Direct Connection: June 27, 2016

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TELEVISION, THIS IS “DIRECT CONNECTION” WITH JEFF SALKIN. >> Jeff: H.L.-hole and welcome
to direct connection. Coming up we connect with expert advice on potentially dangerous
drug interactions p the first tonight the spread of the
volcano Zika virus and the summer of fear when it comes to
routine mosquito bites. Joining sus Mike — professor
entomology at the University of Maryland.
Mike, as always, great to see you.
Thanks for coming by .
>> It’s almost Mike high misnomer.
In one of them bites me on the hand it’s into the biting off a
chunk skin. That’s not what it’s doing.
>> No, they have a pro boss us and this is the business center
of the mosquito right here. These are called the style et
et cetera. She’s going to take those style
styleets, scram them down inside with an anticoagulant, going to
keep you from clotting. You do not want to throw a clot
when she’s feeding. Then she willcly fi your tissue
and turns on I a pump in her head and sucks up the blood.
The protein in your flood is going to become the protein in
her egg so she’s biting to you obtain protein to lay eggs.
>> Jeff: It’s especially problem problematic this year because of the Zika virus.
The Zika virus is a huge problem America, becoming more of a
problem in the Caribbean, can be ways, but in the United States,
while we have had some cases of Zika, they haven’t been
contracted by mosquitoes. Is that right?
>> Absolutely. There’s been no local
transmission. Right now weave about 800 cases
in the United States — we have about 800 cases in United States
States. We have I think 26 its cases
right here in Maryland that are active.
But at the present time Beav we’ve been lucky there is no
local transmission. >> Still we all want the to
avoid mosquito bites this summer summer.
That’s what bee want to zero in on here.
How do we do it? >> How do we do it.
I think the best bet again to avoid mosquito bite in my
opinion is personal protection and there are many ways to do
this. Number one, you can wear
mosquito repellant clothing. That’s always a good idea.
This is pre-treated with a compound called prometh rin.
This is going to give you long long-
long-lasting protection up to 20 But when I’m out the working in
the yard I’m probably going to use a mosquito repellant.
>> Sorry to interrupt but is this better than taking a
regular shirt and spraying it a little bit about the DEET stuff?
>> Well, these again are pre- pre-treated.
I have these clothes that I will the area with malaria, and it’s
always a good idea to wear light whenever you’re outdoors and you have a risk of being bitten by
mosquitoes. If we’re going to treat our own
clothing, I’m going for this one one.
Again, this is promethrin. This will give you even better
protection than DEET. But DEET is also a good protect
ant, good mosquito repellant over clotheing as well.
>> Can you put this on your skin skin.
>> Absolutely not. The promethrin does not go on
your skin and none of the mosquito repellants go on under
underneath clothing. They om go on exposed skin.
That’s important as great as get You brought us a box of
mosquitoes. We love it when guests show up
with — >> A box of mosquitoes.
Which camera are we bowing going >> Somewhere in the middle.
Where do you collect these? Do you Brede mosquitoes at the
University of Maryland? Bly Donte breed mosquitoes.
I Gotti these from my collect who has a laboratory.
He’s doing research on these mosquitoes.
And, Jeff, this is what we call call — thank you so much —
this is what we call the cage fear.
Now, there are about 200 or 300 blood thirsty vam in here.
The first thing we like to do — >> So there’s no fear.
Your just sting your hand right? >>
>> I’m actually terrified at this moment.
Can we get a look at this, gang? >> We can see it great.
They all latched onto your hand. I can do the play.
By play. You’ve got 20 or 30 mosquitoes.
>> Obviously on, these mosquitoes are hungry.
This is quite unpleasant so we’re going to get the hand out
of the cage of fear. So these gasoline are hungry.
They haven’t eaten yet. These gals are hungry.
The good news, Jeff, it would take about 1.5 million of these
little vampires to ex ang win at >> To what?
>> To drain my blood totally in a minute so I’m going to be okay
okay. We’ll go ahead and spray a
little bit of this repellant on. This is one of my firefighters.
This contains the act of ingredient called pickaridin.
This is an alternative to DEET. Not everybody likes DEET.
DEET is the gold standard of mosquito Prell ants.
But this one is going to give me when I go into when I go into
mosquito areas where the risk of perhaps malaria is high.
This is one of the products I think works really well.
Now, Jeff, if you can do the blow-by blow on this.
>> Well, there’s less to see. Right now we’re seeing maybe two or three landings on your
knuckles and they’re taking back >> They’re going to land.
They’re going to say, ah, this isn’t is the right thing and
they’re going to take off. I’m not being bitten right now.
They will rest but nobody here is attempting to feed.
