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Pharmac MAY 2017

Valuable education for pharmacy staff


11 MAY 2017



We all know that brushing our teeth and flossing regularly is vital to healthy teeth and gums, but what about the tiny tots in our midst? Taking care of their teeth can prevent future oral problems


It’s the life in your years, not the years in your life

What’s causing your cough? The first step to treating a cough is knowing whether the culprit is a bacteria or a virus



Oral health for tiny tots

Indigestion and heartburn: what’s the difference

Know your products


It’s never too late to stop smoking, but unfortunately tobacco addiction is one of the most difficult habits to overcome. What smoking cessation products are available?





Volenti Meyer – Frontshop Assistant, Rink Street Pharmacy


Busting myths: causes and treatments of lower back pain

Health and wellness

STUDY: omega-3, B vitamins, and slowing the brain’s decline

Liquid collagen: the complete anti-ageing solution Improve joint and bone health, and skin conditions like eczema with an all-natural supplement that can help reduce the signs of aging by helping the body to heal itself

Too many people mistakenly believe that lower back pain is just something they have to live with, without thinking about the cause or realising that it may result in long term damage

37 20 Front 16 S Assistahop winne nt r the ye of ar

“Invest your time wisely it will have an impact in your future”


B vitamins can help many older adults with mild cognitive impairment, but only if they have good levels of omega-3 fatty acids

Tell them it’s new



Getting older doesn’t automatically mean poor health. Plenty of older adults enjoy vigorous health, often better than many younger people. We feature 8 products engineered for the more mature members of the population



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Although patients often talk about indigestion and heartburn as a single problem, they are in fact separate conditions

NTDs: We’re winning the war


CPD: the right vitamins for osteoporosis Osteoporosis is a common disease characterised by low bone strength that results in an increased risk of fracture. In SA, one in three women and one in five men will develop osteoporosis


THE TEAM EDITOR: Nicky Belseck Email: Tel: 011 877 6155 LAYOUT AND DESIGN: Nazreen Bhyat ADVERTISING SALES EXECUTIVES: Alex Tschumi Cell: 082 697 3437 Email: SALES INTERN: Quanita Pikini Email: PUBLISHING TEAM GENERAL MANAGER: Dev Naidoo PUBLISHING MANAGER: Johann Gerber Email: PRODUCTION MANAGER: Angela Silver Email: ART DIRECTOR: David Kyslinger

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Unless previously agreed in writing Frontshop Pharmacy Magazine, owns all rights to all contributions, whether image or text. SOURCES: Shutterstock, supplied images, editorial staff. While precautions have been taken to ensure the accuracy of its contents and information given to readers, neither the editor, publisher, or its agents can accept responsibility for damages or injury which may arise therefrom. All rights reserved. © Frontshop Pharmacy Magazine. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, photocopying, electronic, mechanical or otherwise without the prior written permission of the copyright owners.

Pharmacy Magazine MAY 2017 |




International Multiple Sclerosis Month Hepatitis Awareness Month Lyme Disease Awareness Month

It’s the life in your years , not the years in your life

World Asthma Day


’ve been blessed with an amazing family with a

Complaining of heartburn and indigestion, patients

delightfully wicked sense of humour, which is why I’m

often make the mistake of assuming they are the same

able to have such fun in May teasing my Dad about

thing. In actual fact indigestion is a condition, while

being a ‘senior citizen’. You see May is Go Turquoise

heartburn is a symptom. We break down the difference

for the Elderly Month and as such Frontshop Pharmacy

between the two gastrointestinal issues on page 21.

Magazine always features a handful of articles specifically

Accounting for an estimated 265 000 deaths

aimed at the more mature members of our population.

annually it’s no wonder a week in May is dedicated

Let’s face it, no one particularly wants to get older, or

to burns awareness. This month’s cut-out-and-keep

think about how our health and bodies may begin to fail

feature focuses on how to treat burns and what not

us. But as medicines continue to develop and we learn

to do (page 18).

more about living healthily there really is less to be afraid

Highlighting World No Tobacco Day (31 May)

of. It’s never too late to change your lifestyle and embrace

we feature three products designed to assist in smoking

healthy living. It can be hugely beneficial to educate

cessation on page 14. A common frustration for smokers,

yourself on the body, how it ages, which ailments you may

coughs can also be caused by many other things. Page 17

become more susceptible to and how to postpone or

focusses on whether a cough is viral or bacterial.

even completely prevent them. With this in mind enjoy our

regularly is vital to healthy teeth and gums, but what

· Products specially developed for the ageing

about the tiny tots in our midst? Is caring for milk teeth

members of our population (page 28) slow brain’s decline (page 31) · Liquid collagen: the complete anti-ageing solution (page 33) · CPD: the right vitamins for osteoporosis (page 39) Lower back pain is one of the most prevalent

as important as caring for permanent teeth and at oral health? Practicing dentist, Dr Laurika Krynauw, shares valuable advice on page 11.

development report last month shows that we’re winning the war on neglected tropical diseases like rabies, bilharzia, dengue, and leprosy (page 6).



Editor Nicky Belseck

“Do not regret growing older. It’s a privilege denied to many” – Author unknown

FEEDBACK Send your letters and any news or events to


| MAY 2017

Pharmacy Magazine


World Lupus Day


World Chronic Fatigue and Immune Dysfunction Syndrome Day


International Nurses Day


Go Turquoise for the Elderly Month


World Hypertension Day

Lastly, the release of the WHO’s Integrating neglected tropical diseases in global health and

myself, it’s encouraging to know that lower back pain is myths of the causes and treatments on page 27.


World Move for Health Day

what age should we start enforcing the importance of

complaints of people both young and old. As a sufferer not something you have to live with. We’re busting the

6 12 Burns Awareness Week

We all know that brushing our teeth and flossing

special Go Turquoise for the Elderly section:

· Study: omega-3 levels affect whether B vitamins can


World Hand Hygiene Day

Spending quality time with my favourite “elderly” person, Bruno (AKA Dad), and my beautiful sister Belinda.



World Aids Vaccine Day

27 2 May Jun National Child Protection Week


International Day of Action for Women’s Health World No Tobacco Day




Simple changes such as running up the stairs instead of taking a lift, taking a brisk walk after work, and doing gardening contribute to increased physical activity every week

With an estimated 1 billion people receiving treatment in 2015 alone, the World Health Organization (WHO) reports remarkable achievements in tackling neglected tropical diseases (NTDs)



we’re winning the war


hile neglected tropical diseases blind, maim, disfigure, and debilitate hundreds of millions of people in urban slums and in the poorest

parts of the world, approximately 90% of all NTDs can be treated with medicines that are administered once or twice annually. Following the release of the WHO report, Integrating

• Only 25 human cases of Guinea-worm disease were reported in 2016, putting eradication within reach. • Cases of human African trypanosomiasis (sleeping sickness) have been reduced from 37 000 new cases in 1999 to well under 3000 cases in 2015. • Trachoma: the world’s leading infectious cause of blindness - has been eliminated as a public health

neglected tropical diseases in global health and

problem in Mexico, Morocco, and Oman. More than

development, last month at the Global Partners’ Meeting

185 000 trachoma patients had surgery for trichiasis

on Neglected Tropical Diseases (NTDs) in Geneva, this

worldwide and more than 56 million people received

month the World Health Assembly will review proposals for a new Global vector control response. The WHO report demonstrates how strong political support, generous donations of medicines, and improvements in living conditions have led to sustained expansion of disease control programmes in countries where these diseases are most prevalent. “WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and

antibiotics in 2015 alone. • Visceral leishmaniasis: in 2015 the target for elimination was achieved in 82% of sub-districts in India, 97% of sub-districts in Bangladesh, and in 100% of districts in Nepal. • Only 12 reported human deaths were attributable to rabies in the WHO Region of the Americas in 2015, bringing the region close to its target of eliminating rabies in humans by 2015.

elephantiasis to their knees,” said WHO Director-General, Dr Margaret Chan. “Over the past 10 years, millions of people

However, the report highlights the need to further scale up

have been rescued from disability and poverty, thanks to

action in other areas.

one of the most effective global partnerships in modern public health”. Since 2007, when a group of global partners met to agree

“Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals,” said Dr Dirk Engels,

to tackle NTDs together, a variety of local and international

Director of the Department of Control of Neglected

partners have worked alongside ministries of health in

Tropical Diseases. Meeting global targets for water and

endemic countries to deliver quality-assured medicines,

sanitation will be key. WHO estimates that 2.4 billion

and provide people with care and long-term management.

people still lack basic sanitation facilities such as

In 2012, partners endorsed a WHO NTD roadmap,

toilets and latrines, while more than 660 million

committing additional support and resources to

continue to drink water from “unimproved” sources,

eliminating 10 of the most common NTDs.

such as surface water.

