over the counter, prescription, & herbal drugs · health literacy •obtain & understand basic...
TRANSCRIPT
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Over the Counter,Prescription, &Herbal Drugs
Ch. 15
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S/S
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Confusing…Overwhelming
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Health Literacy
• Obtain & understand basic health info and services to make appropriate health decisions.
• 12% of adults have proficient health literacy skills• Source: US Dept. of Health & Human Services, Office of Disease Prevention and Health Promotion. Quick Guide to Health Literacy.
Retrieved from https://health.gov/communication/literacy/quickguide/default.htm
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Medication Mode of Delivery
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Taking Medications
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Pain Response
COX1
Trauma,Injury
Cell Damage
Redness, Swelling, Pain, Heat, Clotting
Prostaglandins
COX2
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Pain Response
COX1
Trauma,Injury
Cell Damage
Redness, Swelling, Pain, Heat, Clotting
Prostaglandins
COX2
NSAID
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Pain Response
COX1
Trauma,Injury
Cell Damage
Redness, Swelling, Pain, Heat, Clotting
Prostaglandins
COX2
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Pain Response
COX1
Trauma,Injury
Cell Damage
Redness, Swelling, Pain, Heat, Clotting
Prostaglandins
COX2
https://www.tylenolprofessional.com/adult-dosage
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Work Groups
• MAN Phoenix - OTC: Internal analgesicsBRN Bluegolds - OTC: Cold, Allergy, and Cough RemediesMNT Buccaneers - OTC: Sleep Aids & StimulantsFOX Titans - OTC: Diet AidsBRN Chargers - OTC: Herbals
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MAN Phoenix
• -OTC: Internal analgesics
Brand strength monitoring
Each month survey 1000 respondents- 500 female- 500 male- 130 African Americans- 400 Millennials
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BRN Bluegolds
• OTC: Cold, Allergy, and Cough Remedies
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MNT Buccaneers
• OTC: Sleep Aids & Stimulants
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FOX Titans
• OTC: Diet Aids http://www.buycheapdietpillsonline.com/
http://www.buycheapdietpillsonline.com/
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BRN Chargers
• OTC: Herbals
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Natural Health
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Prescription Drugs
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Rx Drugs
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• https://www.drugabuse.gov/sites/default/files/rx_drugs_placemat_508c_10052011.pdf
https://www.drugabuse.gov/sites/default/files/rx_drugs_placemat_508c_10052011.pdf
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Source: D. O. Sarnak, D. Squires, and G. Kuzmak, Paying for Prescription Drugs Around the World: Why Is the U.S. an Outlier? The Commonwealth Fund, October 2017.
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Prescription Drugs
• 1.3 million ER visits due to adverse effects of Rx drugs
• 124,000 OD deaths
Source: Carr, T. (August 3, 2017). Too many meds? America’s love affair with prescription medication. Consumer Reports. Retrieved from https://www.consumerreports.org/prescription-drugs/too-many-meds-americas-love-affair-with-prescription-medication/
https://www.consumerreports.org/prescription-drugs/too-many-meds-americas-love-affair-with-prescription-medication/
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Pain Management
Analgesic • Pain Relief• (Acetaminophen,
Oxycodone, morphine)
Opiate• Derived from opium• (heroin)
Narcotic• Mood or behavior
altering• Illegal • (cocaine, heroin)
Opioid• Synthetic• Opiate-like effect• (Fentanyl, oxycodone,
morphine)
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Why are opiates so addictive?
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Neurotransmitters - Dopamine
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Why are opiates addictive?
• Human Emotion receptor sites in the brain• Dopamine & serotonin
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Why are opiates addictive?
• Opioid receptor cites• Overlap with emotion, mood, pleasure, pain suppression
Source: https://www.challengemdd.com/opioid-system
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Chemical Action – Side Effects
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Opiates
• Codeine (only available in generic form)
• Fentanyl (Actiq, Duragesic, Fentora, Abstral, Onsolis)
• Hydrocodone (Hysingla, Zohydro ER)
• Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
• Hydromorphone (Dilaudid, Exalgo)
• Meperidine (Demerol)
• Methadone (Dolophine, Methadose)
• Morphine (Kadian, MS Contin, Morphabond)
• Oxycodone (OxyContin, Oxaydo)
• Oxycodone and acetaminophen (Percocet, Roxicet)
• Oxycodone and naloxone
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Side Effects
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Why such an increase in Opioid Prescriptions?
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Disease Mongering
1986
#13%
$
#26%
$1991
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Disease Mongering
1986 1991
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Disease Mongering
• 1987 ADHA APA
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• USA consumes 85% of Ritalin production in the World.
Source: Frontline (2001). PBS. Retrieved from https://www.pbs.org/wgbh/pages/frontline/shows/medicating/drugs/stats.html
1986 1991
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1986 1991
1996
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Physician Productivity
• 1992 – Health Care Financing Administration
• Relative Value System (RVU)
• Physician Expenses• Expertise – time, training, judgement, skill…(52%)
• Practice – Facilities, staff, overhead (44%)
• Malpractice – insurance, legal fees (4%)
• Specialization
• High volume
• Patient Satisfaction
19921986 1991
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Direct to Consumer Advertising
• 1997 – FDA redefined “Adequate Provision”• Fair balance of drug effectiveness and risk/side effects
• Rx Drug advertising• 1993 = $166 million
• 2005 = $4.2 billion
1992 19971986
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Terri Schiavo Case
• 1990 – 2005
• Patient Rights
1992 1997
1990 2005
1986
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Vital Signs
1. Body Temp
2. Pulse
3. Respiration Rate
4. Blood Pressure
• 2001 Pain• VA & Joint Commission
1992 1997
1990 2005
20011986
https://www.jointcommission.org/assets/1/6/Pain_Std_History_Web_Version_05122017.pdf
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1992 1997 20011986
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1992 1997 2001
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/
1996 2006
1990 2005
1986
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/
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Prescription Drug Monitoring System• Implemented 2013
1992 1997
1990 2005
2001 20131986
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1992 1997 2001 20131986
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1992 1997 2001 2013 20161986
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Disease Mongering?
• You have a unhealthy condition…
• I have a cure…
1992 1997 2001 2013 20161986 2019?
Source: Marijuana Business Daily. (April 2014).
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Health LiteracyConversation with health care providers
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Before Leaving the Doctor’s Office
Ask questions
• Why do I need this prescription?
• What is the name of the medication?
• What does it do?
• What are the benefits?
• What are the risks and side effects?
• Are there alternatives to this medication?
• How do I take it?
• Does the medication interact with anything?
• How long do I need to take this medication? When can I stop?
• What if I miss a dose?
• How much does it cost?
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Discussion Groups
• MAN Blue Devils - Rx: AntibioticsMNT Phoenix - Rx: AntidepressantsFOX Cyclones - Rx: Stimulants
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MAN Blue Devils -
• Rx: Antibiotics
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MNT Phoenix -
• Rx: Antidepressants
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FOX Cyclones -
• Rx: Stimulants