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After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Medications Used After a Stroke

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Here’s what to know about stroke causes and medications commonly prescribed during recovery.

A stroke disrupts the flow of blood and oxygen to the brain, potentially damaging brain tissue. This can lead to impaired speech, impaired cognitive function, memory loss, numbness, and paralysis.

Strokes can be life-threatening, so it’s important to seek immediate medical care if you exhibit signs of a stroke such as the following:

Sudden numbness or weakness in the face, arm, or leg

Sudden confusion or difficulty speaking or understanding speech

Sudden severe headache without another cause

There are two types of strokes, with different underlying causes:

An ischemic stroke occurs when blood flow to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels. It is the more common type of stroke. Associated health risk factors include high cholesterol, atrial fibrillation, and diabetes.

A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures, damaging brain cells as a result. Associated health risk factors include high blood pressure and aneurysms.

Additionally, a transient ischemic attack (TIA) — sometimes referred to as a ministroke — occurs when there is temporarily reduced or blocked blood supply to the brain, often as the result of a blood clot. Unlike ischemic and hemorrhagic strokes, a TIA does not result in permanent damage.

Many of the leading risk factors for a stroke are modifiable, including:

Aftercare may include management of these risk factors.

There are a variety of medication classes used during stroke recovery, including the following.

Since high blood pressure is a leading cause of hemorrhagic strokes, stroke recovery may involve the use of several types of blood pressure medications.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering blood pressure. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. Commonly prescribed ACE inhibitors include benazepril (Lotensin®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), and ramipril (Altace®).

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart beats with less force. Commonly prescribed calcium channel blockers include amlodipine (Norvasc®), diltiazem (Cardizem CD®, Tiazac®), nifedipine (Procardia XL®), and verapamil (Calan SR®, Verelan®).

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. Commonly prescribed diuretics include chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®), hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), and indapamide (Lozol®).

Read Common Types of Blood Pressure Medications to learn more about these medications and potential side effects.

Anticoagulants interrupt the body’s natural blood clotting process to prevent new clots from forming and existing ones from growing. The following types of anticoagulants may be prescribed after an initial ischemic stroke.

Warfarin (Coumadin® and Jantoven®) prevents your liver from producing proteins that help form blood clots. It is taken orally as tablets. It has been associated with excessive bleeding in some individuals. Inform your doctor if you have a bleeding disorder so that they can prescribe an alternative.

Direct-acting oral anticoagulants (DOACs) directly block the blood’s ability to form new clots. Commonly prescribed DOACs include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®).

Read How Anticoagulants Prevent Blood Clots From Forming to learn more about these medications and potential side effects.

Like anticoagulants, antiplatelets prevent blood clotting and may be used during recovery from an ischemic stroke. They prevent platelets from coalescing, targeting a particular step in the formation of blood clots. Clopidogrel (Plavix®) is a commonly prescribed antiplatelet during stroke recovery.

Aspirin may also be used for antiplatelet therapy. If you are taking aspirin, avoid taking other nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, as they may interfere with aspirin’s antiplatelet effect.

Atrial fibrillation, or Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers. It can lead to the accumulation of blood and the formation of blood clots, increasing an individual’s risk for stroke. (Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may further increase your risk for a stroke.)

There are several medications that may be used to control heart rate and prevent a secondary stroke, including beta blockers, calcium channel blockers, and an antiarrhythmic called digoxin (Digox®, Lanoxin®, Digitek®).

Since high cholesterol may be associated with an increased risk for an ischemic stroke or ministroke, statins — a type of cholesterol-lowering medication — may be prescribed during stroke recovery. Statins act on the liver to reduce the amount of cholesterol produced by your body, in turn preventing plaque accumulation.

Commonly prescribed statins include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®).

Read How to Manage High Cholesterol: Diet, Medications, and More to learn more about these medications and potential side effects.

If you have diabetes, your doctor may revisit your diabetes treatment plan after an ischemic stroke. Individuals with type 1 diabetes require insulin every day to maintain healthy blood sugar levels. Treatment for type 2 diabetes is more varied and may involve insulin, oral medications such as metform, or a combination of both.

