This document provides guidance on over-the-counter (OTC) treatment for common symptoms. It discusses when to use OTC drugs for abdominal pain, vomiting, diarrhea, constipation, and other issues. Examples of appropriate OTC drugs are given for different conditions, such as antacids for gastritis, anti-emetics for vomiting, anti-diarrheal medications, and laxatives for constipation. The document also includes sample OTC prescription formats.

2. HOW TO PRACTICE
O.T.C
Presented by
Khaled Sobhy

3. Aim Of These
LECTURES
“JUST PUT ME ON THE ROAD”
*How to deal with different symptoms
*When to give OTC drugs
*Practical example of OTC drugs in Egypt
*Examples of OTC prescriptions

4. GIT symptoms
blood
cancer
GIT surgery
Pregnancy
< 3m
exclude

6. Other
symptoms
location
diagnosis
1-Abdominal pain

7. Abdominal pain
Menstrual pain
Renal stone &
renal infection
Gastroenteritis & appendicitis
Gastritis & gall bladder disorder
Upper side
Fever & vomiting
Back pain & urine problem
Expect menses
Gas production & spasm Spastic colon
yes
No
yes
yes
yes
yes
No
No
No
No
antispasmodic
Only spasm

8. Gall bladder
Right side
Fatty meal
Gastritis&
GERD
Central pain
Milk & antacid
NSAID & Cs
Upper abdomen

9. Renal stone
No fever
Dark pinkish colour
Flow interruption
U.T.I
Fever
Pain on urinatin
Frequency
1-Back pain & urine problem

10. appendicitis
Tender palpitation
Right side
gastroenteritis
diarrhoea
left side
2-Vomiting & fever

11. Gastritis
-Avoid Acidic food or hyperosmolar food
“orange, bear, Milk, tomato”
-Avoid smoking, tea, coffee, and stress
-avoid NSIAD or Cs use without physician
contact

12. treatment
1- antacids
2- H2 blockers
3- proton pump inhibitors

13. They neutralize acids which already produced
(symptomatic treatment)
It includes Na+, mg++, Al+3 salts, may be combined
with Simethicone (Anti flatulence)
-Tablets should be chewed thoroughly to obtain
optimum effects.
-they should be taken after meals to neutralize gastric
acid secretion
Antacids

14. antacids

15. antacids

16. Prevent about 70% of acid production.
Examples:-
Ranitidine
150 mg twice daily at breakfast and bed time
300 mg at bed time
Famotidine
20 mg twice daily at breakfast and bed time
40 mg at bed time
H2 Blockers

17. ranitidine

18. famotidine

19. -They inhibit > 90% of gastric acid secretion
-PPI are taken once daily before breakfast
-PPI should not be use more than 2 months without
separation
Examples:-
ex:- Omeprazole
ex:- Pantoprazole
Proton pump inhibitors

20. omeprazole

21. pantoprazole

22. Alucal chewable tab
1
–
2
‫األكل‬ ‫بعد‬ ‫تمضغ‬ ‫قرص‬
3
‫يوميا‬ ‫مرات‬
Zantac 150mg
‫النوم‬ ‫وقبل‬ ‫األكل‬ ‫قبل‬ ً‫ا‬‫صباح‬ ‫قرص‬
Omepral 20 mg
‫يوميا‬ ‫الريق‬ ‫على‬ ً‫ا‬‫صباح‬ ‫قرص‬
Example of OTC prescription:

23. antispasmodics
1- Atropine like derivatives :
EX 1 :- Hyoscine ( Buscopan).
EX 2: Dicyclomine ( Spasmorest )
EX 3: Tiemonium ( Visceralgine )
EX4: Clidinium Br. ( Librax )
2-Papaverine like derivatives :
EX 1: Drotaverine ( Do-Spa)
EX 2: Papaverine ( Vasorin )®

24. Atropine like derivatives

25. papaverine like derivatives

26. Example of OTC prescription:
Buscupan Tab
‫قرص‬
3
‫األكل‬ ‫قبل‬ ‫مرات‬

28. vomiting
Motion sickness
Drug induced vomiting
Fever, abdominal pain
on traveling long distance
On starting drug use
Give anti emetic
yes
No
yes
yes
No
No
Gastroenteritis &
appendicitis

29. *It refers to nausea & vomiting on long
distance travel.
-Avoid reading in cars & ships.
-Shift the field of vision to objects out side
vehicles.
Motion sickness
Prevention:

30. Treatment of motion sickness
Antihistaminic drugs as :
Cyclizine (Emetrex)®
Dimenhydrinate (Draminex)®
Meclozine (Navoproxine)®
Side effects:-
Sedation & Drowsiness
Drugs should be taken 30 min before trip.

