SITUATION A nurse is caring for the patient taking three over-the-counter medications for pain and insomnia. The primary care provider has prescribed a generic drug for the patient for asthma. The patient requests information from the nurse about the over-the-counter medications and the difference between generic and brand-name drugs. QUESTIONS Although over-the-counter drugs have been found to be safe when taken as directed, what should the nurse consider telling the patient about problems related to over-the-counter drugs? *DRUG ABUSE/ADDICTION Abusing over-the-counter medicines or pain relievers can lead to addiction or use of more dangerous drugs down the road. Abuse of any these medications can result in a number of serious physical issues, including increased potential for stroke or heart attack, gastrointestinal issues, liver or kidney damage, significant issues with dehydration, and a number of other issues, such as hallucinations, delusions, depression, anxiety, and other psychological symptoms. EXAMPLE: • Cough and cold medicines (dextromethorphan) ● ● ● Pain relievers (acetaminophen and ibuprofen) Nasal decongestants (pseudoephedrine) Motion sickness pills (dimenhydrinate and diphenhydramine) https://talbottcampus.com/addiction-rehab-programs/prescription-drug-abuse/over-the-counterdrugs/ https://americanaddictioncenters.org/over-the-counter-medications# *ALLERGIC REACTIONS Most people with allergies are allergic to only one medication, but some people are allergic to more than one. Medication can cause mild general allergic symptoms or severe allergic reactions (anaphylaxis). Any medication has the potential to cause non-allergic side effects, but some people can also have allergic reactions to specific medication. All medication, including prescription medication or over-the-counter medication bought from supermarkets and pharmacies, can trigger allergies in some people, but some types are more likely to cause allergies than others. Examples: • Antibiotics -- amoxicillin (Moxatag), ampicillin, penicillin (Bicillin L-A), tetracycline, and others ● ● ● Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen Aspirin Insulin https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/allergies-to-medications https://www.webmd.com/allergies/most-common-drugs-that-cause-allergies *INEVITABLE ADVERSE EFFECTS Adverse effects can vary for each patient, depending on their general health, the state of their disease, age, weight, and gender. They can be mild, moderate, or severe. What these and other drug actions have in common is the potential to do harm. The effective part of most drug molecules is small, and may not be specific for the targeted receptor. For example, the non steroidal anti-inflammatory drugs (NSAIDs) act to reduce mediators of inflammation in joints or elsewhere. While this relieves joint pain in arthritis, it also interferes with the stomach’s ability to resist the damaging effects of gastric acid and may cause peptic ulcers. There are different reasons for side effects linked to drugs. These include: ● ● ● ● dosage, which may need adjusting an individual reaction to an ingredient in the drug a drug killing one type of unwanted cell but also destroying healthy cells interactions between drugs https://iffgd.org/manage-your-health/diet-and-treatments/medications/avoiding-drug-adverseeffects/ https://www.medicalnewstoday.com/articles/196135#types-of-effect *DRUG INTERACTIONS Drug-drug interactions occur when two or more drugs – prescription and/or OTC -- react with each other. Some drug interactions can make the drug you take less effective. And some combinations of drugs can be dangerous. For example, mixing a drug you take to help you sleep (a sedative) and a drug you take for allergies (an antihistamine) can slow your reactions and make driving a car or operating machinery dangerous. Not all drugs work in the same way in all people. You could be harmed and not helped by a drug designed to treat cold symptoms. For example, if you have high blood pressure, cold medications containing a decongestant may actually raise your blood pressure. https://www.fda.gov/drugs/special-features/drug-interactions-understanding-risk What should the nurse tell the patient about the differences between generic and brandname drugs? GENERIC DRUGS- It is the name of the drug itself after the active ingredient used. It usually has a complex and longer name compared to brand-name drugs. BRAND-NAME DRUGS- a name given by the drug manufacturer and identifies it as property of that company. So, the name selected is usually short and easy to remember.
