A cross-sectional evaluation of behavior and attitude of pharmacists toward dispensing non-OTC drugs without prescription in a city of Southern Rajasthan

Background: Over the counter (OTC), drugs are found to be safe and appropriate for use without supervision of a healthcare professional such as physician and they can be purchased by consumers without prescription. The study gains its importance because of the spreading of misuse of antibiotics and various drugs adverse drug reactions in the society. Aims and Objectives: The main aim of the study is to observe as to how many pharmacists/chemists/drug store sellers follow or violate the drug cosmetic act. Materials and Methods: It is an observational and cross-sectional study conducted among pharmacies of Udaipur city, urban areas of Southern Rajasthan. The study includes a sample size of 200 pharmacies selected through convenient random sampling. A detailed semi-structured questionnaire is administered to the pharmacists. The set of questions include types of drugs, reason for dispensing, knowledge, and attitude of pharmacist toward dispensing non-OTC drugs. All the private pharmacies willing to participate were included in the study. Data are entered in Microsoft Excel and statistically analyzed. Results: The results throw light on the behavior and pattern of dispensing habits of the drug store sellers of the city of Udaipur, Southern Rajasthan. It was observed that many pharmacists are in fact in the habit of dispensing non-OTC drugs in almost all the areas. Conclusions: Results give insights about the groups of drugs, logic, behavior, and knowledge level of pharmacists involved in dispensing practices in the city of Udaipur. There should be structured educational campaigns (or use of media, internet, newspaper, radio, television, advertisements, mobiles, etc.) for both pharmacists and public.

Cross-sectional Research on Japanese Pharmacists' Awareness of Emergency Contraceptives Using Web Survey / 日本プライマリ・ケア連合学会誌

Introduction: In Japan, online medical care for emergency contraceptives (ECP) was approved in 2019, but only trained pharmacists can fill the prescriptions. Pharmacists are required to confirm necessary information and provide medication counseling and psychological support for women. The government mentions the need for future consideration regarding over-the-counter (OTC) drugs. Therefore, this study aimed to clarify the awareness and efforts of pharmacists regarding ECP through a questionnaire survey.Methods: A web-based questionnaire survey was conducted involving 229 randomly selected pharmacists.Results: The self-assessment of pharmacists' ECP-related knowledge was low, especially their lack of knowledge of the mechanism of action (31.9%). It was also suggested that 60.3% of pharmacists were concerned about women's psychological support. No pharmacist requested an ECP prescription through online medical care, but 46.9% wanted to attend a training session in the future and request a prescription. A total of 44.5% of pharmacists were against OTC conversion of ECP.Conclusion: At this point, many pharmacists are worried about ECP-related knowledge and the psychological support of patients. Common patient-handling procedure manuals and explanatory documents are required to appropriately respond to patients'. Additionally, improving the knowledge and preparation of pharmacists for OTC drugs was considered necessary.

A publicidade testemunhal de medicamentos difundida por influenciadores digitais e seu enquadramento no direito luso-brasileiro / The testimonial advertising of medicines disseminated by digital influencers and its framework in Portuguese-Brazilian law

A indústria farmacêutica tem encontrado novas técnicas para promover os medicamentos isentos de prescrição médica junto do público geral. Neste contexto, a publicidade testemunhal permite incrementar a credibilidade da mensagem, ficando o seu enquadramento dependente da categoria do emissor nos ordenamentos jurídicos português e brasileiro. Adotando uma perspectiva de direito comparado, o presente trabalho visou analisar a publicidade testemunhal, com especial enfoque nos depoimentos veiculados por influenciadores digitais que recomendam o consumo de medicamentos. Trata-se de um estudo qualitativo, assente no levantamento bibliográfico e legislativo, bem como na análise detalhada de decisões dos organismos de autorregulação competentes, tanto em Portugal como no Brasil. Concluiu-se que alguns influenciadores digitais podem ser considerados pessoas famosas, e não meros consumidores, o que determina a ilicitude da publicidade difundida, atenta a necessidade de acautelar a objetividade e o uso racional dos medicamentos. No entanto, resultou das decisões analisadas uma abordagem tradicional destas novas técnicas de promoção de medicamentos, centrada ainda nas menções obrigatórias e nos princípios gerais vigentes em matéria de publicidade.

The pharmaceutical industry has found new techniques to promote over-the-counter drugs to the public. In this context, testimonial advertising makes it possible to increase the credibility of the message, its framework being dependent on the category of the sender, in the Portuguese and Brazilian legal systems. Adopting a comparative law perspective, the present work aimed at analysing testimonial advertising, with a special focus on testimonies given by digital influencers who recommend the consumption of drugs. It is a qualitative study, based on a bibliographic and legislative survey, as well as on a detailed analysis of decisions by competent self-regulatory bodies, both in Portugal and Brazil. It is concluded that some digital influencers can be considered famous people and not just consumers, which determines the unlawfulness of widespread advertising, considering the need to safeguard objectivity and the rational use of drugs. However, a traditional approach to these new techniques of drugs promotion, still focused on mandatory mentions and the general principles of advertising, resulted from the decisions analyzed.

