صفحه 1:
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www.tabaye.ir
‘e Copyright © 2014 by Mosby, an
imprint of Elsevier Inc.
صفحه 2:
Over-the-Counter Drugs
and
Herbal and Dietary
Supplements
Copyright © 2014 by Mosby, an
imprint of Elsevier Inc.
صفحه 3:
Over-the-Counter
(OTC) Drugs
Nonprescription drugs
Use for short-term treatment of common minor
illnesses
More than 300,000 OTC drugs available
OTC Drug Review (1972)
© Safety and efficacy
© Appropriate labeling standards
© Reclassification
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imprint of Elsevier Inc. 7
صفحه 4:
BOX 7-1 CRITERIA FOR OVER-
Me eae eet
Indication for Use
Consumer must be able to easily:
* Diagnose condition
'* Monitor effectiveness
Benefits of correct usage must outweigh risks
Safety Profile
Drugs must have
+ Favorable adverse event profile
۰ Limited interaction with other drugs
* Low potential for abuse
* High therapeutic index*
Practicality for Over-the-Counter Use
Drugs must be:
+ Easy touse
* Easy to monitor
“Ratio of toxic to therapeutic dosage.
ميمه وه مرج موموت.
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc.
صفحه 5:
5
Label
Drug Facts
‘etive ingredient (in each tablet) Purpose
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2014 by Mosby, an
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@ Copyright ©
* imprint of Elsevier Inc.
صفحه 6:
Reclassified OTC
Drugs
* ibuprofen (Advil)
* naproxen (Aleve)
* diphenhydramine (Benadryl)
* loratadine (Claritin)
+ famotidine (Pepcid AC)
* omeprazole (Prilosec OTC)
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc. *
صفحه 7:
Classroom Response
Question
OTC medications now account for about what
percent of all medications used in the United
States?
A. 5%
B. 15%
C. 30%
D. 60%
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc. *
صفحه 8:
Use of OTC Drugs:
Potential Hazards
٠ May postpone effective treatment of more chronic
disease states
* May delay treatment of serious and/or life-
threatening disorders
٠ May relieve symptoms of a disorder but not the
cause
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imprint of Elsevier Inc. *
صفحه 9:
Potential Hazards
۲ (cont’d)
* Interactions with current prescription medications
may occur
* Abuse
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imprint of Elsevier Inc. *
صفحه 10:
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
this self-treatment is expensive
this self-treatment may be delaying treatment of a more serious problem.
this self-treatment may be the best treatment of his indigestion.
the long-term use of antacids may make the indigestion worse.
ح مه و و
Copyright © 2014 by Mosby, an ۳ و
imprint of Elsevier Inc.
صفحه 11:
Classroom Response
Question
The nurse associates use of which over-the-counter
medication with the development of hepatotoxicity?
A.acetylsalicylic acid (aspirin)
B.ibuprofen (Motrin)
C.pseudoephedrine (Sudafed)
D.acetaminophen (Tylenol)
Copyright © 2014 by Mosby, an ۳ و
imprint of Elsevier Inc. *
صفحه 12:
Herbal and Dietary
Supplements
* 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
Copyright © 2014 by Mosby, an ۳ و
imprint of Elsevier Inc.
صفحه 13:
Consumer Use of
Herbs
+ 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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imprint of Elsevier Inc.
صفحه 14:
Conditions Treated
with Herbal Products
* Anxiety
* Colds and cough
* Depression
* Headache
* Insomnia
* Ulcers
* Premenstrual
syndrome (PMS)
* Arthritis
* Constipation
* Fever
٠ Infection
* Stress
+ Weakness
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc.
صفحه 15:
Commonly Used
Herbal Products
Aloe
للا ]ع لاع ٠
Gingko *
* Goldenseal
* St. John’s wort
* Valerian
* Echinacea
* Garlic
* Ginseng
* Hawthorn
* Saw palmetto
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc. *
صفحه 16:
Herbal and Dietary
Supplements
* 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
2000
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imprint of Elsevier Inc.
صفحه 17:
Alternative/
Complementary Medicine
+ Alternative medicine—use of herbal products and
other nontraditional remedies
* Complementary medicine—simultaneous use of
both traditional and alternative medicine
Copyright © 2014 by Mosby, an &
imprint of Elsevier Inc.
صفحه 18:
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:
“That decision is up to you.”
“You have every right to switch to herbal remedies.”
“You should not go against what the doctor has prescribed for you.”
“Let's explore the evidence that supports the use of garlic to lower your
cholesterol.”
ع ممه
¢ Copyright © 2014 by Mosby, an
imprint of Elsevier Inc.
صفحه 19:
Nursing Implications
* 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
Copyright © 2014 by Mosby, an &
imprint of Elsevier Inc.
صفحه 20:
Nursing Implications
(cont’d)
+ 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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0
صفحه 21:
Nursing Implications
(cont’d)
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
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc.
صفحه 22:
Nursing Implications
(cont’d)
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
Copyright © 2014 by Mosby, an و
imprint of Elsevier Inc.