Monday, 23 June 2014

第2部分:控制高膽固醇藥物和飲食秘訣

歡迎來到3系列博客2部分:高膽固醇
在這篇博客中,我們的藥劑師 Maggie 將討論一些關於膽固醇的藥物和我們的註冊營養師 Rowena 提供如何從我們的飲食中獲得最好的奧米加-3的技巧!

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膽固醇藥物:品牌名稱與通用名稱
一個關膽固醇藥物最常見的問題是何為品牌藥與通用名藥。很多人可能因醫生開膽固醇的治療處方藥而認識品牌名稱立普妥Crestor。在藥,患者有時會驚訝地看到他們被配給這些藥物的通用名藥 (generic drugs)。有些人可能不知道什麼是通用名藥。有的甚至可以要求立普妥或“Crestor,而不是切換到這些藥物的通用版
以下一些信息可幫助您更好地了解品牌藥和通用名藥之間的區別。我們還將討論如果你想繼續在品牌版本的這些藥物會發生什麼。

品牌名稱“立普妥”和“Crestor”與 它們的通用名藥是一樣的嗎?
在加拿大,通用名藥是仿製加拿大衛生部批准的品牌藥物。他們一般具有與品牌藥相同的質量和功效,同時他們必須符合加拿大衛生部設定的藥物審批的科學標準。
通用名藥有時樣子看起來與同類的品牌名藥的不同。相比品牌名藥有些通用名藥會有不同的顏色,形狀,標誌和包裝。通用名藥也可能含不同的味道,防腐劑等,但是,它們必須具有與品牌藥相同的活性成分。
从技术上讲,通用名药的功效应该與相同成份的品牌药一樣。许多保险计划,包括政府給老人的药物補助计划,只補助通用名药的价錢。因此,如果患者选择配品牌药物时,已有通用名药可用,這種情況下患者通常需要支付他們之間的差價。例如,如果配一个 月的品牌药的成本为100元,而配通用名药的成本為60元,患者通常需要支付40元的差價。不过,以下的情況是例外的:

品牌药物制造商提供的保险卡
有些品牌药物的制造商會提供藥物保險卡給药剂师和医生,以支付通用名药和品牌药之间的差價的一部分。那么,选择配品牌药的患者只需要支付一小部份的差價,即$5-10元不等。不是所有的品牌药有这种类型的由制造商提供的保险卡,但你可以随时質詢我们美健药房的藥劑師以了解更多的信息。

如果你不能耐忍通用名药
由政府提供藥物補助的患者如老年人,如果有必需的医疗原因要用品牌藥,衛生部也會支付價高的品牌药。例如,如果你服用通用名藥後出現不良反应,你的医生可以填寫一份不良反應表格,并在處方上標明“不可替代”,這種情況下政府會補助品牌药。

胆固醇与饮食 - 由Rowena Leung,註冊營養師編寫
為了降低你的膽固醇,你要確保從飲食中獲得足夠的奧米加3脂肪酸,降低您的飽和脂肪的攝入量,增加纖維的攝入量和增加身體活動量。在這篇文章中,我們將討論不同類型的奧米加3脂肪酸,以及它們在幫助降低膽固醇水平的關係。
大多數人都知道吃魚對身體有好處。然而,你可知道並非所有的魚都富含奧米加3 (omega-3)脂肪酸?一個簡單的方法教你記住我們鼓勵你多吃的魚是什麼類型。因為心臟的顏色是淡紅色,因此我們希望您能夠多吃粉紅色的魚。
我們建議你至少每週吃2次富含奧米加3的魚,下面的魚是含豐富的奧米加3:
•三文魚
•北極紅點鮭
•沙丁魚
•金槍魚
•青花魚


你可以從上面列出的魚獲得的奧米加3脂肪酸的類型是二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)。這兩種形式的奧米加3脂肪酸很容易被人體吸收,並且非常有效地幫助你降低膽固醇水平。 DHA不僅是奧米加3脂肪酸,還是構建大腦的一個組成部分。
這是否意味著吃白魚類,如羅非魚,黑鱈魚,鯰魚和鱸魚是對你沒有好處?比起紅肉,白色的魚仍然是一個健康的選擇,因為它含較低的飽和脂肪。但是,如果你的目標是降低膽固醇,白色的魚是幫不了你的,因為這些種類的魚含很少的奧米加3脂肪酸。

如果你是素食者,你怎樣獲得到您的奧米加3

亞麻籽,Chia 籽(chia seeds), 核桃及大麻種子 (hemp seeds) 也是奧米加3的良好來源。在亞麻籽和Chia 籽裡的奧米加3類型是α-亞麻酸,簡稱為ALA, 與魚類裡的奧米加3不同。 魚類裡的奧米加3(EPA和DHA)相比於α-亞麻酸類型的奧米加3是更容易被人體吸收。所以如果可能的話, 我們建議多吃粉紅色的魚來獲取奧米加3。
請記住,每天吃1-2湯匙的亞麻籽和Chia 籽是安全的。亞麻籽和Chia 籽之間的主要區別是什麼?只有磨碎的亞麻籽能給你奧米加3;然而,你可以吃整個的Chia 籽來獲取奧米加3。

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散步的好地方

在陰雨天里,我們仍然可以在室內進行步行運動。例如,豪坊的大統華超市二樓商場每天早在上午7點為您開放,你會經常看到人們上午9-10:30時之間在那面做運動。
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Part 2: High Cholesterol - drugs & diet tips

Welcome to Part 2: High Cholesterol of our "3 high's" blog series. In this part, our pharmacist, Maggie Cheung, will discuss some common questions about cholesterol medications and our registered dietitian, Rowena Leung, is back to provide some tips on getting the best Omega-3's from our diet! 