Key achievements included in the report:

of Zika virus disease, and its associated complications,

• 1 billion people treated for at least one neglected

has re-energised efforts to improve vector control. This

Meanwhile, global concern about the recent outbreaks

tropical disease in 2015 alone. • 556 million people received preventive treatment for lymphatic filariasis (elephantiasis). • More than 114 million people received treatment for onchocerciasis (river blindness: 62% of those requiring it.


| MAY 2017

Pharmacy Magazine

month the World Health Assembly will review proposals for a new global vector control response. There are also brighter prospects to prioritise cross-sectoral collaboration to promote veterinary public health. Continued on next page...



“Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health”. – WHO Director-General, Dr Margaret Chan


AN OVERVIEW OF NEGLECTED TROPICAL DISEASES Buruli ulcer: debilitating skin infection causing severe

Leprosy: caused by infection mainly of the skin, peripheral

destruction of the skin, bone and soft tissue.

nerves, mucosa of the upper respiratory tract, and eyes.

Chagas disease: infection transmitted through contact

Lymphatic filariasis: infection transmitted by

with vector insects, ingestion of contaminated food,

mosquitoes causing abnormal enlargement of

infected blood transfusion, congenital transmission, organ

limbs and genitals from adult worms inhabiting and

transplantation or laboratory accidents.

reproducing in the lymphatic system.

Dengue: mosquito-borne viral disease causing flu-like

Mycetoma: debilitating, disabling bacterial/fungal

illness. Occasionally develops into a lethal complication

skin infection thought to be caused by the inoculation of

called severe dengue.

fungi or bacteria into the subcutaneous tissue.

Dracunculiasis (guinea-worm disease):

Onchocerciasis (river blindness): parasitic eye

nematode infection transmitted by drinking-water

and skin disease, transmitted by the bite of infected

contaminated with parasite-infected water fleas.

blackflies. Causes severe itching and eye lesions,

Echinococcosis: infection caused by larval stages

leading to visual impairment and permanent blindness.

of tapeworms forming pathogenic cysts. Transmitted

Rabies: viral disease transmitted to humans through the bites

to humans through ingestion of eggs, shed in faeces of

of infected dogs. Invariably fatal once symptoms develop.

dogs and wild animals.

Schistosomiasis (bilharziasis): larval worm

Endemic treponematoses (yaws): chronic

infection. Transmission occurs when larval forms

bacterial infection affecting mainly the skin and bone.

released by freshwater snails penetrate human skin

Foodborne trematodiases: infection acquired

during contact with infested water.

by consuming fish, vegetables, and crustaceans

Soil-transmitted helminthiases: group of

contaminated with larval parasites.

intestinal helminth infections transmitted through soil contaminated by human faeces.

Human African trypanosomiasis (sleeping sickness): parasitic infection spread by bites of tsetse flies.

Taeniasis and neurocysticercosis: infection by

Almost 100% fatal without prompt diagnosis and treatment.

adult tapeworms in human intestines; cysticercosis

Leishmaniases: transmitted through the bites of infected female sandflies. In its most severe (visceral)

Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals

occurs when humans ingest tapeworm eggs that develop as larvae in tissues.

form, it attacks the internal organs. The most prevalent

Trachoma: infection transmitted through direct

(cutaneous) form causes face ulcers, disfiguring scars

contact with eye or nasal discharge. Causes irreversible

and disability.

corneal opacities and blindness.

Pharmacy Magazine MAY 2017 |




Repair & Protect The benefits of NovaMin® technology and sodium fluoride in a single formulation With twice-daily brushing, it can: • Create an even harder reparative† hydroxyapatite-like layer over the exposed dentine*1-7 • Continually protect your patients from dentine hypersensitivity** – Sensitivity relief can start from week 18, and is still making   a difference to patients’ lives after 6 months of daily use9

Recommend Sensodyne® Repair & Protect to help your patients live life more free from the impacts of dentine hypersensitivity** Forms a protective layer over the sensitive area of the teeth. Brush twice a day for lasting sensitivity protection.*vs. Previously marketed formulation. **With twice-daily brushing. References: 1. Greenspan DC et al. J Clin Dent 2010; 21: 61-65. 2. La Torre G and Greenspan DC. J Clin Dent 2010; 21(3): 72-76. 3. Earl JS et al. J Clin Dent 2011: 22(3); 62-67. 4. Parkinson CR et al. J Clin Dent 2011; 22(3): 74-81. 5. GSK Data on File, ML498. 6. GSK Data on File, ML584. 7. GSK Data on File, ML589. 8. GSK Data on File, RH01422. 9. GSK Data on File, RH01897. Prepared: October 2015 GCSAE/CHSENO/0165/15


Oral health for tiny tots Taking care of tiny tots’ teeth can prevent future oral problems



Children are always observing, so be sure to lead by example and take good care of your own teeth


e all know that brushing our teeth and

encourage good oral hygiene. When cleaning a baby’s

flossing regularly is vital to healthy teeth

mouth, it is imperative to use a special toothbrush that is

and gums, but what about the tiny tots

soft and tailor-made for little mouths. If the bristles of a

in our midst? Is caring for milk teeth as

toothbrush are too hard, it could damage their gums and

important as caring for permanent teeth and at what age

teeth. You can find these special toothbrushes at most

should we start enforcing the importance of oral health?

pharmacies and dentists.

Dr Laurika Krynauw, practicing dentist at Medicross Langeberg, shares valuable advice. “Many parents see milk teeth as something that will

“You should also use children’s toothpaste, it is not just a gimmick,” Krynauw adds. “Most toothpastes contain fluoride and children tend to swallow toothpaste,

‘fall out anyway’ and therefore do not see the need for

because they find it difficult to spit out the excess. If they

oral care at a young age. The truth is, milk teeth are just

ingest too much fluoride, it can lead to fluorosis which will

as important as permanent teeth,” explains Krynauw.

result in permanent white stains on their teeth.

“Even though milk teeth will be replaced by permanent

“Children’s toothpaste contains less fluoride than

teeth eventually, the early loss of milk teeth due to

adult toothpaste and this prevents fluorosis. Also, the

damage or decay, can cause future oral health problems.

mint flavouring in many toothpastes cause a ‘burning’

These problems can be prevented by proper dental care

sensation in their mouths that many children find

from a young age,” she explains. “Premature loss of milk

disturbing. Children’s toothpastes are much milder and

teeth can result in ‘space loss’. This means that there will

gentle to their taste buds.”

not be enough space for permanent teeth to develop

Krynauw mentions that babies should also be taken

and this will most likely create the need for braces in

for regular visits to the dentist. “You should make an

later, teenage years. Also, severely decayed milk teeth

appointment at your local dentist as soon as you see

can cause abscesses that can irreversibly damage the

teeth developing. The first appointment will mainly

permanent teeth underneath the milk teeth.

focus on educating parents on how to properly clean

“The moment you see a tooth in your baby’s mouth, you need to start cleaning it. It is never too early to

Severely decayed milk teeth can cause abscesses that can irreversibly damage the permanent teeth underneath the milk teeth

their baby’s teeth and other ways to protect their child’s Continued on next page...

Pharmacy Magazine MAY 2017 |



enough calcium and magnesium. This will promote healthy teeth and bone development,” she adds. As children get older, they will start developing permanent teeth in place of their milk teeth. “Most children start to lose their milk teeth between the ages of five and six. Each child is different though, some will start developing permanent teeth as early as four and some as late at seven.” Krynauw cautions that even though children might seem old enough to take care of their own teeth, the responsibility for their oral health ultimately stays with the parent. “Remember the golden rule: if a child cannot tie their own shoelaces, they cannot take care of their own teeth. Make sure they understand the importance of oral care and know how to take care of their own teeth before handing over the responsibility to them. “Children are always observing, so be sure to lead by example and take good care of your own teeth. By teaching your children the importance of oral care, they will continue

By teaching children the importance of oral care, they will continue to practice proper oral hygiene into later life

teeth and gums. This will also allow your child to become

to practice proper oral hygiene into later life. By doing so,

comfortable with the dental environment at an early age

they will have better, stronger and healthier teeth as adults

and prevent future fear of going for dental check-ups.

and prevent conditions such as tooth decay, receding gums,

“In order to protect babies’ teeth and gums, you need to be aware of the variety of conditions and risk factors that apply to milk teeth. One of the biggest concerns with milk teeth in babies is early childhood caries, also known as baby bottle caries, a condition which develops when a child goes to bed with a bottle, usually containing some kind of sugary liquid like tea, milk, or carbonated drinks. “Babies often do not swallow the last bit of liquid which causes the teeth to be coated in sugary liquid for the remainder of the night. The sugar in the liquid causes decalcification of the teeth, which could lead to rotting and broken teeth, and inflamed gums.” According to Krynauw diet also plays an important role in the oral health of a baby or toddler. “Sugar intake should be limited. Ensure that your child’s diet contains


| MAY 2017

Pharmacy Magazine

abscesses, and gingivitis,” she concludes.

