About Kristen Dore

Kristen Dore, PharmD, has over 15 years of experience in various areas of pharmacy practice including retail, clinical, managed care, hospital, and compounding pharmacy. Kristen’s direct patient care experience includes performing wellness screenings and delivering educational information to help people manage their health conditions such as cholesterol, blood pressure, diabetes, and bone mineral density. She earned her Doctor of Pharmacy degree from the University of Rhode Island.

Currently with Everyday Health, Kristen provides accurate health information to online users, focusing on prescription and over-the-counter medications, vitamins and supplements – providing users with the knowledge needed to play an active role in their health care.

New Treatment Options for Chronic Hepatitis C

By Kristen Dore // August 10th, 2011 10:00 AM // No Comments

Did you know that Hepatitis C is the most common reason for liver transplants in the United States?

Hepatitis C is a viral infection that affects the liver. Hepatitis C is transmitted through the blood.  The most common way people in the US become infected with the Hepatitis C virus is through sharing of needles or other equipment to inject drugs.  Needle stick injuries in health care settings can also cause the spread of the virus. A new baby born to a mother who is Hepatitis C positive can also become infected.  Less common ways that a person may contract Hepatitis C is by sharing personal items that have come in contact with an infected person’s blood, such as toothbrushes and razors, or having sexual contact with an infected individual.

Hepatitis C can be an acute or chronic infection. About 75% to 85% of people infected with Hepatitis C virus will develop a chronic infection. Chronic Hepatitis C can lead to liver damage, including cirrhosis or liver cancer. According to the CDC, 3.2 million people in the United States have chronic Hepatitis C infection.  Chronic Hepatitis C can lead to serious health complications and even death.

In May 2011, two new medications were approved for the treatment of chronic Hepatitis C – Incivek (telaprevir) and Victrelis (boceprevir). Both medications are protease inhibitors. Protease inhibitors work by binding to the virus and preventing it from multiplying.  These medications must be used in combination with peginterferon alfa and ribavirin. Peginterferon alfa and ribivirin have been the standard of care for people with Hepatitis C infection. Unfortunately, less than 50 percent of people who use this therapy regimen for 48 weeks respond. When one of the 2 new medications is added to peginterferon alfa and ribavirin, much better response rates are seen. According to the FDA, the response rates for therapy that included Incivek were 20% to 45% higher than standard care alone. Also instead of the 48 week regimen used previously, some patients may only have to be treated for 24 weeks to achieve a response.

However, Incivek and Victrelis are not for everyone. These medications can cause birth defects, anemia (low red blood cell count), as well as other adverse effects. Incivek and Victrelis can also interact with a number of medications. If you have Hepatitis C, and want to know if either of these medications would be appropriate for you, talk to your health care provider.

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Horizant — A New Medication for Restless Legs Syndrome

By Kristen Dore // July 27th, 2011 10:00 AM // No Comments

Restless Legs Syndrome (RLS) is a condition that is characterized by a strong urge to move one’s legs.  A person may also experience strange feelings in the legs, such as creeping, crawling, itching and tingling sensations.  Moving the legs helps to reduce these feelings. These urges to move and uncomfortable sensations usually occur when a person is at rest, causing problems with falling asleep and staying asleep. There are lifestyle changes that may help with RLS. However, if lifestyle changes do not work, medication may be needed to relieve symptoms. 

Horizant was approved by the US Food and Drug Administration (FDA) in April 2011 for the treatment of moderate-to-severe RLS. Horizant is an extended release tablet that contains gabapentin encarbil.  Horizant is changed in the body to gabapentin, the active form of the medication. The exact mechanism by which gabapentin relieves the symptoms of RLS is not known.

  • The recommended dose of Horizant is 600mg taken at 5pm once daily with food.
  • If a dose is missed, then it should be taken at 5pm the following day.
  • Horizant tablets should not be cut, crushed, or chewed – they should be swallowed whole. 
  • Horizant is not for use by people who need to sleep during the day and be awake during the night.
  • Horizant is not interchangeable with other gabapentin products because the same dose results in different concentrations of gabapentin in the body.

 

Although other gabapentin products, such as Neurontin, are not approved for RLS, they have been used “off-label” for treating RLS for some time.

The most common side effects of Horizant are dizziness and sleepiness. These side effects may take several weeks to subside. Horizant can also cause slow thinking and affect coordination. Therefore, driving a car or operating heavy machinery should be avoided, even the morning after a dose is taken, until it is known how Horizant affects a person’s ability to perform these activities. Horizant may cause suicidal thoughts or actions in about 1 of every 500 people. It is important to be aware of any sudden changes in mood, behavior, feelings, or thoughts. If these occur, contact a health care provider.  Horizant should not be stopped without first consulting a health care provider.

Horizant provides a new treatment option for people with RLS. However, Horizant is not for everyone. If you have questions about Horizant, talk to your health care provider or pharmacist.

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What’s the big deal about drug resistance?

By Kristen Dore // July 20th, 2011 10:00 AM // No Comments

This year the World Health Organization (WHO) chose antimicrobial resistance as the subject for World Health Day 2011. Why?

