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1 CHAPTER I THE PROBLEM Background of the Study Over-the-counter drugs had been utilized by many people nationwide to treat common illnesses/ailments which is/are not serious enough to seek the help of health care providers. In the past, OTC consist only of relatively small number of medication but to dat, OTC medicines are account for the majority of all medicines used in the US including many that were once available only by prescription. Such drugs used by Americans include everything to treat cough, colds and aches.(www.bemedwise.org) Moreover according to FDA, 1999, Americans buy about five billion over-the-counter drug products each year to treat their routine health problems.As cited by Roper Starch,2011, 82 percent of American women and 71 percent of American men
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CHAPTER I

THE PROBLEM

Background of the Study

Over-the-counter drugs had been utilized by many people nationwide to treat

common illnesses/ailments which is/are not serious enough to seek the help of health care

providers.

In the past, OTC consist only of relatively small number of medication but to dat,

OTC medicines are account for the majority of all medicines used in the US including

many that were once available only by prescription. Such drugs used by Americans

include everything to treat cough, colds and aches.(www.bemedwise.org)

Moreover according to FDA, 1999, Americans buy about five billion over-the-

counter drug products each year to treat their routine health problems.As cited by Roper

Starch,2011, 82 percent of American women and 71 percent of American men have used

a nonprescription medicine in the last six months to treat at least one minor health

problem.

Over four in five U.S. adults who have experienced various illnesses that can be

treated or relieved by non-prescription medications (82%) typically self-medicate for

those conditions. Colds (56%) and coughs (37%) are the most common conditions for

which adults medicate themselves. Adults are less likely to self-medicate for seasonal or

year-round allergies than they are for illnesses such as coughs, colds, heartburn, and

headaches (http://www.bemedwise.org/survey/ExecutiveSummary.pdf).

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On the other hand, according to the consumer poll, a third of Americans say they

take more than the recommended dose of a nonprescription medicine, believing that it

will increase the effectiveness of the product. Of these consumers, two thirds (69 percent)

say they take more than the recommended amount at a single time; three fifths (63

percent) report taking the next dose sooner than directed; and two fifths (44 percent) say

they take more than the recommended number of doses in a day.At the same time, a third

of Americans (36 percent) say they are likely to combine nonprescription medicines

when they have multiple symptoms, like a headache and a sore throat. This practice can

increase the risk that consumers take more than one OTC product at a time that contains

the same active ingredient (http://www.bemedwise.org/survey/summary_survey.pdf).

Cases of drugs abused/misused had been the problem towards OTC drugs all this

years.Abuse of OTC medicines is now so prevalent it is “normalized” among teens. 

Nearly one in five teens (19 percent, or 4.5 million) report abusing prescription

medications to get high and one in 10 (10 percent or 2.4 million) report abusing cough

medicine to get high. Far too many teens have a false sense of security about the abuse of

OTC medicines. Two in five teens (40 percent or 9.4 million) agree that medicines, even

if they are not prescribed by a doctor, are much safer to use than illegal drugs. Nearly

one-third of teens (31 percent, or 7.3 million) believe there’s “nothing wrong” with using

medicines without a prescription “once in a while.

(

http://memorials.drugfree.org/Portal/DrugIssue/Features/Key_Findings_on_Teen_Drug_

Abuse).

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In the Philippines, cases of inappropriate use of drugs has been very common

most especially antibiotics. According to Emmanuel Edwin R. Dy, M.D, many people

just take antibiotics with improper administration with respect to drug, dose, interval,

duration this is because people are prisoned to their beliefs or misconceptions and

likewise to their inability to purchase the prescribed medicine due to financial constraints.

Adolescents used of over-the-counter drugs have been uncontrollable. Some just

take medicines without background or enough knowledge about these medications. Some

takes antibiotics without following the needed time to complete the dose, taking

analgesics and even laxatives without knowing enough about its side/adverse effects.

According to Leochico et al (2010), while self-medication is prevalent among

adolescents, they remain to have significant knowledge deficits, which may predispose

them to medication misuse and/or adverse effects.

With these findings, the researchers are the motivated to look into the variables

that affect the perception of adolescents on OTC drugs. It is hoped that the information

generated with this study will help to bridge the gap in knowledge in OTC drugs.

Statement of the Problem

This study aims to determine the relationship between Socio-demographic

characteristics and Perceptions of the Respondents on OTC drugs.

More specifically, this study gears towards the resolution of the following

problems:

1. What are the Socio-demographic characteristics of the Respondents?

A. Demographic Factors

A.1. Sex

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A.2. Monthly Family Income

A.3. Educational Attainment

A.4. Common Illnesses

A.5. Common Drugs used

B. Sociological Factors

B.1 Sources of Information

B.1.1. Peers

B.1.2. Relative

B.1.3. Media

B.1.3.a. TV

B.1.3.b. Radio

B.1.3.c. Newspaper

2. What are the perceptions of the respondents on OTC drugs in terms of:

2.1. Effects2.2. Dosage2.3. Frequency2.4. Reasons

3. What is the relationship between Socio-demographic characteristics and

Perceptions on OTC drugs?

Statement of the Objectives

In general, the study will be conducted to identify the relationship between Socio-

demographic characteristics and Perceptions of the Respondents on OTC .

Specifically it aims:

1. determine the Socio-demographic characteristics of the Respondents as to:

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A. Demographic Factors

A.1. Sex

A.2. Monthly Family Income

A.3. Educational Attainment

A.4. Common Illnesses

A.5. Common Drugs used

B. Sociological Factors

B.1 Sources of InformationB.1.1. Peers

B.1.2. Relative

B.1.3. Media

B.1.3.a. TV

B.1.3.b. Radio

B.1.3.c. Newspaper

2. determine the perceptions of the respondents on OTC drugs in terms of:

2.1. Effects

2.2. Dosage

2.3. Frequency

2.4. Reasons

3. determine the relationship between Socio-demographic characteristics and

Perceptions on OTC drugs.

Significance of the Study

Nowadays, the use of Over-the-Counter drugs is already been increasing and

somehow the rate of drug abuse or misused of drugs is rising. The health professionals

address such problems by giving health education on over-the counter drugs and

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controlling the dispensing of drugs throughout the market. Thus this study will benefit the

following group along the perception of adolescents in OTC drugs.

