Thursday, December 2, 2010

A guide to OTC's - Over the counter medications

  Let me tell you what the big pharmaceutical corporations hope you don't find out..... When it comes to over the counter cold remedies, there are really only 5 main categories of medications that you can get.  No matter how many different brands, combinations, or brands of combinations there are; the medications are all the same.  Lets compare it to milk.  Milk is milk.  There is chocolate milk, strawberry milk, whole milk, 2%, etc...  No matter what kind of milk, milk is milk.  Okay, so the brands may taste different, but that is irrelevant to medications (unless you prefer the taste of one syrup/cough drop to another).

 The 5 main classes are.... (brand followed by generic in parenthesis)

1. Pain relievers - Tylenol (Acetaminophen or APAP), Motrin/Advil (Ibuprofen), Aleve (Naproxen), and Aspirin (Acetyl-Salicylic Acid or ASA). 

  - Brand name Tylenol is the same as the generic and so on and so forth.  All generic medications are put through extensive testing to ensure that the active ingredient (e.g. acetaminophen) is the same as what is in the brand.  So it doesn't matter which one you get, it will work the same.  And please do not come into a pharmacy and ask for  "name your pain reliever for arthritis" - it is the same drug but dispensed in a higher strength. For example, Tylenol Arthritis is acetaminophen 650 milligrams(mg) per pill where regular strength is 500mg.  This will be the same among all the different types of pain relievers.

  - Baby Aspirin is 81 mg ASA, no matter if it is Bayer, Ecotrin, or any other brand
       - EC is enteric coated - meaning that it will release the drugs in the intestines instead of your stomach -
             thus relieving some of the discomfort usually felt in the stomach after taking ASA (for more 
             information ask in the comments section and I will reply).

 - Do not give children under 18 ASA (aspirin) do to risk of Reye's Syndrome (you will have to look that one up).  The tricky thing is that Pepto Bismol contains salicylates that are related to ASA, so you would avoid this in children as well (except for infants brand Pepto which has the same ingredient as Tum's but labeled Pepto - isn't it ridiculous?)

- Tylenol is hard on your liver and the others are hard on your kidneys.

2. Antihistamines- These medications will stop the action of histamine in your body. When you are allergic or develop an allergy to something, your body responds to it.  This reaction is actually beneficial if you are infected with some kind of virus or bacteria.  However sometimes the allergen (what you are allergic to) is benign like ragweed or pollen. This can result in a runny nose, itchy/watery eyes, sneezing, itchy throat, etc...
Enter antihistamines.  These can help reduce the discomfort felt by allergies (especially seasonal ones). The major difference is this

    - Claritin will not make you drowsy.  Zyrtec is less likely to cause drowsiness. All the others (benadryl, chlorpheniramine, brompheniramine,doxylamine, etcc...) will probably have you dozing off soon.  This fact is not true in young children.  Benadryl (etc..) can actually cause a 2 year old to bounce off of the walls.

From there it is basically trial and error. What works for you. Some swear by one and think the other is garbage.

3.  Cough Suppresant.  There is only one - Dextromethorphan.  This is in Brand name Delsym and Coricidin.  Sadly this is why kids buy "Triple C's" and take 30 at a time (my friends in high school did that), because it can affect the brain at high doses.  Also, please avoid buying Coricidin anything or anything else that says its for people with high blood pressure - THE ONLY DIFFERENCE IS THAT IT LACKS A DECONGESTANT WHICH CAN RAISE YOUR BLOOD PRESSURE.

4.  Nasal Decongestants - Pseudophedrine and Phenylephrine are the only two.  Pseudoephedrine is kept behind the counter and requires a drivers license to purchase thanks to the meth heads in the world, and phenylephrine is over the counter.  From what I hear, phenylephrine is worthless, so you might consider pseudoephederine (Brand name sudafed). These can raise your blood pressure, but how high is your blood pressure?  Is it controlled? If it doesn't run very high, than it might be worth taking.  This medication is by far the best solution for symptom management in my experience. It takes away clogged sinuses, relieves sinus pressure, prevents post nasal drip (which in turn decreases cough) all by shrinking the blood vessels in your body especially your head.  If the theory is correct, it should also decrease headache pain because most headaches occur from dilated vessels in your head.

5. Expectorant - Guaifenesin or brand name Mucinex.  Don't forget that the generic is the SAME as the brand.  This medication will loosen secretions in your chest and help you get them out. Which can help prevent an infection by eliminating a favorable environment in which virus' and bacteria to tend to thrive. 

  So if it is important to cough that stuff up, then why do manufactures produce medications that are combination expectorants and cough suppressants?  Money money money  Dummy men aka crooked crooks.

Also, I have heard on multiple occasions that mucinex (guaifenesin) is no better than drinking plenty of water. Because water will ultimately work the same way.  So if you want to save money, then drink good ol' fashioned water. Of course I haven't read any studies, so I am not fully prepared to back this 100%.  I will have to say that I have felt a lot better after taking mucinex and coughing all that crap up.

Ultimately this post is to show you that when it comes to colds, there are only 5 main ingredients out there. So why then are there so many products? The answer is always money.  With money comes marketing.  Did you know that all sleep aids are anti-histamines with the exception of melatonin (which is questionable as to how well it works). So why not buy some benadryl and use it for all its purposes.  Also, anti-nausea medications are also anti-histamines (except emetrol, whose ingredients are very comparable to a soda). Anyway, lets stop making this harder than it is.  READ the ingredients, please, READ them.  A spade is a spade.

My recommendation is to buy a big box of each single ingredient and keep it on hand. Then treat the person based on the symptom, but be sure to read the dosing.  I would keep one box of benadryl (diphenhydramine) and one box of claritin/zyrtec (due to the drowsiness factor).

  Also, moms, you can get dye free, alcohol free, sugar free (diabetics as well) medications. Just look at the box.  And stop coming up to me and telling me how old your kid is and how much they weigh.  If their age/weight is not on the box, or says consult physician, or do not use...... that is my recommendation. The only thing out there for your precious little one's cold is childrens zyrtec/claritin and vicks baby rub - Unless the dr prescribes something else---

  The pediatrician has more experience with those meds than I do, so stop asking. I am new. Some old fogee pharmacists out there with kids or grandkids may tell you otherwise but not me. I really do love you and your child, so I don't want to have to get gangster on you okay.  I really feel that you come up to me and say, well can't I just give them half, and decide that you won't leave until I say yes.  Seriously, how many times do I have to say call the doctor before you will leave. That's right, you won't leave until I tell you what you want to hear, even if it isn't right.  When that happens I feel like a crip/blood who tells an opposing gang rival to leave my turf before I have to do something I regret.  Then I do something I regret and say, "it might be okay, just be sure to call your dr."

Anyway, these aren't the only OTC's out there, just the ones dealing with colds. Post with your questions if you want to know more.

I'm out.  Know what I'm sayin?

PS to see more of what I am talking about  go to, but be sure to come back here!

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