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1 | mobile-kidney-web-2.0.0.zip\mobile-kidney-web\acceptance_test\watir\datasheet | Pharmacy_Text_Content.xls | Wed Apr 4 20:16:46 2018 UTC |
2 | mobile-kidney-web-2.0.0.zip\mobile-kidney-web\acceptance_test\watir\datasheet | Pharmacy_Text_Content.xls | Tue May 22 21:40:45 2018 UTC |
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1 | SHEET: iro nAndEPOAne mia | |
2 | ||
3 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3 | |
4 | 1, learnMo re>pharmac y>4, blood -cells.jpg , blood ce lls, Treat ments for Anemia, An emia is a shortage o f oxygen-c arrying re d blood ce lls that c an happen with chron ic kidney disease. A nemia is c ommon in p eople with kidney di sease beca use the ki dneys make a hormone (erythrop oietin (EP O)) that t ells the b one marrow to make r ed blood c ells. You can learn more about symptoms of anemia by reading Symptoms of Kidney Disease., The good n ews is, th ere are tr eatments t hat can he lp give yo u back som e of your energy: ir on and EPO . | |
5 | 2, learnMo re>pharmac y>4, anemi a-2.jpg, d iagram sho wing how i ron is use d in the b ones, kidn eys, and b lood cells , How Your Body Make s Red Bloo d Cells, Y our body n eeds both iron and t he hormone erythropo ietin (EPO ) to make red blood cells. Iro n is a bui lding bloc k for red blood cell s. Your bo ne marrow is a red b lood cell factory. E PO tells y our bone m arrow when it is tim e to make more red b lood cells . It’s the switch th at turns o n the fact ory., Sinc e healthy kidneys ma ke EPO, yo u may not have enoug h EPO if y our kidney s don’t wo rk as well as they s hould. You r doctor m ay prescri be both ir on and EPO if you ha ve anemia. | |
6 | 3, learnMo re>pharmac y>4, anemi a-3.jpg, i ron supple ment table ts and IV, Iron Supp lements by Mouth of IV, Your d octor may prescribe iron for y ou if the iron level s in your blood are too low. I n most cas es, this w ill be in the form o f pills. P ills may n ot be abso rbed well by your gu t. Be sure to keep i ron pills— and ALL of your othe r medicine s—in bottl es with ch ildproof l ids* if ch ildren com e to your home. Each year, chi ldren are poisoned b y medicine s and some die., If iron pills don’t giv e you enou gh iron, y our doctor may presc ribe iron to be give n to you i n a vein t hrough an IV. This c an “fill u p your tan k” much fa ster. You would need to come i nto the cl inic for a n hour or two for a nurse to g ive you ir on., *We a ll know th at prescri ption medi cines can cause harm if they a re used th e wrong wa y. But ove r–the-coun ter medici nes can po ison child ren, too! Keep ALL m edicines i n childpro of bottles if there is any cha nce that a child cou ld reach t hem. | |
7 | 4, learnMo re>pharmac y>4, anemi a-4.jpg, E PO vial, E PO Treatme nt for Ane mia, The o ther commo n treatmen t for anem ia in peop le who hav e kidney d isease is a manmade form of er ythropoiet in (EPO). EPO may be called ep oetin alfa or darbep oetin alfa . It may b e given on ce a month , every tw o weeks, o nce a week , or three times a w eek. EPO h elps you m ake more o f your own red blood cells. EP O must be injected u nder the s kin or int o a vein—t here is no pill form . If you n eed EPO an d have chr onic kidne y disease, you may n eed to com e to a cli nic visit to get it or learn t o give it yourself., If your k idneys fai l and you do dialysi s in a cen ter, you w ill most l ikely get your EPO d uring your treatment s. Ask wha t your dos e is so yo u can trac k this. | |
8 | 5, learnMo re>pharmac y>4, anemi a-5.jpg, w arning tri angle, FDA Warning a bout EPO, The U.S. F ood and Dr ug Adminis tration (F DA) has pl aced a “Bl ack Box Wa rning” on EPO. The w arning was added aft er some re searchers found a hi gher risk of strokes and heart attacks i n people w ith kidney disease w hen too mu ch EPO was used., Bu t, having anemia tha t is not t reated can also harm you. Anem ia can mak e it hard to have th e energy t o get thro ugh each d ay and do the things you want to do. You r doctor w ill use th e lowest d ose of EPO possible. The goal is keep yo ur red blo od cell le vel high e nough that you don’t need bloo d transfus ions. Talk with your doctor ab out the be nefits and risks of EPO. | |
9 | 6, learnMo re>pharmac y>4, anemi a-6.jpg, b ag of bloo d, Blood T ransfusion s Make It Harder to Get a Tran splant, If your kidn eys fail a nd you wan t a kidney transplan t, each bl ood transf usion you get could make that harder. Bl ood is a l iving subs tance. It has immune cells fro m the bloo d donor th at may rea ct with yo ur own blo od. Most p eople don’ t need tra nsfusions. Good anem ia treatme nt with ir on and EPO can help you avoid them, too. To learn more about transplan ts, visit the Treatm ent Room | |
10 | ||
11 | SHEET: pai nMedicines | |
12 | ||
13 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7, Segme nt 8 | |
14 | 1, learnMo re>pharmac y>8, pain- 1.jpg, man standing with diffi culty, Tre ating Pain , If you t ake medica tions for pain, havi ng kidney disease, t oo, may me an that yo ur doctor will need to make ch anges to y our pain m anagement. | |
