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Active Living
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My Doctor Says I Need a Test
Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
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Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
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Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
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Smiling through the Senior Years
Teeth for Life
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Tobacco Risks to Oral Health
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Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
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Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
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Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
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Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
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Check-Up
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Contact Lenses
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Cost of Doctor's Visit
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Do I Need a Bone Density Test?
Doctor Visit
Driving Vision
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Do I Need an Annual Physical?
Eczema
Electronic Medical Records
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Family Doctor
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Food Poisoning
5 Ways to Stay Healthy
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Get Active!
Glare
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Stroke
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Win by Losing
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Emergency Care Guidelines
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Can I see Well Enough to Drive?
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Get Active!
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Have Health, Will Travel
Health Tips for Seniors
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Maintaining Quality of Life as You Age
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Skin Over 50
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Travel Tips for Snowbirds
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Modern Living
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Abuse
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Adult ADHD
Aging and Memory
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Barbecue Basics
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Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
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Diabetes Epidemic
Discipline
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Mom Time
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Pet Therapy
Physiotherapy Visit
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Stressed or Depressed?
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Nutrition
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5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
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Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
Weight Loss
Weight Wise Tips
Pharmacy Care
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After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
Insomnia
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Pain Relievers
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports & Nutrition Supplements
Sunscreen
Taking Medication
Take as Directed
Using Antibiotics Wisely
Viagra
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
Alcohol
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
Disaster Planning
Diseases from Pets
Caffeine
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
E-cigarettes
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Meningitis
Norovirus
Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
Sun Safety
Surviving Disaster
Sushi Preparation
Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
Water Smarts
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Water Wisdom
West Nile Disease
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Workplace Alcohol Abuse
Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception
Contraception for Mature Women
Cosmetic Procedures
Cystitis
Endometriosis
Estrogen's Effect on the Brain
Fear of Fracture
Fibroids
Heart Attack
Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menopause
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Osteoporosis
Ovarian Cancer
Ovarian Cysts
Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
Sexually Transmitted Infections
Urinary Incontinence
Vaginitis
Varicose Veins
Viagra for Women
Yeast Infections
Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
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Family Health Magazine - PHARMACY CARE

Adverse Drug Reactions
Are your medications working the way they should?

Any medication, prescription drugs, over-the-counter (OTC) and even herbal product has the potential to cause problems. An adverse drug reaction (ADR) is any unwanted effect that comes from taking a medication. ADRs can be divided into the following categories:

Drug allergy

With a drug allergy, the body’s immune (defence) system reacts to a medication. In this type of ADR, the immune system sees the drug as a challenge that needs to be removed. Skin rash is a mild sign of this reaction, and can range from a rash like the measles to hives. Moderate signs include fever, swollen and aching joints, and swollen lymph nodes. Severe reactions include the swelling of vital organs, such as kidneys. There can even be anaphylaxis, a reaction that closes off breathing.

Certain drugs often cause allergic reactions, including:

If you have an allergic reaction to a drug, even a mild one, get advice from your health care provider. If your skin reacts mildly, the doctor may switch you to another medication. An antihistamine might also provide relief. If the reaction is moderate or severe, stop taking the medication immediately! Get medical advice as soon as possible. 

An anaphylactic drug reaction is life threatening and requires immediate attention. Signs include:

If you think you are experiencing anaphylaxis, have someone drive you to the hospital immediately or call 911 for an ambulance.

Side effects

A side effect is any undesirable effect caused by a medication’s normal action. When you buy a medication, you usually receive an information leaflet. This lists all possible side effects that can occur when taking that drug. The information comes from drug studies done both before and after a drug is available. When a side effect occurs in more than one per cent of those using a particular medication, it is linked to the medication.

The information in the leaflet may be a bit overwhelming. Some side effects listed may be severe or even life threatening. Keep in mind that this is just a complete list, and that certain effects are very rare.

On the other hand, you may experience a side effect that is not listed. Health Canada’s website has a place to report any effects not listed in the drug information leaflet. These reports may then be added to the safety information about a medication.

Some side effects are related to the dose (amount) of medication taken. They may be reduced or even eliminated by taking a lower dose. To have your dose changed, always consult your health care provider.

Other side effects are temporary as you start a new medication. They may improve or even disappear as your body adjusts. Beginning with a lower dose can sometimes prevent such side effects. Gradually increase the amount taken until you are at the recommended dose.

If you’re thinking of using another medication to manage a common side effect, talk with your health care provider first. You must be sure that the drug will not interact with any medications you use or make your medical conditions or allergies worse.

