Brown Bag Consult: Caring for Skin

In this series, Jill Drury, PharmD, a clinical pharmacy specialist, provides patients with "Brown Bag" consultations. Patients bring to the pharmacy their current medications and over-the-counter products, giving the pharmacist an additional resource for pharmaceutical counsel. In this video, a patient with fair skin is planning a tropical vacation. She seeks advice about topical skin protection and potential adverse effects from the sun with her medications.

Jill Drury, PharmD: Hi, Sondra!

Sondra, patient: How are you, Dr. Drury?

Jill Drury, PharmD: Great.

Sondra was here to pick up an antibiotic when she mentioned that she is going on vacation to Mexico. That sounds wonderful. I’m a little concerned about her fair skin, though, and how some make medications can make people more sensitive to the sunlight. So, I asked if she’d like to do a brown bag session. She agreed and went home and got her medications. Brown bag sessions can be for any patient who is interested in talking to their pharmacist in detail about any medication or preventive medicine. To prepare for our session, I already printed out Sondra's medication profile.

Sondra, patient: Yeah, I thought those things were for older people or for those who take a ton of medications.

Jill Drury, PharmD: So, many people think that, but they really are for any age group or anyone on a mediction. So let's get into your profile and see what's going on here. Okay?

I see that you have:

• amoxicillin, 875 mg, twice daily for 10 days
• esomeprazole, 40 mg, once daily
• lo loestrin 24 Fe, once daily
• sertraline, 50 mg, once daily

Does that sound right, so far?

Sondra, patient: Yes.

Jill Drury, PharmD: So, when you gave me your brown bag, I also noticed these additional medications that we didn't have in our computer system:

• adult multivitamin with iron, once daily
• OTC calcium carbonate, 1000 mg, once daily
• OTC omeprazole, 20 mg, once daily, unopened

Does that sound about right?

Sondra, patient: Yes.

Jill Drury, PharmD: OK. As I've mentioned some of these medications that you're on do make you more sensitive to the sun. It's really important when you're on vacation to take preventative care of your skin. Make sure you have a proper sunscreen that not just covers UVA, but UVB as well. And make sure you're constantly reapplying it every 2 to 3 hours, especially if you've been sweating or if you've been swimming. I also think that midday sun should really be avoided. So, pack a hat, pack some longer sleeve clothing, but remember to still enjoy yourself on vacation.

I also want to to follow up with some of your medications that are duplicate. So, I'm going to get in contact with your provider to help you out, streamline your medication profile. Does that sound like a good idea?

Sondra, patient: Yes.

Jill Drury, PharmD: Great. Another question I have for you is if you have ever been to see a dermatologist or if you've done self-check of your moles for any sign of cancer?

Sondra, patient: No. I only see my ob-gyn and primary-care doctor once a year, unless there is a problem. I do occasionally use tanning beds to get my skin to “glow.”

Jill Drury, PharmD: You do not need to avoid the sun altogether, but just take appropriate preventive measures to stay safe in the sun. Sound good?

Sondra, patient: Yes. Thanks. I really appreciate it.

Jill Drury, PharmD: You’re welcome. Have a great trip!