versus
coronavirus” mentality to “us versus coronavirus.” If only we could
get Justin Bieber to remix one of his song 🙂

Question: What are your thoughts on this Covid-19 outbreak madness? Would love to hear them!

Why is the novel coronavirus so scary?

I am curious on why Covid-19 is so scary when there are so many other diseases (diabetes, obesity, opioid addiction) that has killed more (so far). Right away, there are the multiple of reasons that I can think of:

1. There is currently no vaccine for the novel coronavirus. We all hope there will be one but the perpetual uncertainties of the future can be scary.  
2. Herd mentality. If you see someone else panicking, it’s hard not to join in. If everyone around is hoarding toilet paper, it does make you question if you are missing out on something important.  
3. The stock market. It’s harder to be calm about the virus when you see how it is decimating your 401k. You can try and walk the calm walk, but money can really talk quite the talk when you are losing it.

The more news you read, the more reasons you will find but since pop culture is forever my favorite teacher, I will reverently refer to what the joker said in the dark night.

“Nobody panics when things go according to plan. Even if the plan is horrifying! If, tomorrow, I tell the press that, like, a gang banger will get shot, or a truckload of soldiers will be blown up, nobody panics, because it’s all “part of the plan”. But when I say that one little old mayor will die, well then everyone loses their minds.” 

This, I find to be my favorite explanation of why the coronavirus is so scary to us. It’s all “part of the plan” that people die from diabetes, obesity, and more recently opioid addiction. I’m curious if/when we will get use to the deaths from Covid-19.