A stroke may lead to the loss of bone density. This can increase an individual’s risk for osteoporosis, a condition that weakens bones. After a stroke, your doctor may recommend increasing your intake of calcium and vitamin D — the most important nutrients for bone strength and health — depending on your symptoms.

Treatment for osteoporosis may also include medications such as bisphosphonates, which prevent the loss of bone mass. Commonly prescribed bisphosphonates include alendronate (Fosamax®, Binosto®), ibandronate (Boniva®), risedronate (Actonel®, Atelvia®), and zoledronic acid (Reclast®).

Many individuals experience depression after a stroke, both as a response to the emotional challenges of stroke recovery and due to stroke-induced biochemical changes in the brain.

Medication may be necessary to manage symptoms of depression. There are many types of antidepressants, including:

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®), venlafaxine (Effexor®), and desvenlafaxine (Pristiq®)

Atypical antidepressants such as trazodone, mirtazapine (Remeron®), and bupropion (Wellbutrin®)

A psychiatrist can recommend the best option based on your particular symptoms of depression, your overall health history, and other medications you’re taking.

Recovery from a stroke is often a gradual process. In addition to taking medication and practicing a healthy lifestyle, your doctor may also recommend speech therapy, physical therapy, and/or occupational therapy.

It’s important to take care of your emotional and mental health. Speak with your healthcare provider about resources that can support your recovery and help you adjust to the changes a stroke may bring. Individual psychotherapy or support groups can be helpful tools.

At Alto, we make it as simple as possible to follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

No industry is immune to burnout, including pharmacy. At many traditional retail pharmacies, individual pharmacists are often asked to do more than is possible on any given workday. Not only does this deprive talented and extensively trained health professionals of a manageable working environment, it deprives patients of the exceptional care they deserve.

pharmacists-spotlight-roni-hein

The better pharmacy model we’ve created at Alto makes life easier for everyone involved in the prescription process: patients, physicians, and pharmacists. And in restructuring how pharmacists work, we haven’t just separated fulfillment and patient care responsibilities into different roles — we’ve ensured that there’s ample support for each specialization, as there should be in any profession.

To wrap up our series of pharmacist profiles in celebration of American Pharmacist Month, we spoke to Roni Hein, a patient care pharmacist lead who takes care of her team so that they can in turn care for patients.

What motivated you to pursue a career in pharmacy?

It all began with my high school and college job at Target. I interacted a lot with the pharmacy team while working in the health and beauty section and eventually moved into that department.

I never expected it to be more than a college job, but it turned into the beginning of my professional path. As I worked there, I was able to see the impact pharmacists made in customers’ lives each day. It really struck me that in many communities, including mine, pharmacists were the most accessible healthcare providers. That accessibility is so impactful on a person’s well-being.

What challenges have you encountered as a pharmacist?

Limited time and isolation behind the counter, without question. In retail pharmacy, more and more responsibilities were added to my job description, with fewer resources to accomplish them.

All pharmacists value the personal connections we make with patients. I think many of us would say that making an impact through patient counseling is the best part of our day, but that is often what gets lost when pharmacists are asked to do more. Our primary driver for entering the profession is the first thing to go. I found a very refreshing change at Alto.

Everyone at Alto, no matter their department or role, has the same shared goal of improving patient lives by transforming the pharmacy model. As a patient care pharmacist lead, I do that by supporting my people. I create the space for our pharmacists to do their best work. They are able to have better interactions with patients because they are taken care of.

The pandemic has been a trying time for many companies and teams, including mine. I am constantly looking for new ways to ward off burnout and maintain a sense of camaraderie, not only for the pharmacists I manage, but for the benefit of our customers as well.

The individual locations of many retail pharmacies can feel very separate from each other. Each one often serves a single population.

The centralization of Alto’s patient care team is a contrast to that model. We have a cohesive, unified team serving all patients. That means there’s a depth of resources available to each pharmacist, which is also really important for retaining great talent.

Our pharmacists have a great support system in their colleagues. There’s other smart, driven pharmacists to bounce ideas off of. Unfortunately, you don’t always get that in our profession.

It also means that you don’t have to worry about anything falling through the cracks if something comes up outside of work. It's a game changer to be able to take time to grieve a loved one or to care for your child if they’re sick while knowing that your patients are still in expert hands. I never had that in retail pharmacy.