The results of this study will reveal information on how

Adolescents. These adolescents view their use of OTC drugs. This will help them

understand their perceptions and modify these views and behaviour for safe use of non

prescribed OTC drugs.

Nurses. The result of the study will serve as guide by nurses in planning and

rendering nursing care and health education to adolescents.

Employees of Food and Drug Administration/Bureau of Food and Drugs.This

study will increase their awareness on the alarming situation of misused of OTC drugs

hence the result will be utilized as their basis in coming up with guidance or policies or

laws to control the misuse of OTC drugs.

Researcher. The result of the study will be instrumental in conceptualizing

research study that will include variables that are not part of this study to broaden the

understanding on OTC drugs among adolescent.

Scope and Delimitation of the Study

This study focused on the Socio-demographic characteristics affecting the

perceptions on OTC drugs among Adolescents. It focuses on finding out the perceptions

and the socio-demographic characteristics of the respondents.

The research undertaken was limited to Adolescents aged 16-18 who are not

taking any health related course and who are studying at Mariano Marcos State

University. This research will be conducted on Second Semester School Year 2011-

2012.

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The study used the descriptive-correlational research method. This It utilized

survey method using a questionnaire with guided interview to follow-up answers.

Operational Definition of Terms

For better understanding of the research of the research, the following terms are

defined as used in the study.

Adolescents. Refers to the individuals who will be the respondents of the study

aged 15-18 years of age and except those who are taking health related courses offered at

MMSU.

Over-the-Counter drugs (OTC drugs).Refers to drugs/medicines that can be

acquired in pharmacies, market or store with or without the prescription of a physician

that include antibiotics, cough remedies…,etc.

Perception.Refers to the view or opinion of the adolescents on over-the-counter

drugs.

Socio-demographic.Refers to the characteristics of the Adolescents which

includes:

Gender.Refers to the sexual category as to either a boy or a girl.

Socioeconomic Status.Refers to the financial capability of the adolescents

as categorized by NEDA.

5,999 and below – Very poor

6,000-10,999 – Poor

11,000-15,999 – Average

16,000 and below – Above average

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Family.Refers to the who are with the adolescents in the same house.

Friends/peers.Refers to the constant companion of the adolescents outside

the house.

Media.Refers to the main source of current information/s like television

magazines and newspapers.

Place of Residence. Refers to the location of the house of the adolescents

as to rural or urban.

Rural.Refers to an area outside the city/town proper where the

adolescents reside.

Urban. Refers to an area inside the city/town proper where the

adolescents reside.

Common Illnesses.Refers to ailments or conditions that the adolescents

usually treat with over-the-counter drugs.

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CHAPTER II

THEORETICAL FRAMEWORK

Review of Related Literature

This chapter presents a discussion of review of literature, theoretical framework,

conceptual framework and the research paradigm.

Over-the-counter drugs

As technology advances, drugs where classified as over-the-counter drugs or by

prescription. Prescription drugs are those that needs physicians prescription note while

over-the counter drugs are those drugs which can be bought in the store, market and

pharmacy without any physicians’ prescription (Microsoft ® Encarta ® 2008. © 1993-

2007 Microsoft Corporation. All rights reserved).

Over-the-counter (OTC) drugs are the ones that can be purchase at local

pharmacies without a doctor's prescription. These are drug substance that affects the

function of living cells and are commonly used to relieve pains, aches and itches.

According to Alexis Bergen, over-the-counter (OTC) medications currently

account for more than 100,000 drug products on the market. More than 700 of these

products were still prescription-only drugs 30 years ago.

Over-the-counter self-medicating is prevalent in the United States and other

countries. It's widely accepted to go to a local pharmacy and buy the medication to

alleviate unwanted conditions. The FDA has approved these medications for over the

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counter use with just a number of limitations. According the FDA Office of

Nonprescription Products, "Over-the-counter (OTC) drugs play an increasingly vital role

in America's health care system that have more than 80 therapeutic categories, ranging

from acne drug products to weight control drug products.

Within the last few years, several notable drugs have made the switch from

prescription to OTC status, including Claritin, Pepcid AC and Zantac, giving consumers

immediate access to effective medications. But with increased accessibility also comes an

increased risk for drug interactions and side effects, particularly for individuals who

require long-term use (Overboard on Over-the-counter drugs, Alexis Bergen).

Due to the unrestricted use of over-the-counter (OTC) drugs among the public,

problems involving the use of these drugs have arised like self-medication that often lead

to poisonings, allergy, habituation, addiction, and other adverse reactions due to misused

or decrease knowledge about the drug (Dangers of Self-medication, 2009). In other

words, self-medication had always been accompanying OTC drugs ever since this drug

was released to the public.

Classification of OTC Drugs

More than 80 classes (therapeutic categories) of OTC drugs are available in the

market that range from acne drug products to weight control drug products

(http://fdadrugcompliance.com/resources/otc/). The following are the common classes of

OTC medicines that are available currently in the United States:

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  Analgesics are a class of drugs used to relieve pain. The pain relief induced by

analgesics occurs either by blocking pain signals going to the brain or by interfering with

the brain's interpretation of the signals, without producing anesthesia or loss of

consciousness. There are basically two kinds of analgesics: non-narcotics and narcotics.

Acetaminophen is the most commonly used over-the-counter, non-narcotic analgesic.

Acetaminophen is a popular pain-reliever because it is both effective for mild to

moderate pain relief and relatively inexpensive. It must be emphasized though that the

safety of acetaminophen is tied to proper use of the drug (use according to specific

prescribing instructions). If acetaminophen is not used according to the directions on the

label, serious side effects and possible fatal consequences can occur. For example, taking

more than 4000 mg/day or using it long term can increase the risk of liver damage. The

risk of liver damage with acetaminophen use is also increased by ingesting alcohol.

Many people do not realize that acetaminophen is found in more than 600 over-

the-counter drugs. It can be found in combination with other active ingredients in many

cold, sinus, and cough medications. The cumulative effect of acetaminophen must be

considered if you are talking multiple drugs which contain acetaminophen

(http://arthritis.about.com/od/analgesic/a/factsanalgesics.htm).