S2 Adco-FlupainÂŽ. Each 5 ml syrup contains triprolidine HCl 0,625 mg; pseudoephedrine HCl 15,0 mg; paracetamol 125 mg. Reg. No. 27/5.8/0260.


Know your products


31 MAY


Vice Breaker INDICATION: Vice Breaker and natural proprietary components work together to help reduce anxiety, tension, and nervousness, which in turn, helps to calm nerves and reduce cravings. Vice Breaker acts as a barrier to block nicotine receptors in the brain, making it easier to avoid and eventually wean oneself off tobacco. INGREDIENTS: Loquat Leaf Extract, Lobelia Inflata, Ginger Root Extract, Sophora Flavescents Root Extract. DOSAGE: Adults: 1 capsule in the morning with water and 1 capsule in the evening with water. 084 531 0786

SMOKING CESSATION It’s never too late to stop smoking, but unfortunately tobacco addiction is one of the most difficult habits to overcome. Giving up smoking brings both short-term and important long-term health benefits. In recognition of World No Tobacco Day we feature 3 products that may assist patients quit for good. 14

| MAY 2017

Pharmacy Magazine



Nicorette® gum INDICATION: Temporary aid in smoking cessation. INGREDIENTS: Nicorette freshfruit gum 2mg: nicotine-resin complex 20% – 10mg equivalent to 2mg nicotine/piece. DOSAGE: 10-12 pieces daily. Chew slowly over 30 minutes, one at a time, when urge to smoke is felt. Maximum 15 pieces in 24 hours. Reduce number chewed each day as urge to smoke fades. This is usually possible within 2-3 months. Stop only once craving is satisfied with 1-2 pieces daily. Do not use for more than 3 months. 086 041 0032


Smoking is the leading cause of lung cancer


Nicotinell速 TTS 20 INDICATION: Nicotinell速 patches relieve and/or prevent cravings and nicotine withdrawal symptoms associated with tobacco dependence. They are indicated to aid smokers wishing to quit or reduce prior to quitting, to assist smokers who are unwilling or unable to smoke, and as a safer alternative to smoking for smokers and those around them. Nicotinell速 patches are indicated in pregnant and lactating women making a quit

On average, non-smokers live 6-8 years longer than smokers. Even a 60-year-old smoker could gain at least 3 years of life expectancy by stopping smoking

attempt. Nicotinell速 patches should preferably be used in conjunction with a behavioural support programme. INGREDIENTS: Each Nicotinell TTS 20 patch contains 35mg S(-)-nicotine which provides an average absorption rate of 14 mg nicotine in 24 hours. DOSAGE: Users should stop smoking completely during treatment with Nicotinell TTS. One Nicotinell TTS plaster should be applied once daily and left on the skin for 24 hours. The plasters are available in 3 dosage strengths to enable step-by-step weaning over 3 months. STEP 2: Nicotinell TTS 20 is usually recommended for smokers with a consumption of less than 20 cigarettes per day or have completed Step 1. 086 192 9929

Pharmacy Magazine MAY 2017 |


EDUCATION VIRAL VS BACTERIAL Viral coughs are caused by viruses which inflame the throat or lungs and can last up to three weeks without treatment. However, the body can fight the infection if the immune system is strong enough. Viral coughs develop over a day or two and typically worsen after two to three days. They affect the throat (larynx), main airway (trachea), or the airways leading into the lungs (bronchi), and can lead to laryngitis, tracheitis, or bronchitis. Bacterial coughs mainly attack the upper respiratory tract – the nose, throat, and bronchi. A bacterial cough usually results in a chest infection, whooping cough or, in extreme cases, tuberculosis (TB), or pneumonia. Bacterial infections can usually be identified with a doctor’s test. For example, a throat test can check for

What’s causing your cough? As irritating as it may be, coughing is the body’s way of ridding the lungs and airways of foreign substances and mucus


oughs can make breathing difficult

living inside our bodies that help with essential

and irritating. Being aware of the

functions. Viruses are also microscopic beings,

cause of your cough will help you

but they behave differently to bacteria.

treat it quickly and effectively, and

Viruses flourish inside a living organism and

help restore health. The first step? Knowing

can live for a brief period of time outside their

whether the culprit’s a bacteria or a virus.

host, like hovering in the air right after a person

Bacteria are tiny single-celled organisms. Not all bacteria are bad, there are beneficial bacteria

coughs. But in order to multiply they need to settle inside a host.

the presence of the streptococcus bacteria. WHAT TO LOOK OUT FOR Most viral coughs clear with ease, and a little help from an effective cough medication. However, a secondary infection with germs (bacteria) can develop, which leads to more serious conditions like pneumonia. It’s also easy to confuse other causes of a cough (like asthma) with a viral infection. It’s advisable to see a doctor if you have high temperature, chest pains, or consistently severe

Viral coughs are caused by viruses which inflame the throat or lungs and can last up to three weeks without treatment

headaches. Monitor breathing patterns and if you cough up blood and the cough persists, take immediate action with the advice of a health practitioner. TACKLING COUGHS WITH TREATMENT Many people resort to antibiotics when they have an infection. However, antibiotics won’t work to ease a cough caused by a virus. They may even make symptoms worse, as they cause side-effects like diarrhoea and rashes. If you test positive for a bacterial throat or lung infection, your doctor will usually treat it with antibiotics: medicine that specifically inhibits the growth of bacteria. However, be weary of antibiotics in killing bacteria completely as they can also destroy natural bodily mechanisms that protect the body from diseases, resulting in a compromised immune system as a whole.

Pharmacy Magazine MAY 2017 |






MAY 2017



burn is an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction, or contact with chemicals.

The skin has an important role to play in the fluid

and temperature regulation of the body. If enough skin area is injured, the ability to maintain that control can be lost. In South Africa, burns are the greatest cause of unnatural death among children under age five. Burns commonly result from the sun, scalding by hot liquids, fire, electricity, or chemicals. Very young children have especially sensitive skin and even a burn from a cup of coffee can prove fatal. While minor burns on fingers and hands are usually not dangerous, burns injuring even relatively small areas of skin can cause serious complications. It is essential to apply appropriate first aid to any burn or scald as soon as possible. This will limit the amount of damage to the skin.

Burns are a global public health problem, accounting for an estimated 265 000 deaths annually



For minor burns, including first-degree burns and

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· Do not use ice. Putting ice directly onto a burn worsens tissue injury and can cause a burn victim’s body to become too cold.

second-degree burns limited to an area no larger than 7.5 cm in diameter, take the following action: · Cool the burn. Hold the burned area under cool (not cold) running water for 10-15 minutes or until the pain subsides. If this is impractical, immerse the burn in cool water or cool it with

· Do not apply butter or oil to the burn as this could cause infection.

cold compresses. Cooling the burn reduces swelling by conducting heat away from the skin. · Make sure that the person keeps warm.

· Do not break blisters as these are more vulnerable to infection.

Use a blanket or layers of clothing (avoiding the injured area) to prevent hypothermia occurring, when a person’s body temperature drops below 35°C. This is a risk when cooling a large burnt area, particularly in children and the elderly.

· Do not use fluffy cotton or other material that may get lint in the wound.

· Cover the burn with a sterile gauze bandage. Wrap the gauze loosely to avoid putting pressure on burned skin. Bandaging keeps air off the burn, reduces pain, and protects blistered skin. If bandages are not available, cover the burn with a layer of cling film over the burn, rather than


wrapping it around a limb. A clean, clear plastic bag can be

Burns are classified based on their depth,

used for burns on the hands or feet.

however it is important to understand that

· Take an OTC pain reliever. For pain relief use aspirin, ibuprofen, naproxen, or paracetamol. Ibuprofen and naproxen will also help to prevent swelling. Minor burns with reddened skin and no blisters may be treated with a topical burn spray. Use a skin care product that protects and heals skin, such as aloe vera cream or an antibiotic ointment.

burns are not static and may mature. In a matter of hours a first degree burn may involve deeper structures and become a second degree burn. Sun burns are a perfect example of this which may just appear red but a day later may blister. Similarly, second degree burns may evolve into third degree burns. This is what makes urgent treatment


| MAY 2017

Pharmacy Magazine

so important.