15 | 2, learnMo re>pharmac y>8, kidne ys-liver.j pg, locati on of kidn eys and li ver in the body, You r Kidneys & Liver Re move Drug Wastes, Wh en you tak e medicine s, your bo dy breaks them down as they ar e used, an d wastes a re created . These wa stes must be removed from your blood or they could build up to unsafe levels. Yo ur liver a nd your ki dneys remo ve drug wa stes. Whic h organ do es the wor k depends on the dru g. This is true for pain medic ines, too. , If you t ake a pain medicine like morph ine that i s removed by your ki dneys, har mful waste s may buil d up in yo ur blood i f your kid neys don’t work well . Each pil l may last longer. B ut, to avo id harm, y our doctor may need to change your dose or your me dicine. Th is is true even if y ou have be en taking the same p ain medici ne for a l ong time., Talk with your doct or about y our pain c ontrol wit h kidney d isease. Fo r mild pai n that you just have once in a while, as k your doc tor if ove r-the-coun ter acetam inophen is a good ch oice. | |
16 | 3, learnMo re>pharmac y>8, pain- 3.gif, bot tle of NSA IDs with f lashing wa rning symb ol, Avoid NSAIDs, No n-steroida l anti-inf lammatory pain pills , or NSAID S, are a r are cause of kidney failure—mo st often i f they are taken dai ly for a y ear or mor e. Most NS AIDS are o ver-the-co unter, lik e naproxen and ibupr ofen. Avoi d NSAIDS a s much as you can., Some NSAID S are pres cribed by a doctor. These pres cription N SAIDs incl ude:, Indo methacin, Piroxicam, Nabumeton e, Celecox ib, Talk t o your car e team abo ut pain tr eatment th at’s safe for you to use and w on’t hurt your kidne ys., NSAID s can caus e chronic kidney dis ease (CKD) or make i t get wors e faster. If you hav e CKD, it’ s best for your kidn eys if you don’t tak e these fo r daily pa in relief. Talk to y our care t eam about other opti ons to man age your p ain | |
17 | 4, learnMo re>pharmac y>8, pain- 4.jpg, hot or cold w ater bag, Pain Manag ement with Heat and Cold, Some types of pain can b e helped w ith heat, cold, or s witching b etween the two. Neve r use heat for more than 20 mi nutes at a time—it c ould cause nerve dam age., Keep ice in a bag or tow el so it d oes not to uch your s kin. Never use ice f or more th an 15 or 2 0 minutes at a time— you could get frostb ite., Don’ t use the hottest se tting of a heating p ad if you have diabe tes. If yo u are not sure how t o use ice or heat sa fely to he lp relieve pain, tal k to your care team. | |
18 | 5, learnMo re>pharmac y>8, pain- 5.jpg, smi ley face, frown face , Pain Man agement at the VHA, The VA is a leader i n pain con trol. The health psy chology an d pain man agement de partments have many ways to he lp manage pain. Lear n more abo ut VHA pai n manageme nt service s. They ma y be able to help yo u reduce t he dose or numbers o f medicati ons you ne ed, and he lp you to feel more in control . | |
19 | 6, learnMo re>pharmac y>8, pain- 6.jpg, wom an getting back mass age, Pain Relief wit h Massage, Therapeut ic massage can help problems l ike neck a nd back pa in. Studie s have fou nd that pe ople who g et massage treatment s for thes e problems have less pain and more funct ion than t hose who d on’t. Mass age is jus t one type of pain t reatment t he VA can offer you if you nee d it. | |
20 | 7, learnMo re>pharmac y>8, pain- 7.jpg, ner ve stimula tor hooked on a mans arm, Tran scutaneous Electrica l Nerve St imulation (TENS), A TENS unit can be use d to stimu late nerve s through the skin a nd block p ain. Somet imes medic ine can be given thr ough the s kin using the electr ode pads. It can be helpful fo r chronic pain and f or nerve p ain in som e people. If you hav e a pacema ker, using TENS may not be wis e. Talk to your care team to l earn wheth er TENS mi ght help y our pain. | |
21 | 8, learnMo re>pharmac y>8, pain- 8.jpg, man with biof eedback mo nitors att ached to f orehead, B iofeedback May Help You Contro l Pain, Yo u may be a ble to lea rn how to control th e process that leads to your p ain—so you have less pain. How ? Through biofeedbac k., First, you learn to be awa re of what is going on in your body that leads to the pain. This can b e done by using sens ors to mea sure your heart rate , breathin g rate, an d skin tem perature. You will g et feedbac k in your patterns t hrough a n oise or a computer s creen. The n, you can learn to change the patterns by watchin g the feed back. In t ime, you w ill be abl e to chang e your pat terns with out needin g the feed back., Bio feedback m ay help ch ronic pain , headache s, low bac k pain, an xiety, and many othe r problems . Talk wit h your VA care team if you thi nk biofeed back might be helpfu l for you. | |
22 | 9, learnMo re>pharmac y>8, pain- 9.jpg, acu puncture n eedles, Tr eating Pai n with Acu puncture, It may sou nd odd, bu t acupunct ure and ac upressure have helpe d people w ith many k inds of he alth probl ems, inclu ding pain. Acupunctu re is a ty pe of trad itional Ch inese medi cine. Its aim is to affect the flow of e nergy or “ Qi” (“chi” ) in the b ody. It ha s been use d for thou sands of y ears and s tudies hav e found th at it can help pain and nausea ., When yo u have a k idney prob lem, don’t take Chin ese herbs— they can c ontain pro ducts that can damag e your kid neys or li ver. The V A can help you get a cupuncture —talk to y our VA car e team if this is so mething th at you thi nk might h elp you. A cupuncture needles a re made of surgical steel, and are so th in that th ey don’t h urt. You m ay feel pr essure whe n they are put in. O nce the ne edles are in place, you may be asked to rest quiet ly to let them work. | |
23 | ||
24 | SHEET: cho lesterolMe dicines | |
25 | ||
26 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5 | |
