What are two textbooks for OTC products that we should be familiar with?
- Handbook of Non Prescription Drugs (18th edition)
- The Practitioner’s Quick Reference to Non Prescription Drugs (uses algorithms, bullets, and charts–not as thorough and up to date)
What are 3 features of the Non Prescription Drug Handbook?
- general drug facts and product information
- treatment algorithms
- patient cases
(Note: Dr. Wilkinson wrote the Headache chapter)
What are the two textbooks for herbal products?
- Evidence Based Herbal Medicine
* Review of Natural Products
What are the pros and cons to the Evidence Based Herbal Medicine textbook?
- Two authors (Rotblatt and Ziment)
- Pros: includes clinical trial data and discusses background on herbal products in the US
- Cons: only reviews 65 products
What are the pros and cons to the Review of Natural Products textbooks?
- Many authors
- Pros: reviews over 350 herbals, includes documented drug interactions, and good review of chemistry and pharmacology
- Cons: does not focus on EBM
What 4 databases include OTC meds?
- Lexicomp
- Micromedex
- Clinical Pharmacology
- Epocrates
What is the best database source for herbal products?
*Natural Medicines (previously Natural Standard). It is owned by the Therapeutic Research Center
What are some features of Natural Medicines database?
- interaction checker
- nutrient depletion checker
- adverse effects
- pregnancy and lactation
- patient handouts
What is the herbal rating system from best to worst?
Effective, likely effective, possibly effective, possibly ineffective, likely ineffective, ineffective.
What other herbal resource is there? It is through NIH from the office of dietary supplements?
*National Center for Complementary and Alternative Medicine
It is free, compilation of data is available, practice guidelines available–but there is limited information and it is time consuming.
What is the FDA website a good source for?
- recalls
- OTC drug approval process
- OTC and dietary supplement regulations
- educational materials like the orange book, medwatch, and Vrade
What is medwatch?
Where you report adverse drug events
What is Vrade?
Vaccine reporting adverse drug events
What sources will help you to stay up to date on OTC medications?
- APhA Drug Info Line (self care)
- APhA annual meeting (includes CE on OTCs)
- Pharmacist’s Letter
- Magazines (Drug Topics, Pharmacy Today, Pharmacy Times)
What is included in Pharmacy Today magazine?
Has an annual supplement that review the most commonly recommended products
What publications are helpful in staying up to date on herbal products?
- Magazines
- Pharmacist’s Letter
- APhA Drug Info Line
How do you answer OTC drug information questions?
It is similar to answering any DI question, but with a few key points:
- use MeSH terms if possible
- search more than one database to be thorough (Embase + PubMed/Medline, or PubMed/Medline + IPA)
- use appropriate limits (english language and humans)
- avoid limits of date of publication, age of patient, and gender
- possibly use limit type of publication (randomized control trial versus review)
If you have too many results, what can you do?
Add more limits like date of publication, age limits, gender, and type of publication
If you have no results, what can you do?
- search for review articles or guidelines
- search Google Scholar
- contact drug manufacturer
- go to Natural Medicines (herbals)
- last idea–google it to find primary literature
Where would you look to find the maximum daily dose of OTC Advil?
On the back of the bottle or the Handbook of Non Prescription Drugs
Where would you look for the maximum daily dose of prescription ibuprofen?
- package insert
- lexicomp
- Diparo (pharmacotherapy book)
Where would you look to find out if it is safe for a pregnant woman to take St. John’s Wort?
- Natural Medicines
* Pregnancy and Lactation
Where would you look to determine what OTC wart treatment is most effective?
Diparo