 Analgesics are sometimes referred to as painkiller medications. There are many

different types of analgesic medications available in both prescription and over-the-

counter preparations. Examples of analgesic drugs

include aspirin, acetaminophen (Tylenol), ibuprofen(Motrin, Advil), naproxen (Aleve,

Naprosyn), the COX-2 inhibitor celecoxib, and narcotic drugs including

morphine, oxycodone, and hydrocodone (Vicodin). Analgesics may also be combined

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with other drugs in some types of medications (for example, analgesics are combined

with decongestants and/or antihistamine in many over-the-counter cold remedies)

(http://www.medterms.com).

Antipyretic is a type of medication that will prevent or reduce fever by lowering

body temperature from a raised state. They will not affect normal body temperature if the

patient does not have a fever. Fever, or pyrexia, occurs when the body reaches a

temperature above what is considered "average" (http://www.assistpainrelief.com).

Antipyretic is something that reduces fever or quells it. There are 3 classes of

antipyretic medications that are sold OTC (over-the-counter) without prescription:

Salicylates -- aspirin (acetylsalicylic acid), choline salicylate (Arthropan), magnesium

salicylate (Arthriten), and sodium salicylate (Scot-Tussin Original); Acetaminophen

(Tylenol); and Nonsteroidal anti-inflammatory drugs (NSAIDs) -- ibuprofen (Advil),

naproxen (Naprosyn, Aleve), and ketoprofen (http://www.medterms.com).

Cold and Cough Medicines. This are usually used to treat sneezing, sore throat,

a stuffy nose, coughing and other symptoms for common colds. This medicines include

nasal decongestants - unclog a stuffy nose, cough suppressants - quiet a cough,

expectorants - loosen mucus so you can cough it up, and antihistamines - stop runny

noses and sneezing (http://www.nlm.nih.gov).

Antiallergic products. This treat misguided reaction to foreign substances by

the immune system, the body system of defense against foreign invaders, particularly

pathogens (the agents of infection). The most common allergic conditions that usually

address by using anti allergic product include hay fever (allergic rhinitis),asthma, allergic

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eyes (allergic conjunctivitis), allergic eczema, hives(urticaria), and allergic shock (also

called anaphylaxis and anaphylactic shock).

Sleeping pill. A prescription sedative taken for insomnia. This is usually taken to

induce sleep. An over-the-counter pill classified pharmaceutically as an aid to sleeping.

Commonly used sleeping pills, or "hypnotics", such as temazepam and zolpidem, which

is prescribed for short-term insomnia, are associated with more than a fourfold risk of

death, according to the study published in the BMJ Open journal

(http://www.guardian.co.uk),

Gastrointestinal Products. Drugs that are used to intra-abdominal ailments like

for ulcer, constipation and diarrhea. Laxatives can help relieve and prevent constipation.

But not all laxatives are safe for long-term use. Overuse of certain laxatives can lead to

dependency and decreased bowel function. Sometimes it can cause cramping, gas,

bloating, nausea or diarrhea (http://familydoctor.org).

Antidiarrheal medicines include loperamide (1 brand name: Imodium) and

bismuth subsalicylate (2 brand names: Kaopectate, Pepto-Bismol). Bismuth subsalicylate

can also be used for upset stomach and as an antiemetic (a medicine that treats nausea

and vomiting).

Loperamide works by slowing down the speed of fluids moving through your

intestines (bowels). Bismuth subsalicylate works by balancing the way fluid moves

through your intestines. It also reduces inflammation and keeps certain bacteria and

viruses that cause diarrhea from growing in the stomach and intestines

(http://familydoctor.org).

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Antiulcer drugs are a class of drugs, exclusive of the antibacterial agents, used to

treat ulcers in the stomach and the upper part of the small intestine. Recurrent gastric and

duodenal ulcers are caused by Helicobacter pylori infections, and are treated with

combination treatments that incorporate antibiotic therapy with gastric acid suppression.

Additionally, bismuth compounds have been used. The primary class of drugs used for

gastric acid suppression are the proton pump inhibitors and omeprazole

(http://www.enotes.com) .

Dermatological Products. This are used to treat skin complications or

abnormalities like pimples, acne, rashes, and roughness of the skin. One of which is Acne

treatments which work by reducing oil production, speeding up skin cell turnover,

fighting bacterial infection, reducing the inflammation or doing all four. With most

prescription acne treatments, results cannot be seen for four to eight weeks, and skin may

get worse before it gets better (http://www.mayoclinic.com).

Weight Loss Aids. Used to treat obesity should be used as an option for the

following individuals: People with a body mass index (BMI) of 30 and above with no

obesity-related conditions. A person with a BMI of 27 and above with obesity-related

conditions, such as diabetes or high blood pressure

(http://www.webmd.com/diet/guide/weight-loss-prescription-weight-loss-medicine).

Most available weight loss drugs approved by the FDA are for short-term use, meaning a

few weeks or months.

One type of weight-loss medication is "appetite suppressants." These drugs

generally come in the form of tablets or extended-release capsules (pills that release

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medication over a long period of time). Appetite suppressants can be obtained by a

doctor's prescription or purchased over the counter. One common prescription appetite

suppressant is phentermine. Another type of prescription weight loss drug is a fat

absorption inhibitor. Xenical is the only example of this type of treatment approved for

use in the U.S. Xenical works by blocking about 30% of dietary fat from being absorbed.

Xenical is now sold over-the-counter as Alli. Xenical is the only weight loss drug

approved for longer-term use in significantly obese people, although the safety and

effectiveness have not been established for use beyond two years. Newer drugs are being

studied as potential treatments for obesity, some of which are showing promise and may

be available in the near future (http://www.webmd.com).

Antibiotics. Also known as antibacterials, and they are drugs used to treat

infections caused by bacteria. Bacteria are tiny organisms that can sometimes cause

illness to humans and animals. The singular word for bacteria is bacterium

(http://www.medicalnewstoday.com).