27 | 1, learnMo re>pharmac y>7, chole sterol-1.j pg, wooden blocks wi th letters spelling hdl and ld l, Treatin g High Cho lesterol, Heart dise ase is a c ommon heal th problem in the U. S. And, if you have chronic ki dney disea se, you ar e at a hig her risk f or heart d isease tha n most. Ke eping your heart hea lthy can h elp extend your life . Taking c holesterol medicines if your d octor pres cribes the m is one s tep you ca n take eac h day to p rotect you r heart., Eating a h ealthy die t is anoth er way you can prote ct your he art. To le arn about good food choices, v isit the N utrition R oom., Stay ing active is also a great cho ice for he art health ! To learn more abou t staying active wit h kidney d isease, vi sit the So cial Servi ces Room. | |
28 | 2, learnMo re>pharmac y>7, chole sterol-2.j pg, waxy m embrane of blood cel l, Cholest erol Forms Part of Y our Cells, Your body needs som e choleste rol. This waxy fat i s used to make up pa rt of the outer wall (membrane ) of each cell in yo ur body. I t also:, h elps make bile so yo u can dige st your fo od, helps your body convert vi tamin D to its activ e form, ac ts as a bu ilding blo ck for oth er hormone s, Your li ver makes cholestero l—mostly a t night wh ile you sl eep—and he lps recycl e it to be sure you have enoug h. | |
29 | 3, learnMo re>pharmac y>7, chole sterol-3.g if, clogge d artery v ideo, High Cholester ol May Clo g Your Art eries, Som e people h ave too mu ch cholest erol in th eir blood. Studies h ave linked high chol esterol wi th clogged arteries that can d amage your heart. If your bloo d choleste rol levels are high, your doct or may pre scribe med icine to h elp lower it. | |
30 | 4, learnMo re>pharmac y>7, chole sterol-4.j pg, bottle of statin s, Treatin g High Cho lesterol w ith Statin s, Medicin es called statins ar e often us ed to help lower cho lesterol. They work in your li ver to kee p choleste rol from f orming. An d, some st udies have found tha t they can help melt away chol esterol pl aques that have form ed in your arteries. Statins m ay help re duce infla mmation th at can dam age blood vessel wal ls. They m ay also re duce the r ate of som e types of cancer. | |
31 | 5, learnMo re>pharmac y>7, chole sterol-5.j pg, lower back ache, Report Ne w Muscle P ain to You r Care Tea m, The mos t common s ide effect s seen wit h statins are muscle aches and pains. In very rare cases, th is can be due to a p roblem cal led rhabdo myolysis—a breakdown of muscle tissue th roughout t he body. I f this hap pens, the wastes tha t result c ould cause sudden ki dney failu re. If you have musc le pain or weakness with vomit ing and co nfusion, c ontact you r health c are team r ight away. | |
32 | 6, learnMo re>pharmac y>7, chole sterol-6.g if, statin s and fibr ates warni ng, Statin s + Fibrat es = Great er Risk, W hen statin s and chol esterol me dicines ca lled “fibr ates” are both taken , the risk of severe muscle si de effects is higher . Talk to your docto r if you t ake a medi cine that has “fibra te” or “fi brozil” in its gener ic name al ong with a statin. Y our doctor may need to change your dose or take yo u off one of the med icines to protect yo ur kidneys . | |
33 | 7, learnMo re>pharmac y>7, chole sterol-7.j pg, Coenzy me Q10 bot tle, CoQ10 Supplemen ts, Taking statins c an block c oenzyme Co Q10 in you r body. Co Q10 is a b it like a vitamin. I t works in side all o f your cel ls and is key to 95% of your b ody’s ener gy. A lack of CoQ10 has been f ound to be a factor in heart d isease. Lo w levels c an make yo u feel ver y tired., Two studie s have fou nd that su pplements of CoQ10 c an help pe ople with kidney pro blems. If you take a statin, t alk to you r doctor a bout wheth er CoQ10 s upplements might be helpful fo r you. | |
34 | 8, learnMo re>pharmac y>7, chole sterol-8.j pg, fish o il capsule s, Fish Oi l Suppleme nts, Fatty fish like salmon, t rout, herr ing, bluef ish, and s ardines ha ve oils th at are goo d for your heart! (T his works if the fis h is baked or broile d. Fried f ish will n ot help yo ur health. ) If you d on’t like to eat fis h, fish oi l capsules may help lower your cholester ol. Studie s show tha t fish oil can help prevent he art attack s and stro kes. Talk with your care team about whet her a fish oil suppl ement migh t be a goo d choice f or you and your hear t. | |
35 | ||
36 | SHEET: dia betesMedic ines | |
37 | ||
38 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7, Segme nt 8 | |
39 | 1, learnMo re>pharmac y>6, diabe tes-1.jpg, diabetes blood suga r test on finger, Ki dney Disea se May Cha nge Your D ose of Dia betes Medi cines, If you have d iabetes, o r high blo od sugar, you may be taking me dicines to help cont rol your b lood sugar . Diabetes is the le ading caus e of kidne y failure in the U.S . If your kidneys do n’t work w ell, some of these m edicines c ould last longer tha n normal o r build up to unsafe levels in your bloo d. (Health y kidneys remove the se medicin es.) So, y our dose o f diabetes medicines may need to change if you hav e kidney d isease or if your ki dneys fail . If you w ould like to learn m ore about diabetes a nd kidney disease, v isit How t o Slow Kid ney Diseas e: When Yo u Have Dia betes. | |
40 | 2, learnMo re>pharmac y>6, diabe tes-2.jpg, diagrams showing lo cation of intestines , pancreas , and live r, Sugar i n Your Bod y, Use of sugar (glu cose) in y our body i s complex. Most Amer icans eat far more s ugar than our bodies need, as sweets and as starch es like po tatoes, ri ce, corn, and other grains. Wh en we eat sugar, it is first a bsorbed in the gut., Your panc reas makes enzymes t hat help y ou digest your food. It also m akes insul in, a horm one that k eeps blood sugar lev els in che ck., Your liver make s bile to help you d igest your food. It also store s glucose and releas es it if y our body n eeds more. | |
