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MONITORING THE SAFETY ASPECTS OF OVER THE COUNTER MEDICATIONS  [PDF]
M.Z. Subin,V. Vidya,O.A. Halima,G. Geethu
International Research Journal of Pharmacy , 2012,
Abstract: OTC medication is short for over the counter drugs. These medicines have become popular as they are available without a prescription from the doctor. These are medicaments that are usually used to relieve pain and to treat various symptoms of cold. Most of the over-the-counter users believe that these medications are safer and are devoid of unwanted side effects. But their use may become fatal sometimes when they are administered without knowing the prescription pattern, that is, when they are used without properly reading the directions on the label. More over, the consumers are not aware of the safety of these drugs and its frequent use may result in various adverse effects. It is the part of the patient to read out the label packaging instructions for OTC medications to know how much one should take, the possible side effects that may encounter and the various conditions that can result in poor choice of the drug. Various other aspects such as the recommended dose, contraindications and drug interactions should be considered before taking OTC drugs. Pharmacists and drug companies will have an increasingly important role in giving information and advice to the patients. This review highlights the safety aspects of OTC drugs. It summarizes the safety measures that should be taken into consideration when used among different age groups.
Self-medication with over the counter ophthalmic preparations: is it safe?  [PDF]
Rajani Kadri,Sudhir Hegde , Ajay A Kudva , Asha Achar , Sunil P Shenoy
International Journal of Biological and Medical Research , 2011,
Abstract: ABSTRACT: Aim: This study was conducted to evaluate the misuse of ‘Over the Counter’ (OTC) ophthalmic topical preparations, to determine the public attitudes to and knowledge of such self-medication, and the factors motivating the indiscriminate use of these easily available remedies. Method: Responses to a semi-structured questionnaire covering various aspects of OTC eye drops and ointments usage were obtained from patients attending an ophthalmic out-patient department. Results: 116 patients took part in this cross-sectional study. 115 (99.1%) of the patients had no awareness of OTC ophthalmic preparations. Redness in 52 (44.8%) was the most common complaint for which the patient opted self medication, followed by itching in 21(18.1%) and foreign body sensation in 17 (14.7%). 41 (35%) of the patients did not know what drug they had obtained. 28 (24.1%) obtained chloramphenicol ointment, 34 (29.3%), decongestant preparation containing naphazoline hydrochloride, 6 (5.2%), gentamicin and 7 (6%), ciprofloxacin eye drops. Conditions worsened in 11 (9.5%). Accessibility in 88 (86.3%) was the most important motivating factor for obtaining OTC eye medication. Conclusion: OTC ophthalmic topical drugs that are meant for self-medication are of proven efficacy and safety. Misuse and abuse of these medications due to lack of knowledge of their side effects has to curbed. Educating the public about the dangers of self-diagnosis and treatment, possibly leading to delay in detection of more serious underlying ailments, is essential.
Over-the-Counter Medication Use, Perceived Safety, and Decision-Making Behaviors in Pregnant Women  [PDF]
Katie L. Kline, Pharm.D. Candidate 2011,Sarah M. Westberg, Pharm.D., BCPS
INNOVATIONS in Pharmacy , 2011,
Abstract: The purpose of this study was to determine which over-the-counter (OTC) medications women are using during pregnancy, and to assess patients’ perceived safety of these medications. In addition, the decision-making process utilized by pregnant women when choosing OTC drug therapy was explored, including sources of information and recommendation. The subjects included pregnant women 18 years and older. Subjects were solicited as a convenience sample by providing surveys in two urban women’s clinic waiting rooms. Of the 61 respondents, 96.3% had used an OTC medication, herbal, or vitamin during their current pregnancy. The most common products included prenatal vitamins, acetaminophen, cough drops, antacids, calcium, vitamin D, and DHA. The majority of women surveyed regarded over-the-counter medications, vitamins, and herbals as “safe, but would talk to a healthcare professional before using.” The most utilized sources of drug information during pregnancy were a physician (68.9%), midwife (55.7%), and the Internet (44.3%). There were an equal number of respondents obtaining general OTC information from apharmacist as from their family and friends (26.2%). Almost all subjects had used an over-the-counter medication during their pregnancy and the majority considered OTCs safe after first consulting a healthcare professional. Although a high percentage of subjects have obtained their information and recommendations from healthcare professionals, a very small proportion of subjects had utilized a pharmacist as a resource. Being drug experts and easily accessible members of the healthcare team, pharmacists have a responsibility to aid the obstetric population in the appropriate and safe use of over-the-counter drugs, vitamins, and herbals during pregnancy.
