Wrap Up Continued: Responding to our readers questions

Many interested readers gave us their feedback, and now it is time for us to give them ours:

Katherine mentioned:

"interested in seeing further information about OTC misuse"

In response, I would like to go ahead and extend these links to you:
From the Center for Disease Control and Prevention: Poisoning in the United States Fact Sheet:

http://www.cdc.gov/ncipc/factsheets/poisoning.htm

From the World Health Organization: Inventions for Emergency Contraception and their misuse
http://apps.who.int/rhl/fertility/contraception/smcom1/en/

From the Environmental Protection Agency: Cough, Cold, Allergy, Bronchodailator for OTC Use
http://www.epa.gov/EPA-IMPACT/2005/July/Day-13/i13709.htm

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Joyr left a comment that mentioned:

"I have always been very careful with prescription meds but didn't think too
much about taking OTC meds, especially Tylenol and Ibuprofen."

Tylenol and Ibuprofen are very commonly misused OTC drugs, and you made a great point with mentioning them. Here is a link from the National Institute of Drug Abuse about the treatment of chronic pain and how those two OTC drugs are often misused in that instance:
http://www.drugabuse.gov/pdf/monographs/36.pdf

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Natalieunderoath commented:

"I didn't know a lot about that, that's good to know"

For our blog readers, especially those not in the medical field, this information can sometimes be overwhelming. Here is a link from the National Institute of Health website that allows you to explore tons of over the counter medicines and read simplified (not medical talk) versions of how they can cause harm if misused:
http://www.nlm.nih.gov/medlineplus/overthecountermedicines.html
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Pharmacology in Nursing 2009 wrote:

"I'm pretty sure I am currently misusing
Vicks vapor rub at night. I just huff it out of the jar for about 10 min. before
bed. I think we all forget that just b/c drugs are over the counter, they are
still drugs and can be harmful"

This is a great real life example of simple misuse that is normally overlooked. We encourage our blog readers to visit this FDA article covering Poisonous Plants to read on about the effects of Vick's Vapor Rub: http://www.accessdata.fda.gov/scripts/Plantox/Detail.CFM?ID=17952

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Patavia wrote:

"It does not change my perspective because I
am extremely cautious with all medication"

We always like to see people who are extremely cautious with drugs. You will make a great nurse!

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highmedicinecost commented:

"I don't know if you were aware of the young high school girl who died because...[she] rubbed icy hot all over her body before and after practice. She died from massive vasodialation ...from an over the counter cream"

We appreciate your feedback on that story, and we have actually located the news video and placed it on our blog. You can find it by clicking here.

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Ashley made the point that:

"Well, I can add that people just love to self medicate, especially with OTC meds, Why?"

Besides the points you made on this issue, another reason is perhaps patients trust their health in their own hands rather than a doctors. Another theory might be that they know their parents, friends, relatives etc who have taken these over the counter medications and have been fine, whereas you will hear horror stories about those prescription drugs because they are "always in trials" or whatever people may say about them. Thanks for your input! Here is a great link to a story I found on the FDA's web page about that Robitussin you love so much: http://www.fda.gov/ohrms/dockets/ac/07/transcripts/2007-4323t1-Part2.pdf

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Sarah commented that:

"If people are not able to find a solution from their doctor, then they will try to solve the problem on their own, which of course, usually doesn't turn out too well"

It is so true, especially with the health care issues being spoken of within the government right now, that may people do not even have insurance to go to a doctor in the first place. To play devils advocate, sometimes self medication turns out to work very well, its when the medication is misused that problems arise. Unfortunately, more times than not, self medication does end up having issues, causing illness and death. If you are interested in reading more, here is a great abstract I found from the CDC on the statistics of emergency room visits related to self medicating through over-the-counter drugs: http://www.cdc.gov/nchs/data/ad/ad372.pdf

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Antibioticmisusesucks made the point that:

"This will no doubt become of greater concern in the near future as the baby boomer generation is now starting to enter the age where this drug is necessary"

That is a great point. It is also a really big advantage with the possible decline of support for medical assistance for retired people, and elderly patients, that in America, over-the-counter drugs such as Tagamet are offered so that a solution can be created without a prescription.

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LiveLoveLena025 wrote in with:

"This only addresses that it is unsafe if the two medications you're taking have the same active ingredient. Does that mean that if they have different ingredients that it's not as harmful or not harmful at all?

What kinds of effects can happen if two cold/cough medicines are taken that have two different active ingredients?"

When mixing any two over-the-counter medications, it is important to review on websites such as the FDA

if mixing the ingredients in each is okay. You can also call your local pharmacy. It is equally important not to mix drugs containing the same ingredients, as well as making sure there are no interactions between mixing drugs with different ingredients. This link to eHow goes more into depth on that subject: http://www.ehow.com/how_2310994_select-otc-medication-cold-flu.html#at.

Here are the cases of side effects that can occur if two cough/cold medications are taken that have different active ingredients (the list contains the main active ingreidents in cough/cold medications and the effects of taking too much of them)

• "Antihistamines such as Benadry in extreme overdoses can cause increased heart rate, coma and seizures
• Decongestants such as pseudoephedrine can cause excitability and an increased heart rate
  
• Cough suppressants containing dextromethorphan can cause nausea, vomiting, drunken-like behavior, decreased breathing and coma" (source: http://www.kumed.com/default.aspx?id=4232)

. Photo source: https://web1.cybersharks.net/curriculumcore-com/_borders/question_mark_Animatio

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