What’s an antimicrobial?

Antimicrobials are medications, such as antibiotics, antifungals, and antivirals, which are used to treat bacterial, fungal and viral infections. When infections develop a resistance to these medications, they are termed ‘Superbugs’. Resistance occurs when the bugs change in a way that make them immune to the medications used to treat them.

Why is this important?

As resistance to antimicrobials increases, the possibility of complications and death from infection increases. Without antimicrobials that are effective, people will die of diseases that were formerly treatable. Infections that are resistant are around longer increasing the risk of spreading to others. The cost of antimicrobial resistance is staggering. In the United States alone medical costs due to antimicrobial resistance are estimated at more than $20 billion per year. Unfortunately, as antimicrobial resistance is increasing there are fewer new antimicrobial medications being developed.

What can you do to help?

  • Take your medications as prescribed. Do not stop taking them when you feel better or ‘save’ them for the next time you are ill.
  • Do not demand antimicrobial medications, such as antibiotics, from your doctor. Taking antibiotics when they are not needed may allow bugs to become resistant.
  • Do not take other people’s medications. Even if your symptoms are the same, you may not have the same infection.

 

The WHO is calling on not only the public, but also doctors, pharmacists, policy-makers and planners, and the pharmaceutical industry to do what they can to help in the fight against antimicrobial resistance.

Posted In: General Health
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What’s Low T all about?

By Kristen Dore // July 13th, 2011 10:00 AM // No Comments

You may have seen the commercials recently about Low T, and you may be wondering, what is it?

Low T refers to a condition in which a man has a low testosterone level.

Testosterone is the most important sex hormone in men. Testosterone is responsible for the changes a boy goes through during puberty, such as muscle growth, deepening of his voice, increased height, growth of facial and pubic hair, and growth of the penis and testes. Testosterone also maintains scalp, body, and pubic hair, sex drive, and sperm production.

What are some of the short term effects of low testosterone?

  • Sexual dysfunction
  • Low libido (sex drive)
  • Enlarged breasts
  • Low sperm count

 

Low testosterone may also lead to:

  • Loss of body hair
  • Loss of muscle strength
  • Loss of bone mass (osteoporosis)
  • Mood changes
  • Decrease in energy

 

Some men may also experience depression, inability to concentrate, hot flashes and irritability.

There can be many causes of low testosterone. As a man ages, his testosterone level naturally decreases. Low testosterone can also be caused by testicular injury or infection and genetic or hormonal conditions. Diseases, such as type 2 diabetes, obesity, HIV/AIDS, and chronic liver or kidney disease may also lead to decreased testosterone levels. Certain medications, such as anabolic steroids and morphine, may also contribute to low testosterone.

Hormone replacement therapy for men?

Yes. Hormone replacement therapy is not just for women. Testosterone replacement therapy is used to help treat low testosterone levels. Testosterone is available by prescription and in a variety of dosing forms including patches, topical gels, injections, and tablets (special tablets that stick to the gums in the mouth).

If you are experiencing any of the symptoms of low testosterone, consult your health care provider. Testosterone replacement therapy may not be for everyone. Your doctor can determine if you have low testosterone, and the most appropriate way to treat it.

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Are you at risk for metabolic syndrome?

By Kristen Dore // July 6th, 2011 10:00 AM // No Comments

Metabolic syndrome is a group of health problems that can increase the risk of cardiovascular disease, stroke and diabetes. A person that has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes. According to the American Heart Association, about 35% of Americans may have metabolic syndrome.

To have metabolic syndrome, you must have at least three of the following risk factors:

  • Fat around the abdomen (men: waist measurement of 40 inches or more and women: waist measurement of 35 inches or more)
  • Triglycerides >150mg/dL (or you are on medication to treat high triglycerides)
  • HDL <40mg/dL in men or <50mg/dL in women (or you are on medication to treat low HDL)
  • Blood pressure >130/85mmHg (or you are on medication for high blood pressure)
  • Fasting glucose >100mg/dL (or you are on medication for high blood sugar)

 

Being overweight or obese plus being physically inactive are risk factors that are closely linked to metabolic syndrome. Some other factors that may increase the risk of developing metabolic syndrome include:

  • Age – as you age, metabolic syndrome risk increases
  • Family history of type 2 diabetes
  • History of gestational diabetes
  • Hormonal imbalances such as polycystic ovary syndrome (PCOS)

 

What can you do if you are at risk?

  • Lose weight
  • Get at least 30 minutes of physical activity almost every day
  • Eat a healthy diet
  • Stop smoking
  • With your doctor’s help – manage blood pressure, cholesterol and blood sugar
  • Limit alcohol – one study found that men who drank more than 2 drinks/day and women who drank more than 1 drink/day were at an increased risk of metabolic syndrome

 

With obesity rates on the rise in the United States, metabolic syndrome is becoming more common. If metabolic syndrome continues to increase, it may overtake smoking as the number one risk factor for heart disease. Talk to your doctor if you think you may be at risk for metabolic syndrome. You and your doctor can help determine the appropriate lifestyle/medical changes that may help you to reduce your risk.

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