Antibiotics are widely used in the prevention and treatment of infectious diseases

(http://www.answers.com). Antibiotics, first used in the 1940s, are certainly one of the

great advances in medicine. But overprescribing them has resulted in the development of

resistant bacteria, which are bacteria that don't respond to antibiotics that may have

worked in the past. Plus, whenever kids take antibiotics they run the risk of side-effects,

such as stomach upset and diarrhea or even a possible allergic reaction

(http://kidshealth.org). The antibiotics that are commonly used are Amoxicillin,

Clindamycin,Cefalexin, Penicillin and Streptomycin (http://en.wikipedia.org).

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The availability of new and more effective drugs, such as antibiotics, which fight

bacterial infections, and vaccines, which prevent diseases caused by bacteria and viruses,

helped increase the average American’s life span from about 60 years in 1900 to about 78

years in 2005. Drugs have vastly improved the quality of life (Microsoft ® Encarta ®

2008. © 1993-2007 Microsoft Corporation. All rights reserved).

Consumer perspectives

OTC medicines are generally priced much lower than prescription products. An

analysis published in 2005 reported that the average retail price of an OTC medicine in

America was $7, whereas the average price of a name-brand prescription medicine was

$96, and the price of a generic prescription medicine was $28 USD. At the time of their

introduction to the OTC market, Alli (orlistat), Zantac (ranitidine), and Miralax

(polyethylene glycol), were all priced between 50% and 90% lower than the original

branded prescription medicines. Similarly, the cost of a 30-day supply of Claritin

(loratadine) was $96 when the drug was available by prescription and $22 following the

switch to OTC availability. Due to the economic advantage of OTC medicines,

physicians are likely to recommend the use of an OTC medicine as a substitute for an

prescription medicine to assist patients who are burdened with out-of-pocket prescription

costs. By using OTC medications, consumers not only save on drug costs, they also save

the out-of-pocket costs for doctor visits (including insured consumer’s copayments) and

transportation, as well as the cost of time spent traveling and waiting at the doctor’s

office. Using the U.S. June 2010 average hourly wage rate of $22.53, the 2 to 4 hours that

a patient saves from avoiding a doctor’s visit would result in an average savings of $45 to

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$90. According to Temin there are three factors used to assess the economic implications

of the OTC availability of topical hydrocortisone: price of the drug, cost of the doctor

visit to get the prescription, and value of the time used to go to the doctor. He estimated

that consumers saved more than $200 million the first year after topical hydrocortisone

was switched from prescription (Rx) to OTC status and more than $400 million the

second year after the switch. In a study concerning the switch of heartburn medications

from Rx to OTC status, Mansfield et al. found that consumers saved approximately $160

in out-of-pocket drug costs and $14 in physician visit costs annually

(www.pharmacytoday.org).

In the Philippines, according to Dr. Robles, people tend to use over-the counter

drugs because of the advice coming from their relatives, friends and neighbours. The

basis of utilization of drug/s is based on the effectiveness experienced after using these

drugs to treat common illnesses. On the other hand, according to Dr. Dy, the use of over-

the-counter drugs most especially antibiotics is influence by financial constraints.

According to him, due to financial instability, drugs are inappropriately. The right dose,

interval and duration of intake of the drugs are not accurately followed causing the

development of drug resistance.

Reasons of using OTC Drugs

Self-medication has always been a part of normal living. One who suffers from any

minor disease like flu, fever or headache goes to a medical store, purchases his required

medicine and takes it (Self-medication a Dangerous Practice,Zameeruddin Shakeel, Pindi

Bhattian).

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It is a common practice among our people to use a medicine when experiencing

discomfort such as headache, runny nose, cough, fatigue and stomach ache. The fact that

these symptoms seem to disturb people from time to time makes it easier for them to

decide what to buy from a nearby drug outlet. Self-medication, as a practice, is defined

by International Pharmaceutical Federation (FIP) and the World Self-Medication Industry

(1999) as, “the use of nonprescription medicines by people on their own initiatives”. It is

expected that individuals may resort to self-medication (The Dangers of Self-Medication,

Yolanda R. Robles, PhD).

According to Dangers of Self-medication (2009), a large number of people, when

they fall sick, do not consult the physician. They either consult a chemist and obtain a

medicine from his shelf, or may consult a neighbour who may be having some tablets left

over from his previous illness, and readily spares them. May be most of the times nothing

untoward happens on following such advice, but it can be dangerous.

“OTC medications save the consumer time and money because they don’t have to

go to the doctor every time they are sick. “But, it is important to understand that non-

prescription drugs should be used with the same amount of caution as prescription

drugs,” says Kathy Johnson, Pharm.D., Ph.D., associate professor of clinical pharmacy

and pharmaceutical economics and policy at the USC School of Pharmacy (Overboard on

Over-the-counter drugs, Alexis Bergen).

Today self-medication is already common to everybody in both developed and

developing countries. This may be due to different factors like individual’s satisfaction

with the healthcare provider (which is the cause of a major reason in developing

countries). Other includes interactions between prescribed drugs and the drugs taken for

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self-medication, educational level, socioeconomic factors, age and gender, distance from

the health care facilities/services. And based on some studies, the greater prevalence of

self-medication among the younger generation could be due to the better educational

level.

Obtaining OTC medication is much cheaper and easier than seeing a doctor and

going through the process of obtaining a prescription drug. As a result, there is a high

potential for inappropriate used and side effects, especially if people are unaware of the

risks.

In US, adults who self-medicate do so primarily because they are familiar with how

to treat their illness due to past experience (90%). In addition, nearly four of five say they

self-medicate because it saves them a trip to the doctor’s office (78%), their illness isn’t

serious enough to warrant a doctor’s visit (78%), non-prescription medication are just as

effective as prescription drugs (63%) and it saves time (77%) (Self-medication and

Allergies Survey-executive Summary. US Adults’ experiences with Self-Medicating).

Due to its cheap cost, OTC drugs are commonly used by the public to treat common

illnesses like the ones mentioned a while ago, and this include proprietary drugs which

are sold over-the-counter include pain relievers, cough remedies, anti-allergics, laxatives,

vitamins, tonics, antacids and many others. (Dangers of Self-medication, 2009).

