otc practice lec 1
TRANSCRIPT
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HOW TO PRACTICE
O.T.C
Presented byKhaled Sobhy
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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
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GIT symptoms
blood
cancer
GIT surgery
Pregnancy
< 3mexclude
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Other symptoms locationdiagnosis
1-Abdominal pain
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Abdominal pain
Menstrual pain
Renal stone & renal infection
Gastroenteritis & appendicitis
Gastritis & gall bladder disorderUpper side
Fever & vomiting
Back pain & urine problem
Expect menses
Gas production & spasm Spastic colon
yes
No
yes
yes
yes
yes
No
No
No
NoantispasmodicOnly spasm
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Gall bladder
Right sideFatty meal
Gastritis& GERD
Central painMilk & antacidNSAID & Cs
Upper abdomen
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Renal stone
No feverDark pinkish colour
Flow interruption
U.T.I
FeverPain on urinatin
Frequency
1-Back pain & urine problem
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appendicitis
Tender palpitationRight side
gastroenteritis
diarrhoea left side
2-Vomiting & fever
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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
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treatment
1 -antacids
2 -H2 blockers
3 -proton pump inhibitors
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They neutralize acids which already produced (symptomatic treatment)
It includes Na+, mg++, Al+3 salts, may be combined It includes Na+, mg++, Al+3 salts, may be combined with 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
They neutralize acids which already produced (symptomatic treatment)
It includes Na+, mg++, Al+3 salts, may be combined It includes Na+, mg++, Al+3 salts, may be combined with with Simethicone (Anti flatulence)
-Tablets should be chewed thoroughly to obtain optimum effects .
- they should be taken after meals to neutralize gastric
acid secretion
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antacids
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antacids
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Prevent about 70% of acid production.
Examples-:
Ranitidine150 mg twice daily at breakfast and bed time
300 mg at bed time
Famotidine20 mg twice daily at breakfast and bed time
40 mg at bed time
H2 Blockers
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ranitidine
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famotidine
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-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:- Omeprazoleex:- Pantoprazole
Proton pump inhibitors
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omeprazole
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pantoprazole
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Alucal chewable tabاألكل 2 – 1 بعد تمضغ يوميا 3قرص مرات
Zantac 150mgالنوم وقبل األكل قبل صباحا* قرص
Omepral 20 mgيوميا الريق على صباحا* قرص
Example of OTC prescription:
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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 )®
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Atropine like derivatives
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papaverine like derivatives
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Example of OTC prescription:
Buscupan Tab
األكل 3قرص قبل مرات
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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
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*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:
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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.
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antihistaminic
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Example of OTC prescriptionmotion sickness
Draminex tabاللزوم 1-2 عند قرص
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Anti emetics
3-Metoclopramide
22--DompridoneDompridone::
Not show CNS side effects of metoclopramide.
11--AntihistaminicAntihistaminic: :
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domperidonemetoclopramide
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Example of OTC prescription for vomiting
primepran tabاللزوم 1-2 عند قرص
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diarrhea
dysentery
GastroenteritisFever & vomiting
Tensmus & offensive odour, Pain on defecation& small quantity stool
Gas production & spasm May constipation Spastic colon
yes
Noyes
yesNo
NoDrug induced
Dietary induced
On starting drug use
On changing milk type
Give anti diarrheal drug
yesNo
yes
No
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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
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Secindazole Diloxanide
Tibindazole
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metronidazole
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Example of OTC prescription
Furazole suspاالكل 3مل 10 - 5 بعد يوميا* مرات
Fladazole tab
و 2 الفطار بعد العشاء 2قرص بعد قرص
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Antidiarrheal drugs
1-antibacterial agent
2-adsorbent
3-drugs inhibit GIT motility
4-Rehydrin solution
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Nifuroxazid& Sulfa drugs
if fear of infection
1-antibacterial agent
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Acts by adsorption of bacteria, toxin & noxious materials e.g.:
EX 1 : Kaolin & pectin “kaopectate”
2-adsorbent
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3- drugs inhibit motility
EX 1 : Loperamide (lmodium)® EX 2 : Disphenoxylate (Lomotil)®
Avoid using alone in fear of infection
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-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
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Example of OTC prescription
Kapect susp
االكل 3مل 10 - 5 قبل يوميا* مرات ِAntinal susp
االكل 3مل 10 - 5 قبل يوميا* مرات
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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
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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
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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
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osmotic laxatives
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stimulant laxatives
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Lactulose syrup
االكل قبل كبيرة يوميا 3ملعقة مراتPicolax drops
اللزوم 15 عند ماء كوب نصف على نقطة
Example of OTC prescription