Assessment of knowledge, attitude, and practice of self-medication among undergraduate medical students in a tertiary care teaching hospital

Background: Self-medication (SM) is defined as the use of medication by a patient on his own inventiveness or on the suggestion of a pharmacist or a untrained person instead of consulting a medical practitioner (WHO guidelines, 2000). Being future medical practitioners, SM has a special influence in medical students and they inevitably urge SM practice themselves and also for others as they are perusing professional course and will be learning different drugs and their proper use. Aim and Objectives: We had undertaken this study to estimate the prevalence of SM and also to find out the factors that influence SM practices in the second, third, and final year undergraduate medical students. Materials and Methods: The prospective and questionnaire-based study was undertaken among undergraduate medical students in a tertiary care hospital, after getting approval from the Institutional Ethics Committee to obtain information on SM practices. Descriptive statistics were used for analysis of data. Results: In our study, 58% were females and 42% were males. About 81.5% of the students were aware about Over the Counter drugs. About 97% of students had no knowledge on safety of SM, 69.5% did not prefer taking SM, and 92% do not want to prefer SM for non-medical persons. Medical stores were the major (81%) of SM and fever was the major symptoms for which students took SM. Commonly used drug for SM was Paracetamol. Conclusion: Conscientious SM can be promoted in both the medical students and the general public. From the present study, we conclude that SM is quite common in undergraduate medical students that may be because of easy accessibility of drugs and information from text books and classroom teaching.

Self-medication with antibiotics and analgesics among undergraduate medical students in a tertiary care teaching hospital

Background: Self-medication is to obtain and consume the drugs without the advice of a physician about the diagnosis and treatment. Medical students are different from the general population because of their exposure to numerous clinical cases and also the knowledge about diseases, diagnosis and drugs. Aim and Objectives: The objective of the study was to evaluate the self-medication practices among undergraduate medical students in a tertiary care teaching hospital. Materials and Methods: This study was conducted on 150 undergraduate medical students at Rajiv Gandhi Institute of Medical Sciences, Adilabad from September 2021 to November 2021 after obtaining approval from Institutional Ethics Committee. A structured and validated questionnaire was used to collect information regarding self-medication practices. The study was based on their knowledge and attitude about the practice of self-medication. Results: 150 students participated in the study. Out of 150 students, 136 practiced self-medication. Of them 86 were female and 50 were male. The most common reason which lead to the practice of self-medication was their convenience. Fever was the most common indication for self-medication. Paracetamol was the most common analgesic and Azithromycin was the most common antibiotic used for self-medication. Nausea was the most common among adverse drug reactions experienced by the students. Conclusion: This practice of self-medication masks the sign and symptoms of underlying pathology, and thus complicates and delays the diagnosis. It also creates drug resistance. The practice of self-medication assumes a special significance among the medical students as they will be the future medical practitioners and play a crucial role in counseling the patients about the practice and adverse effects associated with self-medication.

A cross-sectional study on knowledge and practice of over-the-counter drugs among 2nd year medical students in a tertiary care teaching hospital

Background: Over the counter drugs (OTC) are the drugs that can be sold by the pharmacist without the prescription of registered medical practitioner. There is an increase in the trend of usage of OTC drugs because of busy lifestyle which can result in adverse drug reactions, drug interaction, abuse, and misuse of drugs. Since medical students are future doctors and play an important role in educating the patients regarding benefits and risks of using OTC drugs, the present study is undertaken to assess the knowledge and practice of OTC drugs among MBBS students. Aim and Objectives: The main objectives of this study was to determine the commonly used OTC drugs and indications for the use of OTC drugs among MBBS students and to assess their knowledge on safety of use of OTC drugs. Materials and Methods: A cross-sectional, observational, and questionnaire-based study was conducted during December 2021 among 2nd year MBBS students, after getting approval from the Institutional Ethics Committee. Students were explained about the purpose of the study and questionnaire was administered to the students. The data collected were analyzed using descriptive statistics. Results: In our study, we observed that 75.3% of students practiced self-medication (SM) using OTC drugs for minor illnesses. The most common drugs used for SM were analgesics, antipyretics and antihistamines. The most common reason for using OTC drugs is due to influence from family and friends/seniors (30.2%). Conclusion: Use of OTC is widely practiced among health care professionals, since they are exposed to knowledge of drugs, from 2nd year MBBS itself. Since students are future doctors and play a very important role in communication of knowledge regarding medical therapy including use of OTC drugs to the patients, they should be educated in a larger way regarding pros and consequences of use of OTC drugs.