41 | 3, learnMo re>pharmac y>6, pill- bottle.jpg , pill bot tle with s pilled tab lets, Drug Classes f or Type 2 Diabetes, If you hav e diabetes , your doc tor may pr escribe pi lls to hel p control your blood sugar. Th ere are si x classes of diabete s pills. T hey work o n your gut , your pan creas, you r liver, y our cells, or more t han one of these:, S ulfonyurea s tell you r pancreas to make m ore insuli n. Some co mmon sulfo nyurea dru gs are gli pizide, gl yburide, a nd glimepi ride., Meg litinides also tell your pancr eas to mak e more ins ulin—but o nly when y our blood sugar is h igh. Some drugs in t he megliti nides clas s are nate glinide, a nd repagli nide., Dip eptidyl pe ptidase IV (DPP-IV) inhibitors , like meg litinides, tell your pancreas to make mo re insulin when your blood sug ar is high . They als o tell you r liver to stop maki ng so much sugar. So me drugs i n the DPP- IV class a re sitalip tin, saxag liptin, an d linaglip tin., Thia zolidinedi ones (TZDs ) make cel ls more se nsitive to insulin s o they tak e more sug ar out of the blood, and help the liver to make le ss glucose . Some com mon TZD dr ugs are pi oglitazone and rosig litazone., Biguanide s help ins ulin move into your cells and keep your liver from releasing glucose i t has stor ed. Metfor min is the most comm on biguani de drug. I t has a nu mber of br and names. , Alpha-gl ucosidase inhibitors block dig estion of starch in your gut s o blood su gar does n ot go up a s fast., S ome diabet es drugs c ombine mor e than one of these classes in to one pil l. Alpha-g lucosidase inhibitor s are acar bose and m iglitol | |
42 | 4, learnMo re>pharmac y>6, metfo rmin.gif, Metformin with flash ing warnin g sign, Av oid Metfor min if You Have Seve re CKD, Me tformin is a strong and helpfu l diabetes medicine. It can be used safe ly in earl y kidney d isease. Bu t, it is N OT SAFE fo r you if y our kidney disease i s severe. If you tak e metformi n (by any name), tal k to your doctor abo ut when yo u may need to switch to a drug that is s afer for y ou., Talk to your do ctor befor e you stop taking an y drug he or she pre scribed fo r you. | |
43 | 5, learnMo re>pharmac y>6, diabe tes-5.jpg, vial of i nsulin, Ki dney Disea se May Low er Your Ne ed for Ins ulin, If y ou use ins ulin, your dose may change if you have c hronic kid ney diseas e. The kid neys help remove ins ulin from your blood . When you r kidneys don’t work as well, less insul in may giv e you the same effec t—or you m ay have mo re low blo od sugars. , In fact, having mo re low blo od sugars can be a s ign that i t’s time t o have you r kidneys checked. T esting you r blood su gar as oft en as your care team advises c an help yo u stay on track., Ta lk with yo ur care te am about d iabetes go als for yo ur stage o f kidney d isease. Ch ronic kidn ey disease (CKD) has five stag es. Stage five is th e most sev ere. The V A has clas ses to hel p you mana ge your di abetes and kidney di sease. The re are sev eral helpf ul diabete s websites , too. Try Medline* or the Nat ional Diab etes Educa tion Progr am.*, To l earn more about the stages of CKD and ho w to manag e them vis it Kidneys and Kidne y Disease. , *Links w ill take y ou outside of the De partment o f Veterans Affairs w ebsite. VA does not endorse an d is not r esponsible for the c ontent of the linked websites. | |
44 | ||
45 | SHEET: pho sphateBind ers | |
46 | ||
47 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5 | |
48 | 1, learnMo re>pharmac y>6, phosp hate-1.jpg , yellow a nd red cap sules bein g poured o ut, Preven ting Phosp horus Buil d-up in Yo ur Blood, Healthy ki dneys cont rol the le vels of ph osphorus i n your blo od. When t he kidneys don’t wor k as well as they us ed to, pho sphorus ca n build up in your b lood. This can lead to severe itching an d other he alth probl ems that y ou can pre vent by ta king phosp hate binde rs. | |
49 | 2, learnMo re>pharmac y>6, calci fied-arter y.jpg, kne e joint x- ray showin g calcifie d artery, Calcium + Phosphorus Can Harde n Blood Ve ssels, Hav ing too mu ch calcium and phosp horus in y our blood at the sam e time is a problem. The two m inerals ca n join and form depo sits in yo ur skin, c ausing pai nful itchi ng. Or, th ey can for m deposits in blood vessels th at may cut off blood flow to a limb. Pho sphate bin ders can h elp keep y our blood levels of phosphorus from gett ing too hi gh. | |
50 | 3, learnMo re>pharmac y>6, phosp hate-3.jpg , location of stomac h and inte stines in the body, How Phosph ate Binder s Work, Ph osphate bi nders work in your g ut when yo u eat food . They bin d chemical ly to phos phate in y our food. Then, the binders an d phosphat e pass out of your b ody in you r stool. | |
51 | 4, learnMo re>pharmac y>6, phosp horus-magn et.gif, ma gnet attra cting circ les labele d phosphor us, Phosph ate Binder s Keep Pho sphorus Ou t of Your Blood, Lik e a magnet , binders attract an d hold pho sphorus be fore it ca n get into your bloo dstream. T aking phos phate bind ers and li miting hig h phosphor us foods g o hand in hand to he lp you fee l your bes t. | |