Now you can recommend Roznal OTC (lansoprazole) , created to put the spice back into the lives of frequent heartburn and indigestion sufferers! 1,2 Unlike antacids that only briefly neutralise the acid, 3 Roznal OTC gets to work where it matters by inhibiting the production of gastric acid. 1

Once a day for 24-hour relief . Make life more flavourful!

FSP 11644

References: 1. Roznal OTC approved package insert, March 2010. 2. Peura DA, Gudmundson J, Siepman N, et al. Proton pump inhibitors: effective first-line treatment for management of dyspepsia. Dig Dis Sci 2007;52(4):983-7. 3. Antacids. [Online] Available at: html. Accessed March 2017. 4. Drugbank. Lansoprazole. [Online] Available at: Accessed March 2017. Roznal OTC. Each capsule contains lansoprazole 15 mg. Reg. No: A40/11.4.3/0154. For full prescribing information, please refer to the package insert approved by the Medicines Regulatory Authority. Adcock Ingram Limited. Reg. No.: 1949/034385/06. 1 New Road, Midrand, 1685. Private Bag X69, Bryanston, 2021. Tel.: +27 11 635 0000. 1028398 04/2017.



Indigestion and heartburn:

what's the difference? Indigestion and heartburn are both gastrointestinal issues experienced by many people

Indigestion the medical term for which is dyspepsia - includes a number of symptoms and can often be a sign of some other health condition


lthough patients often talk about

problems are often caused

indigestion, and heartburn as a single

by lifestyle decisions rather

problem, they are in fact separate

than simply the food we

conditions. Or more specifically, indigestion

eat. “This includes how

is a condition, while heartburn is a symptom. Indigestion (dyspepsia) is a functional condition in

much food we eat, how fast we eat it ,and

which the gastrointestinal organs, primarily the

how late at night we

stomach and first part of the small intestine (and

eat. The stomach is

occasionally the esophagus), function abnormally.

the most sensitive

Heartburn is a symptom caused by reflux of acidic

stress reactor.

stomach contents into the oesophagus, resulting in

Therefore stress is

irritation and burning.

another common

Heartburn can be a symptom of indigestion (since

cause for heartburn

indigestion is a collection of symptoms) however

or indigestion.” As a

heartburn is also its own distinct symptom. Indigestion,

result, by changing eating and

on the other hand, isn’t related to stomach acid.

lifestyle habits patients can manage

Dr Abram Eisenstein, Director of Gastroenterology at

the conditions and alleviate the pain

Cooper Clinic, explains that one can distinguish between

that accompanies their symptoms.

indigestion and heartburn by the fact that they happen

“Other causes for both conditions

in completely different parts of the body. Heartburn is a

may be the medications we take, both

symptom which manifests as pain in the throat or neck,

prescription and over-the-counter

and a burning in the chest area. Indigestion on the other

(OTC). Important risk factors to

hand causes chronic burning pain in the upper and lower

note for heartburn include obesity

abdomen and a feeling of fullness after just a few bites.

and use of tobacco.”

The good news explains Eisenstein is that both

Continued on next page...

Pharmacy Magazine MAY 2017 |



SYMPTOMS OF INDIGESTION Indigestion is a chronic


• Gastroparesis

Indigestion (the medical term for which

• Helicobacter pylori (H. pylori) infection

is dyspepsia) includes a number of

• Irritable bowel syndrome

symptoms and can often be a sign of some

disease in which the

• Lactose intolerance

symptoms fluctuate

other health condition. “Indigestion basically means

• Peptic ulcer disease

in frequency and

‘poor digestion’ and describes some sort of disturbance

• Stomach cancer

intensity usually over

in digestion in the initial stages of digestion (usually

many months or years.

in and around the stomach rather than the bowels),”


It may occur every

explains Nutritional therapist Ali Cullen.

The National Institute of Diabetes and Digestive

The University of Miami Hospital defines

day or intermittently

and Kidney Diseases advises that treatment for

for days or weeks at a

indigestion as a painful or burning feeling in the

indigestion depends on the cause and may include:

time followed by days

upper abdomen and usually accompanied by

• OTC and prescription medicines

or weeks of relief (a

nausea, bloating or gas, a feeling of fullness, and,

• Changing what you eat and drink

pattern referred to as

sometimes, vomiting. While indigestion may be the

• Psychological therapies


result of a disease or an ulcer in the digestive tract, most often it is the result of eating too much, eating

OTC and prescription medicines

be accompanied

too quickly, eating high-fat foods, or eating during

You can buy many medicines to treat indigestion

by a variety of other

stressful situations.

without a prescription, such as antacids, H2 blockers,

Indigestion may

or proton pump inhibitors. However, should the

symptoms. It’s important to remember


indigestion lasts longer than two weeks, the patient

that each person’s

“Indigestion occurs in the upper abdomen just

should see a doctor. The doctor may prescribe

symptoms may vary.

under the breast bone,” explains Eisenstein. It is a

acid-suppressing medicines that are stronger than

burning discomfort in the stomach, sometimes likened

those one can buy, antibiotics, prokinetics,

These symptoms may include:

to hunger pains – except that it occurs on a full stomach

or psychological medicines.

• Feeling full too soon

and a general precaution, is that chest discomfort due


to a heart attack may be incorrectly attributed to either

Doctors often first recommend antacids – OTC medicines

heartburn or indigestion instead.

that neutralise acids in the stomach. Antacids include:

too. One similarity between heartburn and indigestion,

while eating • Pain, burning,

• Calcium carbonate

and discomfort in the upper belly or


• Loperamide


Indigestion is caused when the stomach acid comes

• Simethicone

into contact with the mucosa that lines the stomach

• Sodium bicarbonate

• Feeling bloated

to protect it from the acid. The stomach acids break • Poor appetite • Burping and loud

down the lining, causing the stomach acid to irritate


and inflame the stomach.

To treat a Helicobacter pylori (H. pylori) infection, a doctor will prescribe antibiotics, which kill bacteria. He or she will

stomach gurgling • Acidic taste • Nausea or vomiting • Constipation • Diarrhoea

According to the National Institute of Diabetes and

prescribe at least two of the following:

Digestive and Kidney Diseases some of the common

• Amoxicillin

causes of indigestion include:

• Clarithromycin


• Metronidazole

• Too many alcoholic beverages

• Tetracycline

• Too much coffee or too many drinks containing caffeine

• Tinidazole

• Too many carbonated, or fizzy drinks

• Flatulence These symptoms may increase in times of stress.


H2 blockers

• Too fast or too much during a meal

H2 blockers are medicines that decrease the amount

• Spicy, fatty, or greasy foods

of acid the stomach produces. H2 blockers provide

• Foods that contain a lot of acid, such as tomatoes,

short-term or on-demand relief for many people with

tomato products, and oranges

Sometimes when you have indigestion,


you may also have


heartburn. However,

Certain medicines

heartburn and

• Nonsteroidal anti-inflammatory drugs

separate conditions. Unlike heartburn which can cause you to awaken at night with pain or discomfort, indigestion usually does


| MAY 2017

• Cimetidine • Famotidine • Nizatidine • Ranitidine

• Some antibiotics—medicines that kill bacteria

indigestion are two

not awaken you.

indigestion. H2 blockers include:

Proton pump inhibitors (PPIs) PPIs are most effective in treating indigestion when

Health problems and digestive tract diseases and

patients also have heartburn. PPIs include:

conditions that can cause indigestion, include:

• Esomeprazole

• Acid reflux (GER and GERD)

• Lansoprazole

• Anxiety or depression

• Omeprazole

• Gallbladder inflammation

• Pantoprazole

• Gastritis

• Rabeprazole

Pharmacy Magazine

Continued on next page...

W H E N E FF MILD TO M ECTIVE RELIEF INFLAM MATODERATE PAIN O OF WITHOUT F ORY ORIGIN WI F EVER IS N TH1, OR EEDED 2 Myprodo l’s COMBIN original formulati ES THE on DIFF ACTIONS of codein ERENT e, ibupro and para fen cetamol in an OP RATIO O TIMISED F 1:20:2 5 for effe of pain, ctive li infla ef Myprodo mmation and fe 1,re ver. 2 l suspen s io a pleasa nt blackc n is available in urrant fla vour. 2

® OMENT? M L O D O R P Y M My patient. My reputation. Myprodol®. References: 1. Mitchell D, Gelgor L, Weber J. Antihypernociceptive synergy between ibuprofen, paracetamol and codeine in rats. European Journal of Pharmacology 2010;642:86-92. 2. Myprodol® Suspension approved package insert, June 1994. MYPRODOL® Suspension. Each 10 ml contains codeine phosphate 10 mg; ibuprofen 200 mg; paracetamol 250 mg. Reg. No. Y/2.8/119. For full prescribing information refer to the package insert approved by the medicines regulatory authority. 1023659 02/2017. Adcock Ingram Limited. Reg. No. 1949/034385/06. Private Bag X69, Bryanston, 2021, South Africa. Tel. +27 11 635 0000.


