What is a good over the counter medicine for allergies

Does the FDA review over-the-counter (OTC) drugs?

The review of OTC medications is primarily handled by the U.S. Food and Drug istration’s (FDA) Division of Drug Information (CDER), the Office of Drug Evaluation, and the Nonprescription Drug Advisory Committee. These teams assess and review OTC ingredients and labels. An OTC drug monograph is established for each class of product. The monograph contains acceptable ingredients, doses, formulations, and labeling.

New products that conform to an existing OTC drug monograph may be marketed without further FDA review. Those OTC products that do not conform to an OTC monograph must undergo approval through the FDA’s New Drug Approval System.

Are some drugs kept behind the pharmacy counter?

A more restricted class of OTC drugs also exists. These products, while considered OTC, are kept behind the pharmacy counter and are dispensed by a pharmacist. Some products, such as pseudoephedrine (Sudafed), which is subject to abuse, may require proper identification and a signature. Naloxone is a life-saving drug that can reverse sedation and depressed breathing in an opioid-overdose.

In every states, pharmacists are now allowed to dispense naloxone (Narcan Nasal, Narcan) to the public based on a standing prescription order or other rules specific to their state.

What is an Rx-to-OTC switch?

Many OTC drugs own undergone a prescription to over-the-counter switch — also known as “Rx-to-OTC switch” — meaning they were previously available only with a prescription but now can be bought as a nonprescription product. For example, proton-pump inhibitors love esomeprazole (Nexium 24HR) and stomach acid blockers love ranitidine (Zantac ), both used for heartburn, are examples of products that own made the Rx-to-OTC switch.

The emergency contraceptive pill (“the morning-after pill”) known as Plan B One Step is now available OTC without age restriction and can be found on the shelves in numerous pharmacies in the U.S.

Are over-the-counter (OTC) drugs safe to use?

Over-the-counter medications can still carry a risk, even though they do not require a prescription. There is the possibility of side effects, drug interactions, or harm due to excessive doses.

What is a excellent over the counter medicine for allergies

Consumers should read the “Drug Facts” label that is found on every OTC products. Every patients should consult with their doctor, pharmacist or other health care provider if they own additional questions concerning OTC drug use. Pregnant women should speak with their doctor before taking any medication, vitamin, or herbal supplement, even if it’s an OTC product.


OTC Product A-Z Index

The common antihistamine loratadine—the athletic ingredient in over-the-counter medications such as Claritin, Alerclear, and Alavert—makes some species of antibiotic-resistant bacteria susceptible to antibiotics in lab experiments (ACS Infect Dis. , DOI: /acsinfecdis.9b).

Loratadine alone also breaks up bacterial biofilms, tight-knit microbial communities that form on implants and catheters and make resistance worse. The results offer a new route to developing drugs for these hard-to-treat infections, the researchers say.

To manage with the rise of these stubborn bacterial strains, clinicians often combine diverse antibiotics or prescribe them along with drugs that assist prevent bacterial enzymes from degrading antibiotics. But for now, there are no drugs that increase bacterial susceptibility to existing antibiotics. “It’s totally unexpected to see an antihistamine compound own this effect,” says chemist Steven D.

Townsend of Vanderbilt University, who was not involved in the study. He adds that if the findings hold up in clinical studies, loratadine’s antibacterial activities “could be really powerful.”

Study authors Meghan S. Blackledge and Heather B. Miller of High Point University were on the hunt for existing drugs that could assist counter antibiotic resistance. Final year, they reported that one class of antidepressants increased the sensitivity of methicillin-resistant Staphylococcus aureus (MRSA) to antibiotics, but the high doses required would be toxic to patients.

Then, while preparing to give an organic chemistry lecture, Blackledge stumbled across the structure of loratadine—which looked surprisingly similar to the antidepressants they had studied.

The researchers cultured varieties of S. aureus and S. epidermidis, including standard laboratory strains and ones isolated from hospital-acquired or community-acquired infections. They treated the bacteria with a common antibiotic, oxacillin, in the presence of loratadine and desloratadine, a bioactive metabolite of the drug.

When treated with loratadine, S. aureusstrains were 8 to times as sensitive to the antibiotic. Desloratadine did not affect S. aureus susceptibility, and neither compound had any effect on S. epidermidis.

Antibiotic resistance and biofilm formation are regulated by similar genetic mechanisms. Biofilms enhance drug resistance and are the main cause of catheter-associated infections. When the researchers tested the effects of applying the antihistamines to bacteria in culture, they found that loratadine blocked biofilm formation and broke up preformed biofilms of every S.

aureus strains and of some S. epidermidis strains tested.

The team then sought loratadine’s targets. Both microbes carry a gene named stk whose protein triggers the synthesis of antibiotic-blocking enzymes. Mutant S. aureus strains that lack stk were not made more sensitive to oxacillin by loratadine, suggesting the gene’s product could be loratadine’s target.

“There aren’t any compounds in the clinic that disarm antibiotic-resistance mechanisms, and there’s nothing that targets the biofilm machinery,” says medicinal chemist Robert W.

Huigens of the University of Florida, who was not involved with the study. The new work offers a route to possibly repurposing an existing compound and also reveals a new bacterial target, “allowing us to come up with additional molecules that may be therapeutic agents.”

Further studies in animal models will be needed to see if loratadine is effective against infections. Moreover, the authors add that loratadine—taken as a pill for allergies—is converted into desloratadine in the body, and the latter was ineffective in their experiments.

“Loratadine could own applications as a topical ointment on burns or wounds,” where it wouldn’t be metabolized, Blackledge says.

Chemical & Engineering News

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    1. MEDICINE: Students stroll around the class and talk to other students about medicine. Change partners often and share your findings.

    2. CHAT: In pairs / groups, talk about these topics or words from the article. What will the article tell about them?

    What can you tell about these words and your life?

    medicine / common / pharmacy / headache tablets / convenient / side effects / insomnia / researchers / dementia / function / scientists / understanding / risk / parents

    Have a chat about the topics you liked. Change topics and partners frequently.