52 | 5, learnMo re>pharmac y>6, phosp hate-5.jpg , phosphat e binder t ablets, Ty pes of Pho sphate Bin ders, Some phosphate binders a re calcium -based. Ca lcium bind ers contai n calcium carbonate or calcium acetate. They are m ost often tablets, a nd some ar e chewable . These bi nders may be over-th e-counter or prescri ption drug s. Other b inders do not have c alcium and may taste less “cha lky.” Talk to your d octor abou t which ty pe is righ t for you. | |
53 | 6, learnMo re>pharmac y>6, phosp hate-6.jpg , dinner p late conta ining stea med vegeta bles and g rilled chi cken, When to Take P hosphate B inders, Yo u take pho sphate bin ders WITH food. With ALL food. ONLY with food. The y only wor k if they are in you r gut at t he same ti me that fo od is in y our gut. W hen you ea t a snack, you’ll ta ke a small number of binders. With a lar ger meal, you’ll tak e more bin ders. Your dietitian will go o ver your l ab test re sults with you to se e if your phosphorus level is in the tar get range. | |
54 | 7, learnMo re>pharmac y>6, phosp hate-7.jpg , open pil l holder, Bring Your Phosphate Binders W ith You, K eep some b inders on hand when you’re awa y from hom e so you c an take th em as you need to. Y ou can use a keychai n containe r (also ca lled a pil l fob), pi ll box, or pill bott le to brin g them alo ng. Some p eople keep a bottle of binders in a purs e or backp ack., Any time you e at, you wa nt your bi nders to b e on duty, cleaning up phospho rus. | |
55 | ||
56 | SHEET: bon eDisease | |
57 | ||
58 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6 | |
59 | 1, learnMo re>pharmac y>3, bone- disease-1. jpg, X-ray of knee j oint, Keep ing Your B ones Healt hy, Vitami n D helps you make s trong bone s, and hel ps your bo dy keep th e right am ounts of c alcium and phosphoru s in your blood. Cal cium is a mineral th at helps m ake up hea lthy bones . Phosphor us is a mi neral that helps mak e up healt hy bones. You may ne ed to chan ge what yo u eat to k eep your b lood level s in check . Drugs ca lled phosp hate binde rs can rem ove excess phosphate from your gut befor e it is ab sorbed int o your blo od. If you don’t hav e enough v itamin D, your gut c an’t absor b calcium from food. , To learn about wha t to eat t o maintain the right amounts o f calcium and phosph orus, visi t the Nutr ition Room . | |
60 | 2, learnMo re>pharmac y>3, bone- disease-2. jpg, diagr am of glan ds, kidney s, gut, Ke y Players in Bone Di sease, Hea lthy kidne ys turn vi tamin D fr om food (a nd the sun ) into the active fo rm your bo dy needs. But, if yo ur kidneys don’t wor k well, yo u may not have enoug h active v itamin D., Without a ctive vita min D, you r body can ’t keep th e right ba lance of c alcium and phosphoru s in your blood., Yo ur calcium levels wi ll get too low, Your phosphoru s levels w ill get to o high, Ti ny parathy roid gland s in your neck will make parat hyroid hor mone (PTH) to try to boost the levels of calcium i n your blo od. But, t his won’t work if yo u have too much phos phorus in your blood ., A vicio us cycle b egins. If it keeps u p, your bo nes could get weak a nd break m ore easily . | |
61 | 3, learnMo re>pharmac y>3, bone- disease-3. jpg, vitam in D in ca psules and in as a l iquid in a vial, Vit amin D May Be Given by Mouth o r Injectio n, MANY Am ericans do n’t have e nough vita min D, eve n if their kidneys a re fine. T he good ne ws is, not having en ough vitam in D is a problem th at is easy to treat. Your doct or may ask you to ta ke over-th e-counter vitamin D pills or s oftgels. O r, he or s he may pre scribe act ive vitami n D medica tion drugs such as c alcitriol, paricalci tol, and d oxercalcif erol. This may be gi ven as pil ls or as i njections. , Having t he right a mount of v itamin D i n your blo od will sh ut off the extra PTH so you do n’t lose a s much cal cium out o f your bon es. Your b lood level s of calci um will be checked t o be sure they don’t go too hi gh. | |
62 | 4, learnMo re>pharmac y>3, bone- disease-4. jpg, cinac alcet pill s, Medicin e to Reduc e Your PTH Levels, I n some cas es, vitami n D is not enough to shut off the excess parathyro id hormone . Your par athyroid g lands grow larger as they stru ggle to ke ep making more PTH. In time, t hey can ge t so big t hat they c an’t shut off. In th e past, su rgery had to be done to remove the gland s. But now , a pill c alled cina calcet can help shut off exces s PTH. You r doctor m ay prescri be this dr ug for you if your P TH levels are too hi gh., Most of the sid e effects of cinacal cet are mi nor, like upset stom ach. But s ome can be serious. Tell your doctor abo ut any sym ptoms you have after you start ANY drug. If you ta ke cinacal cet, be su re to call the docto r right aw ay if you have:, Bur ning or ti ngling of your lips, tongue, f ingers, or feet, Mus cle aches or cramps, or a sudd en tight f eeling in the muscle s of your hands, fee t, face, o r throat, Seizures | |
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64 | SHEET: blo odPressure | |
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66 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5 | |
67 | 1, learnMo re>pharmac y>2, blood -pressure- cuff.jpg, blood pres sure cuff, High Bloo d Pressure is a Comm on Problem , High blo od pressur e often go es hand in hand with kidney pr oblems. Yo ur doctor may prescr ibe one or more bloo d pressure pills to help lower your bloo d pressure into the safe range . | |
