Transcript Pharmacology and the Nursing Process, 4th ed. Lilley/Harrington

Chapter 7
Over-the-Counter Drugs and
Herbal and Dietary Supplements
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Over-the-Counter (OTC) Drugs
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Nonprescription drugs
Use for short-term treatment of common minor
illnesses
More than 300,000 OTC drugs available
OTC Drug Review (1972)
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Safety and efficacy
 Appropriate labeling standards
 Reclassification
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Over-the-Counter Drug Label
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Reclassified OTC Drugs
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ibuprofen (Advil)
naproxen (Aleve)
diphenhydramine (Benadryl)
loratadine (Claritin)
famotidine (Pepcid AC)
omeprazole (Prilosec OTC)
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Classroom Response Question
OTC medications now account for about what
percent of all medications used in the United
States?
A.
B.
C.
D.
5%
15%
30%
60%
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Use of OTC Drugs: Potential
Hazards
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May postpone effective treatment of more
chronic disease states
May delay treatment of serious and/or lifethreatening disorders
May relieve symptoms of a disorder but not the
cause
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Use of OTC Drugs: Potential
Hazards (cont’d)
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Toxicity
Interactions with current prescription
medications may occur
Abuse
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Classroom Response Question
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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Classroom Response Question
The nurse associates use of which over-thecounter medication with the development of
hepatotoxicity?
A.
B.
C.
D.
acetylsalicylic acid (aspirin)
ibuprofen (Motrin)
pseudoephedrine (Sudafed)
acetaminophen (Tylenol)
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Herbal and Dietary Supplements
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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 Herbs
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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 with Herbal
Products
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Anxiety
Colds and cough
Depression
Headache
Insomnia
Ulcers
Premenstrual
syndrome (PMS)
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Arthritis
Constipation
Fever
Infection
Stress
Weakness
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Commonly Used Herbal Products
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Aloe
Feverfew
Gingko
Goldenseal
St. John’s wort
Valerian
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Echinacea
Garlic
Ginseng
Hawthorn
Saw palmetto
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Herbal and Dietary Supplements
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Dietary Supplement Health and Education Act
(DSHEA) of 1994
Herbal products are considered “dietary supplements”
 No proof of efficacy or safety required
 No standards for quality control
 May claim effect but do not have to promise a specific
cure
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Alternative/Complementary
Medicine
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Alternative medicine—use of herbal products
and other nontraditional remedies
Complementary medicine—simultaneous use of
both traditional and alternative medicine
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Classroom Response Question
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 Implications
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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 (cont’d)
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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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Nursing Implications (cont’d)
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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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Nursing Implications (cont’d)
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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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