Prokinetics Prokinetics help the stomach empty faster. Prescription

 Limiting spicy, fatty, greasy, or high-fibre foods

• Bethanechol

 Chewing your food well

• Metoclopramide

 Limiting or not having any coffee, soda, or alcohol

aspirin and OTC pain and fever medicines (NSAIDs

drinks that may cause indigestion or make symptoms

or nonsteroidal anti-inflammatory drugs). If you do

• Alcoholic beverages

burning feeling (in the chest or behind the

 Quitting smoking

• Foods that contain a lot of acid, such as tomatoes,

 Getting enough rest

• Spicy, fatty, or greasy foods

 Finding ways to lower emotional and physical stress, such as meditation or yoga  Exercising before a meal or waiting at least one hour after eating

A doctor may recommend a type of psychological therapy

pain, burning in the


called “talk therapy” to help treat anxiety and depression

throat, hot-sour or acidic taste in the back of the throat, difficulty swallowing, feeling of sickness or nausea, feeling of

that may be causing indigestion. If stress is causing

“Heartburn is a symptom of indigestion

indigestion, a doctor may recommend ways to help

and usually describes the intense, burning

reduce stress, such as meditation, relaxation exercises,

feeling (hence the name) in the chest behind

or counselling. Talk therapy can also help a patient learn

the breastbone which occurs as stomach acid travels

how to reduce their stress.

backwards from the stomach into the oesophagus,” explains nutritional therapist Ali Cullen. “Heartburn is

food sticking in the middle of chest or throat, coughing,


usually a result of indigestion and can be so severe people

There are many things patients can do to try to

often mistake it for a problem with their heart.”

prevent indigestion. The University of Rochester

sore throat, etc. Other rare symptoms include pain in the back, jaw, shoulders, neck or arms.

from happening include:

• Foods or drinks that contain caffeine

Psychological therapies

breast bone), chest

take them, do so after you eat. · Other lifestyle changes that may keep indigestion

• Carbonated, or fizzy, drinks

tomato products, and oranges

heartburn include:

· Avoid medicines that hurt your stomach. These include

A doctor may recommend avoiding certain foods and worse, such as:

Symptoms of

for meals

prokinetics include:

Changes in what a person eats and drinks


 Eating slowly and giving yourself enough time

Medical Centre recommends:

The pain of heartburn is the irritation or damage taking place to your oesophagus by the refluxed stomach acid.

· Making changes in your diet and eating habits can help. These include:


 Eating several small, low-fat meals each day instead of

Heartburn is a painful burning sensation in the

three large meals

oesophagus, just below or behind the breastbone. The pain often rises in your chest and may radiate to your neck or throat. CAUSE Essentially heartburn is caused by acid reflux or when the digestive acid flows up into the oesophagus. According to the University of Maryland Medical Center, normally when food or liquid enters your stomach, a band of muscle at the end of your oesophagus closes off the oesophagus. This band is called the lower oesophageal sphincter (LES). If this band does not close tightly enough, food or stomach acid can back up (reflux) into the oesophagus. Usually acidic, the stomach contents can irritate the oesophagus and cause heartburn and other symptoms. Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is a condition which occurs when the top part of the stomach pokes into the chest cavity. This weakens the LES so that it is easier for acid to back up from the stomach into the oesophagus. Pregnancy and many medicines can bring on heartburn or make it worse. Medicines that can cause heartburn include: · Anticholinergics (used for sea sickness) · Beta-blockers for high blood pressure or heart disease · Calcium channel blockers for high blood pressure · Dopamine-like drugs for Parkinson disease


| MAY 2017

Pharmacy Magazine


} · Progestin for abnormal menstrual bleeding or birth control

Heartburn can be treated with the antacid calcium carbonate

· Carbonated drinks · Chocolate

· Sedatives for anxiety or sleep problems (insomnia)

· Citrus fruits and juices

· Theophylline (for asthma or other lung diseases)

· Peppermint and spearmint

· Tricyclic antidepressants

· Spicy or fatty foods, full-fat dairy products · Tomatoes and tomato sauces


Next, try changing your eating habits:

While occasional heartburn happens to most people at

· Avoid bending over or exercising just after eating

some point, Georgetown University Medical Centre

· Avoid eating within 3-4 hours of bedtime. Lying

cautions patients to pay attention to heartburn and

down with a full stomach causes the stomach

treat it, especially if symptoms are experienced often.

contents to press harder against the lower

Over time, ongoing reflux can damage the lining of your oesophagus and cause serious problems. In some cases heartburn responds to lifestyle changes.

oesophageal sphincter (LES) · Eat smaller meals Make other lifestyle changes as needed:

Avoiding trigger foods, shedding excess weight, not eating

· Avoid tight-fitting belts or clothes that are snug around

too close to bedtime and elevating the head of the bed are

the waist. These items can squeeze the stomach, and

all potentially helpful. Eating smaller meals, eating more slowly, not smoking or consuming alcohol and reducing stress may be helpful as well.


Heartburn is a condition in which a person experiences a burning sensation or pain in the chest or just behind the breastbone

may force food to reflux · Lose weight if you are overweight. Obesity increases pressure in the stomach. This pressure can push the stomach contents into the oesophagus. In some cases,

If you still do not have full relief, try OTC medicines: · Antacids help neutralise stomach acid · H2 blockers reduce stomach acid production · Proton pump inhibitors stop nearly all stomach acid production

GERD symptoms go away after an overweight person loses 4-8kgs · Sleep with your head raised about six inches. Sleeping with the head higher than the stomach helps prevent digested food from backing up into the oesophagus Place books, bricks, or blocks under the legs at the head


of your bed. You can also use a wedge-shaped pillow

The University of Maryland Medical Center advises

under your mattress. Sleeping on extra pillows does

that changing your habits can be helpful in preventing

NOT work well for relieving heartburn because you

heartburn. First, avoid foods and drinks that can trigger reflux, such as: · Alcohol · Caffeine

can slip off the pillows during the night · Stop smoking. Chemicals in cigarette smoke weaken the LES · Reduce stress. Try yoga, tai chi, or meditation to help relax Pharmacy Magazine MAY 2017 |



Busting myths: causes and treatments of lower back pain By avoiding certain risk factors, you can greatly reduce your chance of lower back pain as well as improve your general health

TIPS TO AVOID INJURY THAT MAY CAUSE LOWER BACK PAIN: · When lifting heavy objects, try to place most of the weight

Lower back pain is not something you have to live with


on your knees instead of your back.

ccording to recently conducted studies,


around 80% of all South Africans will

“The causes of lower back pain are widespread and

experience some form of back pain in

it is very difficult to pinpoint one or two specific

their lifetime. Lower back pain (LBP)

causes. It is most commonly caused by disc disorders

is a very common musculoskeletal condition that

and muscle injuries in young patients, or degenerative

can often lead to disability.

causes in older people. However, it may be more

The prevalence of this potentially debilitating

serious in the case of fractures or spinal cord

· Avoid sitting for long periods of time. If you have a deskbound job, try getting up and walking around frequently to minimise strain on

condition is increasing rapidly, raising concern

compression. Bearing in mind that there are extra

around the accuracy of diagnosis and treatment

spinal causes of lower back pain such as hernias,

of this condition.

bladder or uterus problems.”

your back. · Exercise regularly and pay special

Dr Jaytesh Pillay, orthopaedic and spine surgeon

attention to your

practising at Netcare Waterfall City Hospital in


Midrand, Johannesburg, says that false perceptions

“Lower back pain can be successfully treated with

exercising. Try to keep

about lower back pain may have a great influence on

the use of non-invasive, low risk methods. These

your back straight and

the proper diagnosis and treatment of the condition.

may include a combination of exercises, provided

your shoulders relaxed.

“Too many people mistakenly believe that lower back

and facilitated by a physiotherapist,

Stretching exercises

pain is just something they have to live with, without

anti-inflammatory and pain medication,

such as yoga or

thinking about the cause or realising that it may result

as well as bed rest,” explains Pillay.