Finally, what is one thing people would be surprised to know about life as a pharmacist?

At a tech-oriented pharmacy like Alto where there’s so much innovation, you’re constantly thinking of new and creative ways to problem solve. It’s challenging in the best possible way. There isn’t a day when I don’t have to put my critical thinking skills to use.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. Meet the other pharmacists featured in this series: patient care pharmacist Travis Allison, specialty patient care pharmacist Gabrielle Kaplan, and medication therapy management pharmacist Wei-Lin Chang.

National Pharmacists Month Spotlight: Roni Hein

For many Americans living with a chronic health condition, prescription medications are necessary to manage symptoms and prevent complications. But following a treatment plan can be easier said than done. There are many considerations involved, from managing medication interactions and side effects to staying on track with related testing and follow-up appointments. And of the 66% of U.S. adults who are prescribed medication, only half take their medication as prescribed.

National Pharmacists Month Spotlight: Wei-Lin Chang

At Alto, medication therapy management pharmacists like Wei-Lin Chang help patients navigate all the complexities of managing a chronic disease. As part of our coverage of American Pharmacist Month 2022, we spoke to Wei-Lin about her professional path, the challenges of retail pharmacy, and the importance of medication education.

I honestly didn’t know what I wanted to do when I first entered college. My parents encouraged me to pursue a career in healthcare, but I knew I was a bit too squeamish around needles to become a doctor or nurse.

I took a chemistry class that I really enjoyed and decided to do all the pharmacy prereqs. I then did an internship with the head of pharmacy at Cook County Hospital in Chicago. Through that experience, I saw firsthand that pharmacists were a critical liaison between patients and doctors, with so much valuable information about medication strength, directions, dosing, and administration.

After that, I pretty much knew that pharmacy was for me. I’ve been practicing since 2002.

Before Alto, I worked in traditional retail pharmacy. In that setting, you’re so busy as a pharmacist — it’s one customer after another after another.

I worked both daytime and night shifts, and it was during the night shift, when the store was much more quiet, that I could really counsel patients without feeling so pressed for time. During the day, I simply didn’t have the free minutes to always answer patient questions or give recommendations.

Another challenge I faced was the perception of our profession. At the beginning of my career, in the early 2000s, many people I encountered didn’t know a pharmacist did much beyond putting pills in bottles and handing them off to customers. Not only did this lead to frustration from my customers, who would wonder what we were doing and why it was taking so long, it led to missed opportunities to more actively participate in a patient’s health journey. 

More medication education for patients is an urgent need within American healthcare. People taking multiple medications have to be mindful of potential side effects and medication interactions.

The growing field of medication therapy management is an opportunity for pharmacists to play an even bigger role in patient health, and I’m very proud to work for a company that prioritizes this particular area of pharmacy.

As a medication therapy management (MTM) pharmacist, I contact patients who take multiple medications — often multiple heart medications — and review their entire regimen over the phone. I make sure that they understand the purpose of each medication they’re taking and are on track with related testing.

For example, it’s important to get your liver function checked every 6-12 months if you’re taking cholesterol-lowering medications that are processed by the liver, or to get your A1C levels checked every 3-6 months if you’re taking diabetes medication.

We also discuss side effects, interactions, when to take medication, and what food to take it with. Too often, there isn’t the space for these conversations between pharmacists and patients, but they are so essential to a patient’s overall health. 

I love our pharmacy specializations. It’s unique to have a team that focuses solely on patients and another team that focuses on fulfillment. Not all pharmacies have a medication therapy management program, and it’s possible at Alto in part because of our smart allocation of resources.

Being able to use all of my time to focus on my core job functions is such a contrast to retail pharmacy, where you’re constantly bombarded from all sides at once.

As a pharmacist, what does “care” mean to you?

Care to me means going above and beyond for your patients and making sure all loose ends are tied. As an example, I recently initiated a transfer for one of the heart medications a patient takes. At Alto, we always complete every single step of the prescription transfer process on the patient’s behalf. He was so appreciative, and when I got off the phone, I could tell from his voice that he was smiling ear to ear. That’s the experience I want all of my patients to have.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison and specialty patient care pharmacist Gabrielle Kaplan.

