Antacids With Large Amounts Of Sodium example essay topic

Running head: OVER-THE-COUNTER DRUGS GROUP PROJECT Over-The-Counter Drugs Project Lyne a Back land Trish Bush Anita Hernandez Katherine L.M. Williams Submitted to Carol Webber, RN, PhD in partial fulfillment of NR 439 Pharmacology Regis University February 25, 2003 Over-The-Counter Drugs Project Part I Go to a supermarket or a pharmacy and examine the over-the-counter (OTC) preparations available on the shelves for "colds,"flue", and upper respiratory infections (URI). Respond to the following questions: 1. If you did not look at the ingredient list, how would you choose one brand over another? There are a few factors that would influence our decision to choose one brand of an over the counter drug over another. Initially we were drawn to a brand from a commercial we have each seen or an OTC that worked for each of us in the past. However, our definitive choice was determined based off of our current symptoms.

For instance, we would examine our condition examining the following factors about our condition. Current symptoms may include a runny nose, cold, sinus inflammation, flu, body aches, allergy, cough, headache, URI, or if it was allergy stimulated. The next two important decisions in choosing one brand over another would be if the brand caused drowsiness and its price. We would want to be very cautious before purchasing an over the counter preparation that caused drowsiness unless we also had a similar brand to take during the day. In addition, being students, we all gravitated to the most inexpensive adult brand that will help us each the most.

Other factors that we discussed but were not as imperative included; if the medication is a coated or uncoated tablet, gel capsule, or liquid. Seventy-five percent of us prefer the gel capsules. 2. What brand would you buy for a 30-year-old student who has a cough, sore throat, runny nose, and exams in 2 days?

There were two OTC brands that I selected for this student. The first is Vicks DayQuil liquid caps. Since the student must study for the exam the DayQuil liquid capsules will not make him drowsy while relieving his sore throat, coughing, and runny nose. Second I choose Maximum Strength Thera Flu. The main reason that I selected this brand is it included a cough suppressant that will let the student get up to eight hours of sleep. Since the student's performance will be enhanced with the proper rest it is imperative that he can suppress his cough throughout the night.

Thera Flu also helps with his relief of sore throat, runny nose, and body aches. Thereby the student should have a fair opportunity to be well prepared and rested for his exam. 3. Find two ingredients that are common to many of the OTC preparations. List their possible adverse effects and the reference you used. Two ingredients that were common to most over the counter drugs were acetaminophen and pseudoephedrine hydrochloride.

The least threatening adverse reactions for acetaminophen were dermatologic (a rash and urticaria). The life threatening adverse effects due to overdose and chronic use included gastrointestinal (hepatic failure and hepa toxicity) and genitourinary (renal failure). (Deglin and Vallerand 2003) Pseudoephedrine also had life threatening adverse effects including seizures and cardiovascular collapse. The most frequent adverse effects for this drug included anxiety, nervousness, palpitations and anorexia. Additional adverse reactions and side effects for pseudoephedrine were dizziness, drowsiness, excitability, fear, hallucinations, headache, insomnia, restlessness, weakness, respiratory difficulty, hypertension, tachycardia, dry mouth and dysuria. (Deglin et al.

2003) 4. Describe the possible adverse effects of one ingredient to Emma Jones, a 26-year-old asphalt layer who has a high school education. Write it as if you are speaking to her. "Ms. Jones, there are a few questions I need to ask you prior to recommending any medications for your current pain and fever".

What other medications and over the counter drugs are you currently taking? Birth control pills. Do you drink alcohol? Yes. How many days within a seven day week do you drink alcohol? 2 How many drinks do you have in one day?

2 Have you ever been treated for a drinking problem? No The reason I ask you these questions is that I am going to recommend acetaminophen, often referred to as Tylenol, for the pain and fever you have been experiencing. Unfortunately, this drug can cause kidney failure in individuals who drink alcohol excessively and regularly. While you are taking this drug I recommend that you not use any alcohol.

Also, if you have any plans to get pregnant while taking this drug, I would contact the office since it can affect the baby. You can purchase this drug at your local drugstore or supermarket. There is no specific brand that is more effective than another so the store brand is fine. As noted on the box, you should take this medication as directed, one tablet every 4-6 hours with a glass of water.

I would recommend taking this medication with food so as to not upset your stomach. Initially it will take about a half hour to an hour to begin to feel any pain relief and will the relief should last about 4-6 hours. If your fever does not improve within 3 days or is above 103 oF please call the office immediately. If your fever does improve but the pain has not within 10 days please make an appointment to return to the office. Do you have any questions? No.

It was nice to meet you Ms. Jones and I hope you are feeling better soon. Part II Read the labels on OTC antacids at your local supermarket to determine their sodium content. List at least three brands and their sodium content that would be appropriate for use by a person who has a sodium-restricted diet due to chronic congestive heart failure (CHF). The best brand to suggest for a person that has a sodium-restricted diet due to CHF would be Zantac 75. It is both sodium and sugar free. Two other brands that would be appropriate for use include Rolaids Antacid and Gaviscom Extra Strength Antacid.