Pilates can also have

in long term damage. Lower back pain can be a sign

posture while

“In extreme cases, surgery may be advised, but only

of serious injuries or another underlying condition and

after all conservative methods have been exhausted

should not be taken lightly,” he cautions.

and the patient is fully worked up using various

“Another big problem is fear of surgery, as many

diagnostic tests, specifically an MRI scan. An MRI

people think that the only way to treat lower back

scan is a non-invasive scan that allows us to visualise

pain is with back or spine surgery, which is incorrect.

the nerves, spinal cord, discs, and muscles.

Pillay holds that a multi-disciplinary approach is

your posture and core strength. · Consider calcium and magnesium supplements, especially if you

In fact, most cases are treated successfully without any form of surgery.”

a positive impact on

are over 40. Also


consider having bone

the best way to treat lower back pain. “At Netcare

“By avoiding certain risk factors, you can greatly

Waterfall City Hospital, we have a fully integrated

reduce your chance of lower back pain as well

spinal team consisting of orthopaedic spine surgeons,

as improve your general health,” Pillay advises.

neurosurgeons, physiotherapists, biokineticists, and

“Risk factors that increase your chances of

dieticians. There are many different causes of the

developing the condition include obesity, a

condition and therefore a variety of skills are required

sedentary lifestyle, poor posture, smoking,

to treat each individual case appropriately,” he says.

and hazards such as lifting heavy objects.”

density tests at this age. · Improve your quality of sleep by sleeping with your spine in a neutral position on a comfortable mattress.

Pharmacy Magazine MAY 2017 |



Healthy ageing With advances in medicine helping more people to live longer lives, the number of people over the age of 60 is expected to double by 2050

{ 28

A healthy lifestyle may do more than simply slow the ageing process. It could actually reverse it

| MAY 2017

Pharmacy Magazine




Staying healthy and feeling your best is important at any age. As we grow older, we experience an increasing number of health challenges. That said, getting older does not automatically mean poor health or that you will be confined to a walker or wheelchair. Plenty of older adults enjoy vigorous health, often better than many younger people. Preventive measures like healthy eating, exercising, and managing stress can help reduce the risk of chronic disease or injuries later in life

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15 MAY – 15 JUNE

Pharmacy Magazine MAY 2017 |





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15 MAY – 15 JUNE

Omega-3, B vitamins, and slowing the brain's decline B vitamins can help many older adults with mild cognitive impairment, but only if they have good levels of omega-3 fatty acids


hile research has already established

Dr Abderrahim Oulhaj, assistant professor at the

that B vitamin supplements can help

UAEU’s Institute of Public Health, said: “We found that

slow mental decline in older people with

for people with low levels of omega-3, the vitamin

memory problems, an international team

supplements had little to no effect. But for those with

has now found that having higher levels of omega-3 fatty

high baseline omega-3 levels, the B vitamins were very

acids in your body could boost the B vitamins’ effect.

effective in preventing cognitive decline compared to the

The team, from the Universities of Cape Town (UCT),

placebo. This result complements our previous finding

Oslo, Oxford, and the UAE, studied more than 250 people

that B vitamins slow the rate of brain atrophy in MCI

with mild cognitive impairment (MCI) in Oxford. MCI is when

only in those with a good omega-3 level to start with.”

brain function is below what is normally expected for a

The team also found that levels of DHA might be

person’s age but is not significant enough to interfere with

more important than levels of EPA, although they

daily life. While it is not as serious as dementia, if untreated

caution that more research must be done to establish

it often progresses to become dementia.

whether this is true.

“We previously found that B vitamins are able to slow

“The next stage will be to see whether providing a

or prevent the atrophy of the brain and memory decline in

combination of B vitamins and omega-3 supplements can

people with MCI,” said Dr Celeste de Jager, senior lecturer

slow the conversion from MCI to Alzheimer’s disease,” said

at the UCT Division of Geriatric Medicine. “This was most

Professor David Smith (Professor Emeritus of Pharmacology

effective in those who had above average blood levels of

at The Oxford Institute of Population Ageing). “This would be

homocysteine, a factor related to B vitamin status that

an important step in the prevention of Alzheimer’s disease.

may be toxic to the brain. Scientists in our team initially

We have high hopes that this trial would work, but funding is

found that there was a link between omega-3 levels,

not easy to contain for such studies.”

homocysteine, and brain atrophy rates. We wanted to find

“These results help us to tease apart who could benefit

out whether omega-3 and B vitamins might interact to

from taking B vitamins, suggesting that they might only

prevent cognitive decline.”

improve cognition in people who have high levels of

At the start of the study, each person was given a set of

Omega-3 oils in their blood,” said Dr Doug Brown, director

tests to measure their cognition, and had a blood test to

of research and development at Alzheimer’s Society.

determine the levels of two omega-3 fatty acids commonly

“Encouragingly, these findings suggest that for some

found in oily fish: docosahexaenoic acid (DHA) and

older people a combination of fish oil supplements and

eicosapentaenoic acid (EPA).

B vitamins may help to improve thinking and memory.

The participants were split into two randomly-selected

Findings from the study may help to explain why research looking at the effects of B vitamins, or the effects of omega-3 oils, have produced inconsistent findings

“As this study shows, the relationship between

groups, who received either a B vitamin supplement of a

nutrition and brain health is complex and we need to

placebo pill over two years. Their cognitive performance

see increased research efforts to help us understand

was also measured and the results compared with the

the role that diet and nutrition can play in reducing a

baseline results from the start of the study.

person’s risk of dementia.” Pharmacy Magazine MAY 2017 |




15 MAY – 15 JUNE Improve joint and bone health, and skin conditions like eczema with an all-natural supplement that can help reduce the signs of aging by helping the body to heal itself



Researchers have concluded that skin, joint, and bone aging can be delayed and prevented by adequate daily supplementation with oral collagen

Liquid collagen:

the complete anti-ageing solution


healthy, youthful body is strong and enjoys a full range of motion. However, as we age, stiffness, soreness, swelling, pain – all common arthritis symptoms –

can make us feel that the years are taking their toll. The good news is that these aches and pains are not inevitable. With liquid collagen, a natural supplement which can help reduce the signs of aging by helping your body restore itself on a molecular level, they can be managed. Unlike pain relievers, liquid collagen doesn’t just reduce symptoms or temporarily relieve inflammation – it actually helps the body repair itself. With age, collagen levels drop off due to a decrease in production and an increase in degradation. Liquid collagen gives the body the nutrients it needs to rebuild collagen and bone, reversing chronic joint pain and enabling regeneration.

Potent hydrolysed collagen supplements provide the optimal daily dosage required for healing and repair of the body, performing several key functions: · Provide external anti-ageing benefits for the skin, hair, and nails · Contribute to normal muscle functioning · Help to improve bone and joint strength, reducing stiffness and soreness · Increase both cartilage mass and the articular cartilage thickness of joints · Boost vitality and general wellbeing · Quicker post-operative recovery time · Powerful antioxidant and immune booster

Used as part of an anti-ageing regime, liquid collagen promotes joint cartilage and bone strength, and contributes to decreasing joint rigidity and mobility pain Continued on next page...

Pharmacy Magazine MAY 2017 |




sports endurance and performance making it perfect for men and women wanting to maintain or increase lean muscle mass. For professional athletes and people hitting

15 MAY – 15 JUNE

the gym alike, it helps to prevent injuries and – in the case of injury – speeds up recovery substantially, allowing you to return to your chosen sport or exercise more quickly. Because it’s in liquid form, it’s also easy to add to a glass of

Unlike pain relievers, liquid collagen doesn’t just reduce symptoms or temporarily relieve inflammation, it actually helps the body repair itself

water or juice, smoothie or even a shake. “Used as part of an anti-ageing regime, liquid collagen promotes joint cartilage and bone strength, and contributes to decreasing joint rigidity and mobility pain too enabling people to resume activities more easily and quickly,” says Dr Julie Sinclair, a medical doctor with a special interest in aesthetics and improving the overall wellness of her patients. “I recommend it for my patients as it helps to reduce pain and inflammation at the joint site, enabling improved mobility and quality of life.” A REMEDY FOR ECZEMA When it comes to eczema, collagen helps to close skin wounds, form new scar tissue, and reduce scars over time. In addition to aiding the formation of new skin, liquid collagen also enables faster healing of the damaged “Suitable for use by anyone, from teenagers to the

tissues, restoring the skin’s firmness and elasticity.

elderly, liquid collagen helps with the management of arthritis and other physical aches and pains, helps with


the prevention of sports injuries, reduces healing time, and

Most people report positive results within a month to six

can even treat eczema,” says Dr Jennifer Irvine, a general

weeks, while others take 3-6 months. Because there are

practitioner with a special interest in aesthetics.

many factors that affect the condition of the skin, such as

Arthritis is the most commonly occurring mobility disease, and the most frequent cause of movement

people have the same results within the same period, which

disability. It affects people of all ages, sexes, and

is why continuous use is advised, especially as we continue

races. Type 2 oral hydrolysed collagen, taken as a food

to lose 1.5% of our collagen per year from age 25.

supplement, has been proven to stimulate collagen production and the proteoglycans found in chondrocytes. It thus provides significant reduction of the rate at which joint cartilage deteriorates, and results in reduced joint strain. “Because it is easily absorbed, hydrolysed collagen is extremely helpful when it comes to joint and bone health,” said Irvine. “Its non-invasiveness has shown excellent results, and has both clinical and scientific backing. Researchers have concluded that skin, joint, and bone aging can be delayed and prevented by adequate daily supplementation with oral collagen (Type 2) peptides at the daily dosage of 10 000mg. It’s about taking care of yourself from the inside out.” Hydrolysed collagen has also been proven to enhance


| MAY 2017

genes, lifestyle, diet, sun exposure, and smoking, not all

Pharmacy Magazine


Liquid collagen gives the body the nutrients it needs to rebuild collagen and bone, reversing chronic joint pain and enabling regeneration



Your blood saves lives A pint of blood is drawn from a volunteer donor.