Each October, American Pharmacist Month is an opportunity to not only celebrate the dedication of pharmacists and pharmacy technicians, but also to shine a light on all that they do.

National Pharmacists Month Spotlight: Gabrielle Kaplan

The average American visits a pharmacy 35 times a year, and the availability of pharmacists has the potential to address many gaps within healthcare, like access to the underutilized HIV prevention medication PrEP.

Many people who could benefit from the medication are unable to get a prescription from their primary care provider, whether it’s because they live too far from the doctor’s office or aren’t comfortable speaking about their sexual health. There's growing recognition that expanding the role of pharmacists in HIV prevention can help increase PrEP usage.

At Alto, we’re committed to maximizing the possibilities of pharmacy care. Not only do we divide our pharmacy roles into fulfillment and patient advocacy — we have numerous specializations under the umbrella of patient advocacy that allow our pharmacists to be part of the solution to precisely these healthcare challenges.

As part of our coverage of American Pharmacist Month, we spoke with Gabrielle Kaplan, a specialty patient care pharmacist who makes HIV prevention medication and treatment for complex chronic conditions more manageable for patients.

I’m a patient care pharmacist in our specialty department. We oversee medications that aren’t as common and which often have more side effects — or more serious side effects — including HIV medications, PrEP for HIV prevention, and injectable medications used to treat chronic conditions like psoriasis, rheumatoid arthritis, and high cholesterol.

The side effects associated with these medications can keep people from continuing with them. Since there’s a team of us whose sole focus is serving the patients who take these medications, they don’t just stop treatment. And they don’t have to worry about reaching out to us — we proactively check in. If anything is bothering them, we’ll take the initiative to call their provider and discuss their concerns.

What motivated you to focus on specialty pharmacy, specifically HIV treatment and prevention?

I was very interested in learning more about HIV treatment back in pharmacy school since a family member had passed away from it. The medications available today have drastically transformed what a diagnosis even means. I was excited by the possibilities, and it was always on my radar as a potential interest for the future. Working at Alto is the first time that I’ve been able to completely immerse myself in this specialization.

It’s a rapidly evolving area of both medicine and pharmacy, and there continues to be so much opportunity for pharmacists to take on a bigger role. In my state of Colorado, pharmacists can prescribe the HIV prevention medications PrEP and PEP. At Alto, we’re always discussing these updates and trying to expand the scope of what we offer patients and how we support their treatment.

By far the biggest pain point I experienced in retail pharmacy was staffing and having the number of pharmacists needed to execute all the day’s tasks while still providing great patient care.

Everyone working in a pharmacy is doing their very best, but there’s only so much we can do in an allotted time. It’s a disservice to patients and to those who work in the field — trying to balance the demands with your own mental well-being becomes nearly impossible.How do Alto’s pharmacy specializations make a difference for you and your patients?

Having a specific focus on patient care allows us to actually deliver quality patient care. At retail pharmacies where one pharmacist is doing it all, you’re trying to fill a prescription while on the phone and with someone yelling at you from across the room.

With fulfillment and patient advocacy separated at Alto, we are each able to focus on what’s in front of us at any given moment. For me, that means I can give patients my full and undivided attention and spend as much time with them as possible.

We have such a great team and plenty of support, so there’s no need to worry about other people’s tasks. We can each do the jobs that we’ve been specifically trained and are uniquely equipped to do.

What else is unique about Alto’s model?

The digital model makes it so that geography is less of an obstacle to care, and that each patient in our service areas has access to all of our resources. This is particularly relevant to my division of specialty pharmacy.

Many traditional retail pharmacies don’t have a specialty pharmacy in every physical location. Sometimes the specialty pharmacy is one centralized location from which everything is mailed. That means you won’t necessarily have a pharmacist in your local store who’s familiar with your medications and able to counsel you.

The medication used to treat or prevent HIV is complex, and it can be difficult to stay on track with treatment. The fact that any Alto customer taking these medications can talk to a pharmacist with deep expertise in that area of pharmacy makes a world of difference.

It means always putting patients first — thinking about the care you would want a family member or friend to receive and delivering just that.

