We've all been there, eating at the dinner table and your dog is waiting for a free hand out or for a child to "accidentally" drop food on the ground for a quick treat. In our line of work there are numerous medications that are harmful to dogs, and even some medications that may be okay in general with canines, but a select few breeds have genetic level genes that make those same medications toxic to them. The same goes with food, there are certain caveats to consider such as how it is cooked, prepped, or what form it is in. While most food is typically safe for pets, there are plenty of foods that will cause minor temporary issues and some that are downright toxic to dogs. As the holiday season approaches, we will take a look at what is ok for your pet, and foods that are not okay. SAFE HOLIDAY FOODS FOR YOUR DOG (SOME WITH SPECIAL CAVEATS) > Potatoes, Sweet Potatoes, Broccoli, Cauliflower, Carrots, Peas, Apples (raw or cooked) - In general most vegetables are safe, the potatoes can be mashed (without the added cream/milk), baked, or roasted, but the important thing with these foods are that they are given to your dog plain. No butter, seasonings, sugar, or salt have been added. > Pumpkin - This is an excellent food for dogs. It is rich in nutrients and high in fiber, pumpkin helps with digestive health and beneficial for the dog's skin and coat. Make sure it is plain without any added sugars and seasonings and has been cooked and chopped. If you are giving pumpkin our of a can, be sure it is pure pumpkin puree and not pre-seasoned with sugar or spices. > Turkey - In short yes, turkey is a great protein for dogs but not without some caveats. Obviously, it should be thoroughly cooked, and needs to be the lean, bone-free, and skinless portion of the turkey. The skin is usually processed with butter, oil, seasoning, or other ingredients that could lead to pancreatitis and digestive issues. FOODS TO AVOID GIVING TO YOUR DOG > Ham - This is a fatty meat and can potentially cause pancreatitis and digestive issues. > Meat with bones - Bones can lead to rare esophageal obstruction, or gastric/intestinal obstruction. > Raisins/Grapes - These are toxic to dogs and can lead to kidney failure. > Macadamia Nuts - Also toxic to dogs and can lead to vomiting, diarrhea, tremors or other severe medical issues. > Onions/Garlic - Toxic in large quantities, eating too much of these can lead to the breakdown of red blood cells and cause hospitalization or the need for blood transfusions. > Chocolate - Most people know chocolate while delicious, is toxic to dogs. > Gravy - Gravy usually will contain onion or garlic and as mentioned those are toxic to dogs, along with the likely high salt content of gravy makes this a no-no to share. > Cranberry Sauce/Juice - Cranberry sauce/juice typically have a high sugar content already. > Stuffing - Much like the gravy explanation, stuffing usually contains garlic/onions. Some stuffing contains raisins which makes it not a good idea to mix in stuffing with your dog's meal. WHAT TO DO IF YOUR DOG ACCIDENTALLY EATS WHAT IS ON THE DO NOT FEED LIST? If you are unsure what or how much your dog ate, contact your local veterinary hospital right away. Other factors come in to play like size of the dog and amount of food ingested, so if you know how much or the type of food the dog ate you may need to keep a close eye on the dog and monitor for severe symptoms. Keep this phone number handy and hope you never have to use it: Pet Poison Helpline at (855)-764-7661 Wishing you and your pets a safe and Happy Thanksgiving!

