第2部分：控制高膽固醇藥物和飲食秘訣

歡迎來到3“高” 系列博客的第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 會提供如何從我們的飲食中獲得最好的奧米加-3的技巧！

別忘到美健藥房免費拾取最新食譜:

香蕉亞麻籽全麥麵包!

膽固醇藥物：品牌名稱與通用名稱

一個有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”或“Crestor”。在藥房，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。有的人甚至可以要求配“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。

為了您的方便，美健藥房現有亞麻籽粉 銷售!
最新食譜:香蕉亞麻籽全麥麵包是降低膽固醇的一個好的零食!現在就來美健藥房免費拾取!

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，朗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。

現在就來美健藥房諮詢詳情!

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!

控制3高系列博客: 高血壓

美健藥房最新推出有關控制3“高”系列博客! 

以下是有關管理高血壓的第一部分。這一期博客我們請來 Rowena Leung,RD CDE, 一位專業營養師，她將會為我們介紹有益于控制好血壓的健康烹飪技巧！

難道我真的有高血壓？

人們經常會問，為什麼他們的血壓測量結果從一分鐘到另一分周鐘可以如此不同，難道是他們的血壓計不準確嗎？
我們的血壓確實每小時甚至每一分鐘都會發生改變。當你站立起來，觀看一個令人興奮的電視節目，吃了一頓，甚至早上或晚上時間都會影響我們的血壓。在血壓測量過程中翹起你的腳或者說話也能影響結果。這就是為什麼單一的血壓測量值可能不足以判斷你的血壓是否控制得好。高血壓患者每天應該在家中測量并計錄自己的血壓兩次。

如果你的血壓結果持續高于135/85毫米汞柱，你需要採取行動來控制它。下面是一些可以幫助你控制好血壓的健康貼示。

降壓藥

在藥房最常被問到的問題是“一旦我開始服用血壓藥，我必須服用一生嗎？”

由於高血壓更常見于老年，隨著年齡漸長你很可能需要持續服用藥物來控制你的血壓。然而，在某些情況下當你改變生活方式，如減肥，鍛煉身體和保持健康的飲食，你可減少通過服藥來控制血壓的需要。有些患者認為，只要他們服用降壓藥，他們就不用改變他們的老習慣。事實上，即使你正在服用藥物來控制你的血壓，也要保持健康的生活方式。

不用醬油,用什麼替代品?

據加拿大高血壓2014年的新指南，鹽的攝入量最多是2000毫克/天。2000毫克轉化為普通家庭的量度，它小於1茶匙/天。事實是，對於51-70歲之間的成年人，1300毫克/天就足夠了。這意味著身體每天需要的鹽不到半茶匙。

醬油是在亞洲烹飪中是一種很常見的調味品。雖然很多品牌都有低鈉的選擇，每湯匙的平均鈉含量在300-700毫克之間不等。但對於以醬油為主要調味成分的人來說，這是很容易超過1300毫克/天鈉鹽攝入量。

其他可替代醬油，以提高風味的食品包括：

姜：

除了可有效地緩解暈車症狀包括頭暈，噁心，嘔吐和出冷汗外，生薑也可以用來添加菜的味道。

蔥屬家族的蔬菜包括各種蔬菜，可以作為很好的增味劑。此外，蔬菜的蔥系列對健康有很多益處如可預防癌症。

 蔥屬系列產品包括：

大蒜

洋蔥

香蔥（溫和的味道比洋蔥，但比韭菜強）

蔥頭（洋蔥＆​​大蒜之間的交叉）

韭菜

檸檬：

人經常喝檸檬水，以提高他/她的新陳代謝;但是，為什麼不考慮在烹調用多一點點的檸檬？

薑黃粉：

為什麼不每週吃一到兩次用咖哩調味的菜呢？這是一個你可考慮另一種不用加鹽的選擇。

蒔蘿：

這種草藥提供了濃郁的味道，做魚時可以用。

 Tamari汁：

對一般人來說，Tamari 與醬油看起來非常相似，可能不知道它們在營養方面有很大的區別。雖然這兩個產品都是由大豆製成的，Tamari在發酵過程中 需要很少或根本不需用小麥。因此，大豆的濃度較高，味道是相當不同的。它比醬油少鹽且更流暢和更濃味。

通常情況下，當你吃壽司時會用到Tamari作為蘸醬; 然而將Tamari用作烹調也是一個不錯的選擇。

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快來美健藥房免費獲取 Rowena 的健康食譜!! 

