Potential Side Effects of otc Medicines in Adults

While OTC medicines have a low risk of side effects when used occasionally by healthy adults, they can pose risks for very young children, the elderly, people with kidney problems, and people taking more than one medicine. These people have an increased risk of side effects when they OTC medicines. Potential side effects are described below.

Aspirin and NSAIDs

The main side effect associated with aspirin and other NSAIDs is gastrointestinal (GI) problems. These problems can range from upset stomach to GI bleeding, a serious event that is more likely to occur in older people. The chances of experiencing GI problems from NSAIDs or aspirin increase the larger the dose you take and the longer you take them. NSAIDs can cause a variety of side effects related to kidney function. These side effects range from reversible inflammation to permanent kidney damage. Aspirin and NSAIDs may make high blood pressure worse or interfere with blood pressure medicines. High doses of aspirin pose a risk of liver damage for people who have liver disease, juvenile arthritis, or rheumatic fever.

Acetaminophen

Although safe in the Majority of users, long-term use of high doses of acetaminophen, especially in products that also contain caffeine (such as Excedrin) or codeine (such as Tylenol with Codeine), has been shown to cause a form of kidney disease called analgesic nephropathy. This serious condition may develop after years or decades of daily use.

Antihistamines

Antihistamines can cause sedation or drowsiness and, therefore, can significantly impair a person’s ability to drive or operate machinery. The sedative effects of antihistamines may increase the risk of falling. Antihistamines can also cause dry mouth or eyes.

Decongestants

Pseudoephedrine can temporarily cause nervousness, dizziness and sleeplessness. It can make you lose your appetite or retain urine. It can also cause heart palpitations, high blood pressure, or high blood sugar levels.

Cough Medicine

Codeine, when used as a cough suppressant, can temporarily cause nausea, sedation and constipation. Dextromethorphan, the medicine in Drixoral, Pertussin CS and Robitussin, has a lower risk of sedation and GI side effects. It can, however, cause feelings of confusion, agitation, nervousness, or irritability.

Drug-Drug Interactions

There body processes or metabolizes every drug differently. If drugs are used together, their metabolism and effect on there body can change. When this happens, the chance that you will have side effects for each drug may become greater.

Alcohol and otc Medicines

Pain Relievers

If you drink more than 1 alcoholic beverage per week and use NSAIDs, including aspirin, you may be at increased risk of GI bleeding. People who consume 3 or more alcoholic beverages each day should consult their physician before using any pain reliever. Acetaminophen is much less likely than NSAIDs to be associated with GI problems, including bleeding. But to minimize the risk of serious liver injury, you should never take more than the recommended daily dose (4 g per day).

Antihistamines, Decongestants, and Cough Medicine

The combination of OTC antihistamines and alcohol can increase drowsiness, especially in elderly people. In addition, alcohol makes the drowsiness, sedation and impaired motor skills associated with the cough suppressants dextromethorphan (in products such as Drixoral, Robitussin) and codeine worse.

Special Groups

Some groups of people may be particularly liable to have the side effects associated with OTC products. The sections below include tips for using OTC medicines in the following special populations: children, older adults, pregnant or breastfeeding women, other groups.

Children

When used properly, OTC medications pose little risk to children. However, children metabolize drugs differently than adults. You should how OTC drugs will affect your children before you use them. Talk with your family doctor if you have questions about giving child OTC medicines.

• Acetaminophen is generally considered the treatment of choice for children’s pain relief.

• Children who are allergic to aspirin are likely to have problems using ibuprofen. Ibuprofen can make your child’s asthma worse, for example.

• Avoid using aspirin in children under the age of 18 because of the risk of Reye’s syndrome (a drug reaction that can lead to permanent brain injury).

• It’s very easy to accidentally give too much of a decongestant to a young child. Use these medicines with extreme care, if at all, and talk with your doctor first.

• Don’t use cough suppressants that contain codeine in young children. Talk to your doctor before using other cough medicines.

It can helpful for parents and other caregivers to keep track of the medicine a child is taking. One way to do that is with a medication log. Using a log can help avoid “double dosing” – giving too much medicine or giving it too often. It can also provide important information to your family doctor if there is a problem.

Older Adults

The elderly use a number of medications at the same time and therefore need to pay careful attention to drug-drug interactions between OTC medications and prescription medications. Older adults talk with their doctor their doctor about the medications they take and potential interactions with OTC medicines.

• there is a relatively high risk of kidney disease and GI bleeding in elderly patients who use NSAIDs. Discuss this risk with your family doctor.

• Pseudoephedrine can increase blood pressure and the pressure in your eye that can lead to glaucoma. It can also make existing blockages in the urinary tract worse. Pseudoephedrine interacts negatively with many other drugs such as beta-blockers, antidepressants, insulin, and some medications that treat low blood sugar.

• If you use a monoamine oxidase inhibitor (MAOI), a type of prescription antidepressant, or take any medication for a seizure disorder, you should avoid using pseudoephedrine.

• Pseudoephedrine can change the way these drugs work in your system. Some common MAOIs include Marplan (generic: isocarboxazid), Nardil (generic: phenelzine sulfate) and Parnate (generic: tranylcypromine sulfate).