Summer is coming to an end which means colder seasons are approaching. The months of fall and winter can be a parent’s worst nightmare because of cold/flu season. The stress of determining if/when you should take your child to their physician, understanding what symptoms your child may be experiencing, and deciding what medications to give them brings a lot of worry and tension into a parent’s life. Although knowing more information and recognizing differences about illnesses your child may be experiencing is beneficial, you should always depend on a provider for a diagnosis and should never self-diagnose yourself or your children. Always double check with a physician or pharmacist about dosing and if you should give a particular medication to your child. What is a Cold? The common cold is an upper respiratory infection that affects millions of people each year. Common colds happen when a virus, most often a rhinovirus, inflames the lining of the nose and throat. There are more than 200 different kinds of viruses that can cause you to catch a cold! This is one of the most common illnesses in children and they can typically get 6 to 8 colds a year. It can be spread airborne from coughs and sneezes, by contact, and even through contaminated objects (especially toys shared amongst children). Kids are more likely to catch a cold because they have weaker immune systems in comparison to adults. Children frequently touch their eyes, nose, and mouths without properly washing their hands which then contaminates toys, door handles, and more. When inhaling tainted air, the virus will stick to the nasal membrane starting the infection process. In the colder seasons of the year, common colds become more apparent because of more time spent inside which encourages close contact with others (daycare/school), hand-to-mouth contact, and because of humidity levels dropping which causes nasal passages drying out and creating a greater risk of infection. Symptoms generally start 1 to 3 days after being in contact with the virus and can last anywhere between 1 to 2 weeks. A few examples of what these symptoms may look like are listed below (there are more symptoms related to common colds than what are on these lists, contact your child’s provider for more information and/or a diagnosis): Frequent Symptoms in Infants: Trouble sleeping/insomnia Fussiness Congestion or stuffy/runny nose Vomiting Diarrhea Fever Frequent Symptoms in Children Congestion or stuffy/runny nose Sore/scratchy/tickly irritation of the throat Watery eyes Sneezing Mild hacking/cough Headaches Muscle/bone aches and pains Low-grade fever Fatigue Watery discharge from the nose that thickens and turns yellow or green Treatment Most children recover from a common cold on their own. Antibiotics will never be prescribed for colds because they don’t fight off viral infections. The best way to provide treatment for your child is by helping ease their symptoms until it passes and keeping them home until they are fever free for at least 24 hours. There are many over the counter (OTC) medications that can be given to your child for easing symptoms, but there are many other steps you should take as well to help ease their symptoms. Ensure your child is intaking plenty of fluids (water, electrolyte solutions, apple juice, warm soup, etc.) to prevent fluid loss/dehydration, have them get plenty of rest, use a cool-mist humidifier, and make sure that medication being used is appropriate. Always have the medication you give your infant or child approved by their provider or a licensed pharmacist and never give children any medication labeled for adults. There are various medications that if given incorrectly can be very detrimental to your child’s health and wellbeing, which is why you need to speak with a healthcare professional. For example, ibuprofen products cannot be given to children under 6 months old because of immature kidneys, children under 12 months old cannot intake any form of honey (even in processed or baked foods) due to the risk of botulism from spores of bacterium called clostridium botulinum (which are relatively heat-resistant) found in honey, children 4 years old and younger cannot have products containing decongestants or antihistamines because life-threatening effects can occur, and anyone under the age of 19 years old cannot take aspirin because of the risk of Reye’s Syndrome. There are several active ingredients you can find in OTC medications that will help different symptoms your child may be experiencing like: guaifenesin- an expectorant that brings up mucus, dextromethorphan- a cough suppressant that will reduce their cough, chlorpheniramine/brompheniramine/diphenhydramine are all antihistamines that will help allergies or itchiness, and phenylephrine/pseudoephedrine- decongestants that provide short-term relief for nasal congestion. Always follow package directions for proper dosing based on age and weight, check with a provider or pharmacist to make sure medication is appropriate for the child, and always use proper measuring tools- do not use kitchen spoons to measure medication. For children 1 year old and older, you can mix 1 to 2 teaspoons of honey in warm lemon water to help with cough. For children 7 years old and older they may suck on non-medicated lozenges to relieve sore throat or gargle warm salt water (¼ to ½ teaspoon of table salt mixed in 8 oz or 1 cup of warm water). Acetaminophen or ibuprofen can be given to children for fever and/or aches/pains if appropriate after doctor or pharmacist recommendation. When Should You Call Their Physician? Under 2 years old: after 1 day with a body temperature of 102° or greater by rectum or 103° or greater by underarm/forehead/ear temperature reading. 2 years and older: after 3 days with a body temperature of 102° or greater by rectum/mouth or 103° or greater by underarm/forehead/ear temperature reading. (Oral temperatures are not recommended for children 4 years old and younger.) If your child is experiencing any of these symptoms, call their physician: hoarse throat, inability to talk, high-pitched or barking sounding cough, difficulty breathing/wheezing or grunting while breathing, bluish or pale skin tone, ear pain/pulling of the ears/rolling head from side to side, difficulty swallowing, refusing liquids for more than 4 hours, no interest in playing/not acting like their usual self, and/or a fever that will not go down or subside from medication. It is not very recurrent, but a few possible complications that can happen to your child while having a cold include pneumonia, throat infections, ear infections, and sinus infections. How Can You Prevent Colds? The spread of viral infections and germs can be put to a stop in numerous ways including teaching your children how to properly wash their hands, carry hand sanitizer with at least 60% alcohol in the ingredients, disinfecting surface areas and objects regularly (especially play areas and toys), and teaching your children how to cover when coughing or sneezing. Going to a provider and learning it's more than just a common cold and your child (or yourself) is required to take prescription medications to treat the illness can be very stressful. This stress can be especially amplified if the prescriptions are sent in during vaccination season since the wait times are multiplied at retail pharmacies during that time. At Sonoran Drugs, we offer affordable pricing on antibiotics, antivirals, and more! We do same day delivery for medications such as these for $5.99 with a minimum total of $22 within a 13-mile radius of our location or if you’re located in Anthem, AZ. If you prefer to come into the pharmacy, we will have medications ready 15-20 minutes after the prescription is sent by the provider. We can even provide a curbside pickup for you as well if you’d like to remain in your vehicle! View our pricing below. For any questions, concerns, or inquiries- call us at (623) 583-2045, email us at support@sonorandrugs.com, or visit our website at www.sonorandrugs.com. The hours of operation are Monday through Friday from 9am to 5pm.

