Robitussin - OTC Drugs - Assignment Example

Placement Exercise 2: Robitussin (OTC Drugs) During my placement, I had the opportunity to observe pharmacist interactions with several patients, oneof whom will be described in this exercise. The first patient, Mr. P, came to the pharmacy complaining of runny nose and a cough which occurred at most times of the day, and sometimes at night. He was on his way home from work and he was going to take a couple of days off from work in order to recover from his cough and colds. I observed that the pharmacist interviewed and asked him how long he had these symptoms and if he already took any prescription or over-the-counter medications for his symptoms. The patient replied that the symptoms manifested the day before, and that he has not had any medications as yet. He appeared to be a very healthy man in his forties. The pharmacist later revealed to me that the patient was a regular at the pharmacy. The patient’s blood pressure and cholesterol levels were within normal range and he did not suffer any medical conditions. The pharmacist also inquired if the patient was taking any herbal or dietary supplements; if he was on MAO inhibitors and if he had been on MAO in the past 14 days; if he was allergic to any food or medications; if he had any history of heart, kidney, liver, adrenal, or prostate problems; if he had a history of hypertension, diabetes, stroke; or if the cough had been manifest for a longer period of time. After the interview, I observed that the pharmacist advised the patient to take Robitussin which is an over-the-counter cough and cold remedy. The pharmacist also advised him to increase his water intake in order to facilitate his recovery from his colds. The pharmacist also advised him not to drive after or do any hard work after taking the medication because Robitussin can make him drowsy or sleepy. The patient replied that he had his daughter with him and she would drive them home and he planned on going to sleep after getting home. The patient also expressed his worry that his cough and colds may be a sign of a weaker immune system because he usually never gets sick. The pharmacist assured the patient that anyone could get a cold and getting one does not necessarily mean that he has a weaker immune system. Robitussin’s generic name is Acetaminophen/Dextromethorphan/Guaifenesin/Pseudoephedrine. It is used to relieve pain, congestion, cough, throat, and airway irritation caused by colds, flu, or hay fever (Drugs.com, 2010). It works by constricting blood vessels and by reducing the inflammation of the nasal passages by loosening mucus and lung secretions in the chest and thereby making coughs more productive (Drugs.com, 2010). It is not advised for patients with high blood pressure, rapid heartbeat or heart problems; those taking MAO inhibitors within the last 14 days; those who are pregnant; those taking any herbal medications or dietary supplements; those with allergies to medicines, foods, or other substances; those with a history of glaucoma, prostate gland problems, diabetes, adrenal gland problems, seizures, stroke, liver problems; and those with chronic cough and lung problems (Drugs.com, 2010). With this knowledge, I now understood why the pharmacist asked such pertinent questions of the patient. Such details are important to establish before Robitussin can be taken. One of the elements of Robitussin is guaifenesin which acts by reducing the cough frequency in young adults with acute respiratory disease. This guaifenesin was assessed in a paper by Kuhn, et.al., (1982, p. 713) and the study was conducted by administering a guaifenesin cough preparation to a patient through the double-blind mechanism. The cough of the 42 patients was recorded over a 24-hour baseline assessment and a 36 hour treatment period. The study was able to establish a diurnal difference in cough frequency among the subject respondents (Kuhn, et.al., 1982, p. 713). No antitissuve effect of guaifenesin was seen and out of 26 patients with productive cough who were given guaifenesin, 25 reported a decrease in their sputum thickness. Twenty three out of those receiving guaifenesin also reported having reduced quantity in their sputum (Kuhn, et.al., 1982, p. 713). One of the ingredients of robitussin which is dextromethorphan has been assessed in a paper by Bem and Peck (1992, p. 190) and the authors were able to gather sufficient information to support the safety and effectiveness of dextromethorphan as a cough and cold remedy. Various adverse events have been assessed and they were able to eventually point out that adverse drug reactions and infrequent were not severe (Bem & Peck, 1992, p. 190). The most common cases where adverse symptoms were seen involved dose-related cases. In these instances neurological, cardiovascular, gastrointestinal disturbances