Title 14. OTC MEDICATION.pdf ✅

PHARMD GURU Page 1 INTRODUCTION:  Majority people treat their ailments through self care using home remedies or over the counter (OTC) medicines.  Self-medication is the selection and use of medicines by individuals to treat self recognized minor ailment or symptoms. Self medication is an age old practice all over the world.  The World Health Organization (WHO) promotes practice of self-medication for effective and quick relief of symptoms where medical services are inaccessible in rural and remote areas.  Self medication with OTC medicines is sometimes referred as 'responsible' use of medicines.  Self medication is widely practiced in both developed and developing countries.  Over The Counter (OTC) medicines may be approved as being safe for self- medication by the national drug regulatory authority for prevention or treatment of minor ailments such as common cold, diarrhea, period pains, or symptoms which do not require immediate medical consultation. DEFINITION: Over The Counter (OTC) medicines are defined as “the medicine, or a pharmaceutical product, or drug, which is considered to be safe and effective in controlling the symptoms of minor ailments and can be sold to the customers by pharmacist without a valid prescription”. In some countries, medicines are categorized into: 1) Prescription Medicines, which are to be dispensed on a valid prescription. 2) Pharmacist only Medicines, which may be dispensed by the pharmacists depending upon the clinical judgment made by the pharmacists to treat minor ailments, and 3) OTC medicines are the medicines available in pharmacies, groceries, and other shopping places to dispense for simple minor ailment such as headache and fever. OTC MEDICATION
PHARMD GURU Page 2 ADVANTAGES OF HAVING OTC MEDICINES LIST: Following are the advantages of having OTC medicines list:  OTC medicines are considered to be safe and effective as they are approved by regulatory authority.  Does not require a medical consultation thus saves the consultation charges to the patients.  As the OTC medicines are deregulated from prescription status, the cost of the medicine may be economical.  Waiting time for consultation is saved.  Pharmacist can dispense OTC medicine without a prescription. OTC MEDICATION LIST: Various countries have used World Health Organization (W.H.O) Anatomical, Therapeutic and Chemical (ATC) classification system and identified the medicines suitable as OTC medicines. A separate list of the medicines approved as OTC is published in majority of countries. OTC MEDICATIONS IN INDIA: H2 RECEPTOR ANTAGONISTS: These drugs may be used in lower doses to relieve heartburn, acid indigestion and sour stomach. These products should not be used for longer than 2 weeks. Not approved for children. Examples: 1) Cimitidine 200 mg twice daily 2) Famotidine 10-20 mg daily 3) Nizatidine 75 mg twice daily 4) Ranitidine 75 Mg twice daily ACNE PREPARATIONS: Apply carefully once or twice daily. Decrease doses if excessive skin irritation occurs. Example: 1) Benzoyl peroxide 2.5%, 5%, 10%
PHARMD GURU Page 3 ALLERGY AND COLD PREPARATIONS: Antihistamines only relieve most symptoms associated with allergic rhinitis or hay fever. Chlorpheniramine, brompheniramine, and clemastine cause less drowsiness than diphenyl-hydramine, methapyrilline, pyrilamine, doxylamine, and phentoloxamine. Occasionally symptoms unrelieved by the antihistamine, but they respond to the addition of a sympatho-mimetics. Examples: 1) Chlorpheniramine 4 mg/4-6 hrs; 12 mg/12hrs 2) Brompheniramine 4 mg/4-6hrs; 12 mg/12hrs 3) Clemastine-fumarate 1.34 mg/12hrs 4) Diphenhydramine 25-50mg/4-6hrs 5) Chlorpherniramine (8-12 mg) with phenyl-propanolamine 6) Clemastine-fumarate (1.34 mg) with phenyl-propanolamine (75 mg)/12hrs 7) Triprolidine HCI (2.5 mg) with pseudo-ephedrine (60 mg) ANALGESICS AND ANTIPYRETICS:  There are several product modifications, including the addition of antacid, caffeine, and methapyriline; enteric coated tablets; long-acting or extra-strength formulations; and various mixtures of analgesics.  None have any substantial advantage over a single-Ingredient product.  Acetaminophen lacks any anti-inflammatory activity but is available as a liquid which is used for infants and children. Examples: 1) Aspirin 300-600 mg/ 4-6hrs. 2) Acetaminophen 300-600 mg / 4-6hrs. 3) Ibuprofen 200-400 mg / 46hrs. 4) Naproxen 200 mg / 8-10hrs. 5) Ketoprofen 12.5 mg / 4-6hrs. ANTACIDS: This combination is less likely to cause constipation or diarrhea and offer high neutralizing capacity.
PHARMD GURU Page 4 Example: 1) Magnesium hydroxide and aluminum hydroxide combinations. ANTHELMINTIC: Treat all members of the household. Disinfection of linens and environment is required to prevent reinfection. Example: 1) Pyrantel pamoate 11 mg/kg ANTI-DIARRHEAL AGENTS: These drugs turn tongue and stools black. Salicylates are absorbed and can cause tinnitus. Examples: 1) Bismuth subsalicylate 600 mg/4 times daily 2) Loperamide 4 mg initially, then 2 mg after each loose stool, maximum 16 mg/day It is a synthetic opioid that does not penetrate the CNS. Avoid in febrile patients. ANTIFUNGAL TOPICAL PREPARATIONS: Examples: 1) Clotrimazole 1% cream, or 100mg vaginal inserts. 2) Tolnafate use as 1% solution, cream, or powder. 3) Mizonazole nitrate 2% cream, or 100 mg vaginal tablets. Fungicidal are successfully effective for the treatment of tineapedis, tineacruris, and tineacorporis. Clotrimazole and miconazole are also effective against candida albicans. ANTI-INFLAMMATORY TOPICAL PREPARATIONS: Examples: 1) Hydrocortisone 0.5%. 2) Hydrocortisone used as 1% cream or spray.