OTC Drugs, Herbal Remedies and Other Stuff - PowerPoint PPT Presentation

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OTC Drugs, Herbal Remedies and Other Stuff

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  1. OTC Drugs,Herbal RemediesandOther Stuff Chapter 14

  2. Lecture Outline • OTC Drugs • Antihistamines • Decongestants • Cough medicine • Analgesics • Herbal Remedies • St. John’s Wort • Ephedra • Ginkgo Biloba • Ginseng • Other Supplements and Prescription Drugs

  3. ADHD Treatments • Primarily treated with stimulants • Ritalin (Methylphenidate) • Concerta (a longer acting form of Ritalin) • Adderal (amphetamine salts) • Strattera (atomoxetine) - SNRI

  4. Antihistamines • Used to treat allergies as well as dermatological conditions • All block H1 (Histamine) receptor • Histamine is an excitatory NT and mediates part of the generalized immune response. • Drowsy vs. Non-drowsy • Based on whether it crosses BBB • Benadryl (Diphenhydramine) – Crosses • Chlorpheniramine (Chlor-Trimeton) - Crosses • Allegra (Fexofenadine) – Doesn’t Cross • Claritin (Loratadine) – Doesn’t Cross • Zyrtec (Citirizine) – Doesn’t cross • Clemastine (Tavist) - Crosses • H2 receptor antagonists are Pepcid, Tagamet, Axid … Anti-ulcer and Antacid drugs

  5. Decongestants • Dilate bronchial passages by constricting blood vessels in respiratory system • Mediated by NE (Agonist) • Pseudoephedrine most common • Ephedrine once common • Activate SNS, but cross BBB weakly • Names • Sudafed • Actifed • Dimetapp

  6. Analgesics • Non-Steroidal Anti-Inflammatory (NSAIDS) • Inhibit Prostaglandins and Proinflammatory Cytokines through inhibition of COX enzymes • Names • Acetylsalycillic Acid (Aspirin) – COX 1 & 2 • Acetaminophen (Tylenol) – COX3 • Motrin (Ibuprofen) – Cox 1 & 2 • Alleve 1 & 2 • Naprosin 1 & 2 • Vioxx (Rofecoxib) 2 • Celebrex (Relecoxib) 2 • Not good to inhibit COX 1 = kidney and stomach problems

  7. OTC Sleep Aids • For temporary relief of insomnia • Vast majority contain antihistamines • Benedryl • Tylenol PM • Unisom geltabs • Sominex • Doxylamine • Unisom sleep tabs

  8. Herbal Remedies • Derived from natural sources • Not currently regulated by FDA • Purity and potency are large issues • Extraction of active ingredient can be a problem • Currently popular • Have been around forever

  9. St John’s Wort • Grows as an invasive weed • Hypericum • For mood disorder (We think this is what it does) • Agonist of catecholamines • SSRI • Increases DA and GABA • Effective if one gets enough (mounting evidence is good) • Speeds up metabolism of birth control pills and antivirals • Induces photosensitivity

  10. Ginseng • Extract from plant • Thought to induce a number of actions • Anti-fatigue • Antioxidant • Lower cholesterol • Stimulant? • Headaches, insomnia, anxiety, breast soreness or tenderness, skin rashes, asthma attacks, increased blood pressure, diarrhea, euphoria, nervousness, skin eruptions, heart palpitations, or post-menopausal uterine bleeding

  11. Ginkgo Biloba • Increases blood flow to brain • Thought to increase memory and cognitive ability • Inhibits Platelet Activating Factor and induces vasodilation • Few side effects. GI distress. Possibly some problems with >2 years use • Effective for people with problems; may not have much effect for “normals”

  12. Ephedra • Ephedra, Ephedrine, Ma Huang • Derived from plant source • NE agonist. Stimulates NE release and acts on receptors • Typical sympathomimetic response • Increase – HR, BP, Respiration, Glycogenesis and Lypolysis • Does not cross BBB very well, so little CNS effect • Used for bronchial dilation, as well as weight loss and narcolepsy in the past • Stroke and arrhythmia

  13. Kava • Plant native to South Pacific • Used much like alcohol • GABA agonist • Associated with liver failure

  14. The Moral • Look up the active ingredient • What is it? • What does it do? • Be aware of drug interactions • Antagonism • Synergism • Intolerance • Allergy