Routine medical check-up and self-treatment practices among population living in mountainous area of a tribal district of Odisha

Background: Self-treatment is recognized as one of the global public health issues. Geographical distance, constrained financial resources, and lack of awareness are the main barriers for people in remote areas to access health care. Self-treatment may also have risky consequences such as side effects and antibiotic resistance. It is assumed that the rate of self-treatment is high in the unreachable hilly tribal areas because of the geographical factor. Aim and Objective: The primary objective of the present study is to find out the prevalence and reason of self-medication, and the sources of drug information. The secondary objective is to assess the awareness of routine medical check-up among the tribal population of the hilly areas of the Koraput district of Odisha. Materials and Methods: A retrospective study was conducted after receiving clearance from the Institutional Ethical Committee, SLN MCH, Koraput. The study was conducted from February 2022 in some hilly villages near Koraput, which is a typical mountainous commune with the terrain divided by many mountains. Simple random sampling was done using computer software for selecting participants (sample size: 200). The participants were contacted and our interviewer visited door-to-door for face-to-face interviews. The research team developed a structured questionnaire to use in the face-to-face interviews. The questionnaire included questions about demographic characteristics, access to medical facilities, frequency of routine medical check-ups in the past 12 months, health information sources, and distance to the nearest health facility. A series of questions regarding self-treatment practices were also asked: Whether they had purchased any medication without prescription in the past 3 months, what the symptoms were, and what kind of medicines they bought, and the reasons they bought the medicines on their own. Results: The study found that prevalence of self-medication was 92 (46%, C.I. 95%). The majority of residents had self-medication when they suffered from common cold and cough (16% of participants), fever (8%), diarrhea (6%), body pain or myalgia (8%), and allergy (2%). The most prevalent groups of drugs used were antipyretics such as paracetamol (36%), antibiotics (30%), antihistamines (14%), and analgesics such as diclofenac and nimesulide (26%). The most common reason for choosing a local practitioner or private pharmacist and health worker was the subjects’ proximity to them. Of the self-medicated population in our study, 62% procured medicines from local practitioners, chemists, or health workers residing in their villages or nearby villages. Conclusion: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time and at the lowest cost to them and their community. Self-medication unfortunately does not follow the standard, scientific, and rational criteria. Due to self-medication quality of medicine, scientific, and rational procurement, rational prescription is always questionable.

Knowledge, attitude, and practice of ‘over-the-counter’ medications among medical and non-medical professionals during COVID-19 pandemic

Background: India is one of the emerging markets for over-the-counter (OTC) drugs and offers significant growth potential for the industry. There has been a huge rise in the use of OTC drugs since the beginning of the pandemic for which some major reasons are lack of time, non-availability of prescribers, and hospital exposure during a pandemic. Aim: To assess knowledge, attitude, and practice (KAP) of ‘over-the-counter’ medications among medical and non-medical professionals during the COVID-19 pandemic. Settings and Design: The study was conducted at Bharati Hospital and Research Center, Pune, Maharashtra, India. Materials and Methods: A descriptive observational study was conducted. Statistical Analysis Used: Descriptive (mean, percentage, and standard deviation) and inferential (chi-square test) statistics were used. Statistical analysis was done using the Statistical Package for the Social Sciences(SPSS) software version 10.0. Results: Out of 310 samples majority showed poor knowledge (50.65%), high practice (56.13%), and negative attitude (70%) towards the use of OTC drugs. There is a significant association found between age (p-value 0) and health care status (p-value 0) with the level of knowledge. Age group (p-value 0.046) and employee status (p-value 0.00033) showed a significant association with the practice of OTC drugs. Healthcare status showed a significant association (p-value 0.0007) towards attitude toward the use of OTC drugs. Conclusion: Participants reported overall poor knowledge with a negative attitude and adopted the high practice use of OTC drugs during the COVID-19 pandemic. Increased awareness about self-medication is important to avoid complications associated with the high practice of OTC medications.

A study on use of over-the-counter drugs among 2nd year medical students – A cross-sectional study

Background: Over-the-counter (OTC) drug is a medicine that is available without a prescription, and hence also referred to as “nonprescription drug.” The sale of OTC medicines from pharmacies can help individual’s self-manage symptoms. However, some OTC medicines may be abused, with addiction and harms being increasingly recognized and found to be more common in undergraduate medical students. Aim and Objective: Objective of this study to analyze the use of OTC drugs among 2nd year medical students. Materials and Methods: A prospective, cross-sectional, and questionnaire based study was conducted among 2nd year medical students of Belagavi Institute of Medical Sciences Belagavi. Details and purpose of the study were explained to students and informed consent was taken. Questionnaires consist of 25 questions related to use of OTC drugs, their knowledge and attitude toward OTC drugs. Questionnaires are then collected back from students on the spot after 15 min. All the data pooled and results are analyzed in descriptive statistics. Results: A total of 88 respondents were analyzed, 87.5% participants knew the definition of OTC and 69.5% use medication without prescription. All the students practiced self-medication however only 37.5% students agree with practice. Fever, cold, and headache are the most common condition for using OTC drugs. Analgesic, antipyretics, and antihistamines are the highest among OTC stocked at home. About 61.3% students have knowledge of Adverse Drug Reactions associated with OTC drugs. Conclusion: Use of OTC drugs is common form of health care having potential benefits and health hazards. Awareness should be created among students to restrict the use of self-medication and pharmacists toward sale of drugs without prescription.