31. antihistaminic

32. Example of OTC prescription
motion sickness
Draminex tab
1
-
2
‫اللزوم‬ ‫عند‬ ‫قرص‬

33. Anti emetics
3-Metoclopramide
2-Dompridone:
Not show CNS side effects of metoclopramide.
1-Antihistaminic :

34. domperidone
metoclopramide

35. Example of OTC prescription
for vomiting
primepran tab
1
-
2
‫اللزوم‬ ‫عند‬ ‫قرص‬

37. diarrhea
dysentery
Gastroenteritis
Fever & vomiting
Tensmus & offensive odour, Pain on
defecation& small quantity stool
Gas production & spasm May constipation Spastic colon
yes
No
yes
yes
No
No
Drug induced
Dietary induced
On starting drug use
On changing milk type
Give anti diarrheal drug
yes
No
yes
No

38. Parasite infection is characterized by diarrhea,
abdominal cramps, anorexia, and offensive odour,
pain on defecation. So treated by antiprotozoal as :
Metronidazole
Diloxanide
Secindazole
Tibindazole
Dysentery

39. Secindazole Diloxanide
Tibindazole

40. metronidazole

41. Example of OTC prescription
Furazole susp
5
-
10
‫مل‬
3
‫االكل‬ ‫بعد‬ ً‫ا‬‫يومي‬ ‫مرات‬
Fladazole tab
2
‫و‬ ‫الفطار‬ ‫بعد‬ ‫قرص‬
2
‫العشاء‬ ‫بعد‬ ‫قرص‬

42. Antidiarrheal drugs
1-antibacterial agent
2-adsorbent
3-drugs inhibit GIT motility
4-Rehydrin solution

43. Nifuroxazid& Sulfa drugs
if fear of infection
1-antibacterial agent

44. Acts by adsorption of bacteria, toxin & noxious
materials e.g.:
EX 1 : Kaolin & pectin “kaopectate ”
2-adsorbent

45. 3- drugs inhibit motility
EX 1 : Loperamide (lmodium)®
EX 2 : Disphenoxylate (Lomotil)®
Avoid using alone in fear of infection

46. -Not affect diarrhea frequency or duration but only
replace electrolyte loss preventing possible
dehydration.
-It contains Na, K, Ca, Mg, citrate, carbohydrate, Cl--,
HCO3 & Zn e.g. : (Rehydran N, Rehydran Zn)®
4-rehydrin

47. Example of OTC prescription
Kapect susp
5
-
10
‫مل‬
3
‫االكل‬ ‫قبل‬ ً‫ا‬‫يومي‬ ‫مرات‬
ِ
Antinal susp
5
-
10
‫مل‬
3
‫االكل‬ ‫قبل‬ ً‫ا‬‫يومي‬ ‫مرات‬

49. constipation
Spastic colon
Drug induced
Rectal pain, itching, prolapse
Gas production ,spasm, may diarrhea
On starting drug use
Give laxative
yes
No
yes
yes
No
No
hemorrhoid

50. Prevention of constipation
- increase fluid intake.
-increase dietary fibers. food contains low fibers
lead to constipation. e.g. (ice cream– cheese)
- increase exercise: exercise promotes bowel
motion.
-returning defactory habits
- Avoid tea , coffee

51. Laxatives
1-Mineral oil (paraffin oil )
Impair absorption of fat soluble vitamins, Late onset
2-osmotic laxatives (lactulose)
Watery bowel movement, so risk of dehydration & diarrhea
3-stimulant laxatives (castor oil)
rapid onset specially suppositories

52. osmotic laxatives

53. stimulant laxatives

54. Lactulose syrup
‫االكل‬ ‫قبل‬ ‫كبيرة‬ ‫ملعقة‬
3
‫يوميا‬ ‫مرات‬
Picolax drops
15
‫اللزوم‬ ‫عند‬ ‫ماء‬ ‫كوب‬ ‫نصف‬ ‫على‬ ‫نقطة‬
Example of OTC prescription