Medication deserts: survey of neighborhood disparities in availability of prescription medications  [cached]
Amstislavski Philippe,Matthews Ariel,Sheffield Sarah,Maroko Andrew R
International Journal of Health Geographics , 2012, DOI: 10.1186/1476-072x-11-48
Abstract: Background Only a small amount of research has focused on the relationship between socio-economic status (SES) and geographic access to prescription medications at community pharmacies in North America and Europe. To examine the relationship between a community’s socio-economic context and its residents’ geographic access to common medications in pharmacies, we hypothesized that differences are present in access to pharmacies across communities with different socio-economic environments, and in availability of commonly prescribed medications within pharmacies located in communities with different socio-economic status. Methods We visited 408 pharmacies located in 168 socio-economically diverse communities to assess the availability of commonly prescribed medications. We collected the following information at each pharmacy visited: hours of operation, pharmacy type, in-store medication availability, and the cash price of the 13 most commonly prescribed medications. We calculated descriptive statistics for the sample and fitted a series of hierarchical linear models to test our hypothesis that the in-stock availability of medications differs by the socio-economic conditions of the community. This was accomplished by modeling medication availability in pharmacies on the socio-economic factors operating at the community level in a socio-economically devise urban area. Results Pharmacies in poor communities had significantly higher odds of medications being out of stock, OR=1.24, 95% CI [1.02, 1.52]. There was also a significant difference in density of smaller, independent pharmacies with very limited stock and hours of operation, and larger, chain pharmacies in poor communities as compared to the middle and low-poverty communities. Conclusions The findings suggest that geographic access to a neighborhood pharmacy, the type of pharmacy, and availability of commonly prescribed medications varies significantly across communities. In extreme cases, entire communities could be deemed “medication deserts” because geographic access to pharmacies and the availability of the most prescribed medications within them were very poor. To our knowledge, this study is first to report on the relationship between SES and geographic access to medications using small area econometric analysis techniques. Our findings should be reasonably generalizable to other urban areas in North America and Europe and suggest that more research is required to better understand the relationship of socio-economic environments and access to medications to develop strategies to achieve
Use of chinese and western over-the-counter medications in Hong Kong
Vincent Chi Ho Chung, Chun Lau, Frank Kin Chan, Joyce Sze You, Eliza Yi Wong, Eng Yeoh, Sian Griffiths
Chinese Medicine , 2010, DOI: 10.1186/1749-8546-5-41
Abstract: In Hong Kong, community pharmacists work independently from medical doctors who often prescribe and dispense medications in a clinical setting. On the other hand, patients often seek first line treatment from community pharmacists [1]. Community pharmacists have long been an underutilized part of the human resources in primary care [2,3] as a result of the interplay between demand, supply and organization factors [4]. In Hong Kong, the use of over-the-counter (OTC) medications is popular in the local population. Previous studies found that 65% of the respondents used OTC medications [5] and that 32.9% of outpatients had taken OTC two weeks prior to their visits [6]. The majority of community pharmacists in Hong Kong admitted that they were most frequently asked about OTC [7].Chinese OTC medications are used as often as their western medicine counterparts in Hong Kong [8]. Unlike pharmacists, tertiary education is not a prerequisite for retailing Chinese medicine OTC [9]. Historically, Chinese medicine retailers worked alongside with Chinese medicine practitioners [10]. Since 1997, Chinese medicine practitioners as a medical profession have been recognized [11] and have become less dependent on Chinese medicine retailers.This article describes the behavioral patterns of both Chinese and western medical consultations and OTC use in a representative sample of the Hong Kong population. This information will provide timely input for planning pharmacists' and Chinese medicine retailers' future roles within the Hong Kong primary care system [12].Thematic Household Survey (THS) was conducted between November 2005 and March 2006 by the Census and Statistic Department (CSD), Hong Kong [13]. The THS covered the entire land-based population of Hong Kong and interviewed a total of 33,263 non-institutional individuals (response rate: 79.2%). The interviews were conducted in Cantonese. The sample represents a population of 6,750,652 persons of the general population.The questionna
