Clinician's Corner

October 29, 2020

Pete Kreckel



Mechanism: keeps the virus from multiplying.

Indications for use: Influenza type A and B. Begin within 48 hours of symptoms. May reduce symptoms by 1 day.

Warnings/Precautions/ Adverse effects: Nausea, vomiting, dizziness, and insomnia. May cause behavior changes in children.

Patient Education

Start as soon as possible. Take two doses the first day.

Not a substitute for the vaccine

Representative Products:

Tamiflu® 75mg capsules and powder for suspension 12mg/ml (available generically)

Adults: 75mg twice daily for 5 days. Get two doses in...


Pete Kreckel

Who should get the flu vaccine?

That’s easy… virtually everyone from age six months and up, regardless of pregnancy status. Patients with laboratory confirmed COVID 19 infection, symptomatic or not, should not get the influenza vaccination until they are no longer acutely and do not require isolation. On average about 45% of the United States citizens get their annual flu shot.

Efficacy of last year’s vaccine: was estimated to be 45% with 50% accuracy for the Influenza-B and 37% for Influenza-A

Flu vaccines for our patients over age 65:

  • Fluzone High-Dose Quadrivalent® contains four times the amount of antigen as the standard-dose inactivated flu vaccine, producing better protection in the...
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If Fayette county with the changing seasons we think of the holidays of Thanksgiving, Christmas, and New Year’s. At Nickman’s we see these three holidays as family gatherings where germs are exchanged from near and far! Flu season starts in October and November and greatly increases in December and January with the highest peak occurring in February in the Northern Hemisphere. Here are some flu basics that we need our patients to become familiar with.

§ Flu is caused by an RNA virus of the orthomyxovirus family. Viruses are truly not alive, but “take over” a cells machinery to reproduce

§ Antigenic drift: Frequent minor changes in antigenic structure of the virus. This can reach epidemic proportions, but not every year. This is what requires minor adjustments in...


Let’s assume you didn’t adequately follow our prevention tips. We can cover two scenarios. The first we will discuss when you find a tick on your skin, and remove it. Then we can discuss treatment when the characteristic rash appears.

Pharmacological Prevention of Lyme disease:

The Infectious Disease Society of America recommends antibiotics for prevention of a tick bite only when:

· Attached tick identified as an adult or nymphal deer tick (Ixodes scapularis)

· Tick is estimated to have been attached for 36 + hours

· The antibiotic can be given within 72 hours of tick removal

· The local rate of tick infection with B. burgdorferi is...



Pennsylvania, for many years has led the nation in number cases of Lyme disease. Now that hunting season is underway on our state, everyone is headed to the great outdoors either a day of hunting or staying home and doing yeardwork! Many of our patients are coming to Nickman’s Drug with questions about Lyme disease. Your Nickman’s pharmacist should be consulted with your questions about Lyme disease.

CAUSE: by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks (Ixodes scapularis) more commonly referred to as the “deer tick”. SYMPTOMS: include fever, headache, fatigue, and a characteristic skin rash called erythema migrans, which occurs 3-30 days...



As we discussed last week, Lyme disease, caused by a bacteria Borrelia burgdorferi, remains the most common vector-borne disease in the United States. Lyme disease was first described in 1977 as "Lyme arthritis" in studies of a cluster in Connecticut of children who were thought to have juvenile rheumatoid arthritis. When some of these kids got ear infections, and were treated with amoxicillin the “arthritis” went away. Of course, amoxicillin doesn’t treat arthritis, so the researchers looked for an infectious agent.

The problem with Lyme disease isn’t so much with the tick we remove, but the one that is never discovered, and the patient gets infected with the bacteria Borrelia burgdorferi . Only about 25 percent of patients with “bullseye rash”...