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Question 1

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Host 0:02
Welcome to The Expert Series brought to you by the Lupus Foundation of America. Our health education team is here to bring you experts in lupus to discuss topics to help you live better. Thank you for tuning into today's episode. My name is Melissa and I'll be your host.

I'm very excited to welcome Dr. Marcia Mueting, who will be speaking to us about the importance of keeping up with your medications. Dr. Mueting is a graduate from the University of Nebraska College of Pharmacy with a doctor of pharmacy degree. She has worked as a staff pharmacist, a pharmacy manager in community pharmacy practice as well as a consultant pharmacist for long term care. She currently serves as the chief executive officer and pharmacist on staff for the Nebraska Pharmacist Association. Marcia's husband was diagnosed with lupus over 30 years ago, he had been on several medications to control his lupus symptoms, and have survived a stroke and cancer. We're delighted to have you join us today, Dr. Mueting. And thank you for giving us your time.

Dr. Mueting 0:59
Thank you for the opportunity to be here. I'm really excited to be part of The Expert Series.

Host 1:05
Great, we're excited to have you. So, why don't we go ahead and get started? So our first question is just about the number of medications people take to manage their disease and side effects. And can you talk a little bit about the role of pharmacists can play in helping lupus patients manage their medications?

Dr. Mueting 1:26
Absolutely, you know, pharmacists are the drug experts on the healthcare team. So lupus patients should take advantage whenever they can of tapping into the pharmacist's knowledge.

I'm hoping that each patient who has lupus has a terrific pharmacist who is watching to make sure that those patients are taking their medication and verifying that with each fill. And if the patient isn't taking their medication on a regular basis. Hopefully the pharmacist is asking why, you know, why would why are you having trouble with side effects. And if side effects are an issue, then maybe the pharmacist can offer some tips or tricks to help to avoid side effects. So for example, a person who takes prednisone might find that that medication upsets their stomach, and prednisone probably should be taken with food. So that's one thing that you know, the patient can talk to the pharmacist about is: how do I best take this medication? Does it need to be taken with food or on an empty stomach? And what other medications can I take with it or not? So those are important questions to ask the pharmacist, especially for patients who are also on non-steroidal anti-inflammatory medications. They need to know which over-the-counter medications they can take with their prescription medications for lupus.

Another thing that a pharmacist can help with too is if a patient's not taking their medication on a regular basis, maybe cost is a barrier. And sometimes pharmacists can help by talking to the prescriber and finding an alternative that might be more affordable for the patient, or helping the patient find a patient assistance program through a drug manufacturer that will lower the cost that monthly cost to the patient.

Host 3:25
Wow, it's so that's great. That's great information and good for people to know, I think about what you know, they can ask their pharmacist to do and you know, instead of just asking to, you know, for the pills, but also ask for information and help. Are there additional ways that pharmacists can help?

Dr. Mueting 3:41
Absolutely. You know, I think one of the most important things that we learned with my husband on his lupus journey is the medications need to be taken on a regular basis. So pharmacists have pill minders. And a lot of them have certain programs that can help patients stick on their meds, like maybe an automatic refill so that the medication is ready on a regular basis for the patient to take.

Host 4:07
That's great. That's great to know. And so you mentioned about you know how important it is to for people to continue on their medications. And so I did want to ask specifically about that. Right? How important is it for people with lupus to continue their medications as directed by their doctors?

Dr. Mueting 4:24
You know, that's probably the most important part lupus patients find out very quickly that medications help most when they're taken on a regular basis or really as a preventative to any kind of a flare-up that they might have. One thing we learned that you know absolutely fascinated me about lupus is we know that lupus flares can be brought about by certain types of triggers, right? It could be triggered by a sun exposure, or it could be triggered by a stressful event. Well, it seems to us that the time between the trigger and the time that the flare occurred could be as much as two weeks. So if a person is only taking their medications when their flares occur, they might be a little bit behind in the game in treating their lupus. You know, the, the anti -inflammatories and some of the other medications that are prescribed are really to prevent flare-ups. And once the patient has a flare-up, they might have to end up playing catch up with a medication in order to feel better sooner. So lupus patients need to be proactive and make sure that they take their medications on a regular basis to prevent a flare up. I think, you know, that's probably a hard lesson that almost all lupus patients need to learn is that the medications really help most when they take it in a preventative manner.

Host 5:44
That's, that's really important. But some of the medications come with side effects. And so can you talk about what a person can do if they experience unpleasant side effects from their medication?

Dr. Mueting 5:56
Absolutely. Any patient that has unpleasant side effects from their medication or they want to know, if what they're experiencing is a side effect from the medication should definitely talk to their pharmacist or their prescriber. Describe the symptoms, describe the issues that they're having. And a lot of times those issues can be addressed either by changing the dose of the medication with the prescriber's approval, or by managing when the patient takes the medication, for example.

Host 6:26
That's great. That's interesting. Um, so people do have a, you know, they have options if they are experiencing unpleasant side effects.

Dr. Mueting 6:33
Absolutely. Absolutely.