>> So the point of the exercise is that you are a really brave
man. >> Well —
>> and that this stuff works in terms of not being bitten.
>> I’ve been called a foolish man for doing this.
But this stuff really does work, is one of your best bets.
Now, as I said, DEET is the gold I like — mosquito repellants.
I like the pick D.artin. This is one the natural route
oil of lemon, eucalyptus. This is going to give me four
hours of very good protection. This would be one I would
probably wear as I work in the lawn here in Maryland.
>> Let me remind our viewers if you have a question about
mosquitoes, how to deal with them in your yard this summer,
gefs a call. We have the number up on the
screen. You can tweet your questions to
@mptnews. Now, I’ve seen ads to get rid of noxious in your yard.
>> Sure. >> I don’t remember seeing them
before this summer but I’m sure it’s always a concern.
>> They’ve been around a while. >> If I call that company, what
are they going to do? >> They’re going to come out and do probably a perimeter
treatment of various kinds of compounds.
There are some that are more residual.
The residual ones will probably be prom canethrin and they’re
going to last for several weeks at the perimeter of your yard
where mosquitoes will be resting resting.
They’ll kill those mosquitoes that are rest can in these
places. resting in these places.
There are other organic approaches and there are a
number of materials that have been applied if you don’t want a synthetic product.
There are some formulations that garlic oil which will give you a
ay shorter period of relief but some people swear by these
things, no question about it. >> There’s a school in my
neighborhood and in front of the sediment control ponds that’s
there to keep sediment from clog clogging up the Chesapeake Bay.
>> Sure. >> But when I walked by it over
the weekend, it’s full of water. >> Right.
>> Or are we breeding mosquitoes >> Probably not.
If you have dragon flies in that there are amphibians, if there
are frogs and such, those guys in that pond are probably going
to do an excellent job controlling those mosquitoes.
Now, if the stand can water bodies, and I get one a little
swail in my yard, it will sometimes fill up with water and stay full for up to two weeks,
that’s long enough to breed mosquitoes.
For situations like this what I use is a BT dunk.
Now, these doughnut shaped objects are formulated with a
bacterium that’s derived from the soil.
It’s called back till us — it’s and it’s going to kill those
developing mosquito larvae so this is an environmentally very
fine way, very sound way to eliminate breeding mosquitoes.
>> Where do you get that stuff? >> You can get these at home and garden centers, the big box
stores. These are readily available in
lots of praises. >> Let’s grab a phone call.
Calvert county this is brenda. Thanks for the call.
Go ahead. >> Thank you for taking my call.
I live at the south end of coffee point beach and we have
to walk through the woods down from our house to get onto the
beach. It’s about Dr. what — a hundred
hundred, couple hundred yards and we do spray ourselves but
what I discovered, and I can’t remember who told me this, that
these past couple of years I’ve taken at least one tablespoonful of vanilla essence, put it in a
spray bottle which is about a pint bottle of water, shaken it
up, and I spray my exposed areas >> Does it make you hungry?
>> Pardon me? >> Does it make you hungry?
>> No, I smell nice, and apparently the mosquitoes don’t
like van I willa. What I would like the ask the
gentleman whom you are interviewing whether that is the case.
Why do they avoid vanilla? >> Thank you very much.
Great call. Also, 11 dar I’ve herd.
>> Brenda — lavender. >> They avoid vanilla because
chocolate really is their favorite flavor.
But awed kidding aside here, essential oils of long been
known to be repellant to many different kinds of insects,
including mosquitoes. Now, the trick here is what we
find with our essential oils is they can repel but it’s usually
only for a matter of minutes. So this is not going to give you long lasting protection, but by
all means if it gets you to the beach safely and it’s working
for you, Brenda, I suggest you continue doing that.
It’s a fine idea. >> Address drill into that for a second because when she gets to
the beach, maybe no standing water.
Mosquitoes I read don’t travel that far.
True? >> It’s variable.
There are some like the pale marsh mosquito that’ll fly up to 20 miles to lay eggs or feed, so they are —
>> Scratch that. >> No, but they are often
associated with vegetation, so they are going to be hanging out in places where there is
vegetation. That walk through the woods is
the most commonplace. But on your salt marshes there
are other species of mosquitoes that breed in brackish water, habitats as well so beach it is
a good idea the use those repel glance let’s go out to Allegany
county this is Lisa. Tation of for the call.
Go ahead? I have two issues here.
One is with pets. Is there a particular
insecticide or spray that you recommend for pets?
And the other one is I have rain drain those rain barrels?
>> Thank you very much. >> Great questions.
I really — I really have no data or no knowledge how the
effect of these would be on pets pets.
