Choose Your Lozenges

By: Pui Yee

Editors: Jordy Wong & Jen Nee

Lozenges are for soothing and/or relieving pain and inflammatory throat and/or mouth conditions. Some lozenges can relieve irritable cough too. These lozenges usually contain antiseptic, antibacterial and some of them also contain anaesthetic (an agent which is used to numb the pain) and/or cough depressant (an agent which is used to depress dry cough). Meanwhile, there are also lozenges mainly for soothing purposes.

Know the DIFFERENCES between antiseptic and antibacterial.

Antiseptic: Kills or reduces a wide range of microorganisms on the throat and mouth surfaces by non-specific mechanisms.

Antibacterial: Kills or reduces certain microorganisms in the tissues (not only the surfaces) of the throat and mouth by specific mechanisms.

Difflam Lozenges

Generally, Difflam lozenges contain benzydamine hydrochloride (to relieve pain and anti-inflammation) and cetylpyridinium chloride (kills and reduces bacteria).  In some Difflam lozenges, they also contain pholcodine (to suppress dry cough) or lignocaine hydrochloride (to numb the throat and/or mouth pain).

*Note: You can click on the diagram for a better view.

Strepsils Lozenges

There are many types of strepsils lozenges in the market. The table below only shows some of the common and/or medicated strepsils lozenges.

Sobenz

Sobenz lozenges contain benzydamine hydrochloride (relieves pain and anti-inflammation) and cetylpyridinium chloride (kills and reduces bacteria).  

Mac Dual Action Lozenges

Mac Dual Action Lozenges contain hexylresorcinol (with antiseptic, bacteria-killing and pain relief effects).

Travel Health Kit - Part II

By Grace and Jen Nee,

Edited by Ker Yee and Jordy

So, we had discussed on the common medications to prepare and bring for your vacation in Part I. Now, let’s take a step further to find out more on what is jet lag and types of vaccination that you can take as a prevention.

Vaccination/ Immunization

If you’re planning to travel overseas, you may need to get vaccinated to prevent some of the serious diseases found in other regions of the world.

Which jabs should travellers required?

Some countries have an International Certificate of Vaccination of Prophylaxis (ICVP) which requires proof of vaccination against certain diseases from the visitors before they are allowed enter to the country. For example, most of the tropical countries in Africa and South America do not accept travellers from countries where there is high prevalence rates of yellow fever (a viral infection transmitted by mosquitoes) unless they have their vaccinations beforehand.

It is also essential that travellers should have the right vaccinations and health advice (based on their duration and season of travel) before travelling so that they can enjoy their trip to the fullest. Some vaccinations need to be started 6-8 weeks before departure. Therefore, travellers should seek for medical advices on the vaccinations needed before their upcoming holiday.

So, this is a brief guide on vaccine recommendations for some of the most visited countries around the globe:

• Africa - Hepatitis A and B, Rabies, Meningococcal disease, Malaria and Yellow Fever
• Cambodia - Hepatitis A and B, Typhoid, Japanese encephalitis
• China - Hepatitis A, Influenza, possibly typhoid and other preventable illnesses (such as rabies, Japanese and tick-borne encephalitis and cholera depending on the length of trip, season of the year and places visited)
• Fiji - Hepatitis A and B, Influenza
• India - Rabies, Japanese encephalitis
• Indonesia - Hepatitis A and B, Influenza, Cholera, Japanese encephalitis and Typhoid
• Thailand - Hepatitis A and B, Malaria, Typhoid and Influenza

Jetlag

Essentially, if you’re planning to travel abroad to the other end of the earth, one of the biggest issues you will encounter is jet lag. Jet lag is a series of symptoms which are caused by the disruption of the body’s “internal clock”, also known as “biological clock”. This disruption of our internal clock usually occurs when we are crossing multiple time zones and furthermore may lead to a few unfavourable symptoms. These symptoms may include malaise, difficulty in sleeping at night, mild indigestion, confusion, lack of attention and decreased in mental and physical performance. However, these jet lag symptoms normally will wear off as our body slowly adapt to the new time surroundings and time zone.

Jet lag seems to be inevitable but there are some general measures you can tale before your flight AND once you have hit the ground of your destination to ensure jet lag doesn’t ruin your first few days in a new country.

How to beat jet lag?

• Rest well before your departure and utilise any opportunity to rest during the long-haul flights. Short naps can be helpful during the flight journey.

• Take melatonin

·   Melatonin is a chemical that causes your brain to release hormones which makes you sleepy. It is often sold as a food supplement which is available over the counter but there are some countries require prescription for melatonin, such as New Zealand and unfortunately, it is not available in Malaysia.

·      However, it is not regulated by the Food and Drug Administration (FDA) due to the unknown side-effects of melatonin, particularly in long-term use. Hence, you should seek for your doctor or pharmacist's advice before taking melatonin.

• Controlling your light exposure.

