Over the counter (OTC)- Sale, rational use.pptx

c) Over the counter (OTC) sales
Introduction and sale of over-the-counter the rational use of common over the counter medications.

1. Over The C ounter (OTC) sales Mr. Ravinandan A P Asst. Prof. Department of Pharmacy Practice Sree Siddaganga College of Pharmacy Tumkur , Karnataka

2. Presentation Outlines ……………………. Introduction and Sale of over the counter Rational use of common over the counter medications

3. Introduction Over-the-counter medicine is also known as OTC or nonprescription medicine. It is also called prescription de controlled drugs All these terms refer to medicine that you can buy without a prescription. They are safe and effective when you follow the directions on the label and as directed by your health care professional. Some OTC medicines relieve aches, pains, and itches. Some prevent or cure diseases, like tooth decay and athlete's foot. Others help manage recurring problems, like migraines and allergies .

4. These have little significant pharmacological activity and therefore the physician need not to be very much concerned about their use by the patients themselves. It is used primarily for symptomatic relief and not as substitutes for prescription drugs. In India, till date there are no guidelines for licensing of OTC medicines. There is no separate category allotted for OTC medicines in India and the drugs which do not come under the prescription medicines schedule are generally sold as over-the-counter medicines OTC medicines allow greater access to treatment of people at large at lower cost for minor or self-limiting illnesses.

5. Significance Comparatively cheaper An increased trend for self-care and increased tendency of patients to maintain their own health Pharmacist himself may prescribe OTC OTC considered as time saving medications. Some patients do not want to spend much time at physicians clinic. Lesser number of side effect compared to prescription medications.

6. Class of drug used as OTC (Examples) Analgesics / Pain killers- E x: Aspirin, NSAIDs, Ibuprofen, Naproxen etc. Antibiotics- Ex: Clotrimazole Ointment , Miconazole Ointment Cough suppressants – Ex: Dextromethorphan Anti acne drugs NSAIDS Antiseptics- Ex: Povidone I odine, Benzalkonium Chloride, Chlorhexidine etc. Decongestants – Ex: Oxymetazoline, Phenylephrine, Antacids – Ex: Pantoprazole, Omeprazole Ranitidine, Anti histamines – Ex: Cetirizine, Loratadine Smoking cessation drugs – Ex: Nicotine Patch OTC Vitamins: Calciferols, Calcium Carbonates, Calcium Citrate, Ferrous Sulphate, Magnesium Sulphate, multivitamins etc. Laxatives- Ex: Bisacodyl Antidiarrheal drugs - Ex: Loperamide.

7. Sale of OTC drugs These drugs are sold over the counter freely by non-pharmacists. Thus, till date, there are no specific unifying regulations related to use and sale of OTC products and this impacts both the accessibility to better health care and patients' safety due to inappropriate use. The need to recognize OTC medicines as a separate category of drugs in India is evident. However, OTC medicine can act as a double-edged sword and due consideration has to be given to safety, abuse, and patient education.

8. Strict regulation for classification, distribution, and sale of OTC medicines is the need of the hour.  “Over-the- counter drug products account for 55 % of drugs used by Indians.” Prescription Drugs 45% OTC Drugs 55% Drugs Used by Indians MARKET ANALYSIS In the case of OTC drugs, the companies directly approach the consumers through mass media like newspapers, magazines, television, radio etc. A good number of brands of OTC drugs are advertised through posters on the selling outlets. Various studies in India have shown that the pain-relieving OTC drugs are most widely used by the people followed by cold relieving items. Streptsils, Vicks inhaler, Vicks action 500 etc. are the examples of widely sold OTC items in India .

9. Rational use of common Over The Counter Medications Antacids: These are the group of drugs that are mostly being used by the patients without the aid of prescriptions. But the most of the public are unaware that this group of drugs can cause interactions with the other medications taking together and decrease its therapeutic action. Therefore the patients should be made aware about these medications and should be given proper guidance in using it.

10. Analgesics: They are the most popular among the non prescription drugs and most abused drugs. So patients have to be counselled adequately regarding their use, indication, side effects etc. ex: paracetamol on prolonged use can cause GI irritation, heartburn and GI bleeding and liver damage. More often patients take same analgesics for all types of pain, as they are not aware that same analgesics cannot work for all type of pain. So when pain is not decreased patient tends to take more tablets without realizing side effects. Therefore patients have to be informed about this by the pharmacist.

11. Antidiarrheal preparations Usually diarrhoea is self limiting so drugs should be taken only when diarrhoea is severe. These drugs should be taken with lot of water, electrolyte imbalance should also be corrected along with it. Ex: ORS should be taken and the patients have to be counselled regarding the importance of rehydration. Also if fever or bloody diarrhoea occurs then immediately contact the physician.

12. Laxatives Many laxatives are available in the market as OTC product generally used by elderly people and pregnant woman. Patient should be counselled by the community pharmacist regarding the importance of the diet, fluids, exercise to prevent constipation. Food should include whole grain bread and cereals, bran, fruits and green leafy vegetables with 6-8 full glass of water. Pharmacist should asked the patient whether he is on special diet as low sodium or sugar diet as some of the laxatives have large amount of sugar and sodium content .

13. Anti histamines These are used to relieve or prevent the signs and symptoms of different types of allergies. This is a group of drug which is taken irrationally without prescriptions. The pregnant woman should be advised to take antihistamines only on the advice of the doctor as it may cause teratogenic effects. The lactating mother should be advised not to take antihistamines during the period of lactating as it passes through the breast milk. The use of this may worsen the condition of the patient in urinary tract blockade, glaucoma, hypokalaemia and liver diseases. So the person should advice not to take antihistamines in these conditions

14. Sympathomimetics Cough syrups and other preparations containing sympathomimetic drugs when used along with beta blockers and other antihypertensives will oppose the antihypertensive effects of the drug.

15. Vitamins These are compounds that one should have for the normal growth and health. They are needed only in small quantities and are usually available in the food that we eat. The patients should be advised the importance of vitamins and the role they play in the normal functioning of the body.  The patients should be advised not to take vitamin preparations unnecessarily in large amounts over long periods as some vitamins gets stored up in the body and additional supplementation may lead to toxicity

16. Dermatological products These products that are sold without prescription meant for local skin itching have a 7 day time limit, although use of these products could sooth the problem temporarily , the patient should consult a physician if the symptoms persist.

17. CONCLUSION A s the public is unaware of the side effects or interactions of the OTC products the community pharmacists have a role in counselling the patients about these issues. Each patient who comes for a request for OTC products should not be encouraged and ask for the medications the patient is taking. The medications should be counter checked for any interactions and necessary advice should be given. Advice on the common group of drugs those are available, as OTC products and their possible side effects should be discussed with the patients .

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