68 | 2, learnMo re>pharmac y>2, bp-me ter.jpg, b lood press ure monito r, You Can ’t Feel Hi gh Blood P ressure, S ome people get heada ches when their bloo d pressure is very h igh. But i n most cas es, high b lood press ure is “si lent”—and you can’t feel it. B lood press ure pills only work when you t ake them e ach day as your doct or prescri bes. These medicines need to b uild up to a certain level in your blood and stay there all the time—w hether you feel like your bloo d pressure is high o r not. The y are not like pain pills that you take only when you feel p ain., Chec k your blo od pressur e at home with a blo od pressur e monitor to see if your treat ment is wo rking. You r VA docto r can writ e a prescr iption for a blood p ressure mo nitor so y ou can get one to ta ke home. | |
69 | 3, learnMo re>pharmac y>2, blood -pressure- 3.png, wat er pills, Diuretics (“Water Pi lls”) Make You Urina te More, H igh blood pressure c an be a ca use—or a r esult—of k idney prob lems. Eith er way, tr eating it can help r educe your risk of h aving a he art attack or a stro ke. If you have a ki dney probl em, keepin g your blo od pressur e in the t arget rang e can also help prot ect your k idneys fro m more dam age. Exerc ise and di et can hel p treat hi gh blood p ressure. I n most cas es, you wi ll need to take bloo d pressure pills, to o. Blood p ressure pi lls come i n “classes .”, A comm on class o f blood pr essure pil ls is diur etics (“wa ter pills” ). The gen eric names for some common diu retics or “water pil ls” are ch lorothiazi de, hydroc hlorothiaz ide, furos emide, and spironola ctone. The re are man y more. Th ese are th e first pi lls most p eople get for high b lood press ure. While your kidn eys still work, “wat er pills” help rid y our body o f extra wa ter and sa lt. This m eans that you will m ake more u rine—at le ast for th e first fe w weeks. T his can wa ke you up at night. Talk to yo ur care te am about w hat time t o take a w ater pill so it does n’t affect your slee p., Water pills are only usefu l while yo u still ma ke urine. If your ki dneys fail and you s top making urine, “w ater pills ” won’t wo rk., To le arn more, visit How to Slow Ki dney Disea se: When Y ou Have Hi gh Blood P ressure. | |
70 | 4, learnMo re>pharmac y>2, light bulb2.jpg, fluoresce nt lightbu lb, “Water Pills” Ca n Change E lectrolyte Levels in Your Bloo d, “Water pills” can change th e levels o f sodium a nd potassi um (electr olytes whi ch are sub stances th at carry a n electric al charge when disso lved in a fluid) in your blood . You may need to ha ve blood t ests and c hange what you eat t o be sure these leve ls stay in the safe range., Ha ving too m uch or not enough po tassium in your bloo d can stop your hear t—so this is importa nt! Always tell your care team about any new sympt oms you ha ve after y ou start o n a new me dicine. To learn mor e about po tassium, y ou can vis it the Nut rition Roo m, or visi t the Labo ratory. | |
71 | 5, learnMo re>pharmac y>2, arter ies.jpg, d rawing of veins and arteries i n the huma n body, So me Blood P ressure Pi lls Keep A rteries Re laxed, ACE inhibitor s and ARBs are two m ore classe s of blood pressure pills. Ang iotensin c onverting enzyme (AC E) inhibit ors block an enzyme that tells the muscl es to sque eze arteri es to rais e blood pr essure. Th e generic names of A CE inhibit ors end in “pril,” - like rami pril, lisi nopril, an d enalapri l. Angiote nsin recep tor blocke rs (ARBs) block an e nzyme that tells the muscles t o squeeze arteries t o raise bl ood pressu re. The ge neric name s of ARBs end in “sa rtan,” lik e losartan , valsarta n, and irb esartan. T hese are u sed often in people with kidne y problems . They can help prot ect the ki dneys from further d amage if y ou have di abetes or another he alth probl em where t here is pr otein in y our urine. If you ar e a woman, ACE inhib itors and ARBs are N OT SAFE if you becom e pregnant . Talk wit h your doc tor about this., A c lass of bl ood pressu re pills c alled alph a blockers and one c alled cent ral agonis ts also wo rk by keep ing your a rteries re laxed. Alp ha blocker s can make you feel dizzy (esp ecially wh en you sta nd up) and speed up your heart rate. The generic n ames of al pha blocke rs end in “azosin,” like doxaz osin mesyl ate, prazo sin hydroc hloride, a nd terazos in hydroch loride. Ce ntral agon ists can m ake you fe el dizzy ( especially when you stand up). They can also cause dry mouth . If your doctor pre scribes a central ag onist, it’ s importan t to not s top taking it sudden ly—your bl ood pressu re could r ise very q uickly to dangerous levels. | |
72 | 6, learnMo re>pharmac y>2, cough ing.jpg, b usiness ma n coughing , Side Eff ects of AC E Inhibito rs, ACE in hibitors c an cause a dry, tick ly cough i n some peo ple. If yo u take an ACE inhibi tor and th is happens to you, t ell your d octor. You may need to switch to an ARB instead. A RBs do not cause a c ough. | |
73 | 7, learnMo re>pharmac y>2, heart -ekg.jpg, EKG printo ut with a heart grap hic on it, Some BP M edicines S low Your H eart Rate, Beta bloc kers and c alcium cha nnel block ers are tw o more cla sses of bl ood pressu re pill. T he generic name of b eta blocke rs ends in “olol” – like ateno lol, metop rolol, and acebutolo l. Some ge neric calc ium channe l blocker names end in “ipine” - like nif edipine, a mlodipine, and felod ipine. But others ha ve differe nt names. The only w ay to know if you ar e taking a calcium c hannel blo cker is to ask your doctor or pharmacist . If your heart rhyt hms are no t even and you have high blood pressure, your doct or may pre scribe one of these. These med icines slo w your hea rt rate an d reduce y our body’s “fight or flight” r esponse to stress. B ecause the y can bloc k the effe cts of the sleep hor mone melat onin, they can cause problems sleeping. They can a lso make y ou feel ti red., If y ou take a calcium ch annel bloc ker, don’t drink gra pefruit ju ice! The j uice react s with the medicine and could make it bu ild up in your body to unsafe levels. | |
