: Drugs which can be purchased 

without a prescription. Usually limited toxicity 

and self-limiting symptom

Toxicity tests

– Prescription drugs

More Difficult

– Use clinical trials  - Often not conducted. 

– Illness is mild

– If symptoms become worse,  see Physician

– Not more than 2 weeks

– Adverse events - Stop the drug

Role of the Health Professional

Watch out for

Self medication may not allow       

diagnosis and condition worsens. 

-Drug interactions

-Toxicity  of  OTC products.

Analgesic 

• Antipyretic

• Anti-inflammatory.

Inhibits cyclo-oxygenase I and II 

-Prostaglandins are involved in mediation of 

pain, inflammation and fever

Gastric irritation, tinnitus (large doses),

Reyes syndrome in children with fever.-rare event. 

Allergic reactions are rare, but do occur –Tartrazine.

– Recent use to inhibit platelet aggregation.– Prevent 

thrombi formation – Low dose ASA.

3 characteristics of Acetaminophen

Analgesic 

• Antipyretic

• NOT anti-inflammatory

Cold preparations, anti-histamines

5 properties

Not a cure

May alleviate symptoms if there is an allregic component. 

May have anti-cholinergic properties

May cause drowsiness - older drugs

Minimal evidence for their use in colds. 

Cold preparations

decongestants

Alpha agonsits - phenylephrine (local application) and pseudoephedrine (oral). There are many other compounds

Use in children under 6 is not approved

Cause vasoconstriction and hence decongestion. 

Doses may alter blood flow and pressure in the hypertensive. 

Doses too low to be effective. 

Local application can lead to rebound congestion. 

Cough suppressants: 

Names

Dose

Efficacy

Codeine or dextromethorphan (drug of choice) - both effective cough suppressants, suppress the cough center in the medulla. 

Doses too low in preparations to be effective

Glyceryl guaiacolate  limited value

– No evidence of efficacy

– Used to reduce viscosity of bronchial 

secretions ??

Name 3 analgesics and antipyretics

How are they used best?

ASA Acetaminophen Ibuprofen

Best used as single agents

Consumers Union - Recommended for Cold 

therapy.  

Rest,  fluids, Analgesics, antipyretics 

– Chicken soup ?  

Suppress cough

– Codeine and dextromethorphan (preferred)

– Effective in sufficient  doses. Suppress the 

cough center – Receptors. 

– Best prep is Dextromethorphan as a single 

agent.

– Contain alcohol. 

– Large placebo response.

Sleep aids

contain

Names

Contain an analgesic and a sedating 

antihistamine 

Acetaminophen and diphenhydramine  

– Large placebo effect.

– Change life style and sleep habits – more 

important than drugs.

An H1 antagonist is the drug of choice

– But do not alleviate all symptoms as histamine is not 

the only cytokine released.

For Treatment of minor skin inflammatory 

conditions.

Calamine lotion- cooling and temporary relief

– 0.5% hydrocortisone Ointment or cream

Most effective - will reduce inflammation, 

sunburn, tanning and 

cancer

Min erythema dose protected/min 

erythema dose unprotected.

Laxatives 

• Stimulant Cathartics

Castor oil--- stimulate the intestinal muscle to 

increase contractions

– Increase secretion of water into stools

– Problems--- Excess loss of electrolytes and 

water  especially in the elderly

Laxatives

Saline Cathartics

– Magnesium Sulfate   Retain water in fecal 

mass by osmotic forces.

Bulk Forming Laxatives

– Methylcellulose—form an emollient gel in 

water and maintain a soft stool.

– Dioctyl Sodium Sulfosuccinate (Colace)  

function as a surface active agent to allow 

water to penetrate fecal mass. 

– Often used for drug induced constipation.

Antidiarrheal agents

Adsorbents

ATTAPULGITE  (clay)--- Add bulk to the G. I. Tract  

and may adsorb bacterial toxin. (Kaopectate)

Antidiarrheal agents

Loperamide 

Antidiarrheal

– Synthetic opioid – does not enter CNS

– Inhibits peristaltic activity- acts on opioid receptors in 

the GIT but not in brain.

– Often used for Traveler’s diarrhea

Antihistamines with CNS depressaants 

including alcohol.

• Decongestants and Monoamine Inhibitors

• ASA and anticoagulants.

• Aluminum antacids decrease absorption of 

some drugs.

• Mineral oil as a laxative decreases 

absorption of drugs.