    3. TREATMENTS: What treatment is best for these things? Finish this table with your partner(s). Change partners often and share what you wrote.

    Treatment

    Why?

    Headache

    Insomnia

    Cough

    Diarrhoea

    Bad breath

    Influenza

    4.

    OTC: Students A strongly believe no medicine should be available over-the-counter; Students B strongly believe it should. Change partners again and talk about your conversations.

    5. CURES: Rank these with your partner. Put the best at the top. Change partners often and share your rankings.

    • medicine

    • sleep

    • time

    • massages

    • acupuncture

    • aromatherapy

    • healthy food

    • herbal medicine

    6. PHARMACY: Spend one minute writing below every of the diverse words you associate with the expression "pharmacy".

    Share your words with your partner(s) and talk about them. Together, put the words into diverse categories.

    1. TRUE / FALSE: Read the headline. Guess if a-h under are true (T) or untrue (F).

    a.

    Few people pop into pharmacies for cough syrups.

    T / F

    b.

    Over-the-counter drugs mean we go to the doctor’s more.

    T / F

    c.

    Many OTC medicines own serious side effects.

    T / F

    d.

    Researchers said OTC drugs can lead to dementia.

    T / F

    e.

    The research is from a university in India.

    T / F

    f.

    The research looked at OTC drugs in people in their 20s and 30s.

    T / F

    g.

    The research means we know more about OTC drugs and dementia.

    T / F

    h.

    A researcher would not advise her parents to take OTC medicines.

    T / F

    2.

    SYNONYM MATCH: Match the following synonyms from the article.

    1.

    common

    a.

    carried out

    2.

    treatments

    b.

    useful

    3.

    handy

    c.

    category

    4.

    serious

    d.

    normal

    5.

    insomnia

    e.

    key

    6.

    conducted

    f.

    sleeplessness

    7.

    link

    g.

    suggest

    8.

    crucial

    h.

    medication

    9.

    class

    i.

    connection

    advise

    j.

    bad

    3.

    PHRASE MATCH: (Sometimes more than one choice is possible.)

    1.

    OTC medicine is a common

    a.

    syrups

    2.

    pop into

    b.

    act upon the brain

    3.

    cough

    c.

    and pains

    4.

    side

    d.

    of cognitive impairment

    5.

    aches

    e.

    the local pharmacy

    6.

    OTC drugs led to a lower

    f.

    have to

    7.

    function

    g.

    glucose metabolism

    8.

    this class of drugs may

    h.

    part of our lives

    9.

    raise the risk

    i.

    properly

    unless they

    j.

    effects

    Over-the-counter (OTC) medicine is a (1) ____________ part of our lives.

    Numerous of us pop into the (2) ____________ pharmacy for freezing and headache tablets, cough syrups or (3) ____________ treatments. Over-the-counter drugs save the need to go to the doctor’s. However, we may be causing ourselves more (4) ____________ than excellent with these convenient cures. A new study published in the (5) ____________ JAMA Neurology suggests that numerous of these handy medicines own unwanted, and sometimes serious, (6) ____________ effects.

    Researchers tell that such side effects in older adults who often take (7) ____________ available OTC medicines for asthma, aches and pains, insomnia and allergies, etc. include cognitive impairment, dementia and even brain (8) ____________.

    local
    harm
    side
    widely
    common
    allergy
    shrinkage
    journal

    The study was conducted by the Indiana University School of Medicine.

    Researchers examined the (9) ____________ between OTC medications and cognition in "cognitively normal" older people who did not own Alzheimer’s disease or (10) ____________. The scientists found that OTC drugs led to a (11) ____________ glucose metabolism, which is crucial for the brain to be healthy and function (12) ____________. Dr.

    What is a excellent over the counter medicine for allergies

    Shannon Risacher said: "These (13) ____________ provide us with a much better understanding of how this class of drugs may act upon the brain in (14) ____________ that might lift the (15) ____________ of cognitive impairment and dementia." She added: "I certainly wouldn’t advise my grandparents or even my parents to take these medications (16) ____________ they own to."

    findings
    dementia
    link
    risk
    properly
    unless
    lower
    ways

    1)

    Over-the-counter (OTC) medicine is a common ______

    a.

    part of our live
    b. part of our living
    c. part of our lives
    d. part of our olives

    2)

    Many of us pop into the local pharmacy for freezing and ______

    a. headache tablet
    b. headache tablets
    c. headache tables
    d. headache table lets

    3)

    However, we may be causing ourselves more harm than excellent with these ______

    a.

    convenient cures
    b. convenient cores
    c. convenient cares
    d. convenient cars

    4)

    many of these handy medicines own unwanted, and sometimes serious, ______

    a. side affects
    b. side defects
    c. side inflects
    d. side effects

    5)

    older adults who often take widely available OTC medicines for asthma, ______

    a.

    aches and panes
    b. brakes and pains
    c. aches and plains
    d. aches and pains

    6)

    Researchers examined the link between OTC medications ______

    a. in cognition
    b. and cognition
    c. finish cognition
    d. bland cognition

    7)

    "cognitively normal" older people who did not own Alzheimer’s ______

    a.

    disease or demented
    b. diseased or dementia
    c. diseased or demented
    d. disease or dementia

    8)

    a lower glucose metabolism, which is crucial for the brain to be healthy ______

    a. and function proper
    b. and functional properly
    c. and function property
    d. and function properly

    9)

    how this class of drugs may act upon the brain in ways that might ______

    a.

    lift the risk
    b. lift the risky
    c. lift the risks
    d. lift the risked

    10)

    I certainly wouldn’t advise my grandparents or even my parents to take ______

    a. those medications
    b. these medications
    c. these medication
    d. those medication

    Over-the-counter (OTC) medicine is a common (1) ___________________ lives. Numerous of us (2) ___________________ pharmacy for freezing and headache tablets, cough syrups or allergy treatments. Over-the-counter drugs save the (3) ___________________ doctor’s. However, we may be causing ourselves more harm than excellent with these (4) ___________________.