• If you use a MAOI, you should not use dextromethorphan. Dextromethorphan interferes with the way MAOIs work.

Pregnant or Breastfeeding Women

Pregnant or breastfeeding women should talk with their doctor before using any medicine. Some can affect your baby. The following are some general guidelines.

Pregnancy

• Acetaminophen is generally considered safe for short-term pain relief during pregnancy.

• Avoid using during pregnancy. It can cause abnormalities in the baby or problems during delivery.

• Avoid using other NSAIDs, especially during the third trimester of pregnancy. They can cause heart abnormalities in the baby.

Breastfeeding

• Acetaminophen and NSAIDs such as ibuprofen provide safe relief for women who are breastfeeding.

• Avoid using aspirin because it is excreted in breast milk and can cause rashes and bleeding problems in nursing infants.

• Limit long-term use of antihistamines. Antihistamines are excreted in breast milk, and may cause side effects such as sedation, irritability, crying, and sleep disturbances in nursing infants.

Antihistamines may also interfere with the production of milk.

General Tips

These steps can help minimize the risk of side effects during pregnancy and breastfeeding:

• talk to your doctor about possible alternatives to medicine.

• Avoid the use of medications during the first trimester.

• take oral medications after nursing or before the infant’s longest sleep period.

• Avoid the use of extra-strength, maximum-strength, or long-acting medications.

• Avoid “combination” products.

• Watch your infant for possible side effects, such as a rash, difficulty breathing, headache or other symptoms that your child didn’t have before taking the medicine.

Other Groups

People with health problems such as kidney disease, heart disease, diabetes, asthma, blood clotting disorders, or gout may be at increased risk of side effects associated with OTC medicines.

Exercise 1. Translate the following sentences, paying attention to the verbs used with Complex Subject.

1. Expectorants, on the other hand, are thought to thin mucus and make coughing more productive in clearing the mucus from the airway.

2. These problems can range from upset stomach to GI bleeding, a serious event that is more likely to occur in older people.

3. Although safe in the majority of users, long-term use of high doses of acetaminophen, especially in products that also contain caffeine (such as Excedrin) or codeine (such as Tylenol with Codeine), has been shown to cause a form of kidney disease called analgesic nephropathy.

4. Acetaminophen is much less likely than NSAIDs to be associated with GI problems, including bleeding.

5. Some groups of people may be particularly liable to have the side effects associated with OTC products.

6. Children who are allergic to aspirin are likely to have problems using ibuprofen.

7. Antihistamines proved to be excreted in breast milk and may cause side-effects such as sedation, irritability, crying, and sleep disturbances in nursing infants.

8. Aspirin during pregnancy happen to cause abnormalities in the baby or problems during delivery.

9. Acetaminophen is generally considered to be safe for short-term pain relief during pregnancy.

10. Aspirin and NSAIDs turn out to make high blood pressure worse or interfere with blood pressure medicines.

11. Codeine, when used as a cough suppressant is expected to cause nausea, sedation and constipation.

12. Pseudoephedrine has been described to cause nervousness, dizziness and sleeplessness.

Exercise 2. Explain the following.

a medication log; double dosing, OTC drugs, NSAIDs, Reye’s syndrome (гепатоцеребральный синдром: внезапный отек головного мозга в сочетании с жировым перерождением печени и почечных канальцев у детей после инфекции верхних дыхательных путей), brand name, combination products.

Exercise 3. Answer the questions.

Pain relievers

1. What medicines are called OTC?

2. What are some non-steroidal anti-inflammatory drugs?

3. How do Aspirin and NSAIDs and acetaminophen relieve pain?

4. In what way do antihistamines work? What are their types?

5. What are decongestants used for? Name decongestant which is used as OTC product.

6. What are the main types of cough medicines?

7. Name a common antitusive.

8. What are expectorants used for? Give the example of an OTC expectorant.

Common cold

9. How common cold is treated?

10. Which OTC medicines are recommended in case of:

    1. runny nose;

    2. stopped nose;

    3. dry cough;

    4. moist, productive cough;

    5. fatigue, mild sore throat.

OTC Drug label

11. Why is it necessary to read and understand the information on the drug label?

12. What information does an OTC drug label contain?

Potential side effects

13. What category of population can OTC medicines pose risk of side effects to?

14. What are GI problems associated with aspirin and NSAIDs?

15. What side effects can NSAIDs and aspirin cause?

16. What is analgesic nephropathy and in what case may this condition develop?

17. Name the main side-effects of antihistamines, decongestants and cough medicines.

18. When may side-effects for each drug become greater?

Alcohol and OTC medicine

19. What are the main recommendation for those who consume alcoholic leverages and use NSAIDs, antihistamine decongestants and cough medicines?

Special groups log

20. What groups of people are particularly liable to have the side-effects associated with OTC medicines?

21. How OTC drugs may affect children?

22. What is the usefulness of a medication log?

23. What should the elderly pay careful attention to?

24. What side-effects may occur in the elderly while taking NSAIDs, Pseudoephedrine, MAOI?

25. Why should pregnant or breastfeeding women talk with their doctor before using any medicine?

26. What medicines should be avoided by pregnant and breastfeeding women?

27. What should be done to minimize the risk of side effects during pregnancy and breastfeeding?

Translate the texts using a dictionary.