Dr. Keith Roach
Dear Dr. Roach:I am concerned and have worried for some time about whether my prescriptions in the mail will be compromised, since they are in the car with the sun shining through the windows heating them up. Additionally, plastic bottles containing prescription medications release toxic emissions when they are exposed to the sun. The instructions that come with some threads also warn about temperature.
My pharmacist told me that heat has a negative effect on the effectiveness of the medicine. So if that really happens, millions of us are taking important medications that essentially don’t work. After all, topics to the pharmacy are also available on attractive media. What do you think?
Dear JZ:All medications should be stored in a cool, dark place, as direct sunlight and heat can damage their effectiveness. Studies have demonstrated that mail-order medications can actually exceed their published temperature ranges. While this happens most often in mailboxes, I understand your point about hot temperatures during shipping.
Liquid medications, hormones and nitroglycerin are the most sensitive substances. Medications that need to be dosed precisely, such as transplant rejection drugs, biologics, and epilepsy drugs, are also especially likely to cause problems if they are damaged during transport. Although some medications are required to be shipped in cooler and insulated packaging, this is not always the case.
I recommend using your local pharmacy, but many have prescription plans that require them to order by mail. Many states have requirements that customers may use retail pharmacies. If that’s not the case for you, try to make sure the medication is delivered when you’re ready to receive it.
If you have a temperature-sensitive medication, such as the ones I mentioned above (you can ask your pharmacist about others), ask your mail-order pharmacy to send it to you. it in special packaging during the warm weather months. You may also consider transporting them to a place where they will be placed in a temperature-controlled environment immediately.
Dear Dr. Roach:Since developing bronchiectasis, I have lost 15 pounds. I can’t seem to get an answer as to why this disease leads to weight loss. Can you shed some light on this?
Dear E.KG:Bronchiectasis, a lung condition that is similar to chronic obstructive pulmonary disease (COPD) and develops after a lung infection occurs in a person at risk for certain underlying conditions.
Weight loss due to chronic lung disease, such as COPD and bronchiectasis, is common. There are many possible reasons. One is that breathing can be hard work! People with chronic lung disease need more energy (10 times more energy) to breathe. Some medications used to treat bronchiectasis promote weight loss, often due to poor appetite. Bronchiectasis is an inflammatory condition, so this can also lead to appetite suppression.
Although many healthy people want to lose weight, weight loss with chronic lung disease is a bad sign and a reason to make some dietary changes. I generally advocate nuts and nut butters; The healthy fats in them are high in calories, and fat passes more easily into your lungs because it produces less CO2 than protein or carbohydrates. You need to maintain your muscle strength.
Finally, a new serious diagnosis always leads to a change in the way we think about our bodies, so depression (which often worsens weight loss) is not uncommon. Your doctor or mental health professional can help.
Readers can email questions to ToYourGoodHealth@med.cornell.edu.
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