An Over-the- Counter drug is still a drug

So what's the big deal if you misuse an over-the-counter drug? Yeah, so what if there are lots of hospitalizations every year? I'm sure many people have misused an OTC without suffering much of a consequence.

If misuse was not such a large issue, then why are large, well known groups such as "United Health Foundation", and "U.S. Food and Drug Administration" making such a big importance about this common act many Americans are guilty of?

The United Health Foundation wrote an article on a great way to remember the safest way to take an over-the-counter drug, by remembering: "Obey The Checklist". The UH Foundation makes the point that there "are over one hundred thousand hospitalizations each year due to the misuse of over the counter drugs" (UH Foundation).

The US Food and Drug Administration, although filled with endless amount of information about OTC and prescription drugs, warns about a usually overlooked non-prescription drug: ointments and creams. The FDA makes the point that after these medications cross the skin barrier, they will eventually enter your bloodstream.

Entering the bloodstream is a pretty big deal, so would this information make you want to double check that box with directions next time you apply an acne treatment, or a cream for those sore muscles after track practice?

Another category of seemingly forgotten OTC drugs, nutritional supplements, are mentioned in the American journal of Pharmaceutical Education article "Nonprescription Drug Therapy: Issues and Opportunities". The author, Covington, makes the point that the issues of self-medicating are endless, and include "polypharmacy involving prescription drugs, nonprescription drugs, and/or nutritional supplements". As a nurse, many patients will not include the "mood booster" nutritional supplement they took with their orange juice that morning, even though it still has just as big of a potential of causing a drug interaction as the Tylenol they mentioned they took at lunch.

The fact that these cremes, rubs, herbal supplements are over the counter means one thing: cheaper. Patients are always looking for ways to get their medications at a cheaper cost to them. If an over the counter steroid cream can provide the same therapeutic effects as the $100 prescription, tell your patient. Though the dangers are mainly stressed in this entry, it is also good to stress that over the counter drugs can be just as therapeutic as prescription, when used correctly.

Take home points for the public:

• Understand that herbals are not regulated by the FDA and therefore do not list as much information on the bottle as does a regulated over the counter drug.
• Remember that all herbal medications, as well as ointments, creams, eye drops, shampoo (if medicated), rubs etc are all drugs, even when bought over the counter.
• Tell your doctor about every over the counter medication you have taken-they could potentially cause drug interactions.

Take home points for nurses:

• Chart every over the counter drug your patient mentions to you. If you suspect that they are simply forgetting an OTC drug they have taken, remind them by bringing up commonly overlooked ones, such as tylenol, or vicks vapor rub.
• Patient teaching: remind your patient that over the counter drugs can mix with their prescriptions. Remind your patient to call and ask the doctor before taking anything-herbal product, muscle rub, etc.
• Over the counter drugs are not always bad-if the same over the counter drug can offer the same therapeutic effects as a prescription, let your patient know, they will comply much more when the cost of a medication is cheaper.
  

Does this change how you see the potential hazards of over-the-counter medications, especially those ointments, creams, and nutritional supplements that many Americans do not consider drugs at all and rarely mention to health professionals?

Please watch the video below about a track runner, Ariel, who tragically passed away from innocently misusing Asprin and muscle rubs
Watch CBS News Videos Online

Sources: http://www.unitedhealthfoundation.org/otc.html,http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049367.htm,

Covington, Initials. (2006). Nonprescription Drug Therapy: Issues and Opportunities. The American Journal of Pharmaceutical Education, 15(70), 137.

Picture source:http://bigriverwholesale.com/zencart2/images/MusRublogo.gif

Video Source: http://www.cbsnews.com/video/watch/?id=2908984n&tag=related;photovideo