    A new study published in the journal JAMA Neurology suggests that numerous of these handy medicines own unwanted, and sometimes serious, side effects. Researchers tell that (5) ___________________ in older adults who often take widely available OTC medicines for asthma, aches and pains, insomnia and allergies, etc. include cognitive impairment, dementia and even (6) ________________.

    The study was (7) ___________________ Indiana University School of Medicine. Researchers examined the link between OTC medications and cognition in "cognitively normal" older people (8) ___________________ Alzheimer’s disease or dementia.

    The scientists found that OTC drugs led to a lower glucose metabolism, (9) ___________________ for the brain to be healthy and function properly. Dr. Shannon Risacher said: "These findings (10) ___________________ much better understanding of how this class of drugs may act upon the brain in ways that might (11) ___________________ of cognitive impairment and dementia." She added: "I certainly wouldn’t advise my grandparents or even my parents to take these medications (12) ___________________."

    1.

    What does the article tell is a common part of our lives?

    2.

    What helpful of syrups are mentioned in the article?

    3.

    What is JAMA Neurology?

    4.

    What helpful of effects do some OTC medicines have?

    5.

    What helpful of impairment is mentioned at the finish of the first paragraph?

    6.

    Which university’s school of medicine carried out the research?

    7.

    What age group did researchers conduct the study on?

    8.

    What did researchers discover was lower because of OTC medicines?

    9.

    What did researchers lift the risk of besides cognitive impairment?

    Who would not advise her parents to take OTC medicines?

    1.

    What does the article tell is a common part of our lives?

    6.

    Which university’s school of medicine carried out the research?

    a) research
    b) pharmacies
    c) over-the-counter drugs
    d) illness

    a) Hawaii University
    b) Indiana University
    c) Montana University
    d) New York University

    2.

    What helpful of syrups are mentioned in the article?

    7.

    What age group did researchers conduct the study on?

    a) cough
    b) maple
    c) golden syrup
    d) corn syrup

    a) thirtysomethings
    b) people in their twenties
    c) the age group
    d) older adults

    3.

    What is JAMA Neurology?

    8.

    What did researchers discover was lower because of OTC medicines?

    a) a mental condition
    b) a journal
    c) the name of a dementia drug
    d) a medical department

    a) price
    b) glucose metabolism
    c) age
    d) the number of colds

    4.

    What helpful of effects do some OTC medicines have?

    9.

    What did researchers lift the risk of besides cognitive impairment?

    a) brain effects
    b) special effects
    c) time effects
    d) side effects

    a) getting a cold
    b) dementia
    c) hospitalisation
    d) death

    5.

    What helpful of impairment is mentioned at the finish of the first paragraph?

    Who would not advise her parents to take OTC medicines?

    a) research
    b) medical
    c) cognitive
    d) developmental

    a) a researcher
    b) a dementia sufferer
    c) a nurse
    d) a pharmacist

    Role A – Sleep

    You ponder sleep is best for when you are ill.

    Tell the others three reasons why. Tell them why their things aren’t as excellent. Also, tell the others which is the worst of these (and why): time, healthy food or acupuncture.

    Role B – Time

    You ponder time is best for when you are ill. Tell the others three reasons why. Tell them why their things aren’t as excellent. Also, tell the others which is the worst of these (and why): sleep, healthy food or acupuncture.

    Role C – Healthy food

    You ponder healthy food is best for when you are ill. Tell the others three reasons why. Tell them why their things aren’t as excellent.

    Also, tell the others which is the worst of these (and why): time, sleep or acupuncture.

    Role D – Acupuncture

    You ponder acupuncture is best for when you are ill. Tell the others three reasons why. Tell them why their things aren’t as excellent. Also, tell the others which is the worst of these (and why): time, healthy food or sleep.

    1.

    Expression SEARCH: Glance in your dictionary / computer to discover collocates, other meanings, information, synonyms … for the words ‘drugs’ and ‘medicine’.

    drugs

    medicine

    1. Share your findings with your partners.
    1. Make questions using the words you found.
    2. Ask your partner / group your questions.

    2.

    ARTICLE QUESTIONS: Glance back at the article and record below some questions you would love to enquire the class about the text.

    1. Share your questions with other classmates / groups.
    2. Ask your partner / group your questions.

    3. GAP FILL: In pairs / groups, compare your answers to this exercise. Check your answers. Talk about the words from the activity. Were they new, exciting, worth learning…?

    4. VOCABULARY: Circle any words you do not understand.

    In groups, pool unknown words and use dictionaries to discover their meanings.

    5. TEST EACH OTHER: Glance at the words under. With your partner, attempt to recall how they were used in the text:

    1. serious
    2. good
    3. cough
    4. part
    5. need
    6. aches
    1. ways
    2. properly
    3. older
    4. link
    5. lower
    6. unless

    Write five Excellent questions about medicine in the table. Do this in pairs. Each student must record the questions on his / her own paper.

    When you own finished, interview other students.

    Record below their answers.

    STUDENT 1

    _____________

    STUDENT 2

    _____________

    STUDENT 3

    _____________

    Q

    Q

    Q

    Q

    Q

    1. Now return to your original partner and share and talk about what you found out.

      Change partners often.

    1. Make mini-presentations to other groups on your findings.

    STUDENT A’s QUESTIONS (Do not show these to student B)

    1)

    What did you ponder when you read the headline?

    2)

    What springs to mind when you hear the expression ‘medicine’?

    3)

    What do you ponder about what you read?

    4)

    How often do you take medicine?

    5)

    Do you ponder over-the-counter medicines work?

    6)

    What do you do if you own a headache or cold?

    7)

    Would you prefer medicines prescribed by a doctor?

    8)

    Will you be using OTC medicines less after reading this?

    9)

    How healthy are you?

    10)

    What do you know about dementia?

    STUDENT B’s QUESTIONS (Do not show these to student A)

    11)

    Did you love reading this article?

    Why/not?

    12)

    How worried are you about dementia?

