OTC Cough and Cold Medications for Technicians

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1 OTC Cough and Cold Medications for Technicians Phillip J. Olsen, PharmD Objec:ves Describe what should be considered when an OTC cough and cold medica:on is recommended List what OTC medica:on is used for a cough, runny nose, and nasal conges:on Discuss counseling points for these medica:ons including side effects, warnings, and precau:ons Self Care Role of the technician Discre:on of the pharmacist Screening pa:ent What pa:ents? What condi:ons? Treatment, no treatment, or refer to physician If something is recommended Give :me frame to see physician if worsening or no improvement 1

2 Lots of products to choose from Overwhelming unless we look at the ingredients Only a handful of drugs in lots of different combina:ons Mul:- symptom products Convenient May take ingredients they don t need Marke:ng on product can cause pa:ents to duplicate ingredients Cold is self limi:ng and lasts 1 to 2 weeks Treatment is based on the specific symptoms of pa:ent Nondrug therapy Hydra:on Sleep Humidifiers Warm showers/baths Vitamins/zinc Saline nasal sprays Ne: pots FDA consumer update Aug 2012 Keep pot clean by washing and air drying it a[er each use Use sterile, dis:lled, or boiled then cooled water to do this Don t share pot with a family member or friend Overuse may cause more sinus infec:ons Food and Drug Administra:on. (2012, August 31). Is Rinsing Your Sinuses Safe? Retrieved from h`p:// 2

3 Should not be used daily for a long period of :me without being monitored by their physician Don t use tap water Sterile or dis:lled water is recommended by the FDA 2 people in 2011 developed a rare parasi:c brain infec:on a[er using contaminated tap water in a sinus rinse product Food and Drug Administra:on. (2012, August 31). Is Rinsing Your Sinuses Safe? Retrieved from h`p:// Symptom: Cough Dry or produc:ve? Dry = dextromethorphan Cough suppressant Produc:ve = guaifenesin Expectorant What about giving both ingredients? Jan 2007 FDA Public Health Advisory Cough and cold medica:ons not recommended for infants and children < 2 years 3 infant deaths 1519 children under 2 years treated in ER in 2004 to 2005 What can be recommended for this age group? Food and Drug Administra:on. (2011, February 23). Public Health Advisory: FDA Recommends that Over- the- Counter (OTC) Cough and Cold Products not be used for Infants and Children under 2 Years of Age. Retrieved from h`p:// professionals/publichealthadvisories/ucm htm. 3

4 5/9/13 Delsym professional product label. Accessed at h`p://dailymed.nlm.nih.gov/dailymed/lookup.cfm?se:d=5daa ba- 4f8e- 86a bc. March 22, Cough and Cold Medica:ons DXM AKA orange crush, triple c s, red devils, ski`les, and dex on the street Analog of codeine Overdose can cause breathing problems, convulsions, hallucina:ons, hyperthermia, and death FDA has linked it to the death of several teenagers Some products abused have acetaminophen and can lead to liver failure U.S. Na:onal Library of Medicine Medline Plus. (2012, February 2). Dextromethorphan overdose. Retrieved from h`p:// Guaifenesin professional product label. Accessed at h`p://dailymed.nlm.nih.gov/dailymed/lookup.cfm?se:d=dd379cdd- 90ab- 42e0- ad89- f50d3220f611. March 22,

5 Symptom: runny nose Cold = virus Allergies = histamine 1 st genera:on an:histamines Diphenhydramine (Benadryl), chlorpheniramine (Chlortrimeton) Drowsiness: o[en used for sleep Taken mul:ple :mes a day An:cholinergic: runny nose from cold AND allergies Cough from post nasal drip An:cholinergic side effects Dry mouth Dry eyes Cons:pa:on Urinary reten:on SLUD = saliva:on, lacrama:on, urina:on, defeca:on Diphenhydramine professiional product label. Accessed at h`p://dailymed.nlm.nih.gov/dailymed/lookup.cfm?se:d=702f9786-7ce9-43e4-921d- e1db March 22,

6 2 nd genera:on an:histamines Loratadine (Clari:n, Alavert), cer:rizine (Zyrtec), fexofenadine (Allegra) Non- drowsy Once a day Prevents runny nose from allergies Needs to be used daily during allergy season not as needed Clari:n professional product label. Accessed at h`p://dailymed.nlm.nih.gov/dailymed/lookup.cfm?se:d=660ac9df- f1b1-4c89-94dd- 9fae0a013f3c. March 22, 2013 Symptom: nasal conges:on Phenylephrine (Sudafed PE), pseudoephedrine (Sudafed) S:mulants In day :me products Combined with an:histamines to treat allergies Nasal sprays: oxymetazoline (Afrin, Sinex) or phenylephrine (4- Way, Neo- Synephrine) Max of 3 days 6

7 Sudafed professional product label. Accessed at h`p://dailymed.nlm.nih.gov/dailymed/lookup.cfm?se:d=d280abe9-6bdf- 4e1e- a0cf- 95fd0451c999. March 22, Afrin professional product label. Accessed at h`p://dailymed.nlm.nih.gov/dailymed/lookup.cfm?se:d=5db0c5ae- 25b7-424a- ba35-93c4fd March 22, Take Home OTC cough and cold medica:ons are commonly used Technicians can play an important role with pa:ents needing a recommenda:on on OTC cough and cold medica:ons There are several factors to consider when recommended an OTC medica:on 7

8 Ques:ons? 8

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