What is it & How Does it Work? Semaglutide it originally was approved by the US Food and Drug Administration (FDA) in higher dosage forms for type-2 diabetics and eventually displayed weight loss as a result. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1) that reduces food cravings and increases feelings of satiety which helps people with obesity or who are overweight manage and begin their weight loss journey. Semaglutide encourages insulin production in your body and regulates blood sugar which in return accelerates the rate that your body uses calories for fat and lowers your appetite, which boosts your body’s natural processes helping you burn more weight. This medication has been approved for usage in obese patients. How Do I Know I’m a Good Candidate? To determine whether someone is a good candidate to take oral semaglutide depends on various factors. Some of those factors include obesity, type 2 diabetic (on occasion depending on the dosage form and how many milligrams are needed for therapy), willingness to follow a healthy diet and exercise regimen, ability to take oral medication, and no underlying health conditions that can prevent you from taking the drug. Underlying health conditions that can prevent you from taking this medication can be, but are not limited to, kidney disease, heart conditions, and other medications or supplements that can affect the efficacy or interact with the semaglutide. Consult with your physician about this medication if it is something you are interested in trying to jumpstart your weight loss journey. Obesity Obesity is a complex disease which includes having too much body fat. About 70% of adults in the US are obese or overweight. Many assume that it is only a cosmetic issue, but it unfortunately increases the patient’s risk of a multitude of other health problems or diseases. Obesity can increase the risk of heart disease, diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea, and even some cancers. Obesity can be inherited, physiological, and be a result of environmental factors. It can lead people down a path of depression, disability, social isolation, feelings of guilt/shame, and lower work achievements. How is Semaglutide Dosed? When determining the dosing for semaglutide, physicians look at multiple factors. These factors include age, weight, gender, height, body mass index (BMI), and medical conditions. Side Effects: As with any medication, there are a few side effects that come with taking oral semaglutide. The most common side effects patients experience are nausea, diarrhea, and vomiting. Most of the side effects that are experienced are in the beginning of starting this therapy and subside the longer oral semaglutide is taken and tolerated by the body. Any symptoms or side effects should be reported to your doctor/prescriber right away to ensure that taking oral semaglutide is still an appropriate method of weight loss for you. Seeing Results: Results of oral semaglutide take time. They do not show overnight or without adding lifestyle changes into your life. It cannot be used to cancel out unhealthy lifestyle or unhealthy diets/eating habits. When you are taking oral semaglutide for weight loss, it is very important that you do not miss a dose. This increases the patient’s risk at low levels of insulin production causing low blood glucose between meals and while sleeping. It’s crucial that you engage in a healthy lifestyle; avoid sugary drinks, eat more fruits, veggies, nuts, and whole grains, limit intake of processed foods. Exercise should start at 30 minutes a day for at least 3 days a week. Pricing: Oral semaglutide can be compounded as oral capsules, troches, rapid dissolving tablets, and sublingual suspension at Sonoran Drugs. Titration Package: Month 1: Semaglutide 500mcg/B12 1mg once daily for 30 days: $139.95 Month 2: Semaglutide 1mg/B12 1mg once daily for 30 days: $169.95 Month 3: Semaglutide 1.5mg/B12 1mg once daily for 30 days: $224.95 All 3 months (not available in this package size for sublingual suspension due to shelf life after compounded): $449.95 Maintenance Dosing Semaglutide 2mg/B12 1mg (still once daily dosing): 30 Days: $284.95 60 Days: $499.95 90 Days: $669.95 3 Times Weekly Dosing Semaglutide 3mg/B12 1mg: 12 count (1 month): $179.95 24 count (2 month): $309.99 36 count (3 month): $424.99 If you are a patient in Arizona and would like to speak directly with a member of our staff, we would be happy to help answer any questions or concerns you may have. Sonoran Drugs will always be transparent about if we are the most cost-efficient route for your healthcare needs. Our operating hours are Monday through Friday from 9am to 5pm. We can be reached by phone at (623) 583-2045, through our social media platforms (including our website: www.sonorandrugs.com), and even through email at support@sonorandrugs.com.