74 | 8, learnMo re>pharmac y>2, pill- assortment .jpg, pile of differ ent colore d pills, Y ou May Nee d More Tha n One Type of Blood Pressure M edicine, S ometimes o ne blood p ressure pi ll doesn’t do the tr ick. Often , people w ith kidney problems need to ta ke more th an one cla ss of bloo d pressure pills to get their blood pres sure into the target range and protect t heir kidne ys. This m ay be beca use the ki dneys are causing hi gh blood p ressure. B ut sometim es it happ ens when s omeone doe sn’t take the pills the doctor prescribe s. Then, t he doctor prescribes more pill s, thinkin g that the first one is not wo rking., Be honest wi th your ca re team. I f a blood pressure p ill is cau sing probl ems for yo u, say so. It’s bett er to swit ch to a ne w medicine than to h ave more a nd more pi lls prescr ibed and n ot take th em. | |
75 | 9, learnMo re>pharmac y>2, blood -pressure- 9.jpg, two hands on a steering wheel, Se e How You Feel Befor e You Get Behind the Wheel, An y medicine can cause side effe cts. You m ay be at r isk of a f all or oth er acciden t. Protect yourself: , Sit befo re you sta nd up, in case you m ay feel di zzy., See if you nee d help to walk., Don ’t drive a car or ru n heavy ma chinery un til you kn ow how a n ew blood p ressure pi ll makes y ou feel., If you are a man, yo u may know that bloo d pressure pills can cause pro blems gett ing erecti ons, or ma ke this pr oblem wors e. A chang e in medic ine or dos e can help if this h appens to you. Talk to your do ctor—but D O take you r blood pr essure pil ls! | |
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77 | SHEET: otc Medication s | |
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79 | Section, N avigatitio n, Section Image, Im age Alt Te xt, Sectio n Header, Content Se gment 1, S egment 2, Segment 3, Segment 4 , Segment 5, Segment 6, Segmen t 7, Segme nt 8 | |
80 | 1, learnMo re>pharmac y>1, medic ations-1.j pg, pill b ottle lyin g on side with pills in and ar ound the b ottle, Tak ing Medica tions, If your docto r has told you that you have a kidney pr oblem, he or she may prescribe medicines for you. Or, you ma y be takin g medicine for other health pr oblems., M edicines a re used to treat dis ease and t o help red uce sympto ms so you feel bette r. Some ma y do just one of the se things, others ma y do both. Remember, over-the- counter (O TC) drugs are medici ne, too. S ome over-t he-counter medicines are not s afe for pe ople who h ave kidney disease., Before yo u take any new medic ine, even a vitamin, ask your doctor if it is safe for you., Medicines work best if you ta ke them th e right wa y—the way your docto r prescrib ed them. I f the cost of your m edicines i s a proble m, talk to your care team. The VA has pr escription benefits. Learn mor e about th e VA presc ription be nefit. | |
81 | 2, learnMo re>pharmac y>1, kidne ys-liver.j pg, diagra m showing location o f kidneys and liver, Your Kidn eys & Live r Remove M edicine Wa stes from Your Blood , When you r body use s medicine s, they ar e broken d own into w astes. The se wastes must be re moved from your bloo d, or they could bui ld up to u nsafe leve ls. Your l iver remov es some me dicine was tes. Your kidneys re move some as well. A nd, some w astes are removed by both the liver and the kidney s., When a new medic ine is pre scribed fo r you, ask the pharm acist if y our liver or your ki dneys will remove th e wastes. If your ki dneys must remove th e wastes, ask to be sure the d ose is saf e for you if your ki dneys don’ t work at 100%. | |
82 | 3, learnMo re>pharmac y>1, medic ations-3.j pg, medici nes: table t, injecti on, intrav enous, Way s to Take Medicines, Most medi cines are given in o ne of thre e ways:, A s a pill, capsule or liquid yo u swallow, As a liqu id that is injected into the s kin or mus cle, As a liquid tha t is flowe d into a v ein, When they can, doctors tr y to presc ribe pills or capsul es. But, s ome medici nes work b etter or l ast longer if they a re given b y other ro utes. Stom ach acid d estroys so me medicin es (like i nsulin), s o they can ’t be give n by mouth ., There a re other w ays that m edicines c an be give n, too. So me can be given with a skin pa tch. Some are spraye d under th e tongue. Suppositor ies are pu t into the rectum. S ome medici nes are in haled, lik e asthma t reatments. | |
83 | 4, learnMo re>pharmac y>1, medic ations-4.j pg, man lo oking up, woman look ing down, How to Tak e a Pill, Softgel, o r Capsule, Do you fi nd it hard to swallo w pills or capsules? These tip s may help :, Pills a nd softgel s are heav y, and the y sink. Ta ke a sip o f liquid, put the pi ll in your mouth, an d look up at the cei ling. The pill and l iquid will go to the back of y our throat where the y are easy to swallo w., Capsul es float. Take a sip of liquid , put the capsule in your mout h, and loo k down at the floor. The capsu le will fl oat to the back of y our throat where it is easy to swallow., Some peop le find th at taking a whole pi ll or a ca psule in a spoonful of a soft food, like pudding, helps them to swallo w. | |
84 | 5, learnMo re>pharmac y>1, medic ations-5.j pg | |
