OTC medications

The use of drugs as a form of medical treatment in the United States is an enormously complex process. Individuals can purchase medications through numerous outlets. Over-the-counter (OTC) medications can be purchased in pharmacies, grocery stores, supermarkets, convenience stores, via the Internet, and through any number of additional outlets. OTCs are widely used by all age groups. Prescriptions can be purchased through... 

Since many AR treatment options are available OTC, patients often self-treat unless symptoms are intolerable. Additionally, patients without medical insurance or formulary coverage are more likely to purchase OTC agents. Health care providers should ask patients about OTC medication history (i.e., effectiveness of and adverse effects with previously used agents) when selecting AR therapy. 

Use OTC medications, such as cough, cold, and diet preparations, cautiously because they may affect blood pressure... 

Do not take OTC medications without first consulting the physician... 

Avoid alcohol ingestion, CNS depressants, OTC medications (cold, weight loss, hay... 

Antacids Popular OTC medication for symptomatic relief of heartburn not as useful as PPI and H2 blockers in peptic diseases... 

Patients, health care professionals, and pharmacists all have roles in preventing the abuse1 of and addiction to prescription medications. For example, patients should follow the directions for use carefully learn what effects and side effects the medication could have and inform their doc-tor/pharmacist whether they are taking other medications [including over-the-counter (OTC) medications or health supplements], since these could potentially interact with the prescribed medication. The patient should read... 

Similarly, some OTC medications, such as cough and cold medicines containing dextromethorphan, have beneficial effects when taken as recommended but they can also be abused and lead to serious adverse health consequences. Parents should be aware of the potential for abuse of these medications, especially when consumed in large quantities, which should signal concern and the possible need for intervention. 

What Are the Trends in the Abuse of Prescription Drugs and OTC Medications ... 

By definition, any medication you can buy at your local pharmacy or grocery store without a prescription—cold medicines, pain relievers, sleep aids—is considered an over-the-counter (OTC) medication. 

The abuse of marketed medications has been at the forefront of public awareness in recent years, mostly due to widespread reports concerning OxyContin and hydrocodone.1 While these are highly regulated, prescription-only medications with recognized potential for abuse, even some over-the-counter (OTC) medications have become problematic, either because of their own effects (e.g., ephedrine) or because they are used in the manufacture of other abused substances (e.g., pseudoephedrine, used to make methamphetamine).2 3... 

Physician s Desk Reference (PDR) for Nonprescription Drugs, Dietary Supplements, and Herbs The Definitive Guide to OTC Medications. Montvale, NJ Thompson PDR 2006. 

Codeine is most often used in the treatment of mild to moderate pain that does not respond fully to OTC analgesics. A number of different cough-suppressant (antitussives) medications contain low concentrations of codeine. The effects of codeine on the nerves and muscles of the intestines make it an effective treatment for diarrhea. However, since equally effective OTC medications are available, codeine is now rarely used for this purpose. 

There are three reasons why it is essential for clinicians to be familiar with this class of products. First, many OTC medications are effective in treating common ailments, and it is important to be able to help the patient select a safe, effective product. Because managed care practices encourage clinicians to limit the cost of drugs they prescribe, many will begin to recommend effective OTC treatments to their patients, since these drugs are rarely paid for by the insurance plan. (See Table... 

The Med Check Program will help patients to improve the safety and effectiveness of their drug therapy, including prescription medications, OTC medications, and herbal products. Patients will receive a comprehensive review of all their medications, with a written report and patient education about each of their drug-related problems. A pharmacist will work with the patients and their physicians to develop a plan to address these problems. 

Pharmacists and technicians play a major role in medication safety in modern pharmacy practice. After summarizing several studies performed in hospitals and long-term care facilities, Allan and Barker (1990) estimated that medication errors occur at a rate of about 1 per patient per day. In a more recent study performed in ambulatory pharmacies, they found an overall dispensing accuracy rate for prescription medications of 98.3 percent (Allan, Barker, and Carnahan, 2003). While most of these errors probably have minimal clinical relevance and do not affect patients adversely, many experts believe that medication error rates may be higher in the ambulatory care setting because errors may not always be evident to the health professionals who work there. For example, medication errors can occur when a patient purchases nonprescription medications without speaking with the pharmacist about any potential interactions with his or her prescription medications or if patients fail to verify the appropriate dose of the over-the-counter (OTC) medication. 

Prescription drug abuse has infiltrated current teen culture. PATS data revealed that 37 percent of teens say they have close friends who have abused prescription painkillers like Vicodin and OxyContin. Some 29 percent say the same about prescription stimulants Ritalin and Adderall . Average teens demonstrate a remarkable sophistication and knowledge when it comes to prescription (Rx) medications, which must be subscribed and supervised by a doctor, over-the-counter (OTC) medications, which are available for general purchase and use, and all other drugs. Teens are familiar with brand names of a wide variety of medications and can accurately describe their effects. 

There are hundreds of drugs available as OTC preparations that are used for self-medication. Obviously, these drugs also lend themselves to interacting with not only prescription medications but also herbal preparations. Table 4.7 lists the generic name of some of the most popular OTC medications, followed by the prescription drug they are most likely to interact with, followed by the effect(s). 

Naproxen and ibuprofen are nonsteroidal antiinflammatory drugs (NSAIDs) widely available as and OTC medications. In both cases the active (S)-enantiomer is far more potent. Selective hydrolysis of racemic esters of these drugs enables the production of both (S)-naproxen and (S)-ibuprofen. A number of... 

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