Eficácia e segurança do enxaguatório clareador sobre o esmalte dental: estudo clínico controlado randomizado e estudo in vitro / Efficacy and safety of whitening mouthrinse on enamel: randomized clinical trial and in vitro study

Enxaguatórios clareadores tornaram-se muito populares devido ao seu fácil uso e disponibilidade. Contudo, não há evidência dos efeitos e segurança desses produtos sobre o esmalte sadio e desmineralizado. Esta proposta foi dividida em duas partes. A primeira foi um estudo clínico randomizado que avaliou a eficácia e segurança do enxaguatório clareador. Participantes (n=45) foram alocados aleatoriamente em três grupos de tratamento: LWE (Listerine Whitening Extreme­peróxido de hidrogênio a 2,5%); PL (Enxaguatório placebo); e OPF (Opalescence PF­peróxido de carbamida a 10%). O tratamento foi realizado 1x/dia por 14 dias durante 2h para OPF, e 2x/dia por 90 dias durante 30s para LWE e PL. A cor dos dentes foi avaliada com escalas de cor (DUEC) e por espectrofotometria. Foram avaliados sensibilidade dental, condição gengival, potencial de desmineralização do esmalte, e a satisfação do participante. As avaliações foram realizadas em diferentes tempos. Para as escalas de cor, KruskalWallis mostrou diferença significante entre os tratamentos nos tempos avaliados (p<0,05). LWE apresentou maiores valores de DUEC comparado ao PL a partir de 60 dias. PL e OPF exibiram valores constantes, sendo significativamente maiores para OPF. Para o espectrofotômetro, RM-ANOVA mostrou diferença significante para os grupos e interação (p<0,05). LWE apresentou maiores valores de alteração de cor do que PL a partir de T14. OPF exibiu os maiores valores de alteração de cor durante todo o período de estudo. Após 2 anos, houve manutenção da cor dos dentes para todos os grupos. Houve baixa intensidade de sensibilidade para LWE e OPF. Nenhum participante apresentou inflamação gengival. LWE e OPF promoveram uma diminuição significativa na concentração de cálcio, mas após 1 semana, os valores foram intermediários. A concentração de fosforo não apresentou alteração nos tempos avaliados. Todos os participantes ficaram satisfeitos com o tratamento com OPF e 67% dos participantes do grupo LWE apresentaram satisfação. A segunda parte consistiu em um estudo in vitro que comparou o efeito do enxaguatório clareador na desmineralização do esmalte e em lesões incipientes de cárie durante ciclagem de pH. Espécimes de esmalte/dentina bovino (n=120) com a superfície dividida em três áreas [esmalte sadio controle, esmalte tratado (ET); e lesão incipiente de carie tratada (LICT)] foram distribuídos aleatoriamente nos grupos experimentais: LWE; PL; OPF e água deionizada (AD). Os tratamentos (2min para LWE, PL e AD; e 2h para OPF) foram realizados durante uma ciclagem de pH de 28 dias (6´60min desmineralização). Intensidade de reflexão superficial (rSRI), perda mineral e concentração de flúor (espécimes adicionais) foram avaliados. Para ET, foi observado maior valor de rSRI em LWE (89,99%±6,94) e maior diminuição de rSRI foi observada para OPF e AD. Não houve perda mineral nos grupos (p>0,05). Para LICT, rSRI diminuiu significativamente após a ciclagem para todos os grupos sem diferença entre eles (p>0,05). Maior concentração de flúor foi encontrada em OPF. LWE e OPF exibiram efeitos semelhantes na perda mineral com valores intermediários. Houve eficácia clareadora tanto para LWE quanto para OPF e manutenção da cor após 2 anos. Houve efeito protetor do enxaguatório durante a ciclagem. (AU)

