McKenna's Pharmacology for Nursing, 2e

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P A R T 1  Introduction to nursing pharmacology

OVER-THE-COUNTER DRUGS OTC medications allow people to take care of simple medical problems without seeking advice from their healthcare providers. Although OTC drugs have been deemed to be safe when used as directed, many of these medications were “grandfathered in” as drugs when stringent testing and evaluation systems became law and have not been tested or evaluated to the extent that new drugs are today. Aspirin, one of the non-prescription standbys for many years, falls into this category. Slowly, the TGA in Australia and MEDSAFE in New Zealand are looking at all of these drugs to determine their effectiveness and safety. Increasingly, drugs that were available only by prescription are becoming avail­ able OTC. Some well-known approved OTC drugs are ranitidine ( Zantac ) for decreasing gastric upset and heartburn; various vaginal antifungal medications for treating yeast infections; and chloromycetin eye drops ( Chlorsig ). Each year several prescription drugs are reviewed for possible OTC status. One factor involved in the review process is the ability of the person for self-care , which is the act of self-diagnosing and determining one’s treatment needs. OTC drugs can also mask the signs and symptoms of an underlying problem, making it dif- ficult to arrive at an accurate diagnosis if the condition persists. These drugs are safe when used as directed, but many times the directions are not followed or even read. The idea that “if one makes me feel better, two will make me feel really good” is not always safe in the use of these drugs. Many people are not aware of the drugs contained in these preparations and can inadvertently overdose when taking one preparation for each symptom they have. Table 6.1 gives an example of the ingredients that are found in some common cold and allergy prepa- rations. People who take doses of different preparations to cover their various symptoms could easily wind up with an unintended overdose or toxic reaction.

■■ BOX 6.1  Evaluating Internet sites

Address identification • .com or .co: commercial, advertising, selling, business site • .edu: education site—school system, university, college • .gov: government site • .net: part of a linked network system, may include any of the above • .org: sponsored by an organisation, including professional, charitable and educational groups Site evaluation • Navigation—Is the site easy to access and navigate or confusing? • Contributors—Who prepared the site? Is it reviewed? Is it purely commercial? What are the qualifications of the person(s) maintaining the site? Is there a mechanism for feedback or interaction with the site? • Dates—Is the site updated frequently? When was the site last updated? • Accuracy/reliability—Is the information supported by other sites? Is the information accurate and in agreement with other sources you have reviewed? Does the site list other links that are reasonable and reliable?

KEY POINTS

KEY POINTS

■■ An overwhelming amount of readily accessible information is available to consumers. This information has changed the way people approach the healthcare system. ■■ Consumer advertising of prescription drugs, mass media health reports and suggestions, and the Internet influence some people to request specific treatments, to question therapy and to challenge the healthcare provider.

■■ TABLE 6.1 Ingredients found in some common cold and flu OTC preparations* Drug name Ingredients Use

Codral Original Cold & Flu

paracetamol, pseudoephedrine, codeine phosphate pseudoephedrine, paracetamol, dextromethorphan pseudoephedrine, paracetamol, dextromethorphan ibuprofen, pseudoephedrine paracetamol, phenylephrine pseudoephedrine, paracetamol, triprolidine

Fever control, nasal congestion, aches

Demazin Cough Cold & Flu

Cough, nasal congestion, aches

Dimetapp Cough Cold & Flu

Cough, nasal congestion, aches

Nurofen Cold & Flu

Nasal congestion, aches

Panadol Cold & Flu + Decongestant Sudafed Sinus Day & Night Relief

Fever control, nasal congestion, aches Aches, nasal congestion, sinus pressure

*Safety Precautions: A person, if poorly advised, could take one preparation for cough, a second to cover sinus pressure, a third to cover aches and pains and a fourth to stay awake or fall asleep—when the total amounts of the drugs contained in these products are calculated, a serious overdosage of certain ingredients could easily occur.