Host 6:36
So, what questions or information should people with lupus ask or share with their pharmacists?

Dr. Mueting 6:44
Sure, you know, some medications are taken to prevent flare-ups as we as we mentioned before, and those medications are it is important for them to be taken on a consistent basis. So patients who have lupus also have other issues like blood pressure. In the case of my husband, he is a rare male lupus patient that also has a syndrome that lupus patients are likely to experience called antiphospholipid syndrome. Antiphospholipid syndrome, yes, is a clotting disorder. So my husband also needs to take a medication that helps prevent his blood from clotting and causing a stroke.

So I guess what's important is, while we want to focus on treating that patient's lupus, we also have to recognize that the patient may have other conditions. And all of those medications need to work well together. And one of the most important questions that any patient can ask their pharmacist is, how do these medications work together? I want to be sure that these medications are working together. And you know, the pharmacist typically reviews that each time they sell a prescription. And I think it's worth the conversation with any patient and their pharmacist.

Host 8:07
So, but can someone with lupus take their medications in conjunction with daily vitamins and supplements? I know you talked about taking all of your prescribed medications together and making sure that you know everything is going to work well together. But a lot of people also like to take vitamins, they take supplements. Can someone take medications with those things?

Dr. Mueting 8:28
Sure. In the end, it's not a very good answer. I'll be the first to admit, but it depends. It depends on what that vitamin is and what the medication is. Some medications should be taken on an empty stomach. Other medications can be taken with other vitamins and or foods. So it depends on the medication. That's why it's so important to ask your pharmacist for help. That's why they're there.

Host 8:54
That's great. Yeah, I think that that is really important to stress that that your pharmacist is a resource for you and that a pharmacist needs to know everything that you take, even if it wasn't prescribed by a doctor.

Dr. Mueting 9:05
Absolutely, absolutely. That that is the key. Even over-the-counter medications like you suggested.

Host 9:13
So one thing I think that is a little confusing is the difference between brand name and generic medications. You know, sometimes the prescription that the doctor writes has a different name than the prescription that you're given at the pharmacy. So can you talk a little bit about the difference between brand name and generic medication?

Dr. Mueting 9:31
Absolutely. Brand-name medications are usually made by a company that maybe they discovered the drugs and they're the first one to market. Oftentimes, brand-name medications might be more expensive than generic medications. But as a pharmacist, I recommend generic medications whenever possible. Generics are required to be the same as their brand-name counterparts in dosage, safety, effectiveness, strength, stability and quality, as well as they're taken the same way.

Generic medications have the same risks and benefits as their brand-name counter counterparts as well. Generics have to be they have to show to the FDA that they are the same as the brand name medication. There really isn't a difference.

Host 10:22
Is there a difference between generic medications that are made by different manufacturers? Is that something that people need to be aware of?

Dr. Mueting 10:31
I think that in rare cases, some people might respond better to one generic thing or another. And I'll tell you why. Because in whether it's the brand name medication, or it's the generic, they all have the same active ingredients. And those active ingredients behave the same way. They are the same strength from tablet to tablet, or capsule to capsule. But what is different between brands, and generic and different generic manufacturers is the inactive ingredients. So if someone is allergic to a dye, for example, one generic may be more compatible for them than another. But typically, they all end in the same result, the same clinical result, which is helping the patient with their lupus symptoms.

Host 11:23
Thank you so much for those, those answers. That is very good to know. That's all of my questions for today. And I just I wanted to know, do you have any, you know, final thoughts for people with lupus who are, you know, maybe for the first time thinking of their pharmacist as someone that they as a resource that they can turn to if you you know, have any final thoughts about that, that you'd like to share?

Dr. Mueting 11:48
Um, absolutely. You know, lupus is primarily treated with medications. So, patients who have lupus need to get to know their pharmacist and they need to be able to ask questions, so I encourage any patient with questions to talk to their pharmacist. And if they need to know about over-the-counter medications or all the medications they're taking together, they should rely on the drug experts, the pharmacist on their healthcare team, to help with any medication questions that they have.

Host 12:19
Thank you so much, Marcia, for your time today. We really appreciate you sharing your expertise with us. I think that it's really important for people to know that they can count on their pharmacists to help them manage their medications, which as you pointed out is such an important part of treating lupus.

For those listening in. You can find more information on lupus on the National Resource Center on Lupus by visiting lupus.org/resources. For the latest information on lupus and COVID-19, please visit lupus.org/Coronavirus. To listen to additional episodes of The Expert Series, you can visit lupus.org/theexpertseries where you can also subscribe to get alerts when podcasts are released. If you would like to speak with one of our health education specialists, you can go to lupus.org/healtheducator or call one 805 5801 to one.

And finally, to connect with others with lupus from all over the world, I invite you to check out our online support community LupusConnect where you can talk with others find emotional support and discuss practical insights for coping with the daily challenges of lupus. You can find the community at lupus.org/resources/LupusConnect. Thank you again Marsha for your time and to all of you who are listening in and have a wonderful day.

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Providing Answers, Support and Hope in Arizona

The Expert Series: Medication Management