I would suspect that they would be very effective just as they
would be on a human. But what I recommend in this
case is to go ahead and consult your veterinarian and their.
But I think the materials I have pets investment.
Now, in terms of the rain barrel barrel, as long as you have that rain barrel well sealed at the
top, you probably are able to get those mosquitoes or prevent
those mosquitoes access to that rain barrel and deny them the
ability to lay eggs. How often would you have to
change an unprotected rain barrel?
Well, I don’t have a recommendation on that, but I
will tell you that I recommend dulling your bird bath twice a
week and scrubbing that out. When temperatures hit 90 degrees
90 degrees, 100 degrees, these mosquitoes will develop in
basically a week, so you need to least once a week or twice a
week. >> Before I’m totally out of
time let’s do a quick recap. So far mosquitoes haven’t
affected anybody in the have you >> Correct.
>> It’s possible. — with the Zika virus.
>> People want to protect themselves.
You talk about long sleeves, light clotheing and a bunch of
different potential sprays in addition to getting rid of the
standing water. Run through the DEET and the
other stuff real fast. >> Okay.
DEET and pick airdiane eight ours of protection under heavy.
This one has an IR 3535. Again this is probably going to
give you four to fife hours. Four hours out in the yard if
you want a botanically based product I’m going with the oil
of Lemmon/eucalyptus. >> Mike route, professor of
entomology University of Maryland with proprietary great
bug of the week website. , should visit that.
Mike, thanks for the time. Take the mosquitoes with you.
Just ahead tonight what you need interactions.
We’ll be right back. >> The MPT app puts our program
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¶ >> You’re makeing a mistake?
>> Am I clear. >> I don’t think this is such a
good idea. >> You’ve been talking to my
mother. >> I am about to commit murder.
>> She always had a bit of a dark side.
>> Trying to scare me now? >> Let me give you a story. >> Stay away from my wife.
>> Do you have any idea of the pressure I’m now under? ¶ >> There is one stage that is
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brings the arts home. >> Jeff: And joining us for this week’s “Your Health” segment
with Jill Logan, emergency medicine clinical pharmacist at
the University of Maryland medical center.
Jill, thank you for being with us.
>> Jill: Thanks for having me, Jeff.
>> Jeff: We want to focus in on drug interactions working in an
emergency setting. Do you see these?
Do you see people who come in having taken something that they shouldn’t have taken with
something else? Adjustments yeah, we see this
almost every day. There’s a lot of common inter
interactions that people just aren’t aware of and they think
that anything that is over the counter is safe.
Unfortunately, that’s not always A lot of disease states require
dose adjustments and a lot of medications will have sper
actions with the products that you can buy at your pharmacy.
>> Jeff: What are the most common drug interaction mistakes that you see?
>> Jill: So some of the things that are Dr. Common in the
emergency department sun intention a overdose so I think
one is the is a see the men fen or Tylenol.
It’s also found in a lot of cold pain, over-the-counter
medications, and it’s really easy to get a little too much of that medication.
>> Jeff: Let me stop you there for a second.
Somebody will have a bad cold and they’ll have a headache so
they’ll take Tylenol or acetaminophen and then maybe
they’ll reach for something they whole bunch of symptoms at once
but that is more of the same stuff in it and you are get to a point where it’s quickly toxic
to the liver, right? >> Jill: Absolutely.
So a lot of the combining medication really apply festival on acetaminophen or Tylenol but
exactly like you said you have somebody with arthritis, they
might take the arthritis medication that also has Tylenol or take Tylenol for their fever
and you can quickly end up having too much especially if
they’re taking it for multiple days at a time.
>> Jeff: In the world of prescription drugs what do you
see? What are some common inter
interactions. >>>Yes so within prescription
drugs a lot of medications will interact with over-the-counter
and sometimes even foods. So, for example, there’s a blood thin are called warfarin which a lot of people that have
irregular heart lates will be taking and that will interact
with many medications. Antibiotics they’re a common
interaction as well as anything that is over the counter that
begins with “G” is the common misconception.
Ginger, begin cobill oak, a ginseng, garlic tablets will
interact with warfarin. That’s an oversimplification so
please ask your physician or pharmacies.
>> What happens? What goes wrong?
>> Jill: Depending on the inter interaction the most common is
it decreases if bodyes ability to get rid of the warfarin and
you will accidental overdose or have too much medication in your system.
It can make your blood too thin and put you at risk for bleeding
bleeding. >> Jeff: So all of that was
probably in the fine minute on the — do you call it a
monograph? >> Jill: Absolutely.
