Over-the-Counter Drugs and Herbal and Dietary Supplements Copyright © 2014 by Mosby, an imprint of...

Over-the-Counter Drugs Over-the-Counter Drugs and and

Herbal and Dietary Herbal and Dietary SupplementsSupplements

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Over-the-Counter Over-the-Counter (OTC) Drugs(OTC) Drugs

• Nonprescription drugs• Use for short-term treatment of common minor

illnesses• More than 300,000 OTC drugs available• OTC Drug Review (1972)

o Safety and efficacyo Appropriate labeling standardso Reclassification


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Over-the-CounterOver-the-Counter Drug Drug LabelLabel


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Reclassified OTC Reclassified OTC DrugsDrugs

• ibuprofen (Advil)• naproxen (Aleve)• diphenhydramine (Benadryl)• loratadine (Claritin)• famotidine (Pepcid AC)• omeprazole (Prilosec OTC)


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Classroom Response Classroom Response QuestionQuestion

OTC medications now account for about what percent of all medications used in the United States?

A. 5%B. 15%C. 30%D. 60%


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Use of OTC Drugs: Use of OTC Drugs: Potential HazardsPotential Hazards

• May postpone effective treatment of more chronic disease states

• May delay treatment of serious and/or life-threatening disorders

• May relieve symptoms of a disorder but not the cause


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Use of OTC Drugs: Use of OTC Drugs: Potential Hazards Potential Hazards

(cont’d)(cont’d)• Toxicity• Interactions with current prescription medications

may occur• Abuse


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A 56-year-old man is taking over-the-counter antacids for relief of indigestion. He tells the nurse that he consumes at least one bottle a week and has done so for over a month because “it works for me.” The nurse’s main concern is that

A. this self-treatment is expensive.B. this self-treatment may be delaying treatment of a more serious problem.C. this self-treatment may be the best treatment of his indigestion.D. the long-term use of antacids may make the indigestion worse.


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The nurse associates use of which over-the-counter medication with the development of hepatotoxicity?

A.acetylsalicylic acid (aspirin)B.ibuprofen (Motrin)C.pseudoephedrine (Sudafed) D.acetaminophen (Tylenol)


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Herbal and Dietary Herbal and Dietary Supplements Supplements

• Dietary supplement—orally administered alternative medicines including herbal supplements

• Herbs—plant components, including bark, berries, roots, leaves, gums, seeds, stems, and flowers, used for their medicinal qualities

• Herbal medicine—using herbs to heal


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Consumer Use of Consumer Use of HerbsHerbs

• Therapeutic agents for treatment and cure of diseases

• Prophylactic agents for long-term prevention of disease

• Proactive agents to maintain health and wellness and “boost” one’s immune system


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Conditions Treated Conditions Treated with Herbal Productswith Herbal Products

• Anxiety• Colds and cough• Depression• Headache• Insomnia• Ulcers• Premenstrual

syndrome (PMS)


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• Arthritis• Constipation• Fever• Infection• Stress• Weakness

Commonly Used Commonly Used Herbal ProductsHerbal Products

• Aloe• Feverfew• Gingko• Goldenseal• St. John’s wort• Valerian


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• Echinacea• Garlic• Ginseng• Hawthorn• Saw palmetto

Herbal and Dietary Herbal and Dietary Supplements Supplements

• Dietary Supplement Health and Education Act (DSHEA) of 1994o Herbal products are considered “dietary supplements”o No proof of efficacy or safety requiredo No standards for quality controlo May claim effect but do not have to promise a specific cure


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Alternative/ Alternative/ Complementary MedicineComplementary Medicine• Alternative medicine—use of herbal products and

other nontraditional remedies• Complementary medicine—simultaneous use of

both traditional and alternative medicine


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A patient tells the nurse that he wants to stop taking his antilipemic drugs and start taking garlic to lower his cholesterol. The nurse’s best reply would be:

A. “That decision is up to you.”B. “You have every right to switch to herbal remedies.”C. “You should not go against what the doctor has prescribed for you.”D. “Let’s explore the evidence that supports the use of garlic to lower your

cholesterol.”


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Nursing ImplicationsNursing Implications• Obtain thorough medication history, documenting

all medications used (prescription, OTC, herbal products, vitamins, minerals, other dietary supplements)

• Assess level of education and understanding• Assess for information specific to various products


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Nursing Implications Nursing Implications (cont’d)(cont’d)

• Assess system functions (especially renal, liver, and cardiac)

• Assess for conditions that are contraindications• Assess for potential drug-drug and drug-herb

interactions


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• Provide thorough and individualized patient education

• Ensure that patients recognize that manufacturers of herbal products/dietary supplements are not required to prove safety and effectiveness


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• Herbal products may not be safe for pregnant or breastfeeding women, infants, children

• “Natural” does not mean safe• Teach patients to monitor themselves for unusual

or adverse reactions as well as therapeutic responses


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Over-the-Counter Drugs and Herbal and Dietary Supplements Copyright © 2014 by Mosby, an imprint of...

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