Contemporary Role and Regulation of Over-the-Counter Sinonasal Medications

2020 ◽  
pp. 019459982096917
Author(s):  
Edward D. McCoul
Keyword(s):  
Health Care ◽  
First Generation ◽  
Care Delivery ◽  
Drug Market ◽  
Over The Counter ◽  
Intranasal Corticosteroids ◽  
Potential Safety ◽  
Pros And Cons ◽  
Alternative Drugs ◽  
Sinonasal Symptoms

Objective Numerous pharmaceutical options are available over-the-counter (OTC) for the relief of sinonasal symptoms. Patients typically utilize these drugs in an unsupervised manner, without appreciation of their relative efficacy or potential for adverse effects. This review covers the scope and regulation of the OTC drug market, the pros and cons of OTC availability, and specific concerns that surround the most common classes of OTC sinonasal drugs. Suggestions are provided for the improvement of patient care and public health. Data Sources MEDLINE publications and market reports. Review Methods Literature review. Conclusions Some of the most commonly used OTC sinonasal remedies, including decongestants and first-generation antihistamines, are less effective than alternative drugs and pose potential safety concerns. Implications for Practice Clinicians should advocate to their patients for the appropriate use of alternative agents, such as intranasal corticosteroids and newer-generation antihistamines, and discourage the unsupervised use of oral and topical decongestants. Furthermore, health care practitioners should encourage dialogue with their patients about the use of OTC sinonasal remedies, with the goals of optimizing individual health and health care delivery.

HOW SAFE IS ON-LABEL DRUG USE IN PAEDIATRICS? THE CASE OF FIRST GENERATION H1-ANTIHISTAMINES

2015 ◽  
Vol 101 (1) ◽  
pp. e1.58-e1
Author(s):  
Pauline De Bruyne ◽  
Koen Boussery ◽  
Thierry Christiaens ◽  
Els Mehuys ◽  
Myriam Van Winckel
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
First Generation ◽  
Health Issues ◽  
Efficacy And Safety ◽  
Over The Counter ◽  
Off Label ◽  
Single Drug ◽  
Published Evidence ◽  
H1 Antihistamines

BackgroundFor obvious reasons, much attention has recently been paid to off-label prescriptions in paediatrics. However, on-label prescribing can cause health issues too: we discuss the case of first generation H1-antihistamines (FGAs). These have been in use for over 70 years, for a variety of indications such as relief of allergic conditions, cough and insomnia.Materials and methodsThe FGAs were listed using their International Nonproprietary Names (INN). For each formulation, the information of the Summary of Product Characteristics issued in five selected European countries (Belgium, France, Germany, the Netherlands and United Kingdom) was collected. This was plotted against the published evidence on efficacy and safety of each FGA.Results16 different FGAs are currently marketed in single-drug oral preparations in the evaluated countries. When investigating each drug separately, a huge variability in labelled indications, licensing age for paediatric use, and availability characteristics in the different countries is observed. Most of the indications are not supported by evidence from published clinical trials.ConclusionBoth health care professionals and consumers generally assume that all approved H1-antihistamines have been shown to be efficacious and safe, but many in this class – in particular those introduced before 1985 – have not been optimally studied. This might explain the inconsistencies in indications and licensing ages of the evaluated drugs in different countries. Moreover, many of the antihistamines are sold over the counter, which may contribute to overuse. Such overuse can be a serious problem, as sedation is a known side effect of all FGAs.

Parental Presence During Their Child's Dental Treatment

2010 ◽  
Vol 4 (3) ◽  
pp. 52-54 ◽  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Oral Health ◽  
Health Care Delivery ◽  
Dental Treatment ◽  
Care Delivery ◽  
Decision Making Process ◽  
Parental Presence ◽  
Team Members ◽  
Pros And Cons

ABSTRACT Parents can play an important role as team members of the oral health care delivery team of their children. The pros and cons of the presence of parents during dental treatment are discussed. This article also describes various factors to be considered during decision making process to either include or exclude the parent during dental treatment of their child to achieve the ultimate goal of providing safe and quality dental treatment.

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