>> Jeff: The sheets of stuff that come from the pharmacy when you get the bottle of pills that probably not everybody is read
reading all the way through. >> Jill: There’s a lot of good
information on that monograph but, you’re right, it’s a little overwhelming to read the 13
pages that goes into that. I think one of the best things
that your viewers can do is make pharmacies or health care
provider and make sure they have It’s important to make sure that everyone is well-informed.
>> Jeff: It is really one of the digital medicine and online
medical records and farm sees automated, and maybe it’s an
argument. You can tell me for keeping
everything at one pharmacy so that when even mult doctors were to prescribe different stuff,
the pharmacy’s computer would recognize if there’s a known
issue. >> Jill: You took the words
right out of my mouth there. Having one pharmacy is certainly going to be superior on for
catching problems with medications because that
pharmacist will be able to see all of the medications you’re on
on. From an emergency department
standpoint I really appreciate that because I will sometimes
call the pharmacy to see what you’re tank and having one place where all that information is
available is extremely helpful to make sure we give you all the right medications when you’re in the hospital and not cause
another interaction or side effect.
>> Jeff: Let me remind our strivers a question about drug
interactions give us a call. Weave the number up on the
screen for tweet us. Twitter address [email protected] news
news. The computer and the pharmacy
still doesn’t know what you had for breakfast or what vitamins
your taking or what Herbst you might be using.
>> Jill: That’s a really good tonight point that, to full
disclosure. Nothing is not important.
So when your health care provider asks what medication
you want to include those creams creams, herbal products, over
over-the-counter medications. For example, a common medication that’s herbalover the counter is St. John’s wort.
It’s touted as a antidepress than the.
It makes one of liver enzymes hyper ab tiff and you can
metabolize mur your medications too fast.
>> Jeff: It’s not that it doesn’t do anything.
It’s that it does something people aren’t aware that it’s
doing. >> Jill: Exactly.
A common interaction with that would be birth Kroll and it can
make the birth control infection St. John’s wort with that as
well. >> Jeff: Let’s take a phone call
call, this is Phillip. Thanks for calling.
Go ahead. >> Yes,-hole.
I just what happened to did — hello.
I just mention today the doctor that I’ve taken Benadryl many,
many times over my life, and then I was prescribed rob axin
by a — robe abs in. The combination of Benadryl plus robaxin caused hallucinations
that were unbelievably scary, so drug Benadryl .
>> Jeff: Phillip, what was the second drub drug?
>> Robe go axein. R-o-b-a-x-i-n.
>> Jill: That’s a scary inter interaction to happen and it is
quite common because Benadryl is that we do oaf the counter like
acetaminophen. It’s called an anticholinergic
and it can cause your body to re recane fluids and so you have
problems urinating and cause constipation and like you
mentioned it can cause mental status, hallucinations and
people become unconscious or start hallucinating to the point where they need to be
hospitalized. >> Jeff: How often do you see in your ER work, I think the
medical term is compliance. Somebody’s been prescribed
something and they’re either taking it the wrong way, they’re taking it at night when it’s
supposed to be in the morning or time.
How do you judge that? >> Jill: It’s difficult to judge and rely the on honestty you of
patients and sometimes they’re not oles forth coming.
They don’t want to admit, no, I haven’t been taking my
medication or I have been taking was in more pain or couldn’t
sleep or whatever the reason might be.
I would certainly encourage everyone to give us the full
next so we can make sure we’re treating everybody appropriately but it is important to take your medications as prescribed to
avoid some of these things that Phillip was just mechsing or
coming into the hospital with other problems.
>> Jeff: One confusing thing from a patient’s perspective is
when you have generic medicine that’s made by a bunch of
different manufacturers. The pills that they make look
completely different for the same drug.
>> Jill: Yeah, that can certainly be very dangerous, so
you have a green pill and a blue exactly the same and so you
might take one of each thinking you’re prescribed two different
medications. It’s really important to read
those labels. Oftentimes the pharmacy will put a description on the bottle of
what the pill should looks like, making sure you have the right
pill inside did decrease the risk.
>> Jeff: Let’s get a quick question from Lauer in Baltimore county.
>> Good evening. Can you tell me what it is about some of the blood pressure
medications that may — my husband seems to cough more and
I’m trying to narrow it down. >> Jeff: Thank you for the call.
>> Jill: There’s a blood pressure class of medication
called ace inhad I been tors. Lisinopril or captain oh prill
are generally I what I think you unfortunately it takes three
weeks for most people for us to see that cough and another two
to three weeks for it to go away away.
>> Jeff: Jill, thank you for being here.
Thank you for joining us for “Direct Connection”.”
We’re back Thursday with “Your Money & Business”.”
Have a good night. MADE POSSIBLE BY MARYLAND
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