Determinants of Medication Adherence to Antihypertensive Medications among a Chinese Population Using Morisky Medication Adherence Scale  [PDF]
Gabrielle K. Y. Lee, Harry H. X. Wang, Kirin Q. L. Liu, Yu Cheung, Donald E. Morisky, Martin C. S. Wong
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0062775
Abstract: Background and Objectives Poor adherence to medications is one of the major public health challenges. Only one-third of the population reported successful control of blood pressure, mostly caused by poor drug adherence. However, there are relatively few reports studying the adherence levels and their associated factors among Chinese patients. This study aimed to study the adherence profiles and the factors associated with antihypertensive drug adherence among Chinese patients. Methods A cross-sectional study was conducted in an outpatient clinic located in the New Territories Region of Hong Kong. Adult patients who were currently taking at least one antihypertensive drug were invited to complete a self-administered questionnaire, consisting of basic socio-demographic profile, self-perceived health status, and self-reported medication adherence. The outcome measure was the Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as MMAS scores greater than 6 points (out of a total score of 8 points). Results From 1114 patients, 725 (65.1%) had good adherence to antihypertensive agents. Binary logistic regression analysis was conducted. Younger age, shorter duration of antihypertensive agents used, job status being employed, and poor or very poor self-perceived health status were negatively associated with drug adherence. Conclusion This study reported a high proportion of poor medication adherence among hypertensive subjects. Patients with factors associated with poor adherence should be more closely monitored to optimize their drug taking behavior.
Improving Appropriate Use of Antifungal Medications: The Role of an Over-the-Counter Vaginal pH Self-Test Device  [PDF]
Subir Roy,James C. Caillouette,Joel S. Faden,Tapon Roy,Diana E. Ramos
Infectious Diseases in Obstetrics and Gynecology , 2003, DOI: 10.1080/10647440300025523
Abstract: Objectives: To determine whether patients can understand and use the vaginal pH device in the diagnosis of vaginitis. To compare whether vaginal pH readings determined by patients and healthcare providers are similar. To determine whether vaginalpHcan reduce inappropriate over-the-counter (OTC) antifungal medication use and improve the correct diagnosis of vaginitis.
Ibuprofen-Induced Hypokalemia and Distal Renal Tubular Acidosis: A Patient’s Perceptions of Over-the-Counter Medications and Their Adverse Effects  [PDF]
Mark D. Salter
Case Reports in Critical Care , 2013, DOI: 10.1155/2013/875857
Abstract: We highlight a case of distal renal tubular acidosis secondary to ibuprofen and codeine use. Of particular interest in this case are the patient’s perception of over-the-counter (OTC) medication use, her own OTC use prior to admission, and her knowledge of adverse reactions or side effects of these medications prior to taking them. 1. Introduction Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) which is available over-the-counter (OTC) as a nonprescription drug. It is used widely as an antipyretic and analgesic. Our patient had hypokalemia secondary to type one, distal renal tubular acidosis (dRTA), after long-term ibuprofen and codeine use. The combination of biochemical abnormalities including hypokalemia, hyperchloremic metabolic acidosis, hypophosphatemia, and urine pH >5.5 was consistent with those found in our patient [1–3]. The mechanism behind ibuprofen-induced renal tubular acidosis is not well understood and is believed to involve the inhibition or deficiency of carbonic anhydrase activity, especially carbonic anhydrase type two, which is the predominant form in the kidneys. Essentially, the hyperchloremic metabolic acidosis is a result of impairment of renal acidification and the hypokalaemia is due to the acidosis impairing proximal sodium reabsorption, causing increased potassium secretion in the distal tubules [4–6]. 2. Case Presentation A 38-year-old patient presents with myalgia, evolving paralysis, and vomiting for 3 weeks on a background of iron deficiency anaemia, migraines, and gastroesophageal reflux disease. Her only medications were esomeprazole 20?mg and amitriptyline 50?mg. She had been sent in by her GP with moderate hypokalaemia (potassium 2.6?mmol/L, range 3–5?mmol/L) and possible myositis (CK 2500?u/L) after blood tests the prior evening. Her examination demonstrated conjunctiva pallor, minor right upper quadrant, and epigastric tenderness. Neurological exam showed generalised upper and lower limbs flaccid weakness (grade 3/5 proximally and 4/5 distally) with normal sensation and cranial nerve examination. Repeat blood tests demonstrated a hyperchloremic metabolic acidosis, hypokalemia (potassium 2.1?mmol/L), a mild transaminitis, an inflammatory response (WCC 27.1 × 109/L and procalcitonin 108?ug/L with normal CRP), and a creatinine kinase 26,100?u/L. This was in the context of normal renal function (urea 5.4?mmol/L and creatinine 85?umol/L). Urinary myoglobin was 266,900?ug/L, pH 9, and spot urinary potassium 22?mmol/L (overall >20?mmol over a 24-hour period). ECG showed mild ST depression without U waves and a