Table 1: Suggested ways to manage side effects

Area affected Side effect Suggested non-drug remedies
Central nervous system Sedation or dizziness
  • lie down for a few minutes
  • avoid sudden body movements
  • avoid driving or operating machinery
  • avoid drinking alcohol
Gastrointestinal Nausea and vomiting
  • take medication with food*
Abdominal pain
  • take medication with food or a glass of milk*
Constipation
  • drink plenty of water and other fluids
  • include more fibre-filled fruits, vegetables, and whole grain products in your diet
Diarrhea
  • eat fewer foods containing sugars that are poorly absorbed by the body (such as artificial sweeteners, fructose, and lactose)
  • drink oral hydration fluids (such as Gastrolyte™) to prevent dehydration
Skin Photosensitivity (light sensitive)
  • stay out of direct sunlight whenever possible
  • apply sunscreen before sun exposure
* Unless this might cause a drug-food interaction

Contact your health care provider immediately if any drug side effect worries you. If a side effect is bothering you and does not go away, switching to a different medication may be best. Side effects that require immediate medical attention include:

Drug-food interactions

With drug-food interactions, the food you eat affects the way your body takes in or gets rid of a drug. This in turn affects how much drug is available to your body.

Some medications are broken down by various liver enzymes. Other medications are eliminated from the body through the kidneys as urine. Foods can affect liver enzymes, in turn affecting how quickly or slowly a drug leaves the body. The longer a medication stays in your body, the greater the effect. As well, the longer it remains, the greater the risk you will react badly to it. Certain foods compete with medications to be eliminated through the kidneys. This increases the time that a drug is in the body.

Some foods affect how the stomach or intestines absorb medication. The process of eating prompts the release of acids to digest food. Some drugs absorb better when the stomach is less acidic. High fibre meals speed up the time stomach contents take to pass through the body. Less time in transit means less time for a drug to be absorbed. Certain vitamins in a food may also bind to a drug, stopping it from working.

Separating the time when you eat, or have an offending food, by at least two hours may prevent drug-food interaction. For instance, the antibiotic Cipro™ reacts to calcium. If you take Cipro™ at the same time, very little of the medication will be absorbed. It is better to take the two at different times.

In some cases, you may need to cut an offending food entirely while on a medication. A classic example involves grapefruit juice and grapefruit products. Grapefruit stops the liver enzyme that breaks down certain drugs, such as Lipitor™, Valium™, Adalat™, and Renedil™.

Drug-drug interactions

Drug-drug interactions occur when two or more drugs react with each other when taken together.

Table 2. Examples of drug-drug interactions

Effect Description Example
Absorption change A drug causes more or less of another drug to be absorbed by the body. Antacids can interact with many drugs and so should be taken at least two hours apart from other medications.
Iron and calcium stop each other from being absorbed and should be taken at different times.
Elimination change A drug causes another drug to be removed from the body more quickly or slowly than normal. Biaxin™ causes Lipitor™ to be removed more slowly from the body. Lipitor™ is usually stopped while Biaxin™ is used. Dilantin™ causes estrogen to be removed more quickly from the body. Women taking estrogen-containing oral contraceptives should be on higher doses of the contraceptive while using Dilantin™.
Additive side effects Two drugs share the same side effect. Both alcohol and codeine (such as in Tylenol™ No. 3) can sedate and affect motor control
Contradictory effects A drug has the opposing effect to another drug. Ventolin™ causes the bronchial airways in the lungs to open, while Lopresor™ does the exact opposite. Someone with asthma should not take Lopresor™ to treat high blood pressure.

Drug-medical condition interaction

Some medications can make an existing medical condition worse. For instance, the common medications below could be dangerous for someone with high blood pressure.

Table 3. Drugs that increase blood pressure

Condition Drugs to avoid
High blood pressure Decongestants, such as pseudoephedrine, phenylephrine, oxymetazoline
NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen, naproxen, Celebrex™
Corticosteroids, such as prednisone
Diet drugs, such as Meridia™
Various herbs, such as caffeine, guarana or ginseng

With some medical conditions, certain drugs absolutely must not be taken. In other situations, where benefits outweigh the risks, you will be advised to use the drug cautiously. You would then watch for any signs that your condition is getting worse.

The way that medications affect your body is very complex. While many people use medications without problems, knowing about ADRs can help prevent or manage them.

If you take medication, be aware of possible side effects, interactions and effects on medical conditions. Make sure your doctor, pharmacist or nurse practitioner know all your drug allergies, medical conditions, and current medications (including herbal supplements and vitamins). Wear a medical bracelet that lists all allergies and medical conditions.

Your pharmacist will always listen to your concerns or questions. Be sure to talk to your health care provider before you stop taking a medication, adjust the dose or change to another because of an ADR. Suddenly stopping or adjusting the dose of a medication may complicate the problem.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6    [PC_FHb09]
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