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Blood is transfused to patients in need. Just one blood donation has the potential to save three lives!

Blood is collected into a sterile bag and labelled.

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Units are transported to the nearest SANBS testing and processing lab.

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What happens to your blood


Red Blood Cells Contain haemoglobin, a protein that carries oxygen throughout the body. Used to treat patients with anaemia or blood loss due to trauma or surgery.

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Blood products are stored prior to transfusion. The shelf life of blood is limited. Platelets expire in 5 days. Red blood cells expire in 42 days. Plasma has a 2 year shelf life from the day of collection.

Local hospitals place orders with SANBS for blood products based on their needs.

Blood is tested to ensure that it is safe for transfusion.

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The right vitamins for

15 MAY – 15 JUNE

osteoporosis Osteoporosis, defined by porous bones, is a common problem in Western countries. It is especially common among elderly women and strongly raises the risk of fractures


A 3-year trial in 244 postmenopausal

It also plays a role in removing calcium from

women found that those taking vitamin K2

areas where it shouldn’t be, such as in the

is a

supplements had much slower decreases in

arteries and soft tissues.


age-related bone mineral density.


disease characterised by low bone

strength that results in an increased risk of

The main function of Vitamin K is to

Lengthy studies on Japanese women

activate the calcium-binding properties

have shown similar benefits, although they

of proteins. K1 is mostly involved in blood

used very high doses. Out of 13 trials, only

clotting, while K2 helps regulate where

one failed to show significant improvement.

calcium ends up in the body.

Seven of those trials also reported

Vitamin K2 activates the

fracture. In SA, one in

fractures and found that vitamin K2 reduced

calcium-binding activity of Matrix Gla

three women and one

spinal fractures by 60%, hip fractures by

protein and osteocalcin, which help to

in five men will develop

77%, and all non-spinal fractures by 81%.

build and maintain bones. It also works

osteoporosis. PREVENT FRACTURES Fractures are associated with serious clinical consequences, including long-term disability, increased risk of death, and high healthcare costs. Early identification and intervention with patients at high risk for fracture is needed to reduce the burden of osteoporotic fractures. The management of a patient with a confirmed diagnosis of osteoporosis or low bone mass (osteopenia) includes assessment of fracture

synergistically with a number of other VITAMIN K Vitamin K2 is rare in the Western diet and

nutrients, including calcium and vitamin D. Vitamin K1 exclusively participates

hasn’t received much mainstream attention.

in blood clotting – its sole purpose.

However, this powerful nutrient plays an

K2 on the other hand comes from a

essential role in many aspects of health.

whole different set of food sources,

It has been postulated that vitamin K2

and its biological role is to help move

may just be the ‘missing link’ between diet

calcium into the proper areas in your body,

and several diseases.

such as your bones and teeth.

Vitamin K was discovered in 1929 as an essential nutrient for blood coagulation. The initial discovery was reported in a German scientific journal, where it was called Koagulationsvitamin. That’s where the ‘K’ comes from. The three types of vitamin K are: · Vitamin K1, or phylloquinone, is found naturally in plants, especially green vegetables – K1 goes directly to your liver and helps you maintain healthy blood clotting. · Vitamin K2, also called menaquinone,

risk, evaluation for

is made by the bacteria that line your

secondary causes

gastrointestinal tract – K2 goes straight

of skeletal fragility,

to your blood vessel walls, bones, and

making decisions on

tissues other than your liver.

HOW MUCH VITAMIN K2 DO YOU NEED? The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180-200 micrograms of vitamin K2 should be enough to activate the body’s K2-dependent proteins to shuttle the calcium where it needs to be, and remove it from the places where it shouldn’t. A Western diet contains as little as 10% of that or less. About 80% of Americans do not get enough vitamin K2 in their diet to activate their K2 proteins, which is similar to the deficiency rate of vitamin D. Vitamin K2 deficiency leaves patients vulnerable for a number of chronic diseases, including: · Osteoporosis · Heart disease

initiation of treatment,

· Heart attack and stroke

and identification of all

· Vitamin K3, or menadione, is a synthetic

relevant clinical factors

form not recommended recommend –

that may influence

it’s important to note that toxicity has

patient management.

occurred in infants injected with this

· Brain disease

synthetic vitamin K3.

· Cancer

· Inappropriate calcification, from heel spurs to kidney stones Continued on next page...

Pharmacy Magazine MAY 2017 |


Influenza is a serious threat…

A healthy start today

Rea t othe dy to infec rs tomorrow

…to life 3 to 5 million cases of severe influenza illness result in 250 000 to 500 000 deaths per year1.

…to society

The economic impact of influenza because of healthcare costs and lost productivity is considerable2. Vaccination results in a significant reduction in hospitalization due to chronic respiratory conditions and pneumonia. Overall mortality – a decrease of up to 50%3 References: 1. Van de Witte SV et al. Trivalent inactivated subunit influenza vaccine Influvac®: 30-year experience of safety and immunogenicity. Trials in Vaccinology 1 2012; pp42-48. 2. Rohde G et al. Vaccinating High-risk Patients Against Influenza: Doing More to Protect Patients with Asthma. Annals of Respiratory Medicine 2010; 1:1-7. 3. Nichol KL et al. Influenza Vaccination and Reduction in Hospitalizations for Cardiac Disease and Stroke among the Elderly. N Engl J Med 2003; 348:1322-1332. S2 Influvac Subunit 2016. Composition: Each 0,5 ml Influvac Subunit 2016 influenza vaccine contains influenza virus surface antigens (haemagglutinin and neuraminidase) of strains: A/ California/7/2009 (H1N1) pdm09-like strain used (A/California/7/2009, X-181) 15 µg HA; A/Hong Kong/4801/2014 (H3N2)-like strain used (A/New Caledonia/71/2014, X-257A) 15 µg HA; B/ Brisbane/60/2008-like strain used (B/Brisbane/60/2008, wild type) 15 µg HA. Abbott Laboratories S.A. (Pty) Ltd, Reg. No. 1940/014043/07, Abbott Place, 219 Golf Club Terrace, Constantia Kloof, 1709. Tel No.: 011 858 2000 For full prescribing information refer to the package insert approved by the medicines regulatory authority. Date of publication: March 2016 Promotional Review Number: ZAEINF150254.

Vaccinate your patients with ABBOTT’s Influvac® this winter!