Whitening mouthrinses have become very popular because they are easy to use and are accessible. However, there is no evidence of the effects and safety of this product on sound and demineralized enamel. The proposal comprised in two parts. The first one was a randomized clinical trial that evaluated the efficacy and safety of the whitening mouthrinse. Participants (n=45) were randomly allocated to three treatment groups: LWE (Listerine Whitening Extreme­2.5% hydrogen peroxide); PL (placebo mouthrinse); and OPF (Opalescence PF­10% carbamide peroxide). The treatment was performed 1x/day for 14 days during 2h for OPF, and 2x/day for 90 days during 30s for LWE and PL. Tooth color was measured using shade guides (DUEC) and spectrophotometer. Tooth sensitivity, gingival condition, enamel demineralization potential, and participant satisfaction were analyzed. The analyses were performed in different times. For shade guides, Kruskal-Wallis showed a significant difference between treatments in the evaluated times (p<0.05). LWE showed higher DUEC values compared to PL after 60 days. PL and OPF exhibit constant values, being significantly higher for OPF. For spectrophotometer, RM-ANOVA showed significance for the groups and interaction (p<0.05). LWE showed higher color difference values than PL from T14. OPF exhibited the highest values throughout the study. After 2 years, there was maintenance of tooth color for all groups. There was lower intensity of sensitivity for LWE and OPF. No participant exhibited gingival inflammation. LWE and OPF promote a significant decrease in calcium concentration, but after 1 week the values were intermediate. Phosphorus concentration did not alter over time. All participants of OPF group were satisfied with the treatment and 67% of the participants of LWE group showed satisfaction. The second part of the study consisted of an in vitro study that compared the effect of whitening mouthrinse on enamel demineralization and on initial caries lesions. Bovine enamel/dentin specimens (n=120) had their surface divided into three areas [control sound enamel, enamel treated (ET); and initial caries lesion treated (ICLT)] and were randomly assigned to the experimental groups: LWE; PL; OPF; and deionized water (DW). The treatments (2min for LWE, PL and DW; and 2h for OPF) were performed during a 28-day pH cycle (6x60min demineralization). Surface reflection intensity (rSRI), mineral loss, and fluoride concentration (additional specimens) were performed. For ET, a higher value of rSRI was observed in LWE (89.99%±6.94) and a greater decrease in rSRI was observed for OPF and DW. There was no mineral loss in the groups (p>0.05). For ICLT, rSRI was significantly significant after cycling for all groups with no difference between them (p>0.05). Higher fluoride concentration was found in OPF. LWE and OPF exhibited similar effects on the mineral loss with intermediate values. There was whitening efficacy for both LWE and OPF and color maintenance after 2 years. There was a protective effect of the mouthrinse during cycling (AU)

Statistical analysis of shape of auricular concha for mass customization of OTC hearing aids / Análisis estadístico de la forma de la concha auricular para la personalización masiva de audífonos de venta libre

SUMMARY: A detailed data of shape of auricular concha is currently not available. Therefore, this study constructed a framework to statistically analyze the shape of the auricular concha based on a database of 3D scanned images. The 3D models of the auricular concha from 308 study participants are converted into compatible NURBS surfaces generated through 795 data points to perform a requisite statistical analysis. Subsequently, the shape of the auricular concha of the participants is grouped into 29 clusters with a modified hierarchical clustering algorithm. Finally, a wear trial and simulation test are carried out to validate the wear comfort of a designed OTC hearing aids based on the average shape of each cluster. The experimental results show that the average shape obtained as per the cluster is capable of representing the common geometric properties of their corresponding members, and could thus be used as a reference in designing mass-customized OTC hearing aid. The method in this study is superior to conventional methods that rely on sparse results for shape analysis because it takes into account the intricate geometric shape of the auricular concha. The quantitative description of conchal morphometry will be beneficial for plastic surgeons, and for the ergonomic design of ear-related products.

RESUMEN: Actualmente no se dispone de datos específicos de la forma de la concha auricular. Por lo tanto, este estudio construyó un marco para analizar estadísticamente la forma de ella a partir de una base de datos de imágenes escaneadas en 3D. Los modelos 3D de la concha auricular de 308 participantes del estudio se convirtieron en superficies NURBS compatibles generadas a través de 795 puntos de datos para realizar un análisis estadístico requerido. Posteriormente, la forma de la concha auricular de los participantes se agrupó en 29 grupos con un algoritmo de agrupamiento jerárquico modificado. Finalmente, se llevó a cabo una prueba de uso y una prueba de simulación para validar la comodidad de uso de unos audífonos OTC diseñados en función de la forma promedio de cada grupo. Los resultados experimentales mostraron que la forma promedio obtenida de la concha auricular, según el grupo, es capaz de representar las propiedades geométricas comunes de sus miembros correspondientes y, por lo tanto, podría usarse como referencia en el diseño de audífonos OTC personalizados en masa. El método de este estudio es superior a los métodos convencionales que se basan en resultados escasos para el análisis de forma, porque tiene en consideración la intrincada forma geométrica de la concha auricular. La descripción cuantitativa de la morfometría de la concha auricular será beneficiosa para los cirujanos plásticos y para el diseño ergonómico de productos relacionados con el oído.

