Jerome H Jaffe

OVER-THE-COUNTER (OTC) MEDICATION This class of medication can be purchased without a prescription. Which medications require prescriptions and which do not varies widely from country to country. Common examples of OTC medications in the United States include ANALGESICS (aspirin, Tylenol®), cough and cold products (Sinutab®, Drixoral®), allergy medications (Benadryl®, Tavist), gastrointestinal products (Maalox®), antidiarrheals (Imodium®), and nicotine replacements (e.g., Nicorette® Gum, Nicoderm® Patch). Recently, a number of medications that previously were sold only by prescription have been made available over-the-counter. These include medications that block the production of gastric acid to relieve heartburn (Axid AR®, Tagamet HB 200®, Zantac 75®) and nicotine gum (Nicorette CQ®) and the nicotine patch (Nic-otrol®, Nicoderm CQ®) for smoking cessation.

Prescription medications are labeled with patient-specific instructions determined by a physician whereas OTC products provide general information for use by consumers. OTC products are drugs, and as such they may cause side effects or adverse effects, or they may interact adversely with foods, ALCOHOL, or other medications. Some of the

A drugstore clerk in Deerfield, Illinois removes Tylenol capsules from the shelves after reports of tampering, February 18, 1986. (© Roger Ressmeyer/CORBIS)

more than 500,000 OTC products that are available have the potential to be misused or abused. Antihistamines, hypnotics, decongestants, analgesics, laxatives, and diet pills are often consumed in higher than recommended quantities; they have caused physical and/or psychological dependence. An epidemic of the early 1990s among adolescents has been ''baby speed,'' the combining of OTC CAFFEINE pills with the decongestant pills pseudoephedrine. Handfuls cost only a few dollars and are responsible for overstimulating the heart and central nervous system, causing strokes and death.

An estimated 28 percent of adults in the United States use all kinds of OTC products, often responsibly but also in combination with prescription medications or alcohol. The high cost of visits to a physician and stays in a hospital has generated heightened interest in self-medication, which has increased opportunities for pharmacists to counsel

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