• 檸檬Tamari雞食譜
• 健康煎魚凱撒沙律食譜
• 香炒Kale (羽衣甘藍) 菜 & Quinoa (藜麥)食譜

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散步的好地方

每天步行0.5至1小時，可以幫助維持正常血壓。現在，天氣逐漸回暖，我們可以選擇在戶外或者室內行走。如果你正在萬錦市尋找一個戶外活動場所，在美健藥房（郎豪坊）附近就有一個很好的花園。圍繞水池走一大圈約1公里，你也可以過橋，步行0.5公里。

地圖https://www.google.ca/maps/place/South+Unionville+Storm+Pond/@43.8593585,-79.291941,17z/data=!3m1!4b1!4m2!3m1!1s0x89d4d5d5395234ef:0xaba8de5e39485fd5

從2014年5月開始，Maggie 將於每週五上午10時（除了陰雨天）到10:30與你步行，您可以聯繫美健藥房905-305-0111參與，並獲得免費的T卹和運動袋！

"The 3 high's" blog series: Part 1 High Blood Pressure

Custom Care Pharmacy is launching a new blog series on "The 3 high's for seniors: high blood pressure, high cholesterol and high blood sugar" This is the 1st of 3 blogs on the topic of high blood pressure. In this issue, we invited Rowena Leung, a certified dietitian, to give us some very helpful tips on cooking with soy sauce alternatives!

Do I really have high blood pressure?

People often ask why their blood pressure measurements can be so different from one minute  to another, is the blood pressure monitor accurate?  

It is important to know that our blood pressure does change from hour to hour, sometimes even minute to minute. Standing up, watching an exciting TV show, eating a meal, even the time of day can influence our blood pressure. Crossing your feet or talking during your blood pressure measurement can also affect the results.  This is why a single blood pressure measurement may not be that useful to determine if your blood pressure is well controlled.  Patients with high blood pressure should measure and record their blood pressure twice daily at home. If your blood pressure results are consistently higher than 135/85 mmHg, you need to take action to control it. Here are some blood pressure healthy tips to help you.

Blood pressure medications

One of the most common question asked at the pharmacy about blood pressure medication is this: “Once I start taking blood pressure medication, do I have to take it for life?”

Since high blood pressure is more common as you get older, it is likely that you will need to continue taking the medication to control your blood pressure as you get older. However, there are some cases when lifestyle changes, such as weight loss, exercise and committing to a healthy diet, may reduce the need for medication in controlling blood pressure. Some patients feel that once they are taking blood pressure medication, they can go back to their old habits. In fact, it is very important to continue with healthy lifestyle changes even when you are taking medication to control your blood pressure.

Soy Sauce Alternatives - By Rowena Leung, RD CDE

According to Hypertension Canada in 2014, the new guidelines for salt intake is a maximum of 2000 mg/day. How does 2000 mg translate into common household measures? It is less than 1 teaspoon/day. The truth is, for adults between the age of 51-70, 1300 mg/day is sufficient. This means that the body needs less than a half a teaspoon of salt per day.

Soy sauce is a very common element in Asian cooking. Although many brands have lower sodium options, the average sodium content per tablespoon ranges between 300-700 mg. It is very easy for an individual who relies on soy sauce as a main seasoning ingredient to exceed 1300 mg/day limit for sodium intake.

Other alternatives to soy sauce to enhance flavour in food include:

Ginger:

Often known for its effectiveness in helping to relieve symptoms of motion sickness including dizziness, nausea, vomiting and cold sweat, ginger can also add alot of flavour to a dish.