This is part of a series of pharmacist profiles to recognize American Pharmacist Month 2022. To keep the Pharmacist Month celebrations going, meet patient care pharmacist Travis Allison.

Pharmacists are one of the most accessible healthcare professionals, seeing people 5 to 8 times more frequently per year than primary care providers. Their role has become more expansive than ever, and many people don’t realize just how integral they are to a patient’s health and well-being.

National Pharmacists Month Spotlight: Travis Allison

At Alto, fulfillment pharmacists focus on dispensing medication — ensuring that the entire process is carefully monitored every step of the way — while patient advocacy pharmacists tackle anything related to a patient’s wellness, from provider communication and insurance coordination to guidance on managing chronic health conditions.

These specializations have opened up entirely new possibilities for the patient-pharmacist relationship at Alto. And this October, as we celebrate American Pharmacist Month, we’re spotlighting a few of the extraordinary Alto pharmacists who focus on patient advocacy.

To kick things off, we’re pleased to introduce Travis Allison, a patient care pharmacist based in Dallas, Texas.

I took the long and winding road here. I didn’t always know this was what I wanted to do. In college, I started off as an English major but had a change of heart after a semester or two. I went on to study agriculture, and those experiences made me believe that I could pursue a path grounded in science.

My childhood memories of visiting the pharmacist were always in the back of my mind. As a kid, I hated going to the doctor. When those dreaded appointments were over and done with, I knew I’d get to see a guy in a white coat who would give me something to feel better. I always saw pharmacists as a comfort in the often scary world of healthcare.

At any chain pharmacy — which is where I spent my career before Alto — pharmacists are inundated with so many tasks. It isn’t that these tasks are unrelated to pharmacy, but they interfere with our ability to deliver patient care.

On a typical day, I would give 100 Covid shots and fill 200 prescriptions by myself while also coordinating billing and calling doctors’ offices. We also had to think about corporate metrics. I was frequently asked to get more people signed up for text message alerts and hit specific quotas.

Patient care is always the priority, for any pharmacist, but the reality of my job made it extremely difficult, and often impossible, to give patients the time they deserved.

The first thing I noticed when I started at Alto were the specializations. We have many different team members to handle all the responsibilities that fall on a single person’s shoulders at a traditional retail pharmacy.

I’m a patient care pharmacist, which is distinct from fulfillment pharmacists who process prescriptions.

I review prescriptions for accuracy and initiate medication transfers, and I interact with both patients and doctors. I’m here to answer any questions a patient has about their medication.

In a way, I feel like I’m on the frontlines the same way that I was when I worked in a pharmacy chain. It’s all of what I liked about retail pharmacy without the distractions of retail. We’re able to practice our most important functions as pharmacists without the noise.

We’re utilizing technology in a way no other pharmacy does, which allows us to communicate with patients and providers in so many different ways — without having to rush through interactions.

And the wheels of change turn much more quickly at a tech-oriented company than they do at a massive corporation. At my previous job, you could have conversations all day about what improvements were needed, but nothing ever happened. Alto was founded by software engineers, and we’re able to easily make changes in real time.

As a digital pharmacy, we serve so many patients that only we can serve. I talk to many who are homebound without a caretaker. Because of Alto’s model, I’m able to communicate with them, and we’re often their only point of contact within the healthcare system. I don’t know of another way these patients could get pharmacy care.

The digital model also allows us to get a broader view of healthcare, and to make an impact on a larger scale. Alto was one of few places where New Yorkers could get the Covid medication Paxlovid when it was first introduced.

It was incredible to be sitting here in Texas, getting prescriptions out in New York City just as a new variant came out that was really devastating to the city. At no other pharmacy would I have been able to help out my neighbors in New York.

Those moments where you can tell in a patient’s voice that you seriously helped them. To me, that’s an indication of how well I’m doing my job, much more so than the number of prescriptions processed or dollars generated.

A child’s diabetes care needs don’t stop during the school day, and starting a new school year or returning to the classroom after a diagnosis can be overwhelming for students and parents alike. Advanced planning and coordination with school staff can ease the transition and ensure that your child has everything they need to stay safe and healthy while at school. Below, we highlight the most important steps to take.

