Over the Counter Medication Use:

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Over the Counter Medication Use

• Basic information for educators.
• Matthew Perri Ph.D, R.Ph., UGA College of Pharmacy

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Goals for next hour

• Help you take better care of yourself and those
  you care for
• Learn about some key features of OTC medications
  including
• Problems
• Side effects
• Choices
• Special considerations
• How use of these medications could affect
  classroom behavior

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How many of you have taken an OTC medication in
the last week or two?

• Well come back to this in a minute.

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Basic Points

• Medication v. Drug
• MOST medications can cause
• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Drowsiness

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Overview of OTC Medications (Harris Survey)

• gt 100,000 OTC Products
• Few unique active ingredients
• gt 700 are former Rx meds

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Some Interesting OTC Facts

• 3/5 people have used an OTC medication in the
  last 6 months
• This is slightly more than who used an Rx
  medication in the last 6 months
• Implication You are more likely to encounter
  OTC use in school than Rx!

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Interesting Facts and OTC Problems

• People dont consider OTCs real medicine.
• People just dont know what is in these
  medications, and many contain the same active
  ingredients.
• Only 34 of consumers could identify the active
  ingredient in the medicine they were taking.

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OTC Medication Use by Category

• Most common uses include
• Pain (78)
• Cough, cold, flu (52)
• Allergy and sinus (45)
• Heartburn, stomach (37)
• Constipation, diarrhea (21)
• Skin problems (10)

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For Example

• Pain
• Most common ingredients
• Acetaminophen (Tylenol aka, APAP)
• Aspirin (Many)
• Ibuprofen (Motrin IB, Advil)
• Naproxen (Aleve) and ketoprofen (Orudis)
• Caffeine
• Buffers, coatings, long acting, strongest pain
  reliever you can buy without a prescription.

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OTC Medication Use Focus on School Age Children

• Some specific recommendations and considerations

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Key Point

• Recognizing the rules about medication use in
  school we still have to be aware of what people
  might be doing without our knowledge
• Communicate with parents
• If they are taking Rx meds, chances are they use
  OTCs as well
• Communicate with students
• Dosed before school
• Taken while at school without knowledge
• Taken after school
• Smoking? Illicit drugs?

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Pain

• Acetaminophen (apap)
• first line treatment in those lt 18
• Generally causes few problems
• Is very safe to use
• Aspirin
• should be avoided in the under 18 age group
• Reyes syndrome
• Other problems usually associated with stomach
  distress (NVD)

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Pain

• Ibuprofen
• Fine to use in the lt18 age group
• Works about as well as apap
• Caution if kids are dehydrated
• Sometimes used in combo with APAP
• Dizziness, plus stomach problems
• CAUTION
• Aspirin / ibuprofen allergies a concern, in some
  cases you are seeing students after their first
  dose of a medication!
• Hives, shortness of breath, facial swelling,
  difficulty breathing or swallowing, itching,
  feeling funny
• Seek medical assistance immediately

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Cough, Cold and Flu, Allergy and Sinus

• Decongestants (stuffy)
• Pseudoephedrine (Sudafed)
• PPA removed from the market, others include
  phenylepherine, and some nasal sprays (Afrin)
• Have been associated with hallucinations,
  hypertension, irritability and hyperactivity
• Can also cause drowsiness, especially as as the
  dose wears off
• Products are available for very young children,
  but dosing is critical, so use pediatric dosage
  forms and measure carefully

15
Cough, Cold and Flu, Allergy and Sinus

• Antihistamines (runny)
• Claritin, Alavert (loratidine) Diphenhydramine
  (Benadryl), chlor and brompheniramine
  (Chlortrimeton, Dimetapp)
• Alone, usually cause drowsiness
• In combination, variable effects
• NLD 105 AM
• Kids need plenty of fluids when taking these,
  helps with drowsiness and dry mouth, PLUS MORE

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Cough

• Cough suppressants
• DM dextromethorophan
• Drowsiness, dizziness, NV
• Codeine
• Have to sign for OTC use
• Not recommended for infants
• Small or young children, can be used with caution
• Expectorants
• Guiafenesin (basic ingredient in most)
• Usually no problem, need to use with water, works
  about as well as water in OTC doses.
• No, water probably works better

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Combination Products

• Robitussin and Triaminic brands are very popular
  with pharmacists because they have many choices
• Plain, DM, CF, PE, Orange, Grape
• These products may contain
• Antihistamines
• Decongestants
• Cough suppressants
• Expectorants

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Heartburn, Stomach, Gas

• Antacids many, many
• Maalox, Riopan, Gaviscon, and plenty more
• Tagament, Zantac, Pepcid, etc.
• Gas
• Simethicone
• Breaks up the gas bubbles so they can be expelled
  and not cause pain. These products do not reduce
  the amount of gas!
• Gas X
• Mylicon
• Many generics available

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Constipation and Diarrhea

• The most amazing products that treat both! How do
  they know?
• Equilactin
• Balances water in the colon to properly form
  stools, adds fiber.

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Skin Problems

• Key here is contagiousness
• Is the problem going to spread?
• Bacterial, fungal, yes.
• Contact dermatologic problems, usually not.
• OTC Skin products usually present few problems
• Neosporin, Polysporin, Micatin, Lotrimin,
  Lamasil, Aveeno, Bacitracin, Ivy Dry, Calamine,
  Hydrocortisone, etc.
• Local reactions possible, sensitivity

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Surprising?

• 49 percent of consumers get information from ads
• 57 percent get their information from a health
  professional

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Ask Your Pharmacist!
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10 Tips on OTC use

• Read the label
• Treat only the symptoms you have
• Know what to avoid while taking OTCs beware of
  interactions
• ASK before you buy
• Use as directed on the label
• Be careful if you take gt 1 OTC
• Dont mix Rx and OTCs including herbals
• Give your doctor a list of ALL meds
• For kids, use pediatric formulas
• Throw meds away if they are expired

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Keep in mind

• If you have students taking OTC meds, more than 1
  medication, Rx and OTC meds, and something seems
  out of character, it could be the cause.
• These kinds of problems need to be brought to the
  attention of a health professional asap.