Considerations on Relevant Technical Requirements for Listing Application of Over-the-counter Traditional Chinese Medicine / 中国实验方剂学杂志

In this paper， a comparative analysis is carried out on the policy of listed drugs in Australia， the policy of over-the-counter drugs in Japan， the policy related to the conversion of Chinese patent medicines to over-the-counter drugs， and the policy related to health food. The focus is on one of the possible situations for the registration of over-the-counter traditional Chinese medicines （TCMs）， namely new prescription-composed over-the-counter TCMs. This paper discussed separately from the three parts of the scope of Chinese medicinal materials in the prescription medicines， the scope of indications， and the technical requirements， in order to provide references for the technical requirements related to the registration of over-the-counter TCMs. Recommendations on the marketing and registration of new prescription-composed over-the-counter TCMs：①It is recommended to formulate a list of medicinal materials for the use of Chinese herbal medicines， and consider including raw materials of health food. On this basis， a batch of safe Chinese medicinal materials/decoction pieces was added. And consider dynamic supervision， such as allowing the addition or recall of Chinese medicinal materials/decoction pieces in the list of medicinal materials. ②The scope of indications is recommended to consider the scope of indications for the conversion of Chinese patent medicines to over-the-counter TCMs in China， and the selection of medium-risk indications can reflect the characteristics and advantages of TCM treatment. ③Efficacy evaluation needs to provide high-quality scientific evidence， including clinical research data， and consider relaxing the requirements for non-clinical pharmacodynamic trials.

A Study of the Association between Activities Concerning Medicines and the Recognition of Self-medication by Participants of an OTC Promotion Education Event / 社会薬学

This study aims to examine the recognition and practice of self-medication, stockpiling of medicine, attitudes when choosing over-the-counter (OTC) medicines, and provision of information services about medicine by pharmacists and registered OTC-medicine sellers. In this study, a questionnaire survey was conducted at an OTC promotion education event. As a result, it was the stockpiling of leftover prescription drugs and the practice of self-medication that were associated with the recognition of self-medication. Also relevant to the practice of self-medication were age, awareness of self-medication, stockpiling of leftover prescription medications, and viewing of OTC drug package inserts. This suggests that it is necessary to consider the enlightenment method and contents according to the age stage of the target for self-medication, and whether or not to read the package insert of OTC drugs should be practiced for self-medication. It was considered that it could be used as a concrete action index to show. Based on the results of the stockpile of prescription drugs left over, it is necessary to further investigate the understanding of prescription drugs by non-professionals and how to deepen their understanding. In order to disseminate and enlighten self-medication, it is necessary not only to enlighten OTC drugs but also to promote a correct understanding of prescription drugs at the same time.

Analysis of Decision-making Data for Payment of Adverse Drug Reaction Relief System to Over-the-counter Drugs to Promote Their Proper Use / 社会薬学

Adverse Drug Reaction Relief System is intended for people who suffer adverse health effects from drugs despite their proper use, including over-the-counter (OTC) drugs. The decision-making data for the payment of relief benefits associated with OTC drugs and the instructions-for-use provided by community pharmacists and registered retailers were investigated. The results showed that the relief benefit nonpayment rate for OTC drugs was 3.9% and the number of cases was 9, of which 5 were due to improper use. Among the OTC drugs covered by relief benefits, the most common were schedule II pharmaceuticals, which were sometimes used in combination with prescription drugs. These results suggest that pharmacists and registered retailers should check for the use of concomitant drugs (e.g., with drug notebooks) at the time of the OTC drug sale. Pharmacists and registered retailers should provide a detailed explanation of the drugs to consumers and confirm that the information is understood, especially when schedule II pharmaceuticals or psychotropic drugs are sold. Additionally, information on the initial symptoms of an adverse drug reaction and treatment should be provided to prevent serious reactions. Follow-up with consumers during OTC drug use may also reduce the risk of misuse.

Over-the-counter tooth whitening agents: a review of literature

Abstract There is an increased accessibility of over-the-counter (OTC) whitening agents with very little data in the literature regarding their effectiveness. This review was done to determine their effectiveness of the predominant OTC whitening agents from 2006 until 2018 where a comparison of each agent was made with a placebo, no treatment or with other OTC whitening agents. The major categories of OTC whitening agents such as dentifrices, whitening strips and paint on gels. Dentist prescribed bleaching applied at home and in-office bleaching studies and studies that demonstrated whitening products to participants were excluded. Articles were searched for in the databases of Medline (Ovid), PubMed, the Cochrane Library and Cochrane Central Register of Controlled Trials. Twenty-four articles were included in the systematic review and the quality of studies was determined by the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) ranking criteria. Compared to other OTC, strips are reported to be effective. Two studies determined whitening strips to be effective. Whitening strips have been shown to be effective when compared with placebos and other OTC whitening agents. Dentifrices are effective in changing the shade of the tooth "by removing extrinsic stains" when compared to a placebo and non-whitening dentifrices, but they are not as effective in comparison to whitening strips. There is a lack of evidence with regards to the effectiveness of paint-on gels. While there is some evidence that OTC can alter shade in the short term, there is a need for better-designed studies.

