Editorial: The 2009 H1N1 Flu, the Media, and the RxTriad

With all the media hype over the airways, it's difficult to really know what or who to believe. Some reporters say that the swine flu is really serious, and others report that its virulence is decreasing; some report that the vaccine is safe, and others are not so sure; some advise to just be reasonable, and others say the sky is falling!

It's interesting that when the media calls up for an interview, they basically tell you what they want you to say. When I get these calls and tell them that I disagree with them and cannot say what they want, their next question is "Can you recommend someone that will?" So it is evident that they may ask numerous "practitioners, scientists, etc." until they finally get someone that will go on the camera and state the position they are interested in. It's also interesting that this "opinion" appears authoritative and representative when, in fact, it may even be a minority opinion, but that is not evident in the presentation.

Another potential source of confusion concerning the flu is the signs at doctors' offices, pharmacies, etc. that say "Influenza Shots $25." How many patients are aware that it is referring to the "seasonal flu" and not to the swine flu? Patients need to be aware of which immunization they are receiving.

As many of you know, we publish a monthly newsletter, the RxTriad, which is designed to assist compounding pharmacists in marketing their practice to physicians, etc. The current issue is on the "2009 H1N1 Flu" and is updated as of September 25, 2009 from the CDC. It is loaded with factual information, as well as numerous callout boxes, or "lists" covering many different aspects of the swine flu, including:

1. Symptoms
2. What to do to stay healthy and prevent the spread of the flu
3. Target groups to get the H1N1 flu vaccine
4. What people being cared for at home should do
5. What the caregiver should do
6. Warning signs that emergency medical care should be sought
7. Emergency warning signs in children requiring urgent medical attention
8. Emergency warning signs in adults requiring urgent medical attention

The following is an example:

WHAT TO DO TO STAY HEALTHY AND PREVENT THE SPREAD OF THE FLU

• Avoid touching the eyes, nose, or mouth (germs spread that way)
• Cough or sneeze into your elbow. Note: Flu is thought to spread mainly person to person through coughing or sneezing of infected people.
• Cover your nose and mouth with a tissue when you cough or sneeze. Note: Discard the tissue in the trash after it is used.
• Encourage healthy behaviors; eating well, sleeping well, being outside.
• Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
• Stay home if you get sick (for at least 24 hours after fever is gone, without using an antipyretic medication). Note: Exception would be for medical care or for other necessities.
• Stay informed.
• Try to avoid close contact with sick people.
• Wash hands often with soap and water (or alcohol-based hand cleaners) for at least 15 to 20 seconds, especially after coughing or sneezing.

In addition, this issue of the RxTriad discusses and clarifies the dosing of Tamiflu, both commercial and compounded, and lists a number of compounded preparations that can be used in the treatment of the swine flu. It's a great educational tool for your practice.

Next Week: Compounding with Thyroid USP.


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief

The current issue of our publication, the RxTriad, covers the 2009 H1N1 Flu. Containing updated data (September 25, 2009) from the CDC in an easy-to-read format, this publication is a two-page, colorful presentation on what everyone should know about the Swine Flu. Although directed towards healthcare practitioners, it contains information that might be of great benefit to your patients; this brochure can serve as an excellent "bag stuffer." Contact Deb Mehlhaff at 800-757-4572 to order bulk quantities (groups of 50) of this very timely publication.

MCQs in Pharmacy Practice
2nd ed.
Azzopardi LM
London, UK: Pharmaceutical Press
September 2009; Paperback; 417 pages; $34.99

A great review for pharmacists, pharmacy students, and for use in an intern program. This latest edition is divided into both "open book" and "closed book" sections and contains a total of 800 multiple-choice questions designed to assess participant's knowledge, analytical skills, and the ability to apply this knowledge base in clinical practice.

The book is divided into eight different topics, including: (1) general pharmacy practice interventions, (2) pharmaceutical calculations, (3) doses and strengths, (4) nomenclature and abbreviations, (5) dosage forms, (6) biochemical tests, (7) side-effects, and (8) common diseases.

Although written primarily from a European viewpoint, the majority of this book is applicable in any country

There are some H1N1 flu audio and video resources available for self-education. Check out the following:

• Audio and Video Podcasts
  Protection from H1N1 Flu (Swine Flu), general instructions for disposable respirators, symptoms of H1N1 (swine flu), response actions and goals
• Audio Public Service Announcements (PSAs)
  H1N1 flu (swine flu) preparedness, community planning for H1N1 flu, and hygiene habits to help fight swine flu
• Press Briefings
  Current and archived audio press releases, media advisories, and press briefings
• Social Media
  Widgets, mobile info, buttons, videos, podcasts, e-cards, RSS feeds, twitter/microblogs updates, image sharing, social networking
• Messages for Pediatrician Clinics Caring for Children
  Recorded audio message (3.5min) for phone triage in clinics caring for children, including basic novel H1N1 influenza information, when to seek emergency care, keeping your child healthy, and where to seek additional information.

Sing Along
Remember a little song we learned back in grade school? It's really appropriate today!

"This is the way we wash our hands,
wash our hands, wash our hands,
This is the way we wash our hands,
early in the morning�"

I guess we should add "and throughout the day!!!!"