In vitro fertilization (IVF) is one of many techniques that are used to help people have children who have the misfortune of having fertility inconsistencies. This extensive process includes being poked and prodded, having a horde of testing done, facing many hormone replacement therapy options, egg retrieval from the ovaries, attempting to fertilize the egg with sperm in a laboratory to create an embryo, inserting the embryo back into the womb, and it sadly doesn’t end there. There are expanded wait times with hopes that it was successful, which tragically isn’t always to outcome. For many, this journey is a trial-and-error kind of experience. IVF can be physically, mentally, and emotionally painful. Many insurances do not cover procedures, treatment, or medications for IVF which puts a financial strain on many families that endure this. At Sonoran Drugs, we have a desire of trying to help with more cost-efficient pricing and having the medications mailed or delivered straight to your door at no extra fee for your convenience. Fees may apply if the prescription is a refrigerated item. Thomas Shaw, PharmD is the founder and owner of Sonoran Drugs. He and his wife Ashley had to undergo financial, emotional/mental, and physical tension with IVF for two of their three astounding children. By choosing Sonoran Drugs to help take care of your medication needs, you will have a pharmacist who can empathize and understand first-hand what you’re going through. Thomas will always stay transparent with you and will admit if specific prescriptions aren’t at a better price through his pharmacy. He has an aspiration to help alleviate stress, that’s all too familiar, that others must go through to obtain this beautiful goal. IVF is a journey that no one has ever dreamt of participating in. Another common fertility treatment is called intrauterine insemination (IUI). Intrauterine insemination is a procedure that includes a type of artificial insemination. Instead of doing egg retrieval, fertilizing in a lab, and reimplanting into the womb, the partner or donor’s sperm gets washed and concentrated then placed directly into the uterus around the time the ovary releases egg(s) to be fertilized. IUI may be attempted with and without fertility medications. By adding fertility medications for this procedure, the chances of ovulating and conceiving after insemination are raised. (See charts below for pricing information) Key Words Gonadotropins- peptide hormones that regulate ovarian and testicular function which are essential for normal growth, reproduction, and sexual development. Chorionic Gonadotropins (hCG)- a hormone that the placenta produces during pregnancy. It can be found in the blood and the urine around 10 to 11 days after conception. Levels of hCG are at the highest towards the end of the first trimester of pregnancy then begin to decline for the rest of the pregnancy. This hormone triggers your body to produce more estrogen and progesterone. LHRH Agonists (or LHRH analogs)- synthetic proteins that are structurally like LHRH and bind to the LHRH receptor in the pituitary gland. Gonadotropin Releasing Hormone Antagonists (GnRH)- stimulates the female body’s production of estrogen and progesterone, which are predominant female sex hormones that play a key role in ovulation and conception. Progesterone- supports implantation and pregnancy. Estradiol- a hormone that is critical to the normal growth of and development of the female reproductive organs and the maturation of the egg in the ovary. During the menstrual cycle, estradiol levels increase, which causes the maturation and release of the egg, then thickening the lining of the uterus to allow a fertilized egg to implant. Estrogen- a group of hormones that play an important role in the normal sexual and reproductive development in women. If you would like to speak directly with a member of our staff, we would be happy to help answer any questions or concerns you may have. Sonoran Drugs will always be transparent about if we are the most cost-efficient route for your healthcare needs. Our operating hours are Monday through Friday from 9am to 5pm. We can be reached by phone at (623)583-2045, through our social media platforms, and even through email at support@sonorandrugs.com. Visit our website at www.sonorandugs.com.