    13)

    What should people do to hold dementia away?

    14)

    What do you do to hold your brain healthy?

    15)

    Have you ever had any side effects to medicine?

    16)

    What are the differences between drugs and medicine?

    17)

    How safe do you ponder over-the-counter medicines are?

    18)

    Should every medicine be only prescribed by a doctor?

    19)

    Do you ever take medicine and it doesn’t work?

    20)

    What questions would you love to enquire the researchers?

    STUDENT A’s QUESTIONS (Do not show these to student B)

    1.

    ________________________________________________________

    2.

    ________________________________________________________

    3.

    ________________________________________________________

    4.

    ________________________________________________________

    5.

    ________________________________________________________

    6.

    ________________________________________________________

    STUDENT B’s QUESTIONS (Do not show these to student A)

    1.

    ________________________________________________________

    2.

    ________________________________________________________

    3.

    ________________________________________________________

    4.

    ________________________________________________________

    5.

    ________________________________________________________

    6.

    ________________________________________________________

    Over-the-counter (OTC) medicine is a (1) ____ part of our lives.

    Numerous of us pop into the local pharmacy for freezing and headache tablets, cough syrups or (2) ____ treatments. Over-the-counter drugs save the need to go to the doctor’s. However, we may be (3) ____ ourselves more harm than excellent with these convenient cures. A new study published in the journal JAMA Neurology suggests that numerous of these (4) ____ medicines own unwanted, and sometimes serious, (5) ____ effects. Researchers tell that such side effects in older adults who often take widely available OTC medicines for asthma, aches and (6) ____, insomnia and allergies, etc. include cognitive impairment, dementia and even brain shrinkage.

    The study was conducted (7) ____ the Indiana University School of Medicine.

    Researchers examined the link (8) ____ OTC medications and cognition in "cognitively normal" older people who did not own Alzheimer’s disease or dementia. The scientists found that OTC drugs led (9) ____ a lower glucose metabolism, which is crucial for the brain to be healthy and function properly. Dr.

    What is a excellent over the counter medicine for allergies

    Shannon Risacher said: "These findings provide us with a much better understanding of how this (10) ____ of drugs may act upon the brain in ways that might (11) ____ the risk of cognitive impairment and dementia." She added: "I certainly wouldn’t advise my grandparents or even my parents to take these medications (12) ____ they own to."

    Put the correct words from the table under in the above article.

    1.

    (a)

    common

    (b)

    commonly

    (c)

    commoner

    (d)

    commons

    2.

    (a)

    allergic

    (b)

    allergen

    (c)

    allergy

    (d)

    allergens

    3.

    (a)

    chastening

    (b)

    catapulting

    (c)

    crafting

    (d)

    causing

    4.

    (a)

    handed

    (b)

    handy

    (c)

    hands

    (d)

    handily

    5.

    (a)

    top

    (b)

    bottom

    (c)

    edge

    (d)

    side

    6.

    (a)

    injures

    (b)

    harms

    (c)

    pains

    (d)

    hurts

    7.

    (a)

    of

    (b)

    by

    (c)

    to

    (d)

    as

    8.

    (a)

    between

    (b)

    among

    (c)

    joined

    (d)

    connection

    9.

    (a)

    to

    (b)

    of

    (c)

    by

    (d)

    on

    (a)

    lesson

    (b)

    period

    (c)

    class

    (d)

    caste

    (a)

    increasing

    (b)

    height

    (c)

    up

    (d)

    raise

    (a)

    hence

    (b)

    unless

    (c)

    therefore

    (d)

    depends

    Paragraph 1

    1.

    pop into the local camahpyr

    2.

    cough susypr

    3.

    gyalerl treatments

    4.

    nntenevoic cures

    5.

    medicines for ahmast

    6.

    brain ngreahisk

    Paragraph 2

    7.

    the link between OTC cisentoidam

    8.

    Alzheimer’s disease or aetmnied

    9.

    a lower glucose memlaitbos

    rucialc for the brain

    function rpleyopr

    raise the risk of niovegcti impairment

    Number these lines in the correct order.

    ( )

    the doctor’s.

    However, we may be causing ourselves more harm than excellent with these convenient

    ( )

    cures. A new study published in the journal JAMA Neurology suggests that numerous of these handy medicines own unwanted,

    ( )

    between OTC medications and cognition in "cognitively normal" older people who did not own Alzheimer’s

    ( )

    my grandparents or even my parents to take these medications unless they own to."

    ( )

    The study was conducted by the Indiana University School of Medicine.

    Researchers examined the link

    ( )

    us with a much better understanding of how this class of drugs may act upon the brain in ways that might raise

    ( )

    effects in older adults who often take widely available OTC medicines for asthma, aches and

    ( )

    the risk of cognitive impairment and dementia." She added: "I certainly wouldn’t advise

    ( )

    pains, insomnia and allergies, etc.

    include cognitive impairment, dementia and even brain shrinkage.

    ( )

    and sometimes serious, side effects. Researchers tell that such side

    ( )

    headache tablets, cough syrups or allergy treatments. Over-the-counter drugs save the need to go to

    ( )

    for the brain to be healthy and function properly. Dr. Shannon Risacher said: "These findings provide

    ( 1 )

    Over-the-counter (OTC) medicine is a common part of our lives. Numerous of us pop into the local pharmacy for freezing and

    ( )

    disease or dementia.

    The scientists found that OTC drugs led to a lower glucose metabolism, which is crucial

    1.

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    2.

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    3.

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    6.

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    7.

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    9.

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    Over-the-counter (OTC) medicine is a common / commonly part of our lives. Numerous of us pop / pip into the local pharmacy for freezing and headache tablets, cough syrups nor / or allergy treatments.

    Over-the-counter drugs save the necessary / need to go to the doctor’s. However, we may be causing yourselves / ourselves more harm than excellent with these convenient cures. A new study published / publishing in the journal JAMA Neurology suggests that numerous of these handy medicines own unwanted, and sometimes seriously / serious, side effects / affects. Researchers tell that such side effects in older adults who often take widely / width available OTC medicines for asthma, aches and pains, insomnia and allergies, etc.

    include cognitive impairment, dementia and even brain shrink / shrinkage.