Adherence to Medications after Hospital Discharge in the Elderly  [PDF]
Elie Mulhem,David Lick,Jobin Varughese,Eithne Barton,Trevor Ripley,Joanna Haveman
International Journal of Family Medicine , 2013, DOI: 10.1155/2013/901845
Abstract: Objectives. To evaluate the adherence rate to prescribed medications in elderly patients 24–48 hours after being discharged from the hospital. Methods. Family medicine residents visited patients over the age of 65 years at their homes one to two days after being discharged from the hospital and documented all the medications that they were taking since coming home from the hospital. The list of medications was later compared to the medications recorded in hospital discharge instructions. Results. Complete data was available for 46 participants. The average patient age was 76 years; 54.4% were women. Only three patients (6.5%) adhered completely to the discharge medication list found in the medical record. Thirty-six patients (78.2%) reported taking at least one additional prescription medication, twenty patients (43.4%) missed at least one prescription medication, twenty patients (43.4%) reported taking the wrong dose of at least one medication, and nineteen patients (41.3%) reported taking medications at an incorrect frequency. Conclusion. The vast majority of elderly patients in our study did not adhere to the medication regimen in the first two days after hospital discharge. Cost-effective improvements to hospital discharge processes are needed to improve adherence and reduce preventable posthospitalization complications. 1. Introduction The elderly are at a significant risk for medication-related problems, including nonadherence, especially at times of transition in and out of the health care system. Many factors contribute to the risk of nonadherence in older patients including a higher prevalence of chronic diseases, a higher number of prescription and nonprescription medications compared to any other age group, and age-related physical and mental capabilities that also may pose a challenge to their ability to adhere to prescribed medications regimens [1]. It is well known that nonadherence to medications can result in worsening clinical outcomes, including rehospitalization, exacerbation of chronic medical conditions, increased healthcare costs, and death [2–4]. Robin Dimatteo et al. reported that the odds of poor health outcomes are nearly three times higher for patients who do not adhere to recommended therapies compared to patients who follow providers instructions [2]. The transition from hospital to home is a particularly vulnerable time for elderly patients, and nonadherence to prescribed medication regimen after discharge from the hospital increases the risk of postdischarge complications. Forster et al. reported that one in five
Analysis of the evidence of efficacy and safety of over-the-counter cough medications registered in Brazil
Reis, Adriano Max Moreira;Figueras, Albert;
Brazilian Journal of Pharmaceutical Sciences , 2010, DOI: 10.1590/S1984-82502010000100016
Abstract: the objective of this study was to analyze the level of evidence regarding the efficacy, effectiveness and safety of over-the-counter (otc) cough medications registered in brazil. the national health surveillance agency database was used to identify the drugs. clinical trials, systematic reviews, meta-analyses, and studies on safety were searched on the medline baseline, the cochrane library and sietes (system of essential information in therapeutics and health; database in spanish). most drugs (62.5%) were sold as a fixed-dose combination of two or more drugs. randomized clinical trials were found for only three drugs: bromhexine, dextromethorphan and guaifenesin. no clinical trials were found for fixed-dose combinations. systematic reviews on cochrane did not report any evidence in favor of or against the effectiveness of cough drugs. efficacy is also unclear, especially regarding fixed-dose combinations. the evidence for the efficacy of otc cough medications available in brazil is poor due to the lack of quality studies. pharmacovigilance of otc cough medications should be encouraged.
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