Chapter 14: OTC and Other Drugs

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Chapter 14: OTC and Other Drugs

  1. 1. OTC Drugs,OTC Drugs, Herbal RemediesHerbal Remedies andand Other StuffOther Stuff Chapter 14
  2. 2. Lecture OutlineLecture Outline  OTC Drugs – Antihistamines – Decongestants – Cough medicine – Analgesics  Herbal Remedies – St. John’s Wort – Ephedra – Ginkgo Biloba – Ginseng  Other Supplements and Prescription Drugs
  3. 3. ADHD TreatmentsADHD Treatments Primarily treated with stimulants – Ritalin (Methylphenidate) – Concerta (a longer acting form of Ritalin) – Adderal (amphetamine salts) – Strattera (atomoxetine) - SNRI
  4. 4. AntihistaminesAntihistamines  Used to treat allergies as well as dermatological conditions  All block H1 (Histamine) receptor – Histamine is an excitatory NT and mediates part of the generalized immune response.  Drowsy vs. Non-drowsy – Based on whether it crosses BBB  Benadryl (Diphenhydramine) – Crosses  Chlorpheniramine (Chlor-Trimeton) - Crosses  Allegra (Fexofenadine) – Doesn’t Cross  Claritin (Loratadine) – Doesn’t Cross  Zyrtec (Citirizine) – Doesn’t cross  Clemastine (Tavist) - Crosses  H2 receptor antagonists are Pepcid, Tagamet, Axid … Anti-ulcer and Antacid drugs
  5. 5. DecongestantsDecongestants  Dilate bronchial passages by constricting blood vessels in respiratory system – Mediated by NE (Agonist)  Pseudoephedrine most common  Ephedrine once common  Activate SNS, but cross BBB weakly  Names – Sudafed – Actifed – Dimetapp
  6. 6. AnalgesicsAnalgesics  Non-Steroidal Anti-Inflammatory (NSAIDS)  Inhibit Prostaglandins and Proinflammatory Cytokines through inhibition of COX enzymes  Names – Acetylsalycillic Acid (Aspirin) – COX 1 & 2 – Acetaminophen (Tylenol) – COX3 – Motrin (Ibuprofen) – Cox 1 & 2 – Alleve 1 & 2 – Naprosin 1 & 2 – Vioxx (Rofecoxib) 2 – Celebrex (Relecoxib) 2  Not good to inhibit COX 1 = kidney and stomach problems
  7. 7. OTC Sleep AidsOTC Sleep Aids For temporary relief of insomnia Vast majority contain antihistamines – Benedryl  Tylenol PM  Unisom geltabs  Sominex – Doxylamine  Unisom sleep tabs
  8. 8. Herbal RemediesHerbal Remedies Derived from natural sources Not currently regulated by FDA Purity and potency are large issues – Extraction of active ingredient can be a problem Currently popular Have been around forever
  9. 9. St John’s WortSt John’s Wort  Grows as an invasive weed  Hypericum  For mood disorder (We think this is what it does) – Agonist of catecholamines  SSRI  Increases DA and GABA  Effective if one gets enough (mounting evidence is good)  Speeds up metabolism of birth control pills and antivirals  Induces photosensitivity
  10. 10. GinsengGinseng  Extract from plant  Thought to induce a number of actions – Anti-fatigue – Antioxidant – Lower cholesterol – Stimulant?  Headaches, insomnia, anxiety, breast soreness or tenderness, skin rashes, asthma attacks, increased blood pressure, diarrhea, euphoria, nervousness, skin eruptions, heart palpitations, or post- menopausal uterine bleeding
  11. 11. Ginkgo BilobaGinkgo Biloba  Increases blood flow to brain  Thought to increase memory and cognitive ability  Inhibits Platelet Activating Factor and induces vasodilation  Few side effects. GI distress. Possibly some problems with >2 years use  Effective for people with problems; may not have much effect for “normals”
  12. 12. EphedraEphedra  Ephedra, Ephedrine, Ma Huang – Derived from plant source  NE agonist. Stimulates NE release and acts on receptors  Typical sympathomimetic response – Increase – HR, BP, Respiration, Glycogenesis and Lypolysis  Does not cross BBB very well, so little CNS effect  Used for bronchial dilation, as well as weight loss and narcolepsy in the past  Stroke and arrhythmia
  13. 13. KavaKava  Plant native to South Pacific Used much like alcohol GABA agonist Associated with liver failure
  14. 14. The MoralThe Moral Look up the active ingredient – What is it? – What does it do? Be aware of drug interactions – Antagonism – Synergism – Intolerance – Allergy

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