Common ailments treated with OTC Drugs

According to Self-medication and Allergies Survey-executive Summary. US

Adults’ experiences with Self-Medicating, the common illness that the American

experience and commonly treated with OTC drugs are chest congestion (38%), coughing

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(36%), nasal congestion (35%), sinus headache (31%). Adults are less likely to self-

medicate for seasonal or year-round allergies than they are for illnesses such as coughs

and colds, heartburn and headache.

In India, the most common ailments for which self-medication are resort are

headaches, colds, fevers, digestive problems – diarrhea, constipation or acidity (© 2011

Window2India.com).

Self-medicating not only can be for all the wrong reasons, but it may have started

innocently as a way to alleviate an unwanted condition such as sleeplessness, pain,

anxiety, allergies, etc. Without proper professional guidance (and sometimes even with

it), abuse can ensue creating an even bigger problem for the user. Some people go to

great lengths to self-medicate starting with mild remedies and graduate to stronger and

sometimes even illegal substances (Self Medicating - Drug Rehabilitation - Help for

those who self medicate - Drug rehabs©2010 SelfMedicating.info. All Rights Reserved).

The common ailments that the public commonly treated with OTC drugs are

fever, headache, cough and colds, digestive problems, muscle ache and pains. And

paracetamol, analgesics (NSAID’s) and antimicrobials are the most commonly used class

of drugs. Herbs were also used for self-medication (Journal of Public Health

Medicine.Vol). 18,No. 4,pp. 437-442).

Misused of OTC Drugs

Common over-the-counter drugs that among college students includes laxatives,

pain reliever, cold remedies and antacids. According to the Journal of American College

Health (Vol. 56, No. 5), about 75% of students reported self-administering OTC pain

medication when they experienced pain symptoms including headache, ear and throat

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pain, stomach pain, menstrual pain, and musculoskeletal pain. And the most common

medication used is acetaminophen. In addition, the used of sleeping aids like OTC night

time cold medications were noted since 80% of 278 students had difficulty falling asleep

for 1-4 per month.

In recent years there has been an increasing trend in self-medication with non-

prescription drugs [sometimes referred to as over-the-counter (OTC) medicines] available

in pharmacies and in retail outlets. According Waszaifya et al (2004), more than half of

their respondents take OTC drugs on regular basis, though females has higher frequency

in taking than OTC drugs males. They said that what mostly influences them is the

pharmacist’ recommendation and that majority of them claimed that they read the

package insert of the drug that they usually buy in the pharmacy or market though some

reported of not reading the package insert before using the drugs because they claimed

that they already read this from previous occasion.

On the other hand, some even reported encountering cases of inappropriate OTC

drug use that they had classified as abuse. Some participants reported cases of mixing

OTC products with alcohol. Wills (1997) described the use of soluble aspirin tablets

along with fizzy cola drinks or beer in order to produce a ‘high’, despite the lack of

pharmacological evidence. The use of laxatives to lose weight especially by young

women with eating disorders has been often cited (Waszaifya et al 2004).

On the other hand, in the Philippines setting, there are lots of cases wherein

misused of OTC drugs is very evident most especially antibiotics. According to Dr.

Emmanuel Dy (Inappropriate antibiotic use in the Philippines), Filipinos are fond of

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taking medications without proper administration with respect to drug, dose, interval,

duration. Like what mostly observe in the community, some would just take antibiotic

just for one day not knowing that this may lead to the development of resistance to

specific bacteria causing now the decrease effectiveness of the drug to some strains of

bacteria.

Furthermore, there are self-medication can be harmful to people with the wrong

choice of drugs. According to a local survey, many people ask advice on medicines from

their relatives, friends and neighbours. The latter judge effectiveness of drugs from their

own experience then uses it as a basis for giving advice. The problem with that practice

is, while there is commonality in symptoms of diseases, the extent and nature of a disease

may not be the same. Thus, rather than helping solve the problem, the chosen drug may

contribute to the problem or aggravate the condition. Let us take asthma, for example. It

is characterized by wheezing, cough and difficulty of breathing. For cough, a friend may

recommend an antitussive (anti-cough). When such drug is given, the sick person may

find it more difficult to breathe due to accumulated pleghm. A bronchodilator and an

expectorant could have been used instead. Second is the problem of contra-indications.

What is good for Juan may not be good for Juana because the latter is allergic or

hypersensitive to the medicine of Juan even when they have the same condition. Also, the

cause of the medical condition may be different. In hypertension, for example, a doctor

may give a patient a beta-blocker but to another he will prescribe a diuretic. Because the

nature of hypertension in these two patients is not the same and will require different

drug treatment. Third, the problem of adverse drug interactions. Even OTC medications

are not harmless if used improperly. They are notorious for producing undesirable effects

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like reduced effectiveness, reduced absorption of another drug and also of increasing the

possibility of toxicity from another drug. This problem is common among people who

use many drugs for various ailments. It is not safe to add a drug to a therapeutic regimen

without the knowledge of the prescriber. This problem is also encountered with herbal

supplements which can be bought from groceries and health shops. They were implicated

in many adverse drug interactions with prescription and non-prescription medications.

Again, their concomitant use with maintenance drugs must be communicated with

prescribers (Robles 2006).

All of these problems carry a cost, not just in terms of pesos but also in terms of

health and well-being of a person. While self-medication is more economical, wrong self-

medication may be even more costly and dangerous. It is a virtue to seek advice from

well-informed health professionals who have access to scientific information before they

give advice to laymen on the use of OTC medications (Robles 2006).

Factors that Affects the Utilization of OTC Drugs

The following are the factors that affect the utilization of OTC Drugs among

Adolescents:

Age. According to Erik Erickson, development mostly depends upon what is

done to us. From here on out, development depends primarily upon what we do. And

while adolescence is a stage at which we are neither a child nor an adult, life is definitely

getting more complex as we attempt to find our own identity, struggle with social

interactions, and grapple with moral issues. Our task is to discover who we are as

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individuals separate from our family of origin and as members of a wider society.

Unfortunately for those around us, in this process many of us go into a period of

withdrawing from responsibilities, which Erikson called a "moratorium." And if we are

unsuccessful in navigating this stage, we will experience role confusion and upheaval. A

significant task for us is to establish a philosophy of life and in this process we tend to

think in terms of ideals, which are conflict free, rather than reality, which is not. The

problem is that we don't have much experience and find it easy to substitute ideals for

experience. However, we can also develop strong devotion to friends and causes. It is no

surprise that our most significant relationships are with peer groups

(http://www.learningplaceonline.com).