were also apparent. Adverse effects were also seen in cases involving the simultaneous use of monoamine oxidase inhibiting drugs (MAOIs) and dextromethorphan (Bem & Peck, 1992, p. 190). The safety profile of dextromethorphan has also been affected by episodic abuse of the drug. Abuse has emerged as one of the most significant hazard identified for the use of this drug. In general however, the safety profile of dextromethorphan has so far proved to be reassuring, especially in relation to its use among adults and children (Bem & Peck, 1992, p. 190). There are various misconceptions about cough and colds; one of these misconceptions is that a person who gets a cough or a cold has a weak immune system. This misconception has been rejected by medical experts and they point out that anybody with a healthy immune system can develop cough or colds (Nierenberg, 2008). Having cough or colds just means that one has been exposed to a virus which has entered the body through the nose or the mouth and the immune system was not successful in fighting off such virus (Nierenberg, 2008). There are over 200 viruses which can cause cough or colds and the immune system may not be able to build up enough resistance to all of these viruses; but it does not mean that the immune system is not functioning or not doing its job in fighting off these viruses (Nierenberg, 2008). Mr. P’s misconception were rightly corrected by the pharmacist The two peer-reviewed journals discuss how the elements which make up robitussin have been proven to be effective remedies for cough and colds. It is scientifically-based and well analysed using the orderly and scholarly process of research. The misconception, on the other hand was not scientifically-based. No research was done before it was raised as a possible explanation for the patient’s cold. The clear difference between the journals and the misconception is evidence, research, or proof. Such evidence is important basis for supporting an idea, or in this case, a belief. The patient’s use of robitussin is a practice supported by research, whereas, the patient’s belief of a lowered immune system is not supported by scientific proof. Hence, it remains misconception. During my placement in the pharmacy, I noticed that I felt more confident after each interview. The more interactions I was able to observe and handle, the more confidence I gained in my interviews and interactions. I enjoyed every interaction with the patients and as the interviews progressed, I was able to gain more confidence in speaking freely and straight to the point. Every time I was in the pharmacy, I continually hoped that more patients would come my way in order to give me more experience in dealing with patients. There were various over the counter branded medications. This is fortunate because the patients could choose what medication would best suit them. When patients can choose their own medications, the chances of compliance are increased. Most of the customers knew the staff members and vice versa. They called each other by name. This shows that the pharmacy staff is doing a very good job in taking care of the customers, and they have a very good relationship with their customers. I noticed that they were able to talk to each other about everything like politics, favorite sports teams, and the economy. There is a feeling of being treated with respect in the pharmacy and this makes the customers, even myself, easily approach the pharmacy and the staff about problems or questions. I noticed that if the pharmacy staff knows about the ingredients of an over the counter medicine, they will help the customer choose which medicine is best suited for them. There are many outstanding medications available to customers. And some patients prefer these medications because they can get better quickly. Unfortunately, I noticed that when a patient wanted a very strong medication for his illness, the pharmacist gave him a medication which he claimed will make him better within the next two days. This is not actually accurate because, it usually takes time for the drug to have a therapeutic effect on the patient. Hence, two days is not enough the patient to feel better. Works Cited Bem, J., & Peck, R. (1992) Dextromethorphan. An overview of safety issues, Drug Safety, volume 7, number 3, pp. 190-9. Kuhn, J., Hendley, J., Adams, K., Clark, J., Gwaltney, J., (1982) Antitussive effect of guaifenesin in young adults with natural colds. Objective and subjective assessment, Chest Journal, volume 82, number 6, pp. 713-718 Nierenberg, C. (28 October 2008) 10 Misconceptions About Cold and Flu, ABC news, viewed 13 May 2010 from http://abcnews.go.com/Health/ColdandFluNews/story?id=6120016&page=1 Robitussin Cold/Cough/Flu (2010), Drugs.com, viewed 13 May 2010 from http://www.drugs.com/cdi/robitussin-cold-cough-flu.html Read More