Each of these antacids contains 1 mg and 1.3 mg of sodium respectively. Thereby both are considered to be dietetic ally sodium free and safe antacids for patients with CHF. 2. List at least two brands and their sodium content that would not be appropriate for a person who has a sodium-restricted diet. The most offensive antacid we found that would not be appropriate for an individual with a sodium-restricted diet was Alka Seltzer. It contained 1916 mg of sodium in just two tablets.

It would also be inappropriate for this individual to take the Safeway brand which contains 15 mg of sodium per tablet. 3. Did any of the Brands omit sodium information on the label? Which ones?

How could you access this information? We were surprised that many of the brands did not list the sodium amounts on the container. Some of the brands this included are listed below: o My lanta did not have sodium listed except for in inactive ingredients. There was no amount given. o Maalox soft chews had no sodium content listed. If you read under inactive ingredients it had 15 mg sodium per tablet. o Fast acting Surpass had no sodium listed anywhere and had no assessment of sodium content. o Pepcid Ac had no sodium listed under inactive or active ingredients. As a general consumer it would be troublesome to access this information.

However, this information can be researched in a variety of places including the internet (specifically the specific drug web site) or by writing the company for further information. Another very reliable source may also be the pharmacist as they often have a database of drugs that they can easily access. 4. Prepare a one-page handout to teach a 72-year-old woman who has CHF how to determine which antacids she can use. This should teach her a skill, not just appropriate brands. (See page handout on next sheet) Your CHF and antacid use Description - Antacids are taken by mouth to relieve heartburn, sour stomach, or acid indigestion.

They work by neutralizing excess stomach acid. Some antacid combinations also contain simethicone, which may relieve the symptoms of excess gas. Antacids alone or in combination with simethicone may also be used to treat the symptoms of stomach or duodenal ulcers Before Using This Medicine - If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For antacids, consider the following: Allergies - Tell your health care professional if you have ever had any unusual or allergic reaction to aluminum-, calcium-, magnesium-, simethicone-, or sodium bicarbonate-containing medicines. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Diet - With CHF you are on a low-sodium diet.

DO NOT take any antacids with a higher sodium intake of 1.5 mg. Make certain your health care professional knows if you are on a low-sodium diet. Some antacids contain large amounts of sodium. Older adults - Aluminum-containing antacids should not be used by elderly persons with bone problems or with Alzheimer's disease. The aluminum may cause their condition to get worse. Other medical problems - The presence of other medical problems may affect the use of antacids.

Make sure you tell your doctor if you have any other medical problems Dosing - The dose of an antacid will be different for different patients. Follow your doctor's orders or the directions on the label. You are on a sodium-restricted diet: Some antacids (especially those containing sodium bicarbonate) contain a large amount of sodium. DO NOT TAKE antacids with large amounts of sodium or sodium bicarbonate. Side effects - may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine.

However, check with your doctor if any of the following side effects continue or are bothersome: More common = Chalky taste Less common = Constipation (mild); diarrhea or laxative effect; increased thirst; speckling or whitish discoloration of stools; stomach cramps Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. Part Interview a relative in your clinical setting who takes a prescription medication on a long-term basis and self-administers it. Answer the following: 1. How does she remember to take it at the scheduled time?

My aunt Rose takes two medications for her rheumatoid arthritis. The first is Bextra 10 mg which she takes nightly. She stated that she remembers to take this nightly by incorporating it into her nightly routine after brushing her teeth. She also must give herself two SC injections a week of Enbrel entanercept 25 g / vial. Rose initially remembers her injection as she will start to experience aches and pains the day before an injection is due. Though she best remembers her injection schedule concurrent with her favorite television shows and a calendar posted on her refrigerator.

On the calendar she writes either an "L" or "R" (so she can rotate) depending on which leg she administered the medication in. 2. What does she know now about managing the medication that would have made it easier if a nurse had taught when she first started taking it? Rose had an allergic reaction to the injections and gets large red spots indicative of the injection sight. Since she was not warned about this adverse effect she wasn't sure if the medication was working, if she was doing something wrong, or how to relieve the itching. 3.

How does she manage the medication during trips? During trips Rose ensures that she has an adequate amount of Bextra on hand. She stated that she usually ensures that she has an extra weeks (seven pills) worth of pills in case of any problems with travel she may encounter. She then stated that traveling with the Enbrel entanercept was a little more difficult as it needs to be refrigerated. Since she only needs to administer her injections twice a week she does not need to take in on short weekend trips. Rose said that longer trips require a lot more planning ahead.

She needs to make sure that where she is staying has a refrigerator and remember to take a small bio-degradable container for disposal. One her most recent flight to Florida she warped the medication in plastic bags with ice packs and checked it in with her luggage. Though she said she also carry's her prescription with her in case there are any questions she has not encountered any problems traveling thus far. 4.