Resumo Há um aumento da acessibilidade dos agentes clareadores de venda livre com poucos dados na literatura sobre sua eficácia. Esta revisão foi feita para determinar a eficácia dos agentes clareadores de venda livre predominantes de 2006 a 2018, onde foi feita uma comparação de cada agente com um placebo, sem tratamento ou com outros agentes clareadores de venda livre. As principais categorias de agentes clareadores de venda livre, como dentifrícios, tiras branqueadoras e géis. Estudos em que o dentista prescreveu clareamento caseiro e em consultório, e estudos que demonstraram os agentes clareadores para os participantes. Os artigos foram pesquisados ​​nas bases de dados do Medline (Ovid), PubMed, Cochrane Library e Cochrane Central Register of Controlled Trials. Vinte e quatro artigos foram incluídos na revisão sistemática e a qualidade dos estudos foi determinada pelo critério de classificação GRADE (Classificação de Recomendações, Avaliação, Desenvolvimento e Avaliações). Em comparação com outros clareadores de venda livre, as tiras são relatadas como eficazes. Dois estudos determinaram que as tiras de clareamento são eficazes. As tiras de clareamento mostraram-se eficazes quando comparadas com placebos e outros agentes clareadores de venda livre. Os dentifrícios são eficazes na mudança da tonalidade do dente "removendo manchas extrínsecas" quando comparados a dentifrícios com placebo e sem clareamento, mas não são tão eficazes em comparação com as tiras de clareamento. Há uma falta de evidência com relação à eficácia dos géis de tinta. Embora exista alguma evidência de que os clareadores de venda livre possa alterar a tonalidade no curto prazo, há necessidade de estudos melhor projetados.

O que é bom para tosse? Uma perspectiva médico-sociológica sobre os remédios para tratar tosse e resfriado em pediatria / What is good for cough? A medical-sociological perspective on medicines to treat coughs and colds in pediatrics

As medicações para tosse e resfriados são amplamente conhecidos e utilizados pela população brasileira. O objetivo dessa dissertação é entender por que essas medicações são tão populares apesar das preocupações médicas a respeito do seu uso em crianças. A metodologia utilizada foi a busca de evidências científicas sobre o padrão de segurança e eficácia dessas substâncias, além do fichamento e análise de uma reunião ocorrida em 2008 pelo Food and Drugs Admnistration. Também foram utilizados autores da filosofia e sociologia para analisar os resultados encontrados como Van der Geest, Fernando Lefèvre, Philipe Pignarre e Georges Canguilhem. Os resultados obtidos indicam que essas substâncias são utilizadas pelo seu potencial sedativo em diversos casos; o estudo não encontrou evidências médicas que sustentem o uso das medicações no ponto de vista biomédico baseado em eficácia e padrão de segurança. No entanto, a análise sociológica permitiu a elaboração de que esses medicamentos assumem o papel de cuidado médico, atribuindo valores simbólicos para os processos que envolvem os quadros de resfriado e gripe. A conclusão do estudo permite afirmar que um olhar exclusivamente bioquímico sobre a substância é insuficiente se quisermos compreender o lugar social desses medicamentos, suas formas de uso e os sentidos a eles atribuídos. Os xaropes, como essa pesquisa optou por nomear genericamente essas medicações apesar do seu efeito bioquímico questionável, são capazes de exercer grande impacto nas atribuições simbólicas de doença e cura. (AU)

The medications for cough and cold are widely known and used by brazilian population. The purpose of this dissertation is to understand why these medications are so popular despite medical concerns about their use in children. The methodology used was the search for scientific evidence on safety and efficacy of these substances, in addition to the record and analysis of a meeting that took place in 2008 by the Food and Drugs Admnistration. Philosophy and sociology authors were also used to analyze the results found, such as Van der Geest, Fernando Lefèvre, Philipe Pignarre and Georges Canguilhem. The results obtained were that these substances are used due their sedative potential in several cases; the study found no medical evidence to support the use of medications in the biomedical point of view based on efficacy and safety concerns. However, the sociological analysis allowed the elaboration that these drugs assume the role of medical care, attributing symbolic values to cold and flu processes. The conclusion of the study allows us to affirm that the exclusive biochemical view of the substance is insufficient to understand the social place of these medications, their kinds of use and their meanings. Syrups, as this research chose to name these medications generically, even though they have a questionable biochemical effect, are capable of having a great impact on the symbolic attributions of disease and cure. (AU)