**Come to Custom Care Pharmacy today to pick up Rowena's recipe for Banana flaxseed Bread!!**

Cholesterol Drugs: Brand name vs. Generic name
One of the most common questions regarding cholesterol medications is about brand name drugs vs. generic drugs. Many people may recognize drug names like 'Lipitor' or 'Crestor' as prescribed by their doctor for the treatment of high cholesterol. At the pharmacy, patients are sometimes surprised to see the generic versionsof these drugs being dispensed for them. Some people may wonder what a generic drug is. Others may even request to stay on 'Lipitor' or 'Crestor' (the brand name versions) instead of switching to the generic version of these drugs. 

The information below will help you better understand the difference between
brand name drugs and generic drugs. We will also discuss what happens if you wish to continue on the brand name drugs.

Are generic versions of 'Lipitor' and 'Crestor' the same as the brand name versions?
Generic drugs in Canada are 'copies' of brand name drugs that have been approved and declared by Health Canada to be equivalent to a comparator brand name product. They generally have the same quality and efficacy as brand name drugs and they must meet the scientific standards set by Health Canada as part of the approval process.  
The generic version can sometimes look different than the brand name version of the same drug. Some will have a different colour, shape, markings and packaging compared to the brand name version. The generic version may also contain different flavour, preservatives, etc., however, they must have the same active ingredients as the brand name version.  
Technically speaking, generic drugs should work the same way as the brand name versions of the same drugs. Many insurance drug plans, including the senior's drug plan, will cover only the cost of the generic drugs. So if a patient chooses to take the brand name drug when a generic drug is available, the patient will usually have to pay for the cost difference. For example,  if a 1- month-supply of the brand name drug costs $100 and the generic drug costs $60, the patient will usually have to pay for the $40 cost difference out-of-pocket.  However, there are some exceptions: 
Brand name drug manufacturer insurance card
Some brand name drug manufacturers will provide pharmacists and doctors with an insurance drug card to cover part of the cost difference between the generic drug and the brand name drug. So the patient who chooses to take the brand name drug will only have to pay for a small difference i.e. $5-10 per month. Not all of the brand name drugs have this type of insurance drug card from manufacturers, but you can always ask our pharmacists at Custom Care Pharmacy to find out more.  
What if I cannot tolerate the generic versions of the drug? 
For seniors covered under the ODB, the ministry will only pay for a higher cost brand name drug if it is required for medical reasons. For example, if you had a bad reaction to a lower cost generic drug, your doctor can complete an adverse reaction form along with a "no substitution" prescription to request for the cost of the brand name drug to be covered. If you have questions about adverse reactions to a generic drug or if you need the adverse reaction form, come and speak to our pharmacist. 
Cholesterol & Diet - By Rowena Leung, Registered Dietitian, CDE
To lower your cholesterol, it’s all about making sure you get enough omega-3 fatty acids in your diet, lowering your saturated fat intake, increasing your fibre & increasing the level of physical activity. Within this article, we’re going to discuss the different types of omega-3 fatty acids and their relationship in helping to lower cholesterol levels.
Most individuals know that eating fish is good for you; however, did you know that not all fish have omega-3 fatty acids?  An easy way to remember what type of fish we encourage you to have is to remember that the colour of the heart is pinky-red; therefore, we’d like you to have pink fish more often.
Did you know we recommend having omega-3 rich fish a minimum of two times/week?  What are some examples of omega-3 rich fish?
·        Salmon
·        Trout
·        Arctic Char
·        Sardines
·        Tuna
·        Herring
·        Mackeral
The type of omega-3 fatty acid that you get from the fish listed above is in the form of eicosapentaenoic acid ( EPA) and docosahexaenoic acid (DHA). Both these forms of omega-3 is easily absorbed by the human body and is extremely effective in helping to lower cholesterol levels. DHA is also the type of omega-3 fatty acids that is an integral part of building the brain. 
Does this mean that eating white fish such as tilapia, black cod, catfish and/or sea bass is no good for you? White fish is still a healthier choice than red meat as it is lower in saturated fat; however, if your goal is to lower cholesterol, white fish cannot help you since these types of fish have very little omega-3 fatty acids.
What happens if you follow a vegetarian lifestyle? How can you get your omega-3?
Flaxseed, chia seeds, walnuts & hemp seeds are good sources of omega-3. The type of omega-3 found in flaxseed and chia seeds is Alpha-linolenic acid (ALA).  Keep in mind that it is safe for someone to have anywhere between 1-2 tablespoon of flaxseed and/or chia seeds per day. What is the key difference between flaxseed and chia seeds? In order to obtain the omega-3 fats, you must grind the flaxseed; however, with chia seeds, you can eat them whole and still get the omega-3. The ALA form of omega-3 is not as absorbable by the human body This is why we would prefer if an individual eats pink fish to obtain EPA/DHA (i.e. the more absorbable form of omega-3) EPA/DHA is more effective in lowering cholesterol. 
Custom Care Pharmacy has a copy of Rowena's latest healthy-cholesterol recipe: Banana Bread with Flaxseed.  Be sure to come in to pick up a free copy!!

Where to take a walk in Markham?
For rainy days, we can still do exercise by walking at a nearby indoor facility. For example, did you know that the 2nd floor of the T&T supermarket building is open for walking as early as 7am each morning? Inside, you will often see people doing exercise between 9 -10:30am. Come to Custom Care Pharmacy to ask for more information!