Look up the medications in the drug book. Does any of the information surprise you? Can you identify anything this person needs to know to help manage this medication? None of the information surprises me about Bextra. Rose was very informed about this medication. It may be helpful for Rose to know that Bextra can also cause rashes in case she begins to develop them in places other than her injection sights.

Since she only takes the medication nightly she may also want to know that she can take it early in the morning if she missed the dose the night before. With her entanercept she may want to know that it has a half life ranges from 98 to 300 hours. This is helpful as sometimes she reports not needing an injection as much as other days. I found all of the same information that Rose reported to me. However, I was surprised that there is a drug-drug interaction in which entanercept may decrease the antibody response to live-virus vaccine. To help Rose manage this medication she can also be taught other appropriate injection sights to minimize repeated local injection site reactions.

Part IV Find an article about a medication in the popular press. Attach a copy. (See appendix A) Respond to the following. 1. What implication does this article have for a professional nurse? o First pass effect: Drug does not work immediately but people may expect immediate happiness. o Antidepressants are often over prescribed. They are also contraindicated with MAO's (monoamine oxidase inhibitors), Dislfiraam, Moclobemide, and Warfarin / Digitoxin. o Dietary / Lifestyle changes - no grapefruit juices & no exposure to the sun. o Chronic diseases associated when taking this medication: Brain disease (possible damage) Mental retardation Seizure disorders may increase Kidney disease (unknown) Liver disease may increase Mania may be activated Large weight loss or anorexic like symptoms This drug is used in mental depression, OCD, & panic disorder (PTSD).

2. Make a list of questions that this article raises for you. o Why does it indicate in the brochure that it is not habit forming but in the PDR it states that the patient may experience withdraws, which would signify physiological or psychological dependency? o What is the purpose of taking Zoloft two weeks before a woman's period if it indicated in the PDR that it can't be stopped abruptly because of withdraw symptoms? o Is the increase in taking antidepressants problematic in the United States, especially in populations of women? Thereby marking Zoloft (which is used for mental depression, OCD, panic disorders, and PTSD) directed at women like in the attached article. 3. Ask the layperson what questions this article raises for him / her. o Will I have all of these side effects? o Are there other side effects are not listed? o Can I just take this medication on days I am sad? o Is my crying, irritability, or fatigue enough to need Zoloft? o The impression that the article gives is that once I take Zoloft I will be happy. How true is this? o Are there withdraw symptoms?

Part V Watch a television commercial for an OTC preparation. Answer the following questions: 1. Assume that your instructor has not seen the commercial and describe it briefly. There is middle-aged man playing outside with his grandchildren and he leans forward to pick up a ball and his back gives out.

The commercial consists of two over the counter medications stating which medication is better for arthritis? The two medications competing are Tylenol and Advil liquid gel. Advil liquid is the preferred medication for arthritis. It is stated that Advil liquid gel is an anti-inflammatory medication. 2. Look up the active ingredients in a drug book and make a chart with these headings: Active ingredient, Drug Class, Therapeutic actions, Common adverse effects.

Active ingredient: ibuprofen (Generic name also) Drug class: Nonsteroidal anti-inflammatory drug (NSAID), Analgesic (non-narcotic), & Prop ionic acid derivative. Therapeutic action: Anti-inflammatory, analgesic & antipyretic activities largely related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known. Common adverse effects: NSAIDs CNS: headache, dizziness, somnolence & insomnia Dermatologic: rash GI: nausea, dyspepsia, GI pain & constipation 3. Identify a misconception that may be fostered by the commercial. The biggest misconception in the commercial was the false hope given to individuals with arthritic pain similar to this middle-aged man on the commercial. Like him they could simply get the Advil liquid gel and be healed.

In no time they would be able to be back to playing ball in the yard with their grandchildren. For many individuals the Advil does not provide sufficient pain relief for the joint inflammation. In our society individuals seek the miracle drug that will take the pain away quickly. Unfortunately, this commercial contributes to a quick cure resolution by implying that your life can change with just one pill.

It may encourage individuals taking other prescribed medications to partake in their treatment or not encourage those that truly need relief from arthritic pain to seek necessary help. 4. Describe two specific things that you as a nurse want to teach a person who uses this preparation. It is important that patients attempt to administer this medication with food or after meals. This is increasingly important if the patient has GI concerns or problems. Another important issue to teach the client is not to exceed the required maximum dose over a give time frame.

Thereby decreasing likelihood of overdose as well as the possibility of bleeding and other severe complications will be reduced. As with any medication any severe side effects should be reported immediately to a physician. Cited Sourced Deglin, J.H., & Vallerand, A.H. (8th ed. ). (2003). Davis's Drug Guide For Nurses.

Philadelphia: F.A. Davis Company..