Monthly Family Income. This involves certain factors which influence

utilization of OTC Drugs. Underlying the process of utilization of over-the-counter drugs,

it may constitute a crucial situation to Adolescents. Most adolescents submit to self-

utilization/medication as needed. This means that when the family income is increased,

the frequency of consultation to health facilities or duration of medical visit, before an

individual is prompted to utilize OTC drugs, increases. It was also noted that Over-the-

counter drug utilization is determined in a significant manner by the financial status of

the family (Oano, 2004).

Educational Attainment. The higher the educational background of on

individual, the higher the knowledge with regards to a certain thing. Like in the

utilization of OTC drugs, the more the individual expose to higher education, the

higher/advance he/she is in understanding the uses, effects and complications brought

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about by drug used. Several studies also shows that many are ill informed on the use and

side effects of drugs like pain medications. And that more education is still needed

(http://www.ncbi.nlm.nih.gov).

Peers. A recent study suggests that adolescents with a large network of

friendships on such social cause them to be more apt to drink alcohol. Parents don’t deny

the influence their children’s’ peers have on them, but they do wonder just how far their

influence stretches. A recent article also suggests that there are other factors that increase

the risk of alcohol onset among teens such as age, race, team sports and their position in

the social network arena. The study further found that being in close proximity to the

most popular peers was a definite factor in the onset of drinking. The study showed that

the density of the networks magnified the spread of influence among the adolescents and

also amplified the dynamics. The findings also suggest that limiting the size of these

social peer groupings may have a positive influence on delaying the onset of alcohol

usage. If adolescents are easily influence by their peers in drinking alcohol, how much

more in just taking OTC drugs (http://www.addictiontreatmentmagazine.com).

Relatives. Family and peer relationships are important for adolescent drug use

because both are primary groups where attitudes and behaviors are learned. According to

social learning theory, an individual learns to take drugs in small, informal groups (Akers

& Sellers, 2004; Bahr, Maughan, Marcos, & Li, 1998; Petraitis, Flay, & Miller, 1995). It

is in these intimate settings that people are taught, through imitation and reinforcement,

to hold attitudes that are favorable or unfavorable to drug use (Reed & Rountree, 1997).

Within families where alcohol is used, adolescents may observe alcohol use, acquire

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favorable attitudes toward alcohol use, and begin using alcohol themselves (Wills,

Mariani, & Filer, 1996). Similarly, if their friends drink alcohol, adolescents are likely to

receive positive social reinforcement from their friends for drinking (Petraitis, Flay, &

Miller, 1995). Many social learning theorists focus on peers because of the significance

adolescents place on friends as adolescents mature and gain autonomy from their parents.

However, families also appear to be important for learning attitudes and behaviors about

alcohol and other drug (Bahr et al 2005).

Media. The large proportion of OTC advertising does have serious effects in that

there is a possibility these ads can help further a trend for today’s youth to find a pill for

any type of pain that they might have possibly inducing an overmedicated population

which can have serious long-term health effects (http://www.utexas.edu/nursing/).

Theoretical Framework

Imogene King defined perception as an individual’s representation or image of

reality, each one view of what is going on in the world. What we see and perceive is

influenced by what we know, what we look for and what is familiar to us. Perception is a

process in which data is obtained through the senses and from memory are organized,

interpreted and transformed.

King’s Conceptual System or the Open System Model includes goal, structure,

function, resources and decision making. The Conceptual System has health as a goal in

nursing. Structure is represented by the three open systems. Functions are demonstrated

in reciprocal relations of individuals in interactions and transactions. Resources include

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both people (health professionals and their clients) and money, goods, and services for

items needed to carry out specific activities. Decision making occurs when choices are

made resource allocation to support attaining system goals.

King’s presents assumptions that human being are open systems in constant

interactions with the environment.

The Conceptual System is composed of three interacting systems: the personal

systems, the interpersonal systems and the social systems.

Personal systems. Represents an individual/person who values their perceptions,

self, growth and development, body image, time and space.

Interpersonal systems. Represents interaction of the individual to others. It

includes communicating, transaction, role and stress.

Social systems. Represents group interaction with one another. It is always an

important role in goal attainment which includes organization, authority, power status

and decision making.

The used of over-the counter drugs will be dependent on the interaction of the

person/individual. He uses OTC drugs if he recognizes it as beneficial to his health or

may be due to his transaction, interaction and communication within his environment

which includes his family, friends, health care provider and the society.

The Open System Model is being used because human being is categorized as an

open system because its perception, belief and understanding changes upon experience

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and the environment. It is used as the framework of the study because it states that a lot

of factors always affect the person’s perceptions and behaviour. With this, the Open

System Model will be employ to determine if the environment, together with the

experiences and the different factors that will be identified affects the perception of the

adolescents on utilization of over-the-counter drugs.

Conceptual Framework

Figure 1 shows the research paradigm of the study which indicates that socio-

demographic profile of the respondents which are considered as factors that could affect

the perception of adolescents on over-the-counter drugs.

The research paradigm of this study consists of 2 boxes. The first box encloses the

socio-demographic profile of the respondents as to sex, monthly family income,

educational attainment, and sources of information which includes peers, relatives and

media. This profile represents the independent variable. The second box encloses the

perception of the respondents on OTC drugs as to effects, dosage, frequency and

reason/s. This box represents the dependent variable.

The arrow between the first and second box indicates the possible relationship

between the 2 variables: the socio-demographic profile and the perception of the

respondents on OTC drugs. The origin of the arrow represents the independent variable

while the point of the arrow represents the dependent variable.

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Research Hypothesis

This section will try to determine the possible outcome of this study with regards

to the relationship between the independent (socio-demographic profile) and dependent

variables (perceptions on OTC drugs).

In relation to this research study, the following hypothesis will be proposed:

1. There is a relationship between the socio-demographic profile and the

perceptions on OTC drugs among the respondents.