The Allium family of vegetables include a variety of vegetables that can serve as wonderful flavour enhances. In addition, the allium family of vegetables offer many health benefits related to prevention of cancer. The Allium family includes:

Garlic
Onion
Scallions (milder in flavour than an onion but stronger than chives)
Shallots (a cross between onion & garlic)
Leeks
Chives

Lemon:

Individuals often drink lemon water to boost his/her metabolism; however, why not consider using a little bit more lemon in cooking?

Turmeric Powder:

Why not have a curry flavoured dish one to two times a week? This is another salt free option for an individual to consider.

Dill:

This herb provides a tangy taste and often pairs well with fish.

Tamari Sauce:

To the average person, tamari sauce & soy sauce look very similar and may not know there is a big difference in terms of nutrition. Although both products are made from soybeans, tamari sauce is fermented through a process requiring very little or no wheat at all. As a result, the concentration of soybean is higher and the flavour is much different. The flavour is less salty than soy sauce and is smoother and thicker than regular soy sauce.

Typically, tamari sauce is currently used as more of a dipping sauce for when you eat sushi; however, there is nothing wrong with using Tamari sauce as a cooking option as well.

Come into Custom Care Pharmacy today to pick up a copy of Rowena's recipes using these ingredients!!

• Tamari Lemon Chicken Recipe
• Homemade Healthy Cesar Salad Sauce
• Kale & Quinoa Stirfry Recipe

Where to take a nice walk in Markham?

Walking for 1/2 hr to 1 hr a day can be helpful in controlling your blood pressure. Now that the weather is getting warmer, we can choose to walk outdoors and enjoy the blooming flowers. 

If you are looking for an outdoor spot to walk in Markham, there is a nice park close to Custom Care Pharmacy on Castan Ave. & Piera Gardens. There is a nice walking trail around the South Unionville Storm Pond. Walking a full circle is about 1km but you can also cross the bridge and walk for 0.5km.

Map: https://www.google.ca/maps/place/South+Unionville+Storm+Pond/@43.8593585,-79.291941,17z/data=!3m1!4b1!4m2!3m1!1s0x89d4d5d5395234ef:0xaba8de5e39485fd5

Maggie will be walking there every friday morning (except for rainy days) from 10:00am to 10:30am starting in May 2014. You can contact Custom Care Pharmacy 905-305-0111 to join and receive a free t-shirt and walking bag!

A1电台调幅1430与Maggie的访问: 加拿大卫生部主动发布新的药物安全性评价总结

       4月8日，美健药房的Maggie被邀请到A1电台调幅1430回答关于加拿大卫生部主动发布在其网站上的新的药物安全性评价总结的问题。

      在这个月的博客中，我们将解释加拿大卫生部在审批和监管药物安全性的作用。我们还将为您提供可看到张贴安全审查的链接。 

加拿大卫生部是如何确保在加拿大使用的药物是安全的？

      授权在加拿大销售的所有处方药都必须由加拿大卫生部审批和标簽并清楚地列出药品的好处和危害。一旦藥品上市后，加拿大卫生部将继续监测药品的安全性，以确定潜在的安全问题。如果发现藥品有安全问题，就會進行安全审查以确定是否有与健康产品相關的新风险。加拿大卫生部會采取的多项措施包括：

•通知加拿大人或卫生专业人员

•请求更改产品标签

•请求提供附加的信息，研究或更多的监控

•如有必要，撤出加拿大市场。

这些安全评论摘要现在将公布在加拿大卫生部的网站上：

http://www.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/review-examen/index-eng.php

目前，只有1篇关于痤疮的药物Diane-35的安全性的评论文章。

我是否需要查閱我現正服用的药物的安全性评价？我的医生和药剂师是否知道我現正服用的药物的安全性信息的更改？

      加拿大卫生部會通知医生和药剂师有關药品安全性信息的更改，最近加拿大卫生部把藥品的安全审查摘要放到網上，使患者也能看到此信息。本摘要可为病人提供任何审查药物的安全性的新的变更。然而，病人有任何疑虑還是要與他们的医生和药剂师就有关他们目前正在使用的药物的安全性進行讨论。

如果你对你正在服用的药物有问题，我们的药剂师可以帮助你。我们的电话号码是905-305-0111美健药房