Conditions, diseases and medications that cause or contribute to osteoporosis and fractures:

Lifestyle factors

Low calcium intake Vitamin D insufficiency Excess vitamin A High caffeine intake High salt intake Aluminum (in antacids) Alcohol (3 or more drinks per day) Inadequate physical activity Immobilisation Smoking (active or passive) Falling Thinness

Genetic factors

Cystic fibrosis Homocystinuria Osteogenesis imperfecta Ehlers-Danlos syndrome Hypophosphatasia Parental history of hip fracture Gaucher’s disease Idiopathic hypercalciuria Porphyria Glycogen storage diseases Marfan syndrome Riley-Day syndrome Hemochromatosis Menkes steely hair syndrome Hypogonadal states Androgen insensitivity Hyperprolactinemia Turner’s and Klinefelter’s syndromes Anorexia nervosa and bulimia Panhypopituitarism Athletic amenorrhea Premature ovarian failure


15 MAY – 15 JUNE

When lacking vitamin K2, patients are at much greater risk for osteoporosis. Researchers are also looking into other health benefits. For example, one recent study published in the journal Modern Rheumatology found that vitamin K2 has the potential to improve disease activity besides osteoporosis in those with rheumatoid arthritis (RA). Another, published in the journal Science, found that vitamin K2 serves as a mitochondrial electron carrier, thereby helping maintain normal ATP production in mitochondrial dysfunction, such as that found in Parkinson’s disease. VITAMIN K2 DEFICIENCY

Endocrine disorders

Adrenal insufficiency Diabetes mellitus Thyrotoxicosis Cushing’s syndrome Hyperparathyroidism

health conditions, they’re likely deficient in vitamin K2 as they are all

Gastrointestinal disorders

Celiac disease Inflammatory bowel disease Primary biliary cirrhosis Gastric bypass Malabsorption GI surgery Pancreatic disease

Haematologic disorders

Haemophilia Multiple myeloma Systemic mastocytosis Leukaemia and lymphomas Sickle cell disease Thalassemia

Rheumatic and autoimmune diseases

Ankylosing spondylitis Lupus Rheumatoid arthritis

Miscellaneous conditions and diseases

Alcoholism Emphysema Muscular dystrophy Amyloidosis End stage renal disease Parenteral nutrition Chronic metabolic acidosis Epilepsy Post-transplant bone disease Congestive heart failure Idiopathic scoliosis Prior fracture as an adult Depression Multiple sclerosis Sarcoidosis


Anticoagulants (heparin) Cancer chemotherapeutic drugs Gonadotropin releasing hormone agonists Anticonvulsants Cyclosporine A and tacrolimus Lithium Aromatase inhibitors Depo-medroxyprogesterone Barbiturates Glucocorticoids (≥5mg/d of prednisone or equivalent for ≥3mo)

There’s no way to test for vitamin K2 deficiency. But by assessing diet and lifestyle, one can get an idea of whether or not patients may be lacking in this critical nutrient. If patients have any of the following connected to K2: · Osteoporosis · Heart disease · Diabetes. If patients do not have any of those health conditions, but do not regularly eat high amounts of the following foods, then the likelihood of being vitamin K2 deficient is still very high: · Grass-fed organic animal products (i.e. eggs, butter, dairy) · Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500mcg per serving · Certain cheeses such as Brie and Gouda (these two are particularly high in K2) Note that not every strain of bacteria makes K2. For example, most yoghurts have almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria. This SAMA accredited article first appeared in the Medical Chronicle in May 2017. CPD points cannot be guaranteed as they are awarded at the South African Pharmacy’s discretion.

TO COMPLETE THE CPD QUESTIONS VISIT WWW.MEDICALCHRONICLE.CO.ZA INSTRUCTIONS: 1. Go to 2. Click the tab labelled ‘CPD Portal’ on the far right tab near the top of the page. 3. Select the relevant questionnaire from the list and complete the form.

Pharmacy Magazine MAY 2017 |



Tell them it’s new


Retailing is finding it difficult at present and therefore we need to relook at some of the basic retail skills and challenge ourselves to develop new opportunities n this grab and go society the consumer is still look-


ing for something new. It may be a new colour, new


design, or a completely new item on the shelf. New

New products need to be seen by as many people as

products can be the life blood of a retail business.

possible. They are major new impulse lines and this means

They create interest and even if the customer does

they can be taken out of category and displayed on their

not buy, it encourages them to linger longer in your

own. The new product needs to be on or close to the

store. This is why I am often surprised at retailers that

customer racetrack to ensure they get maximum exposure.

get a new product in and put it on the shelf without even bothering to promote it. I was reminded of the importance of new product

New products can be the life blood of a retail business

RULE 3: ATTEND TO THE SIGNAGE New products have to be promoted and signage is critical

marketing recently when working with a client. They had

to the success of the launch. Make sure that the sign uses

developed a brand new locally made product, it was a

big letters using words such as:

Christmas tree decoration. It was displayed next to other


Christmas tree decorations that were made in China and


were a third of the price of the new product. The client


commented that the new decorations were not selling and


that they had got the price point wrong.


On looking at the product, it had no reference to where it was made, in fact on the box the only communications

The words your use are key motivators to draw attention to the product.


was the price. There was no signage to promote the

John Stanley is a retail business coach, speaker and consultant

product. It was literally just sitting on the shelf.



New products often need extra information to sell them, a

New products give you, as a retailer, the opportunity to

sales member of your team may not always be available to

get excited. If you do not get excited, then do not expect

pass this information on to the customer. Provide a leaflet

your customers to get excited.

holder and leaflets to help the customer make a decision.

When a new product comes into store it is an opportunity to grow sales and to get the customer excited

This could include extra information on the products origin and making process.

about your business and the products you sell, but there are some rules that need to be adhered to if you are going


to create the excitement a new product deserves.

IF APPROPRIATE If your customer has never seen this product before they


may need a demonstration on how to use it in their home. It


is your job to bring the product to life for the consumer.

People get excited if other people get excited. This has to start with your team. They need to know all the features and benefits of the new product and to understand what are the hot but-

RULE 6: PROMOTE, PROMOTE, PROMOTE The product needs maximum exposure and you should take the opportunity to promote new items whenever

tons to sell the product to a consumer

you can. Talk about this product on your Facebook page,

who has never seen this product before.

Twitter and more traditional marketing techniques you use

I suggest you present the team with a

in your business. Send out flyers and give samples to your

fact sheet on the new product and a list

staff to use so they can talk from their own experiences.

of the most common questions you expect the customer to ask about the


product. Allow time for the team to

The world is full of new products that have failed. Before

digest the information and get them

you buy do your homework and buy with caution. Do not

together to brainstorm ideas on how

buy just because it is new, buy with the customer in mind

they can increase the sales.

and sell with passion.

Pharmacy Magazine MAY 2017 |



hop ront S 2016 F stant Assi r of winne ar e y the

“Invest your time wisely it will have an impact in your future”

Health aficionado 1 4 2 6 9 3 7 5 10 8 Where did you grow up?


I grew up in a small town

Volenti Meyer

in the Eastern Cape, called Loerie.

PHARMACY: Rink Street Pharmacy

Who inspires you and why?

JOB TITLE: Frontshop Assistant AGE: 40

with people who are not

instilled a fascination in

my soul. I would love

fortunate enough to know

the health industry. I’ve

to take my career to

better is very rewarding.

always been keen to

the next level should

learn about new

the opportunity to be a

developments in the

pharmacy technician

pharmacy industry.

arise. Being part

What is the hardest part of your job?

of the health and fitness

My mom, because of her

some customers are

dedication, hard work,

unable, or not yet ready to

How long is your commute to work?

loyalty, and dependability.

recognise the power they

My commute to work is

have to make changes in

about 25 minutes.

Having to accept that

utter exhaustion that

Be kind, listen carefully,

follows a trail run through

and always have a

a valley, farm, or the bush.

positive mind-set.

the odd antibiotic

What is your dream (where would you like to be in say 5 or 10 years time)?

What have you learnt that you wish you could tell your 16-year-old self?

growing up, I was

Hopefully to have lived

Invest your time wisely

exposed to living healthily

to my full potential in

it will have an impact in

at a very early age which

all the things that excite

your future.

Definitely learning

exercise to their day.

to share my knowledge

my ultimate dream.

I find relaxation in the

their own lives to improve

day. Also, the opportunity

fitness instructor would be

What advice do you have for front shop and pharmacist assistants?

What do you enjoy most about your job? something new every

industry as a qualified

their health. Like simply adding some form of

Why did you choose a career in the pharmacy industry? Although I only really knew the names of

Borstol, Panado, and

What do you do to relax?

“Be kind, listen carefully, and always have a positive mind-set”

Do you want to feature on our profile page or perhaps nominate a worthy colleague? Contact the editor on:


| MAY 2017

Pharmacy Magazine

Dual action, expectorant and bronchodilator.

opens your chest to get you active again.

S2 ActophlemÂŽ Cough Syrup. Each 30 ml contains theophylline 100 mg; etofylline 10 mg; diphenylpyraline hydrochloride 8 mg; ammonium chloride 720 mg; sodium citrate 300 mg. Reg. No. W/10.1/194. For full prescribing information refer to the package insert approved by the medicines regulatory authority. Adcock Ingram Limited. Reg. No. 1949/034385/06. Private Bag X69, Bryanston, 2021, South Africa. Tel. +27 11 635 0000 1026275 03/2017.

Frontshop Pharmacy Magazine - May 2017  

Valuable education for pharmacy staff for Pharmacists, Pharmacist Assistants, Front Shop Assistants, and Clinic Sisters

Frontshop Pharmacy Magazine - May 2017  

Valuable education for pharmacy staff for Pharmacists, Pharmacist Assistants, Front Shop Assistants, and Clinic Sisters