85 | Photo Cred it: Ms. Ch anel Weave r (USACE), Veteran a t doctor a ppointment , Tell You r Doctor i f You Have Side Effe cts, Any m edicine ca n have sid e effects. These may be good—m inoxidil i s a blood pressure p ill that h as the sid e effect o f helping hair grow. But, in m ost cases side effec ts are ann oying, pai nful, or e ven harmfu l. Or, you may have an allergy to a medi cine., Som e side eff ects will go away in time. Som e will go away if yo u take a m edicine in a certain way—like with food or on an e mpty stoma ch. Some w on’t go aw ay, and yo u will nee d to chang e to a new medicine or learn t o get used to them i f the medi cine is he lping your health pr oblem. Alw ays tell y our doctor about sid e effects you notice . He or sh e may be a ble to hel p. | |
86 | 6, learnMo re>pharmac y>1, pill- assortment .jpg, medi cation ass ortment, S ome Medici nes Can In teract Bad ly—Watch f or Symptom s, When yo u take two or more m edicines, they may n ot work we ll togethe r. Pharmac ists have lists of p roblems th at can occ ur when tw o medicine s are take n. But whe n you take more than two, no o ne can pre dict what may happen ., Know yo ur body. M ake a note when you start a ne w medicine so you ca n see if i t seems to be causin g a new sy mptom or m aking an o ld one wor se. If you have a ne w symptom, tell your doctor an d your pha rmacist. Y ou may nee d a change in medici ne, in the timing of when you take it, o r in the d ose., Use this sympt om diary t o keep tra ck of your symptoms. Ask your VA provide r about an y of your symptoms. You can ca ll his/her office, u se secure messaging (available through M yHealtheVe t), or bri ng the sym ptom diary to your n ext clinic appointme nt. | |
87 | 7, learnMo re>pharmac y>1, medic ations-7.j pg, grapef ruit slice d in half, glass of grapefruit juice, So me Foods C an Interac t with Med icines, To o, Some fo ods and dr inks can b e unsafe w ith prescr iption med icines, to o. Grapefr uit and ot her citrus fruit and juice can keep some medicines from brea king down, so they c an build u p to harmf ul levels in your bo dy., You m ay be taki ng medicin es that ar e broken d own by you r liver. A dding alco hol puts a n extra st rain on yo ur liver. Ask your d octor and your pharm acist if t here are a ny foods o r drinks t hat you sh ould avoid when you take a med icine. | |
88 | 8, learnMo re>pharmac y>1, medic ations-8.j pg, variou s fresh he rbs, Herbs and Folk Remedies a re Medicin es—Tell Yo ur Doctor, Sometimes people th ink that i f a doctor doesn’t p rescribe a product, it’s not a “real” me dicine. Wr ong!, Medi cines incl ude:, Vita mins, Herb al product s, Folk or tradition al remedie s, Over-th e-counter (OTC) prod ucts like pain pills , antacids , cold rem edies, etc ., Just be cause some thing is “ natural” o r an herb does not m ean that i t is safe for you. W hen your k idneys don ’t work as well as t hey should , wastes f rom these products c an build u p in your body and h arm you. O r, they ca n react in bad ways with presc ribed medi cines you take., For example, some antac ids contai n aluminum or magnes ium. These can harm you when y our kidney s don’t wo rk well. A lways tell your care team abou t ALL medi cines you take—presc ribed or n ot. | |
89 | 9, learnMo re>pharmac y>1, medic ations-9.j pg, medici ne bottle with a que stion mark on the la bel, Know Your Medic ines and W hat They D o for You, You owe i t to yours elf to kno w the basi cs about A LL of the medicines you take. That way, you can he lp keep mi stakes fro m being ma de. It’s r are, but s ometimes t he wrong p ills are p ut in the bottle at the drugst ore. Or, t wo product s with nam es that so und alike are mixed up. Don’t let this h appen to y ou. Ask yo ur care te am about e ach medici ne that is prescribe d for you. It is imp ortant to know the f ollowing a bout each medication you take: , What eac h medicine is called , What hea lth proble m it is fo r, What it looks lik e, When to take it, What to do if a dose is missed , What sid e effects may occur | |
90 | 10, learnM ore>pharma cy>1, medi cations-10 .jpg, medi cation war ning label s, Labels Can Help Y ou Take Me dicines th e Right Wa y, A presc ription la bel has a lot of inf ormation a bout a med icine. (Yo u may need reading g lasses to see it!) T he label w ill tell y ou the bra nd and gen eric name, the dose, how to ta ke it, and how many refills yo u get. The label wil l also hav e your nam e, the pha rmacy’s na me, and yo ur doctor’ s name. Th ere will b e a prescr iption dat e and a us e-by date, too. | |
91 | 11, learnM ore>pharma cy>1, pill -box.jpg, pill box, Make a Sys tem to Hel p Yourself Remember, It can be hard to r emember to take medi cines each time you should. An d, the mor e pills yo u need, th e harder i t can be. Figure out a way to remind you rself. Som e people u se pill bo xes or tim ers on a w atch or ce ll phone. Or, your c are team m ay have a card with your medic ines on it . Ask abou t it. If n ot, maybe you can ma ke one for yourself. | |
92 | 12, learnM ore>pharma cy>1, medi cations-12 .jpg, asso rtment of colorful m edications to show t he dangers of their similarity to candy, Medicine Can Look L ike Candy – Use Chil dproof Bot tles, Each year, chi ldren are poisoned b y adult me dicines—li ke iron pi lls. Keep your medic ines in bo ttles with childproo f lids if there are ever any c hildren in your home (even if they just visit now and then). If it’s h ard for yo u to open a childpro of lid, ta lk to the pharmacist . There ma y be an op tion that will work better for you. |
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