Managing Your Child’s Diabetes at School

To ensure effective management of your child’s diabetes during the school day, school staff should be informed of your child’s treatment plan as well as what to do in the event of a hypoglycemia or hyperglycemia emergency. There are two important plans to finalize and share with the school.

A diabetes medical management plan (DMMP) is the foundation of your child’s care regimen at school. It translates your endocrinologist’s recommendations into actionable items for your child’s school nurse, teacher, and other school staff members who are responsible for students.

A DMMP should cover every aspect of your child’s diabetes management, including the following. The American Diabetes Association has a detailed DMMP template that you can use as a starting point.

Insulin therapy needs, including the delivery device and timing of dosages and whether to contact you to adjust a dose

Important considerations for physical activities

Diabetes care needs — and the amount of support a child needs with them — evolve with time. Include information about your child’s self-care skills in your plan, clarifying specifically what support will be required from staff. Each school year, revisit your child’s DMMP with your endocrinologist and make updates if needed.

As you finalize your child’s treatment plan and your DMMP, consult with your endocrinologist about your insulin delivery device options. Many children find it convenient to use an insulin pump while at school, given the ease of use and automated timing of injections.

Insulin pens, which combine insulin and a syringe into a single device, also allow for faster and easier administration than syringes. (Some types of insulin pens are covered under pharmacy benefits — Alto may be able to help your child get started with these devices.)

You may also want to explore a continuous glucose monitoring (CGM) device for your child’s blood glucose monitoring needs. In contrast to traditional blood glucose meters (BGMs), which provide a single blood glucose reading by pricking a finger, CGMs automatically collect glucose readings regularly throughout the day. They can identify patterns that aren’t as easily captured by a traditional BGM and eliminate the need to step away for blood sugar readings. (Some CGMs give you the option of adding “followers,” so that you can alert your child’s provider and the school nurse to a potential emergency.)

504 Plan or Individualized Education Program (IEP)

After your DMMP has been finalized, the next step is to draft a 504 plan or individualized education program (IEP). This plan takes all of the information about your child’s care needs from the DMMP and documents the school’s specific responsibilities.

If the school nurse will typically oversee your child’s care, a 504 plan should address who will step in if the nurse is unavailable. Account for after-school activities and events and field trips as well.

Share any relevant information with your child. For example, make sure they know who to go to for help with blood sugar testing or if they experience symptoms of low blood sugar.

This plan should be revisited each year and shared with anyone who will be responsible for your child during the school day or at school events. View the ADA’s template for a 504 plan.

Many staff members are integral to a child’s diabetes management during the school day: the school nurse, your child’s teacher, and administration, as well as the sponsors of extracurricular activities and nutrition service staff. Their knowledge of diabetes and level of comfort overseeing care may vary. In addition to distributing the DMMP and 504, consider asking your healthcare professional to lead a special training for key staff members.

Have one-on-one conversations as needed to get any information about school policies that impact your child’s diabetes. Here are some topics to cover with specific staff members.

Make sure that you, your child, and your child’s teacher are on the same page about each other’s needs. Ask about classroom rules and guidelines, such as what a student needs to do in order to leave the room — is it necessary to ask permission each time? Let the teacher know more about your child’s specific signs of hypoglycemia, as these vary by individual.

Many children with diabetes find it helpful to bring lunch to school, for carbohydrate counting purposes. If your child will eat meals in the cafeteria, request information about the menu and dietary guidelines from a member of the nutrition services team.

Participating in physical activities is both beneficial to your child’s diabetes management and important for their social life. Share any relevant information with the physical education instructor or another staff member to ensure that your child can safely participate.

Make sure your child’s school has all diabetes essentials on hand, including the following:

Blood glucose meter and extra batteries (include these as a backup even if your child uses a CGM)

Insulin and syringes or pens (include these as a backup even if your child uses a pump)

In addition, be sure that the school has the supplies needed to treat hypoglycemia in an emergency. Ideally, there will be one emergency kit in the nurse’s office and another in the classroom. Label it with your child’s name and include the following:

During your conversations with school staff, discuss a system for keeping track of supplies and notifying you when low.

Lastly, your child should wear a medical ID necklace or bracelet to school every day. This will ensure that they receive prompt and correct treatment in the event of an emergency.