Self-administration of MTP Pills and its Complications: An Observational Study

Background: Medical termination of pregnancy (MTP) has been legalized in India since 1971. MTP pills are well effective inthe early weeks of gestation and safe only when used under medical supervision.Aims and Objectives: The aim of the study was to find out the clinical presentations and complications following selfadministration of MTP pills.Materials and Methods: This was a retrospective observational study conducted at SMGS Hospital, Government MedicalCollege Jammu from July 2018 to June 2019. Hundred patients were included in the study. Following factors were studied suchas chief complaints, complications, treatment given, and blood transfusion.Results: Majority (57%) of patients were aged between 30 and 39 years. About 66% were gravid three or more. Only 28% hadtaken the pill within prescribed gestational age limit for MTP, i.e., <7 weeks. Mid-trimester pill intake was encountered in 14%patients. About 41% presented with incomplete abortion. Anemia was present in majority of patients and blood transfusion wasdone in 38% patients. About 24% patients presented with life-threatening shock. Sepsis was present in 5% patients. Emergencylaparotomy was required in 4% cases. Hysterotomy was done in 2% cases. Continuation of pregnancy was noted in 6% patients.Unintended pregnancy and limiting family size were main reasons for abortion 62% and 32%, respectively.Conclusions: Unauthorized over-the-counter availability despite legal ban and ignorance of women have led to increasednumber of unsafe abortions. Increasing awareness among women regarding complications of unsupervised pill intake andeasily availability of safe contraceptive methods can help control this health hazard.

Study on usage of over the counter medication among college students in Telangana: a cross sectional study

Background: The use of over the counter medications (OTC) has been reported to be on rise internationally. The OTC drug market in India currently ranks 11th in the global OTC market. Since Indian patients have a huge tendency of self-treatment, the Indian market is characterized by a huge demand for OTC drugs. Hence the current study is undertaken to know the practices of over the counter medication among college students.Methods: Institutional based cross sectional study carried out in Pharmacy College and all interested students were included with sample size of 141. Data was collected by interview method by using questionnaire. Results were presented in percentages using SPSS statistical package version 23.Results: Subjects were opting for the over the counter medication. Most common drugs dispensed were cough remedies (52.4%) followed by antibiotics (38.2%). Most (47.5%) common source of medication was parents.Conclusions: Majority of the students were opting for the over the counter medication and it is need of the hour to improve the knowledge regarding its adverse effects and about rationale use of drugs and drug resistance

Evaluate use of over the counter drugs among medical students in a tertiary care teaching hospital

Background: In our country there is easy availability of drugs over the counter leading to their unintentional misuse and abuse. Over the counter availability of drugs does offer the benefit of easy access to medicines and allows individuals to become in charge of their own health. It is important to understand that medical education can impact the OTC drug use amongst medical students. In order to observe the pattern of OTC drug use among the first and second professional MBBS students we planned this study. The aim of the study was to evaluate use of over the counter (OTC) drugs among medical students in a tertiary care teaching hospital.Methods: Our study was a cross sectional study conducted on first and second professional MBBS students. Authors administered a self structured, prevalidated questionnaire to the students. The data obtained was tabulated, analyzed and the results calculated in percentages.Results: The use of OTC drugs is common amongst undergraduate students. All (100%) the students who participated in the study had used OTC drugs at some point in their life. The common conditions prompting use of OTC drugs include head ache, body aches (74%), fever (72%), respiratory conditions such as: cold (60%), cough (28.5%), abdominal symptoms such as: abdominal pain (14%), gastritis (7.5%), diarrhea (6%), vomiting (5%) and allergies (10%). Very few students reported adverse drug reactions with these drugs.Conclusions: From our study we have concluded that OTC drugs are commonly used amongst medical students. So, periodic training and talks on self medication are necessary for them. Student knowledge in this aspect will help them in future counseling of their patients.

Self medication practices of over the counter analgesic drugs among medical students in a tertiary care hospital in Jharkhand, India

Background: Self-medication is a very common practice which is gradually spreading all over the world. Analgesics are the most commonly available over the counter (OTC) drugs. They are used for pain relief in many diseases. Use of these analgesics has become a serious ailment because self- medication practices of analgesic drugs are increasing among general population as well as medical students. Being future medical practitioners, self-medication has a special impact in medical students. Various data are available regarding usage of OTC analgesic drugs but still data in Jharkhand are lacking. So, the present study aims to provide an insight into the practice of OTC analgesics among 3rd and 4th year medical students in RIMS, Ranchi, Jharkhand.Methods: It was a cross-sectional study conducted among medical students in RIMS, Ranchi, Jharkhand in November-December 2018. Data were collected through questionnaire filled by the students and results were expressed as percentage frequency.Results: Questionnaire were filled completely by 253 students out of 287 students. 85.8% of males and 90.41% of females were practicing self-medication. Advice from seniors and books were the major source of information about the drugs. Paracetamol was the most common drug used (54.87%) and headache (27.43%) was the most common indication. Mild nature of illness (30.34%) and quick relief (29.10%) were the most common reason of self-medication. About 83.39% of them were using these drugs according to need.50.98% had not felt any side effects. 51.38% students were of the view that self-medication practices are not always acceptable.Conclusions: Medical students use OTC analgesics for various kinds of pain like headache, muscle pain, menstrual pain etc. They generally use different non-steroidal anti-inflammatory drugs (NSAIDS) among which paracetamol is the most common. But self-medication practices are always associated with some risks. So, the students must be educated properly regarding their rational use and advantages and disadvantages of OTC drugs.