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CHAPTER III

METHODOLOGY

This chapter presents the methods that will be utilized by the researcher. This

includes the research design, locale of the study, samples and sampling procedures,

instrument/tool, data gathering procedure, and statistical treatment of data.

Research Design

The study will employ a descriptive-correlational design.

Descriptive will be used to determine the profile of the respondents as to sex,

monthly family income, educational attainment, and sources of information. It also tries

to determine the common illnesses experience by the respondents and the common drugs

they used to treat these illnesses. It is likewise correlational because it will work into the

relationship of the independent and dependent variables. The independent variable is

considered to be the socio-demographic profile/characteristics of adolescents while the

dependent is the adolescent’s perception on over-the-counter (OTC) drugs.

Locale of the Study

This study will be conducted at Mariano Marcos State University, Batac Campus,

except the College of Health Sciences. Mariano Marcos State University is the largest

tertiary school in the province. It is a state-funded institution of higher learning that

serves the Ilocos region and its surrounding regions. It is covers a vast of land of

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approximately 300 hectares (though the land is separated). It is has different campuses,

mainly located at Batac, Laoag, Paoay, Currimao and Dingras. It has approximately has

18,000 officially enrolled students and about 10,000 students are studying at Batac

campus. The university has 9 colleges and under these colleges several courses are being

offered. At Batac campus, there are 5 colleges that offer different courses. At College of

Health Sciences in offers BS in Pharmacy, BS in Nursing, BS in Physical Therapy;

College of Business and Accountancy the following courses are being offered - BS in

Accountancy, BS in Economics, BS in Business Administration (Management

Accounting, Marketing Management, Human Resources Development Management), BS

in Tourism Management, BS in Cooperative Management, BS in Entrepreneurship, BS in

Hospitality Management. The College of Agriculture, Food and Sustainable

Development - BS in Agriculture, BS in Forestry, BS in Development Communication,

BS in Home Technology, BS in Agricultural Technology, Bachelor of Agricultural

Technology, Diploma of Agricultural Technology, Forest Ranger, Technical

Homemaking, Associate in Home Technology, Associate in Technical Homemaking.

College of Arts and Sciences offers the following - BS in Mathematics, BS in Computer

Science, BS in Biology, BS in Environmental Science, AB in Sociology, AB in English

Studies, BS in Chemistry. College of Engineering- BS in Agricultural Engineering, BS in

Ceramic Engineering, BS in Chemical Engineering, BS in Civil Engineering, BS in

Computer Engineering, BS in Electrical Engineering, BS in Electronics Engineering, BS

in Mechanical Engineering; College of Law that offers only Bachelor of Law. Outside

Batac Campus includes College of Industrial Technology that offers the following

courses- BS in Industrial Education, BS in Industrial Technology (ladderized), BS of

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Automotive Technology; College of Teacher Education - Bachelor in Secondary

Education, Bachelor in Elementary Education, Short-Term Programs; and College

Aquatic Science and Applied Technology- BS in Marine Biology and BS in Fisheries.

Samples and Sampling Procedures

The target population of the study includes adolescents aged 15-18 and are

currently studying at Mariano Marcos State University, Batac Campus.

Data will be gathered through a tool where list of names of students will be taken.

Multi-Stage Sampling will be used wherein the researchers use two sampling

method. First, the Cluster Sampling, wherein the researchers will divide the population of

MMSU, Batac Campus per course to group the samples and then used the Systematic

Sampling Method to select the elements to be included in the sample. In this case, the

researchers list all the different courses at MMSU, Batac Campus and get the samples by

using an interval in between the list of subjects (courses). The interval is determined by

getting the quotient of the total population over the 20% of the total population (k=N/n,

wherein k is the interval, N is the total population and n is the sample that will represent

the total population, it is the 20% of the N).

The Instrument or Tool

The research instrument that will be used in gathering data is a Survey-

Questionnaire. This research questionnaire will be submitted to the research adviser for

improvement and approval and upon this, questionnaires will be revised. It has 3 parts:

Part 1 of the questionnaire deals about the socio-demographic profile of the respondents.

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Part 2 determines the common illnesses experience and the common drugs used by the

respondents. Part 3 will determine the respondents’ perception on OTC drugs as to its

effect, dosage, frequency and the reason of taking these drugs.

Data Gathering Procedures

Before the distribution of the survey-questionnaires, a letter will be presented to

the dean to obtain a permission to conduct the study. After which, a letter will be

forwarded to the dean of different colleges, where the samples are located, to have their

approval to conduct the study to their college. After obtaining an approval from the

different deans of the colleges where the study will be conducted, the researchers will

distribute the survey-questionnaire to the respondents with guided instructions. After

which, the data will be collected, arranged and interpreted according to the appropriate

statistical treatment.

Statistical Treatment

The data that will be gathered on the profile of the respondents will be tabulated

and will be analyzed using a distribution and percentage.

Frequency counts and percentage will be used to present the profile of the

respondents.

The mean will be used to describe the perceptions of the respondents on OTC

drugs.

Pearsons r – to determine the degree and test the relationship between the

respondent’s profile and to the perceptions on OTC drugs.

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Point Biserial correlation will also be used to determine and test the relationship

of the respondents’ socio-demographic data/profile and their perceptions on OTC drugs.

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QUESTIONNAIRE

SOCIODEMOGRAPHIC FACTORS AFFECTING THE PERCEPTION

OF OTC DRUGS OF ADOLESCENTS

General Direction: Please provide the necessary answers to the questions.

I. Personal Profile

Name (Optional) : __________________________________________________

Address : _________________________________________________________

Age : _____ 15 _____ 17

_____ 16 _____ 18

Sex : _____ Male _____ Female

Year Level : _____ 1st _____ 3rd

_____ 2nd _____ 4th

Course : ____________________________

Family Income (Monthly) : __________ below 1000

__________ 1001-3000

__________ 3001-5000

__________ 5001-10000

__________ Others (please specify)

Sources of Information Regarding OTC Drugs: _____ peers

_____ relatives

_____ media

_____ Others (please specify)

II. You are allowed to answer the following questions freely in a relatively

unrestricted manner.

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1. Put a check on the space provided before each of the following common illnesses

which you had experienced.

