Page 1138 - Basic _ Clinical Pharmacology ( PDFDrive )

1124 SECTION X Special Topics

TABLE 63–2 Ingredients of known efficacy for selected over-the-counter (OTC) classes. (Continued)

Generic Name
OTC Category (Brand Example) Labeled Use Warnings Considerations
Antidiarrheal Adverse effects include:
agents (cont.) fecal discoloration (black,
tarry), tongue discoloration
(darkening), and tinnitus (dose-
related and more likely when
coadministered with aspirin).
Loperamide
Avoid use in: children <12 years
of age; patients with bloody or
black stools.
Adverse effects include: abdom-
inal pain, nausea, constipation,
drowsiness, dizziness, and dry
mouth.
Antifungal Butenafine Relieves itching, For external use only. Avoid • For treatment of athlete’s foot, apply
preparations (Lotrimin Ultra) burning, scaling, contact with eyes, nose, mouth, product to spaces between toes and
(topical) chafing, and or other mucous membranes. change shoes and socks daily.
Clotrimazole discomfort asso- Avoid use: in children <2 years
(Lotrimin Antifungal) ciated with tinea of age (clotrimazole, micon-
Miconazole pedis (athlete’s azole, tolnaftate) or children
(Desenex, Lotrimin AF) foot), tinea cruris <12 years of age (butenafine,
(jock itch), and terbinafine).
Terbinafine tinea corporis
(Lamisil AT) (ringworm). Adverse effects include:
erythema, irritation, itching, and
Tolnaftate (Tinactin) burning.
Antifungal Clotrimazole Treatment of For vaginal use only. Avoid use: • Topical vaginal antifungals should only
preparations (Gyne-Lotrimin) vaginal yeast in children <12 years of age; if be used for treatment of recurrent
(vaginal) (candidiasis) patient has lower abdominal, vulvovaginal candidiasis in healthy,
Miconazole infections and back, or shoulder pain, or fever, nonpregnant women who were previously
(Monistat-1, for the relief of chills, nausea, vomiting, or foul- diagnosed by a clinician.
Monistat-3, external vulvar smelling vaginal discharge; in
Monistat-7, itching and irrita- combination with tampons, • Therapy should be discontinued if symp-
Vagistat-3) tion associated douches, spermicides, or other toms do not improve within 3 days or if
symptoms persist after 7 days of treatment.
Tioconazole with vaginal vaginal products. • Vaginal products (7-day therapy preferred)
(Monistat-1 1-Day, yeast infections. Adverse effects include: vaginal can be used for treatment in pregnant
Vagistat-1) itching, burning, vaginal women.
soreness, and swelling. • Products with similar brand names may
contain different antifungal products; read
labels and instructions for use carefully.
• Condoms and diaphragms may be dam-
aged by the products and fail to prevent
pregnancy or sexually transmitted disease.
Antitussives Dextromethorphan Temporary relief Avoid use: in patients taking a • Dextromethorphan is a nonopioid
(Delsym, Robitussin of cough due to monoamine oxidase inhibitor congener of levorphanol without analgesic
Cough, Vicks 44) minor throat and (MAOI), or for 2 weeks after or addictive properties. Health care providers
bronchial irrita- discontinuation of an MAOI. should be alert for problems of abuse or
tion with the misuse.
common cold or Use with caution in patients • Often used with antihistamines, decon-
inhaled irritants. with a chronic cough that gestants, and expectorants in combination
occurs with smoking, asthma,
and emphysema and in patients products.
with cough with production of • Notify provider if symptoms do not improve
mucus. in 7 days or are accompanied by fever, rash,
or persistent headache.
Adverse effects include:
confusion, excitement, irritability,
nervousness, and serotonin
syndrome (uncommon).

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