A partner in your child’s diabetes care

Navigating your child’s diabetes diagnosis is easier with a reliable pharmacy partner. At Alto, we’re committed to making it as simple as possible to manage diabetes, with free same-day delivery and medication management tools like reminders and auto refills in our app. And our dedicated diabetes support team is here to ensure that you have all the information you need to follow the treatment plan your child’s doctor recommends.

Reach out any time by phone at 1-800-874-5881 or secure in-app messaging.

Recognizing and Treating Anxiety, The Most Common Mental Health Disorder

Some degree of anxiety is natural. In fact, it can even be beneficial in certain contexts, like pre-interview butterflies. Other times, however, anxiety can become so debilitating that it interferes with daily life. Frequent and intense feelings of nervousness may be indicative of an underlying mental health disorder.

Anxiety disorders are the most common type of mental health disorder in the U.S., affecting more than 40 million adults, or about 19%. It is also estimated that 7% of children and adolescents between the ages of 3-17 struggle with symptoms of anxiety.

Over the past few years, as Covid-19 brings much upheaval and change, the number of Americans suffering from anxiety disorders and depression continues to increase. As a result, the U.S. Preventive Services Task Force is now recommending that all adults under the age of 65 be screened for anxiety. 

For many of those with an anxiety disorder, treatment — in the form of medication, psychotherapy, or both — is necessary to manage symptoms and maintain an active and fulfilling life. Below, we explain more about some of the most common treatment options.

Many factors can contribute to anxiety, including genetics, environment, behaviors, and situations. Common causes and risk factors include:

Having another mental health disorder such as depression

Genetics - having a relative with an anxiety disorder is considered a risk factor

Certain personality traits such as shyness

Individual experiences of anxiety can vary, so your anxiety symptoms may be different from those of a friend or family member with the condition. Anxiety can cause physical sensations like butterflies in your stomach or a racing heart. It can also bring an overall feeling of fear or unwanted thoughts.

Digestive issues, stomach pain, or nausea

Thoughts or flashbacks of a traumatic experience

Anxiety disorders are highly treatable with medication and therapy. (A combination of both is necessary for many people with an anxiety disorder.) While it can be difficult to share your feelings with a healthcare provider, it’s an important first step in managing symptoms.

These are some indications that you may benefit from treatment for anxiety:

Anxiety, fear, or worry has interfered with work and relationships

You find it difficult to control your anxiety, fear, or worry

You are concerned about your use of alcohol or other substances

There are many options for medication to treat anxiety. Some are used on a short-term basis or as needed while others are taken daily in the long term. Your provider will make recommendations based on your specific symptoms.

Though it can be frustrating, finding the right medication for your anxiety symptoms can take some trial and error.

There are several types of medications commonly used to treat anxiety disorders.

Benzodiazepines are sedatives that induce a feeling of calm. They amplify the effects of certain chemicals that act as a messenger between brain cells.

Benzodiazepines commonly prescribed for anxiety include:

These medications are typically used for short-term treatment of acute symptoms and may be prescribed on an as-needed basis. They often cause side effects like drowsiness and difficulty with balance and memory.

While benzodiazepines are effective, they have the potential for dependence and misuse. As a controlled substance under the U.S. Drug Enforcement Administration’s guidelines, there are tight regulations for prescribing and dispensing benzodiazepines.

Benzodiazepines are not safe to abruptly discontinue. If you have been taking a benzodiazepine for longer than two weeks, speak with your doctor about slowly tapering off to avoid withdrawal symptoms and lower the risk of seizure.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) increase a person’s levels of serotonin, a chemical in the brain that affects mood. Increased serotonin levels can alleviate symptoms of anxiety. These medications are considered a frontline treatment option for anxiety disorders and are also used to treat depression.

SSRIs commonly prescribed for anxiety include:

While SSRIs are very effective for many people with anxiety, it typically takes several weeks to experience their benefits. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you still have concerns several weeks into treatment, speak with your doctor.

Always consult your doctor before stopping an SSRI. It is not recommended to frequently start and stop SSRIs, and they should not be taken on an as-needed basis.

SSRIs have been linked to the following side effects, though they are mild in the majority of cases. Speak with your doctor about any concerns.

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