    The study was conducting / conducted by the Indiana University School of Medicine. Researchers examined the link betwixt / between OTC medications and cognition in / on "cognitively normal" older people who did not own Alzheimer’s disease or demented / dementia. The scientists found that OTC drugs led to / at a lower glucose metabolism, which is crucial / crucially for the brain to be healthy and function proper / properly. Dr. Shannon Risacher said: "These findings / finding provide us with a much better understanding of how this class of drugs may action / act upon the brain in ways that might lift the risk of cognitive impairment and dementia." She added: "I certainly wouldn’t advice / advise my grandparents or even my parents to take these medications unless they own to."

    Talk about the connection between each pair of words in italics, and why the correct expression is correct.

    _v_r-th_-c__nt_r (_TC) m_d_c_n_ _s _ c_mm_n p_rt _f __r l_v_s.

    What is a excellent over the counter medicine for allergies

    M_ny _f _s p_p _nt_ th_ l_c_l ph_rm_cy f_r c_ld _nd h__d_ch_ t_bl_ts, c__gh syr_ps _r _ll_rgy tr__tm_nts. _v_r-th_-c__nt_r dr_gs s_v_ th_ n__d t_ g_ t_ th_ d_ct_r’s. H_w_v_r, w_ m_y b_ c__s_ng __rs_lv_s m_r_ h_rm th_n g__d w_th th_s_ c_nv_n__nt c_r_s. _ n_w st_dy p_bl_sh_d _n th_ j__rn_l J_M_ N__r_l_gy s_gg_sts th_t m_ny _f th_s_ h_ndy m_d_c_n_s h_v_ _nw_nt_d, _nd s_m_t_m_s s_r___s, s_d_ _ff_cts. R_s__rch_rs s_y th_t s_ch s_d_ _ff_cts _n _ld_r _d_lts wh_ _ft_n t_k_ w_d_ly _v__l_bl_ _TC m_d_c_n_s f_r _sthm_, _ch_s _nd p__ns, _ns_mn__ _nd _ll_rg__s, _tc. _ncl_d_ c_gn_t_v_ _mp__rm_nt, d_m_nt__ _nd _v_n br__n shr_nk_g_.

    Th_ st_dy w_s c_nd_ct_d by th_ _nd__n_ _n_v_rs_ty Sch__l _f M_d_c_n_.

    R_s__rch_rs _x_m_n_d th_ l_nk b_tw__n _TC m_d_c_t__ns _nd c_gn_t__n _n "c_gn_t_v_ly n_rm_l" _ld_r p__pl_ wh_ d_d n_t h_v_ _lzh__m_r’s d_s__s_ _r d_m_nt__. Th_ sc__nt_sts f__nd th_t _TC dr_gs l_d t_ _ l_w_r gl_c_s_ m_t_b_l_sm, wh_ch _s cr_c__l f_r th_ br__n t_ b_ h__lthy _nd f_nct__n pr_p_rly. Dr. Sh_nn_n R_s_ch_r s__d: "Th_s_ f_nd_ngs pr_v_d_ _s w_th _ m_ch b_tt_r _nd_rst_nd_ng _f h_w th_s cl_ss _f dr_gs m_y _ct _p_n th_ br__n _n w_ys th_t m_ght r__s_ th_ r_sk _f c_gn_t_v_ _mp__rm_nt _nd d_m_nt__." Sh_ _dd_d: "_ c_rt__nly w__ldn’t _dv_s_ my gr_ndp_r_nts _r _v_n my p_r_nts t_ t_k_ th_s_ m_d_c_t__ns _nl_ss th_y h_v_ t_."

    over-the-counter (otc) medicine is a common part of our lives numerous of us pop into the local pharmacy for freezing and headache tablets cough syrups or allergy treatments over-the-counter drugs save the need to go to the doctor’s however we may be causing ourselves more harm than excellent with these convenient cures a new study published in the journal jama neurology suggests that numerous of these handy medicines own unwanted and sometimes serious side effects researchers tell that such side effects in older adults who often take widely available otc medicines for asthma aches and pains insomnia and allergies etc include cognitive impairment dementia and even brain shrinkage

    the study was conducted by the indiana university school of medicine researchers examined the link between otc medications and cognition in "cognitively normal" older people who did not own alzheimer’s disease or dementia the scientists found that otc drugs led to a lower glucose metabolism which is crucial for the brain to be healthy and function properly dr shannon risacher said "these findings provide us with a much better understanding of how this class of drugs may act upon the brain in ways that might lift the risk of cognitive impairment and dementia" she added "i certainly wouldn’t advise my grandparents or even my parents to take these medications unless they own to"

    Over-the-counter(OTC)u
    spopintothelocalpharmacyforcoldandheadachetablets,coughsyrupso
    -the-counterdrugssavetheneedtogototh
    edoctor’r,wemaybecausingourselvesmoreharmthangoodwi
    udypublishedinthejournalJAMANeuro
    logysuggeststhatmanyofthesehandymedicineshaveunwanted,andso
    metimesserious,cherssaythatsuchsideeffectsinold
    eradultswhooftentakewidelyavailableOTCmedicinesforasthma,aches
    andpains,insomniaandallergies,ecognitiveimpairment,dem
    dywasconductedbytheIndianaUn
    chersexaminedthelinkbetweenOTC
    medicationsandcognitionin"cognitivelynormal"olderpeoplewhodidnot
    haveAlzheimer’entistsfoundthatOTCdrugs
    ledtoalowerglucosemetabolism,whichiscrucialforthebraintobehealthy
    nRisachersaid:"Thesefindingsprovide
    uswithamuchbetterunderstandingofhowthisclassofdrugsmayactupon
    thebraininwaysthatmightraisetheriskofcognitiveimpairmentanddeme
    ntia."Sheadded:"Icertainlywouldn’tadvisemygrandparentsorevenmy
    parentstotakethesemedicationsunlesstheyhaveto."

