New OTC drugs and devices 2000: a selective review.

OBJECTIVES: To create a heightened awareness of the issues confronting pharmacists in the self-care arena. To educate pharmacists about newly introduced nonprescription products, devices, and diagnostic products. DATA SOURCES: Recently published governmental, clinical, and pharmaceutical industry literature. DATA SYNTHESIS: Several developments during the previous year have important implications for patient self-care. The Food and Drug Administration recommended the withdrawal of phenylpropanolamine from the market and denied proposals to switch lovastatin, pravastatin, and omeprazole to nonprescription status. Widespread use of dietary supplements in the face of insufficient data on their safety and efficacy continued to be a problem in 2000, although there were several encouraging developments. In 2000, new over-the-counter products were introduced for, among other purposes, treating acid-peptic disorders, musculoskeletal injuries, dermatologic disorders, and minor wounds. Numerous nonprescription products, including sophisticated home diagnostic products and accessories, continue to become available on the U.S. market. It is important that the pharmacist become as knowledgeable as possible about these products so he or she can educate patients about their appropriate use. CONCLUSION: Patients will continue to place an increasing emphasis on self-care. To assist them, pharmacists must remain up to date on trends and have a balanced understanding of new products. The new nonprescription medications and diagnostic products discussed in this review article represent valuable additions to the growing array of self-care products.

New OTC drugs and devices 1999: a selective review.

OBJECTIVES: To educate pharmacists about newly introduced nonprescription products/devices/diagnostic products, and to create a heightened awareness of the dilemma of dietary supplements and the problems their use poses for consumers and pharmacists. DATA SOURCES: Recent clinical and pharmaceutical industry literature. DATA SYNTHESIS: It is critical for the pharmacist to be knowledgeable about dietary supplements to be able to appropriately counsel patients on benefits and risks associated with their use. In addition, numerous other nonprescription products, including home diagnostic products and accessories, will continue to become available on the U.S. market. It is important that the pharmacist become as knowledgeable as possible about these and be capable of educating the consuming public about their appropriate use. CONCLUSION: Dietary supplements will continue to flood the self-care market. Pharmacists need a balanced understanding of these products to assist the consumer. The new nonprescription medications cited in this review represent valuable additions to the growing array of self-care products for consumer use.

New OTC drugs and devices 1998: a selective review.

OBJECTIVE: To create a heightened awareness of the marketing strategy of dual labeling, i.e., labeling of two benefits on a nonprescription drug product, and to review a selection of new self-care products that became available in 1998 for consumer use in the United States. DATA SOURCES: Recent clinical and pharmaceutical industry literature. DATA SYNTHESIS: It is critical for the pharmacist to be aware of the use of dual labeling and to be able to appropriately counsel and direct patients on how to read and understand dual labeling. In addition, numerous nonprescription products, including home diagnostic products and accessories, will continue to become available on the U.S. market. It is important that the pharmacist become as knowledgeable as possible about these, and be well positioned to educate patients about their appropriate use. CONCLUSION: The new products cited in this review represent valuable new additions to the self-care product pool.

New OTC drugs and devices 1997: a selective review.

OBJECTIVE: To create a heightened awareness of the proposals for nonprescription product labeling changes being explored by the Food and Drug Administration and the Nonprescription Drug Manufacturers Association, and to review selected new self-care products that are now available in the United States. DATA SOURCES: Recent clinical and pharmaceutical industry literature. DATA SYNTHESIS: The debate continues about what constitutes sufficient labeling information for a nonprescription drug product. However, one fact remains. Numerous nonprescription drug products, including home diagnostic products and accessories, will continue to become available on the U.S. market. It is important that the pharmacist become as knowledgeable as possible about these products, and be capable of educating consumers on their appropriate use. CONCLUSION: New products cited in this review article are valuable new additions to the self-care product pool that provides an increasing array of products for consumer use.

Smoking cessation: Part 2--Pharmacologic approaches.

OBJECTIVE: To present the concept of nicotine-replacement therapy (NRT) and the pharmacologic approaches, nonprescription and prescription, to smoking cessation. DATA SOURCES: Current clinical literature. DATA SYNTHESIS: NRT can be delivered through a number of different nicotine-containing dosage forms (e.g., gum, patch, nasal spray, oral inhaler). The Agency for Health Care Policy and Research (AHCPR) recommends using the nicotine patches for routine clinical practice and the American Psychiatric Association (APA) recommends the use of the patches and gum as initial pharmacotherapies for smoking cessation. There are no comparative studies indicating the superiority of one form or another at relieving nicotine withdrawal symptoms. Of the other pharmacologic agents used for smoking cessation, bupropion hydrochloride demonstrates the most promise. CONCLUSION: The pharmacist can assist the consumer with the selection of an OTC smoking cessation product and serve as an informational resource to consumers and physicians desiring information on prescription drug products for smoking cessation.

Drug therapy for obesity: an update.

As a method of losing weight and maintaining weight loss, calorie-restricted diets are proving ineffective and counterproductive. The best candidates for drug therapy for obesity include patients with comorbidities that can be decreased with weight loss and those at risk for obesity-related comorbidities. The central nervous system properties of the amphetamines have led to chemical alterations of the original molecule in the hope of creating an appetite-suppressant drug without the potential for abuse. Studies demonstrate that serotonergic drugs can induce weight loss in the short term. Patients using nonprescription drugs for weight loss that have not been approved for that purpose should be informed that efficacy is unproved and warned that, in some cases, adverse effects could be serious.

Nonpharmacologic treatment of obesity.

Experts agree that overweight and obesity pose a significant public health problem in the United States. Obesity is considered to be a complex, multifactorial disease involving genetics, physiology, psychology, and environment, and is influenced by cultural messages. Comorbidities linked to obesity include coronary heart disease, stroke, hypertension, diabetes mellitus, gout, dyslipidemias, cholecystitis, and gallstones. Pharmacists can help patients with dietary goals by understanding sound principles of weight management.

Rx-to-OTC switches: from prescription to self-care.

One often hears, "The only thing certain is change." Change, whatever its nature, is fraught with uncertainty. Product switches from prescription to nonprescription status are no exception. These transitions pose immediate challenges to consumers and to the health care professional, who may be poorly prepared to confront them. However, the benefits are tangible and profound. On the whole, the benefits far outweigh the drawbacks; FDA should be recognized for facilitating this process.

Developing and implementing a pharmaceutical care model in an ambulatory care setting for patients with diabetes.

This study evaluated pharmaceutical care as an adjunct to an existing, coordinated-care program at a Regional Diabetes Center. The progress of a control group receiving the standard pharmacist instruction was compared with two treatment groups receiving additional small group or individual supplementary education for a 2-month period. Outcome evaluation included assessment of individual diabetes management through blood glucose monitoring and responses on a pretest and posttest questionnaire. Patients in the treatment groups demonstrated significantly lower average weekly blood glucose levels and a decreased incidence of hyperglycemic episodes compared with the control group. Questionnaire data for both treatment groups demonstrated a significant increase in patient understanding of diabetes medications and medications for associated illnesses, an increase in knowledge about blood glucose monitoring, and a positive difference in perceptions/attitudes toward diabetes and communication with the pharmacist. This approach is consistent with the concept of pharmaceutical care in which the pharmacist helps patients avoid long-term complications and thus improve their quality of life.