·    This is the most effective measure to fight jet lag. The cycle of light and darkness is one of the most crucial factors in regulating the body’s internal clock. Adaptation will normally take place in a well-time exposure to daylight or the sun. When flying from the east to west, exposure to daylight in the evening and avoidance in the morning (i.e. by using sunglasses or eye shades) may improve jet lag; when flying from the west to east, exposure to daylight in the morning and avoidance in the evening are normally suggested.

• Adjust your schedule/ plans before you leave

·   Upon reaching your destination, try to create the optimum conditions when preparing for sleep and try to get as much sleep as possible in the first 24-hour upon arrival. The most recommended amount of sleep should be minimum of 4-hour-sleep during the local night to allow the body’s internal clock to adapt to the new time zone.

·      Exercise during daytime may also improve your good night’s sleep. However, strenuous or excessive exercise should be avoided.

 

• Consume light meals and limit alcohol consumption.

·    Sleep may be disturbed when alcohol is consumed. This is because alcohol increases urine output and urge of urination. Alcohol can accelerate the onset of sleep but it might impair the quality of sleep. Caffeinated drinks, such as soft drinks, coffee and tea, should also be limited to small amounts or avoided within 4-8 hours before sleep.

Frequent flyers normally adapt to jet lag in a short time. However, minor individuals react in different ways to time zone changes. It is encouraged that travellers should learn how their bodies react and adapt to new surroundings accordingly.

Advice for Travellers with Pre-existing Medical Conditions

As much as you wish to stay away from your daily routine during the holidays, you must not stop taking your medication if you have pre-existing medical condition such as asthma, diabetes, high blood pressure or heart problems. For example, an inhaler needs to be with an asthmatic patient at all times while for a patient with heart problems, GTN (a medication used to relieve chest pain during emergency) should always be carried with them.

If you are concern of the amount of liquids that might prevent you from taking your medication to the flight, it shouldn’t be a problem. As long as your medications are accompanied by the relevant documentation (such as a prescription) from your doctor, you should be allowed to take on board with you to your flight.

If you are having diabetic conditions, please seek for medical check-up to make sure your blood sugar control is optimal before you enjoy your holiday. Please ask for a prescription and a letter from your doctor. The letter should explain what you need to do for your diabetes, such as using insulin injections or taking pills. Besides that, it should list insulin, syringes, and any other medications or devices you use. The prescription should be for insulin or diabetes pills. You should have more than enough insulin and syringes or pills to last through the trip. But the prescription may help in case of emergency.

The prescription laws may vary from countries to countries. If you're going out of the country, do some research about the laws where you'll be going.

Below are some TIPS on how to prepare and pack your regular medications for the trip:

Tip #1

Prepare enough prescription medication that will last you for the whole trip. Don’t forget to prepare some extras in case of emergencies or if you wish to extend your stay.

Tip #2

Always carry your medication in your hand luggage or places that you can easily assess. Never put your medications in your checked-in baggage in case your bag is lost or delayed by the airline.

Tip #3

Remember to get a letter from your doctor to prove your entitlement to the prescription medication. It is important for you to carry it with your medications at all times in case there is an airport security check.

Tip #4

Always keep your medication in its proper/original packaging. It is also advisable to keep a separate note of your medication’s name in case you lost your current medication or it is being stolen. This way, you may still be able to purchase it even though you are in a foreign country.

Tip #5

Consider the climates of your travel destination as it might affect your medication. For example, in a diabetic patient who takes insulin, it is advisable to take a cool bag to store your insulin if you are visiting a hot country.

Tip #6

Many travellers tend to forget their normal routine to take their medication during their holidays. Therefore, always ask your family or loved ones to constantly remind you to take your medication. You won’t want your condition to be worsen after your vacation isn’t it?

Tip #7

For patients with asthma who uses the inhaler or heart problem patient who requires the GTN, always make sure that you have one next to you at all times! Like they always say, always expect the unexpected.

If your medication is an important part of your daily life at home, why should you neglect it during your vacation? Always, always, ALWAYS do some research or discuss with your nearest doctor or pharmacist so that you will be well prepared to have a chaotic free holiday.

So, if you still think that preparing your travel medication kit is daunting, think twice!! After reading both Part I and Part II article, you should be able to pack your travel health kit as easy as ABC.

Let’s put it this way, you should know the importance of a complete travel health kit. If you are well protected and fully equipped with the basic knowledge and medications, you won’t have to struggle for the risks and consequences while travelling. So, prepare your travel health kit and enjoy your holidays!

8 Common Medication Myths

BUSTED!!!

By Jijien and Jen Nee

Edited by Sue Fern and Ai Ven

Myth No. 1

If my pain or discomfort persists or worsen, it’s okay to take more than the prescribed dose.

It is recommended to inform your doctor or pharmacist about your condition and let them revise your medication that you are taking instead of taking more than the prescribed dose. Overtaking your prescribed dose may lead to dangerous consequences such as liver or kidney damage.

For example, paracetamol or acetaminophen are regularly found in prescriptions and bought as over-the-counter (OTC) medication to reduce fever and pain. The maximum daily dose of paracetamol for adults is 4000mg, a maximum of 8 tablets per day (paracetamol is commonly found in 500mg per tablet in the market). Normally, patient will be advised to take 1-2 tablets three to four times a day, depending on their condition. This indicates patient might be prescribed with maximum daily dose of paracetamol already. Therefore, patient is at risk of overdosing if he/she takes extra paracetamol tablets.