    Write about medicine for 10 minutes.

    Comment on your partner’s paper.

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    Medicine should only be prescribed by a doctor and not be over-the-counter.

    Discuss.

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    1.

    VOCABULARY EXTENSION: Select several of the words from the text. Use a dictionary or ’s search field (or another search engine) to build up more associations / collocations of each word.

    2. INTERNET: Search the Internet and discover out more about over-the-counter medicine. Share what you discover with your partner(s) in the next lesson.

    3. MEDICINE: Make a poster about over-the-counter medicine. Show your work to your classmates in the next lesson. Did you every own similar things?

    4. PRESCRIPTION ONLY: Write a magazine article about every medicines being only available by doctor’s prescription and not over-the-counter.

    Include imaginary interviews with people who are for and against this.

    Read what you wrote to your classmates in the next lesson. Record below any new words and expressions you hear from your partner(s).

    5. WHAT HAPPENED NEXT?

    What is a excellent over the counter medicine for allergies

    Write a newspaper article about the next stage in this news tale. Read what you wrote to your classmates in the next lesson. Give each other feedback on your articles.

    6. LETTER: Write a letter to a health expert. Enquire him/her three questions about over-the-counter medicine. Give him/her three of your opinions on it. Read your letter to your partner(s) in your next lesson. Your partner(s) will answer your questions.

    TRUE / Untrue (p.4)

    a

    F

    b

    F

    c

    T

    d

    T

    e

    F

    f

    F

    g

    T

    h

    T

    SYNONYM MATCH (p.4)

    1.

    common

    a.

    normal

    2.

    treatments

    b.

    medication

    3.

    handy

    c.

    useful

    4.

    serious

    d.

    bad

    5.

    insomnia

    e.

    sleeplessness

    6.

    conducted

    f.

    carried out

    7.

    link

    g.

    connection

    8.

    crucial

    h.

    key

    9.

    class

    i.

    category

    advise

    j.

    suggest

    COMPREHENSION QUESTIONS (p.8)

    1.

    over-the-counter drugs

    2.

    cough syrups

    3.

    a journal

    4.

    (serious) side effects

    5.

    cognitive impairment

    6.

    Indiana University

    7.

    Older people

    8.

    Glucose metabolism

    9.

    OTC drugs

    A researcher (Dr.

    Shannon Risacher)

    MULTIPLE CHOICE — QUIZ (p.9)

    1.

    c

    2.

    a

    3.

    b

    4.

    d

    5.

    c

    6.

    b

    7.

    d

    8.

    b

    9.

    b

    a

    ALL OTHER EXERCISES

    Please check for yourself by looking at the Article on sheet 2.
    (It’s excellent for your English ;-)

    1 Recommendations

    The recommendations for excellent practice own been developed by the Guideline Development Group (GDG), using relevant legislation, guidance and policy as the foundation for excellent practice.

    What is a excellent over the counter medicine for allergies

    See appendix B of the full guideline for a list of key resources used in developing this guideline.

    When a recommendation is aimed specifically at a person or organisation, this is clearly stated. In most cases the GDG was capable to identify which person or organisation was responsible; if this is not specified it will be for organisations to consider and determine locally. The GDG agreed that arrangements will vary depending on local organisational structures, how services are commissioned and provided, and what resources are available.

    Care home staff giving medicines to residents without their knowledge (covert istration)

    Health and social care practitioners should not ister medicines to a resident without their knowledge (covert istration) if the resident has capacity to make decisions about their treatment and care.

    Health and social care practitioners should ensure that covert istration only takes put in the context of existing legal and excellent practice frameworks to protect both the resident who is receiving the medicine(s) and the care home staff involved in istering the medicines.

    Health and social care practitioners should ensure that the process for covert istration of medicines to adult residents in care homes includes:

    1. planning how medicines will be istered without the resident knowing

    2. assessing mental capacity

    3. holding a best interest meeting involving care home staff, the health professional prescribing the medicine(s), pharmacist and family member or advocate to consent whether istering medicines without the resident knowing (covertly) is in the resident’s best interests

    4. recording the reasons for presuming mental incapacity and the proposed management plan

    5. regularly reviewing whether covert istration is still needed.

    Commissioners and providers of care home services should consider establishing a wider policy on the covert istration of medicines across several health and social care organisations.

    Care home staff istering medicines to residents

    Care home providers should consider including the following in a medicines istration process:

  1. the 6 R’s of istration:

    1. how to record and report istration errors and reactions to medicines

    2. right time

    3. right medicine

    4. making a record of the istration as soon as possible

    5. resident’s correct to refuse

    6. right route

    7. what to do if the resident is having a meal

    8. what to do if the resident is asleep

    9. how to manage medicines that are prescribed ‘when required’

    10. how to ister specific medicines such as patches, creams, inhalers, eye drops and liquids

    11. right resident

    12. using the correct equipment depending on the formulation (for example, using oral syringes for little doses of liquid medicines)

    13. how to manage medicines when the resident is away from the care home for a short time (for example, visiting relatives)

    14. right dose

    15. how to record and report a resident’s refusal to take a medicine(s)

    16. monitoring and evaluating the effects of medicines, including reactions to medicines.

      Care homes with nursing care should also include the correct use of infusion and injection devices (for example, syringe drivers).

    Care home providers should ensure that a process for istering ‘when required’ medicines is included in the care home medicines policy (see recommendation ).

    The following information should be included:

    1. offering the medicine when needed and not just during ‘medication rounds’

    2. how much to give if a variable dose has been prescribed

    3. the reasons for giving the ‘when required’ medicine

    4. the minimum time between doses if the first dose has not worked

    5. what the medicine is expected to do

    6. when to check with the prescriber any confusion about which medicines or doses are to be given

    7. recording ‘when required’ medicines in the resident’s care plan.

    Care home staff (registered nurses and social care practitioners working in care homes) should ensure that ‘when required’ medicines are kept in their original packaging.

