Kristina Ward '94, clinical professor of the URI College of Pharmacy, led the March 2008 Web Chat
Dr. Kristina Ward, of URI-ABC6's popular Ask the Pharmacist feature, joined us on Tuesday, March 11, 2008 at 1:00 p.m. EST for a Web Chat.
Dr. Ward, who is also director of the College of Pharmacy's Drug Information Services, responded to your medication questions, including those dealing with drug interactions, pain management, over-the-counter treatments, herbal remedies, drug trials, and issues related to TV advertising of drugs. Dr. Ward's Web chat coincided with the URI College of Pharmacy's 50th anniversary this month.
Dr. Ward earned her bachelor's degree in pharmacy from URI in 1994, her doctor of pharmacy degree from the University of Pittsburgh in 1996, and completed two years of postdoctoral residency training at University Medical Center in Jacksonville, Florida.
Web chats are a feature of the URI Division of University Advancement electronic communications program. Answers to other frequently asked questions can be found in our FAQs. If you have other questions about Web chats, please contact the URI Publications Office at 401-874-4383 or email: eservices@advance.uri.edu
Dr. Kristina Ward, College of Pharmacy: Hi! I'm Kristina Ward and I'm here to answer your questions about medications and pharmacy.
Amy (Newport): Hi Dr. Ward,
Because the data on SSRIs Â- selective serotonin reuptake inhibitors Â- come from short-term trials, they donÂ't capture the long-term problem of weight gain. Why do SSRIs eventually cause significant weight gain? Do they slow metabolism? Increase appetite? Both? Neither? And, what are some proven ways to avoid significant weight gain while taking SSRIs?
Thank you.
Dr. Kristina Ward, College of Pharmacy: Great question. Based on the mechanism of action of SSRIs, we would expect them to increase the feeling of being full and, consequently, experience weight loss. However, we see both weight gain and weight loss with SSRIs. A couple of long-term trials ranging from 2.5-3 years have shown SSRIs to increase weight while weight loss was not as frequent. Unfortunately, we don't know exactly why weight gain occurs with SSRIs. At this point, the best thing to do is to eat healthy, watch portion sizes, and exercise regularly.
North Kingstown: Are there any homeopathic remedies or alternitive medications for lyme disease?
Dr. Kristina Ward, College of Pharmacy: Lyme Disease is caused by bacteria called Borrelia burgdorferi. Treatment should include an antibiotic, such as doxycycline or cefuroxime. Advanced cases may require use of intravenous antibiotics. I am not aware of any homeopathic or herbal remedies that are effective treatment for Lyme Disease.
Toby (Warwick): Can you talk a bit about the problem of drug interaction? Since many of us take medications prescribed by more than one physician, it seems as though it would be awfully easy to be taking meds that do not interact well with each other. Any advice?
Dr. Kristina Ward, College of Pharmacy: Toby, this is a great question. The safest thing you can do is always use the same pharmacy. That way, the pharmacy has a record of all the medications that you are taking and can check for drug interactions whenever you have a new prescription. It's also important to let the pharmacy know what over-the-counter products you are taking, including any herbal remedies as these can potentially interact with prescription medications as well.
North Kingstown: How can herbal remedies hurt ones body?
Dr. Kristina Ward, College of Pharmacy: Homeopathic and herbal remedies are not evaluated for safety by the Food and Drug Administration. There have been studies showing that some products don't contain any "active" ingredient or contains more than is stated on the label, so it's difficult to know the quality of what you are getting. Also, depending on the homeopathic or herbal remedy, you can have different toxicities. For example, ephedra (Ma-huang) can cause heart rhythm changes that can cause death. Some, such as St. John's Wort, can interact with prescription drugs causing severe or life-threatening problems. These examples underscore the need to talk with your pharmacist about homeopathic and herbal remedies before you start taking them.
Westerly: Why am I losing so much weight while on Topamax? Does the weight loss end? If I stop taking Topamax (I was prescribed it for migraine prevention), will I gain the weight back? Also, do you know of any side effects that could occur if I take the medication for a long period of time?
Dr. Kristina Ward,College of Pharmacy: Topamax is known to cause weight loss. While this doesn't happen in everyone that takes it, it is not uncommon. Usually you will not gain the weight back until you stop taking the medication. If the weight loss is concerning you or it is substantial, I would recommend talking with your physician to see if another treatment option is right for you.
Kim, Richmond, RI: Several of my family members suffer from conditions of arthritis. What are some of the current treatments? Is there an equivalent replacement for Vioxx that is safe?
Dr. Kristina Ward, College of Pharmacy: Kim, the most commonly used medications for osteoarthritis are the nonsteroidal anti-inflammatory drugs (NSAIDs for short). There are many different NSAIDs on the market and some work better for some people than others. The ones that are most closely related to Vioxx (meaning, it affects the stomach less) are Celebrex and Mobic (meloxicam). Cardiovascular effects (such as heart attack that was seen with Vioxx) are less common with Celebrex and the other NSAIDs currently on the market.
Dave, Kings Bay, Georgia: I'm an 89 year old man in good health ... only taking a low dose of blood pressure medication that also regulates my irregular heart beat. Other than that, I'm fit as a fiddle.
I had a quite disturbing experience with Sudafed, however. I was taking it for a cold and found that after 3 days of taking it I started rambling ... I knew I was saying odd things, but couldn't control it.
I stopped the Sudafed, and it went away. What happened?
Dr. Kristina Ward, College of Pharmacy: Dave, I have not heard of this before. You may want to discuss this with your physician at the next visit.
Dr. Kristina Ward, College of Pharmacy: Thank you, everyone, for participating! If you're in the area, you can catch Ask the Pharmacist on ABC6 in the morning and at noon on Thursdays. If I didn't get to your question here, consider submitting it through Ask the Pharmacist.