Myth No. 2  

Once I feel better, I should stop taking my long termed prescribed medication.

You should never stop taking your long termed prescribed medication, unless you are advised to do so by your doctor. Sometimes, the alleviation in symptoms does not mean the illness has been resolved, especially for high blood pressure. In fact, you need to continue your blood pressure medication despite your blood pressure being normalised to healthy range. You might experience that your blood pressure reading remained in the healthy range even when you have forgotten to take the medicine for a certain day. This is because there are still some drug effect remaining in your body to control the blood pressure. However, your blood pressure will raise up to a dangerous level (>150/90 mmHg) if your stop your medication without consulting your physicians. In fact, uncontrolled high blood pressure may cause harmful complications such as stroke, heart attack and kidney failure.

There are also some medications that require tapering of the dose over time in order to prevent any adverse effects associated with premature drug termination.  For example, the proton pump inhibitors, namely omeprazole (Losec) and esomeprazole (Nexium), which is used to suppress the production of stomach acid, so stopping them abruptly may cause the stomach condition to rebound and overproduce acid.

Myth No. 3

It is not important for me to inform the health care professionals on what supplements that I am taking.

It is very important for you to tell the health care professionals about all the supplements including herbs and vitamins that you are taking. There is risks of your supplements having drug interactions with the medicines prescribed by your doctor. Most of the supplements are not labeled with complete safety warnings on their packing and it is difficult for consumers to realise if there is any interaction occur.

For example, some people take ginkgo biloba for improve blood circulation and enhance memory. However, ginkgo biloba has been reported to increase the risks of bleeding. Hence, it might cause bleeding in people who is taking blood thinner, such as aspirin and clopidogrel. Thus, you may need a dose adjustment done by your doctor to take both the medication and supplement safely.

Myth No. 4

I can store my medications anywhere I want, be it in the bathroom, near the kitchen sink or in the car as long it is easily accessible for me.

Most of the medications need to be stored in a cool and dry place.

Placing them in the bathroom or near the kitchen sink can ruin the medication as these places tend to be damp while placing the medications in the car is a bad idea as the car can get too hot if placed under the sun for a long time.

There are some medications that must be placed away from the lights (or in dark areas) as it may affect the effect of the medication. One of the reason is that it will affect the stability of your medications.

Myth No. 5

It doesn’t matter  how I take my medication (chew, crush or take with any liquid) as long it gets into my stomach.

If you think that you can take all your medications and paired it up with your favourite drinks such as coke, milk, chinese tea or fruit juice to avoid the bitter taste, THINK TWICE!!!  

Every medication has its own specific pH and are only able to work in its natural environment. Taking it with liquids other than water may lose the efficacy of the drug.

It is not wrong that most of you assume that by chewing or crushing the medication, they can be absorbed faster due to its smaller surface area in the body. However, little do you know, some medications have a specific outer coating to protect it from being dissolved in your stomach as it is meant to be dissolved in other areas of your body for a better absorption. Hence, do not simply crush or chew your medication unless indicated by the manufacturer or advised by the doctor or pharmacist.

Myth No. 6

I can share my medications with all my family members if they are having the same symptoms as mine because sharing is caring.

Never ever share your prescribed medication, especially antibiotics, with anyone, be it your kids, family or friends. You must finish your whole course of antibiotics by yourself or antibiotic resistance may occur. ( Please refer to our ‘Myths of Antibiotics’ article for more elaborations.)

As for your prescribed medication, it is definitely a NO-NO as every patient’s condition is different. Always visit the doctor if you uncomfortable and never self-diagnose even though your symptoms are similar with your friends or family as different illnesses may posses similar symptoms.

If you are sharing the common over the counter medications, always understand and be aware of the ingredients contained in the medication. Some medication will have interactions to your current medication condition and you may not be aware of it.

If you are unsure of anything, always consult your pharmacist or doctor so that they are able to provide a suitable medication for your condition.

Myth No. 7 

I can still consume any expired medication as long it is being kept in the refrigerator.

Although some claimed that expired medication can still be consumed after 6 months from the expiry date, it is always advisable not to as the medication might lost its effectiveness. Some medications such as certain eye drops should be discarded after opening for 1 month to prevent contamination, let alone using it after the expiry date, while some eye drops such as Allergo-COMOD® can last for 3 months.

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So, get a new supply of medication for goodness sake!!! Why risk your health to prevent wastage??

Myth No. 8

My over the counter medications (for adults) can be shared with my child as long as I halved my normal dose.

Not all medications that are suitable for adults can be consumed by children as well. In fact, some medications are contraindicated among children below 12 years old and taking it may be placing their lives at risk.

Always consult your pharmacist when you are purchasing over the counter medications. It is important to inform the pharmacist details such as the person taking medication, the patient’s medical condition and allergies so that they are able to recommend the best choice for you and your child.