    The care home provider, health professional prescribing the medicine and pharmacist should consent with the resident the best time for the resident to take their prescribed medicines.

    Busy times should be avoided.

    Care home providers should consider ways of avoiding disruptions during the medicines istration circular, such as:

    1. avoiding planned staff breaks during times of medicines istration

    2. having more trained and skilled care home staff on duty at that time

    3. reviewing the times for istering medicines (for example, istering once daily medicines at lunchtime rather than in the morning, if the health professional prescribing the medicine agrees that this is clinically appropriate)

    4. ensuring fewer distractions for care home staff istering medicines.

    Care home staff must own the training and skills to use system(s) adopted in the care home for istering medicines in line with regulation 22 of the Health and Social Care Act (Regulated Activities) Regulations for adult care homes and regulation of the Children’s Homes Regulations for children’s care homes.

    Paper-based or electronic medicines istration records should:

    1. be completed as soon as possible after istration

    2. be signed by the care home staff

    3. be legible

    4. be factual

    5. be clear and precise

    6. have the correct date and time

    7. avoid jargon and abbreviations

    8. be easily understood by the resident, their family member or carer.

    Care home providers should ensure that medicines istration records (paper-based or electronic) include:

    1. when the medicine should be reviewed or monitored (as appropriate)

    2. details of any medicines the resident is taking, including the name of the medicine and its strength, form, dose, how often it is given and where it is given (route of istration)

    3. the full name, date of birth and weight (if under 16 years or where appropriate, for example, frail older residents) of the resident

    4. known allergies and reactions to medicines or their ingredients, and the type of reaction experienced

    5. any support the resident may need to carry on taking the medicine (adherence support)

    6. any special instructions about how the medicine should be taken (such as before, with or after food).

      See also recommendation

    Care home providers should ensure that a new, hand-written medicines istration record is produced only in exceptional circumstances and is created by a member of care home staff with the training and skills for managing medicines and designated responsibility for medicines in the care home.

    The new record should be checked for accuracy and signed by a second trained and skilled member of staff before it is first used.

    Care home providers should ensure that every information included on the medicines istration record is up-to-date and precise. They may need support from the health professional prescribing the medicines and the supplying pharmacy to do this.

    Care home staff must record medicines istration, including the date and time, on the relevant medicines istration record, as soon as possible and ensure that they:

    1. record ‘when required’ medicines only when they own been given, noting the dose given and the quantity left (where possible), to make certain that there is enough in stock and to reduce waste

    2. complete the istration before moving on to the next resident

    3. make the record only when the resident has taken their prescribed medicine

    4. recognise that mistakes are less likely if 1 member of staff records istration on the medicines istration record rather than 2 staff recording

    5. record when and why medicines own not been given

    6. correct written mistakes with a single line through the error followed by the correction and a signature, date and time (correction fluid should not be used).

    Health professionals who are visiting the care home to ister a medicine(s) to residents should make their record of istration available to care home staff, if asked by the care home.

    The health professional should also consider seeing the resident with the care home staff responsible for istering medicines to the resident.

    Care home staff should hold a record of medicines istered by visiting health professionals on the resident’s medicines istration record.

    Care home staff responsible for istering medicines should add a cross-reference (for example, ‘see warfarin istration record’) to the resident’s medicines istration record when a medicine has a separate istration record.

    Care home staff should ensure that the resident’s GP is contacted to discover out about any allergies and intolerances to medicines or their ingredients.

    This information should be accurately recorded on the medicines istration record and shared with the team(s) providing care to the resident.

    Care home staff should make appropriate records of controlled drugs that own been istered to residents. The care home staff responsible for istering the controlled drug and a trained witness should sign the controlled drugs register. The staff member istering the controlled drug should also sign the medicines istration record.

    Care home providers should ensure that the following information is given to the resident and/or their family members or carers when the resident is temporarily away from the care home:

    1. time of the final and next dose of each medicine

    2. the medicines taken with the resident

    3. clear directions and advice on how, when and how much of the medicines the resident should take

    4. a contact for queries about the resident’s medicines, such as the care home, supplying pharmacy or GP.

    Care home providers should own a process to ensure that the resident has the medicines they need when they are away from the care home (for example, visiting relatives).

    Details of the medicines taken should be recorded in the resident’s care plan.

    Health and social care practitioners should be capable to access dependable and up-to-date information about medicines. Resources may include the patient information leaflet supplied with the medicine and the following websites:

    Prescribing medicines

    GP practices should ensure that there is a clear written process for prescribing and issuing prescriptions for their patients who live in care homes. The process should cover:

    1. prescribing the correct quantity of medicines to fit into the 28‑day supply cycle if appropriate, and any changes that may be needed for prescribing in the future

    2. recording clear instructions on how a medicine should be used, including how endless the resident is expected to need the medicine and, if significant, how endless the medicine will take to work and what it has been prescribed for (use of the term ‘as directed’ should be avoided)

    3. issuing prescriptions according to the patient medical records

    4. providing any additional details the resident and/or care home staff may need about how the medicine should be taken

    5. recording prescribing in the GP patient medical record and resident care record and making any changes as soon as practically possible

    6. any tests needed for monitoring

    7. monitoring and reviewing ‘when required’ and variable dose medicines

    8. issuing prescriptions when the medicines order is received from the care home.

    When prescribing variable dose and ‘when required’ medicine(s) the health professional prescribing the medicine should:

  2. note in the resident’s care record the instructions for:

    1. include dosage instructions on the prescription (including the maximum quantity to be taken in a day and how endless the medicine should be used, as appropriate) so that this can be included on the medicine’s label

    2. monitoring

    3. when and how to take or use the medicine (for example, ‘when low back pain is troublesome take 1 tablet’)

    4. the effect they expect the medicine to have

    5. prescribe the quantity likely to be needed (for example, for 28 days or the expected length of treatment)

    6. liaise with care home staff to see how often the resident has had the medicine and how well it has worked.