“Why do my prescriptions cost so much?”, “Why do my copays change so frequently?”, and “How are the prices of my medication determined?” are all commonly asked questions by patients at the pharmacy. When you go into your pharmacy and ask these questions, most of the time pharmacy staff will respond with an answer involving your insurance or telling you to give them a call to inquire about these questions you continue to have. In the United States, the prices of medications are not directly regulated or negotiated, pharmacies can set their own prices. When it comes to these corporations deciding how much their medications will cost, there is a series of steps they must take and people they need to communicate with to ensure that they make a sizable profit. When it comes to creating copays they work hand in hand with Pharmacy Benefit Managers, also known as PBMs. How are the prices of medications determined? The average wholesale price (AWP) is decided individually by retail pharmacies which is why you may see different prices for the same prescription drug at different corporations. AWP is the retail listed price for the drugs sold by pharmacies. It typically has a 20 percent mark-up from the wholesale acquisition (WAC) price given by the manufacturers of the drugs. AWPs can vary based on a multitude of factors including, but not limited to, manufacturer, active ingredients, dosage form, strength, and package size. Throughout the years, there has been an average inflation rate on drug prices at an 8.5 percent increase. Between July 2021 and July 2022 for over one thousand different medications, the average inflation within big retail pharmacy chains was 31.6 percent! Luckily, the Inflation Reduction Act implemented a new requirement for manufacturers to pay rebates to Medicare for Part D drugs whose price increases exceeded inflation to reduce the frequency and size of increased prices. Tragically, this still doesn’t provide affordable health care services or products for the public. Unfortunately, with insurance and big retail pharmacy chains, the discussion of your out-of-pocket cost does not end there. PBMs are third-party administrators of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. Pharmacy Benefit Managers help control drug costs, public access to medications, and how much payment pharmacies can receive. They also process and pay prescription drug claims and hold the responsibility of creating and updating your health insurance plan’s drug formulary, which is the list of medications that a particular health insurance plan will cover. At Sonoran Drugs, we strive to provide excellent pricing for all our customers. Although we do not bill coupon cards or insurance companies, we offer competitive cash prices on prescriptions. We work hard to keep costs low, and do not let middlemen such as Pharmacy Benefit Managers (PBMs) mark up our prices by avoiding the use of insurance. Our patients can be confident that they are receiving the best price possible when they fill prescriptions with us, along with the reassurance that our prices do not and will not fluctuate with such drastic measures. At Sonoran Drugs, we believe that it should not be expensive to maintain your health and take care of yourself. We still have better prices in comparison to big retail chain pharmacy’s standard coupons on the GoodRx website. These prices for these commonly prescribed medications on GoodRx were gathered on 08/24/23 (their prices also fluctuate by the day and never stay stagnant). See charts below for comparison (and this is just showing a few examples, if only we could list every medication in comparison): Insurance is a wonderful resource to utilize and can be of use in various situations. This regrettably does not eliminate the chance of higher copays that patients must endure from time to time. At Sonoran Drugs, we have no intention in tricking people, we just want to ensure that patients are receiving high quality products at an affordable rate. Not only do we have amazing cash prices on maintenance medications, but we have nominal costs for compounded medications as well. Sonoran Drugs can compound for various specialties including, but not limited to, podiatry, dermatology, weight loss, oncology, dentistry, and sexual health. For your convenience, we offer a free mail-order service to all patients. If you would like to speak directly with a member of our staff, we would be happy to help answer any questions or concerns you may have. Sonoran Drugs will always be transparent about if we are the most cost-efficient route for your healthcare needs. Our operating hours are Monday through Friday from 9am to 5pm. We can be reached by phone call at (623)583-2045, through our social media platforms, and even through email at support@sonorandrugs.com.

Low dose naltrexone (LDN) is an FDA-approved medication with the potential to improve symptoms of a wide range of health conditions. LDN has been used since the 1980s to treat opioid and alcohol addiction, and in doses of 5-10% of the normal dose of naltrexone, LDN has been found to be effective in treating various autoimmune diseases, chronic pain, depression, fibromyalgia, and more. With its low dose, LDN is a safe and potentially effective treatment option for many people. Studies have shown up to 60% of patients experience reduced pain, fatigue, stress and headaches. LDN is typically taken in capsule form once a day at bedtime and can be taken in doses ranging from 1.5 mg to 4.5 mg. Patients often take a few weeks up to even a couple of months before seeing improvements when taking LDN; during the early stages of taking the medication, the dosage will often increase gradually. This prescription is usually well tolerated by patients however some do report vivid dreams after beginning the prescription. They typically are able to adjust to this the longer they take the prescription. Some people actually experience a “gut” detox as the LDN really can improve your immune system. Other variety of symptoms that can occur in patients are flushing after a dose increase, nausea, difficulty sleeping, skin rash, general fatigue. These symptoms typically resolve with little time. LDN can be a great treatment option for those looking to reduce inflammation without the side effects of other medications. If you or someone you know are already taking LDN, or you plan to talk to your doctor about it, let us fill the prescription for you at Sonoran Drugs and have it delivered to you anywhere in AZ free of charge.