_____ fever _____ cough _____ others (please specify)

_____ headache _____ constipation

_____ flu _____ wounds

_____ dizziness _____ toothache

_____ diarrhea _____ stomach ache

2. Put a check on the space provided before each of the following over-the-counter

drugs which you usually use in treating common illnesses as indicated below:

Fever Cough

_____ Paracetamol (Biogesic) _____ Guiafenesin

(Robitussin)

_____ Ibuprofen (Alaxan) _____ Carbocisteine

(Solmux)

_____ Aspirin (Tylenol) _____ Lagundi (Ascof)

_____ Others (please specify) _____ Others (please specify)

Flu Headache

_____ Paracetamol (Biogesic) _____ Aspirin (Tylenol)

_____ Ibuprofen (Alaxan) _____ Mefenamic acid

(Dolfenal)

_____ Aspirin (Tylenol) _____ Ibufropen (Advil)

_____ Others (please specify) _____ Others (please specify)

Stomach ache Dizziness

_____ Aspirin (Tylenol) _____ Diphenhydramine (

_____ Ibufropen (Advil) _____ Meclozine (Bonamine)

_____ Mefenamic acid (Dolfenal)

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_____ Others (please specify) _____ Others (please specify)

Diarrhea Constipation

_____ Diphenoxylate/Atropine (Lomotil) _____ Diphenylmethane

(Bisacodyl)

_____ Loperamide (Diatabs) _____ Others (please specify)

_____ Others (please specify)

Wounds Toothache

_____ Amoxicillin _____ Aspirin (Tylenol)

_____ Clindamycin _____ Mefenamic acid

(Dolfenal)

_____ Others (please specify) _____ Ibufropen (Advil)

_____ Others (please specify)

3.a. Direction: Please answer the following questions by putting on check mark to the

response that is true to you.

A. OTC drugs used for Fever

1. Effect of the drug:

___ this drug decreases my temperature

___this drug relieves pain when I have fever

___ this drug will restores my energy quickly

___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

B. OTC Drugs used for headache

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1. Effect of the drug:

___ this drug relieve my headache

___ this drug relieves the pain that I felt and help me resume my

activities immediately

___ this drug relieve dizziness when I have headache

___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

C. OTC Drugs used for Flu

1. Effect of the drug:

___ this drug relieves body pain

___ this drug relieves all of my symptoms

___ this drug lowers down my elevated temperature

___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

D. OTC Drugs used for Dizziness

1. Effect of the drug:

___ this drug relieves my dizziness

___ this drug prevents nausea and vomiting

___ this drug relieves the pain that I felt when I feel dizzy

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___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

E. OTC Drugs used for Diarrhea

1. Effect of the drug:

___ this drug hardened my stool

___ this drug decreases peristaltic movement

___ this drug decrease the frequency of defecating

___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

F. OTC Drugs used for Cough

1. Effect of the drug:

___ this drug loosen my phlegm, thus it will easily come out

___ this drug decreases the frequency of coughing

___ this drug relieve the itchiness that I felt on my throat when I have

cough

___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

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________thrice _________ Others( please specify)

G. OTC Drugs used for Constipation

1. Effect of the drug:

___ this drug softens my stool

___ this drug help me defecate easily

___ this drug helps me attain normal defecation

___ others (please

specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

H. OTC Drugs used for Wound

1. Effect of the drug:

___ this drug prevent infection

___ this drug promote faster wound healing

___ this drug treat the wound

___ others (please

specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

I. OTC Drugs used for Toothache

1. Effect of the drug:

___ this drug relieves toothache

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___ this drug kill the bacteria that causing toothache

___ this drug treats toothache

___ others (please

specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others (Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

J. OTC Drugs used for Stomach ache

1. Effect of the drug:

___ this drug relieves stomach ache

___ this drug treats stomach ache

___ this drug prevent complications

___ others (please specify)___________________________________

2. Dosage: _____250 mg ________750 mg

______500mg _______others(Please Specify)

3. Frequency per day: _______once ________twice

________thrice _________ Others( please specify)

3.b Please put a check to the response that is true for you:

Reasons

Fev

er

Hea

dach

e

Flu

Diz

zine

ss

Dia

rrhe

a

Cou

gh

Con

stip

atio

n

Wou

nd

Too

thac

he

Sto

mac

h ac

he

I take this drug because

my friends told me that

it is effective for them in

curing this illness

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42

I take this drug because

my friends told me so

I take this drug because

my friend/s use it

I take this drug because

my mother and my

family members told me

that this drug is effective

in curing this illness

I take this drug because

my mother and my

family told me so

I take this drug because

my because my mother

and my family use it

I take this drug because I

saw in television that it

was effective in curing

this illness

I take this drug because I

heard from the radio that

it was effective in curing

this illness

I take this drug because I

read it from the

newspaper

I take this drug to save

time and effort in going

to the physician

I take this drug because I

believe that it is cheaper

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43

than the one that is

prescribed by the

physician

I take this drug because

whenever I experience

this illness, this drug

always effective in

curing my condition

I take this drug because

it brings me happiness.

I take this drug because I

don’t want to miss my

class

I take this drug because

it is not serious that it

need medical

consultation

I take this drug because I

have no confidence on

my doctors

Others(Please

Specify):____________

______________

3.c. Please answer the following by putting a check mark to the response that is true for

you. You can check more than one of the responses:

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Reasons

Fev

er

Hea

dach

e

Flu

Diz

zine

ss

Dia

rrhe

a

Cou

gh

Con

stip

atio

n

Wou

nd

Too

thac

he

Sto

mac

h ac

he

if I take more

tablets, it will

increase the

effectiveness of the

drug.

If I take the tablet

one after the other,

it will take effect

immediately

I can take any

medication even

without the

prescription of the

physician

I can take two

drugs at the same

time so that my

illness will easily

be cured

I can stop taking

my medications

when the

symptoms had

already

disappeared

There are no side

effects if I take

more tablet than

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45

what is needed

I should seek

consultation before

taking any

medications

I should follow the

recommended dose

and frequency to

avoid harmful

effects

I should complete

the specified

duration for taking

the medication to

prevent

complication

Others (please

specify)_________

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