Over the Counter
Medication Use:
Basic information for
educators.
Matthew Perri Ph.D, R.Ph., UGA College of
Pharmacy
Goals for next hour:
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Help you take better care of yourself and
those you care for
Learn about some key features of OTC
medications including
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Problems
Side effects
Choices
Special considerations
How use of these medications could affect
classroom behavior
How many of you have
taken an OTC medication
in the last week or two?
We’ll come back to
this in a minute.
Basic Points:
Medication v. Drug
 MOST medications can cause

• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Drowsiness
Overview of OTC
Medications (Harris Survey)
> 100,000 OTC Products
 Few unique active ingredients
 > 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 don’t consider OTC’s real
medicine.
 People just don’t 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:
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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:
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Pain
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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….
OTC Medication Use:
Focus on School Age
Children
Some specific
recommendations
and considerations
Key Point:
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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
OTC’s as well
• Communicate with students
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Dosed before school
Taken while at school without knowledge
Taken after school
Smoking? Illicit drugs?
Pain
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Acetaminophen (apap)
• first line treatment in those < 18
• Generally causes few problems
• Is very safe to use
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Aspirin
• should be avoided in the under 18 age
group
• Reye’s syndrome
• Other problems usually associated with
stomach distress (NVD)
Pain
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Ibuprofen
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•
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Fine to use in the <18 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
Cough, Cold and Flu,
Allergy and Sinus
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Decongestants (stuffy)
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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
Cough, Cold and Flu,
Allergy and Sinus
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Antihistamines (runny)
• Claritin, Alavert (loratidine)
Diphenhydramine (Benadryl), chlor and
brompheniramine (Chlortrimeton,
Dimetapp)
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Alone, usually cause drowsiness
In combination, variable effects
NLD – 1:05 AM
Kids need plenty of fluids when taking these,
helps with drowsiness and dry mouth, PLUS
MORE
Cough
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Cough suppressants
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DM = dextromethorophan
• Drowsiness, dizziness, NV
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Codeine
• Have to sign for OTC use
• Not recommended for infants
• Small or young children, can be used with caution
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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…
Combination Products
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Robitussin and Triaminic brands are
very popular with pharmacists because
they have many choices
• Plain, DM, CF, PE, Orange, Grape
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These products may contain
• Antihistamines
• Decongestants
• Cough suppressants
• Expectorants
Heartburn, Stomach, Gas
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Antacids – many, many
• Maalox, Riopan, Gaviscon, and plenty more
• Tagament, Zantac, Pepcid, etc.
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Gas
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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
Constipation and Diarrhea
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The most amazing products that treat
both! How do they know?
• Equilactin
• Balances water in the colon to properly form
stools, adds fiber.
Skin Problems
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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
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!
10 Tips on OTC use
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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 > 1 OTC
Don’t 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
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.
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