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The Misuse of Prescription and Over the Counter Drugs: What is the Problem and What Can We Do?
Program Overview:Anytime you take more of a drug than is recommended on the label, you are abusing that drug. People think if 2 pills don't work for them, they can take 3. But the lables on these medications clearly state all ingredients; there is more going into the body than just the extra milligrams of the drug. And because of the long process drugs take to metabolize, people actually overdose accidentally on both OTC and prescription medications. Unfortunately, the drug may do irreparable damage to the body before any important symptoms develop. Most surviving victims of drug overdose are fortunate and have no long term effects; but some who are not so fortunate suffer from kidney, liver, or heart failure; and even death.
Objectives: • Outline the actions that lead to misuse of OTC and prescription drugs.• Identify the signs and symptoms that can occur following accidental overdoses of either common OTC’s or prescription drugs to include acetaminophen, detroxomethorphan, opioids, and stimulants• Describe how pharmacists can interact with patients to minimize the misuse and abuse of OTC and prescription drugs.
Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before us ing any therapeutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity.
PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education
Speaker: Dr. Lisa Booze is the Clinical Coordinator and a Certified Specialist in Poison Information at the Maryland Poison Center, a division of the University Of Maryland School Of Pharmacy. She is responsible for developing and implementing toxicology continuing education programs for health professionals in Maryland. She is a co-coordinator of the Poison Center Surveillance for Chemical and Bioterrorism and Public Health Program, supported by the Maryland Department of Health and Mental Hygiene. Dr. Booze is a member of the American Association of Poison Control Centers, the American Academy of Clinical Toxicology, and the Expert Consensus Panel that develops Out-of-Hospital Management Guidelines for U.S. poison centers
Speaker Disclosure: Dr. Booze has no actual or potential conflicts of interest in relation to this program
This webcast has been supported by PharmCon
Outline the actions that lead to misuse of OTC and prescription drugs
Identify the signs and symptoms that can occur following accidental overdoses of either common OTCs or prescription drugs including acetaminophen, dextromethorphan, opioids, and stimulants.
Describe how pharmacists can interact with patients to minimize the misuse and abuse of OTC and prescription drugs
The Misuse of Prescription and Over the Counter Drugs: What is the Problem and What Can We Do?
Reproduction in whole or in part without permission is prohibited.
Page 2
Do not follow directions Do not read ingredients…take multiple
products with the same ingredient Take drugs not prescribed for them OTC’s are perceived safe even in large doses Dependence Abuse More socially acceptable
Perceived to be safer
Easier to obtain
Misuse/abuse of Rx and OTC’s is equal to or greater than the abuse of illegal drugs
15% of 12th graders have used Rx drugs nonmedically in past year (Monitoring the Future 2010)
41% of teens believe they are safer than illegal drugs; 61% say they are easier to get (Partnership for a Drug Free America 2008)
2005-2008: rate of prescription drug abuse by military tripled (11%)
Physical dependence
Inappropriate medical treatment
Drug interactions
Unintentional overdoses
Adverse effects
Tolerance
Illicit Drugs Pharmaceuticals
Drug Abuse Warning Network
The Misuse of Prescription and Over the Counter Drugs: What is the Problem and What Can We Do?
Reproduction in whole or in part without permission is prohibited.
Page 11
CNS
• Agitation
• Paranoia
• Hallucinations
• Tremors
• Seizures
CV
• Tachycardia
• Hypertension
• Chest pain, MI
• Hemorrhagic stroke
• CV collapse
Other
• Hyperthermia
• Warm skin, diaphoresis
• Dilated pupils
Benzodiazepines
Physicalcooling
Use Haldolwith caution!
Vasopressors, antiarrhythmics
Hydration
16 year old girl found sleeping outside of her home. She was confused and hallucinating. She admitted to ingesting 20 Coricidin HBP Cough & Cold tablets 3 hours ago.
HR 150, BP 170/100, RR 18, 5 mm reactive pupils with horizontal nystagmus.
50 grams activated charcoal, IV fluids
Discharged 72 hours later
14-16 year olds
DXM, robo, CCC, velvet, rojo, triple C
72.4% increase in ER visits, 2004-2008
Abused dose = >200-400 mg
Rapid tolerance – doses as high as 1200-1500 mg
The Misuse of Prescription and Over the Counter Drugs: What is the Problem and What Can We Do?