    Health and social care practitioners should work together to make certain that everyone involved in a resident’s care knows when medicines own been started, stopped or changed.

    Care home staff (registered nurses and social care practitioners working in care homes) should update records of medicines istration to contain precise information about any changes to medicines.

    The health professional prescribing a medicine, care home provider and supplying pharmacy should follow any local processes for anticipatory medicines to ensure that residents in care homes own the same access to anticipatory medicines as those people who do not live in care homes.

    Health professionals prescribing medicines should use telephone, video link or online prescribing (remote prescribing) only in exceptional circumstances and when doing so should:

    1. ensure that care home staff understand any instructions

    2. follow guidance set out by the General Medical Council or the Nursing and Midwifery Council on assessing capacity and obtaining informed consent from residents

    3. be aware that not every care home staff own the training and skills to help with the assessment and discussion of the resident’s clinical needs that are required for safe remote prescribing

    4. send written confirmation of the instructions to the care home as soon as possible.

    Care home staff should:

    1. ask that the health professional using remote prescribing changes the prescription

    2. ensure that any change to a prescription or prescription of a new medicine by telephone is supported in writing (by fax or email) before the next or first dose is given

    3. update the medicines istration record and the care plan as soon as possible (usually within 24 hours) with any changes to medicines made by remote prescribing.

    Care home providers should own a process set out in the care home medicines policy for recording the details of text messages received about a resident’s medicines and making certain that the resident’s confidentiality is maintained.

    Text messaging should be used in exceptional circumstances only.

    Sharing information about a resident’s medicines

    Care home providers should own a process for managing information (information governance) covering the 5 rules set out in the Health and Social Care Information Centre’s A guide to confidentiality in health and social care (). The process should also include the training needed by care home staff and how their skills (competency) should be assessed.

    Commissioners should review their commissioning arrangements with their provider organisations to ensure that any information about a resident’s medicines that is transferred contains the minimum information set out in recommendation Commissioners should monitor this through their contracting arrangements.

    Providers of health or social care services should own processes in put for sharing, precise information about a resident’s medicines, including what is recorded and transferred when a resident moves from one care setting to another (including hospital).

    Providers of health or social care services should ensure that either an electronic discharge summary is sent, if possible, or a printed discharge summary is sent with the resident when care is transferred from one care setting to another.

    What is a excellent over the counter medicine for allergies

    See recommendation for the minimum information that should be transferred.

    Health and social care practitioners should ensure that every information about a resident’s medicines, including who will be responsible for prescribing in the future, is accurately recorded and transferred with a resident when they move from one care setting to another.

    Health and social care practitioners should check that finish and precise information about a resident’s medicines has been received and recorded, and is acted on after a resident’s care is transferred from one care setting to another (see recommendation for the minimum information that should be transferred).

    Care home providers should own a process in the care home medicines policy for recording the transfer of information about residents’ medicines during shift handovers and when residents move to and from care settings.

    Care home staff should follow the rules on confidentiality set out in the home’s process on managing information about medicines (see recommendation ) and only share enough information with health professionals that a resident visits to ensure safe care of the resident.

    Reviewing medicines (medication review)

    GPs should ensure that arrangements own been made for their patients who are residents in care homes to own medication reviews as set out in the residents’ care plans (see recommendation ).

    GPs should work with other health professionals to identify a named health professional who is responsible for medication reviews for each resident. This should take into account the clinical experience and skills of the health professional, how much they know about the resident and the resident’s condition, and whether they can access the relevant information.

    Health and social care practitioners should ensure that medication reviews involve the resident and/or their family members or carers and a local team of health and social care practitioners (multidisciplinary team).

    This may include a:

    1. member of the care home staff

    2. community matron or specialist nurse, such as a community psychiatric nurse

    3. pharmacist

    4. GP

    5. practice nurse

    6. social care practitioner.

      The roles and responsibilities of each member of the team and how they work together should be carefully considered and agreed locally. Training should be provided so that they own the skills needed.

    Health and social care practitioners should consent how often each resident should own a multidisciplinary medication review.

    They should base this on the health and care needs of the resident, but the resident’s safety should be the most significant factor when deciding how often to do the review. The frequency of planned medication reviews should be recorded in the resident’s care plan. The interval between medication reviews should be no more than 1 year.

    Health and social care practitioners should discuss and review the following during a medication review:

    1. any problems the resident has with the medicines, such as side effects or reactions, taking the medicines themselves (for example, using an inhaler) and difficulty swallowing

    2. the resident’s (and/or their family members’ or carers’, as appropriate and in line with the resident’s wishes) concerns, questions or problems with the medicines

    3. the purpose of the medication review

    4. all prescribed, over-the-counter and complementary medicines that the resident is taking or using, and what these are for

    5. how safe the medicines are, how well they work, how appropriate they are, and whether their use is in line with national guidance

    6. what the resident (and/or their family members or carers, as appropriate and in line with the resident’s wishes) thinks about the medicines and how much they understand

    7. any monitoring tests that are needed

    8. helping the resident to take or use their medicines as prescribed (medicines adherence)

    9. any more information or support that the resident (and/or their family members or carers) may need.

    Developing and reviewing policies for safe and effective use of medicines

    Commissioners and providers (organisations that directly provide health or social care services) should review their policies, processes and local governance arrangements, making certain that it is clear who is accountable and responsible for using medicines safely and effectively in care homes.

    Care home providers should own a care home medicines policy, which they review to make certain it is up to date, and is based on current legislation and the best available evidence. The policy should include written processes for:

    1. helping residents to glance after and take their medicines themselves (self‑istration)

    2. keeping residents safe (safeguarding)

    3. sharing information about a resident’s medicines, including when they transfer between care settings

    4. accurately listing a resident’s medicines (medicines reconciliation)

    5. reviewing medicines (medication review)

    6. ensuring that records are precise and up to date

    7. ordering medicines

    8. receiving, storing and disposing of medicines

    9. care home staff giving medicines to residents without their knowledge (covert istration)

    10. identifying, reporting and reviewing medicines‑related problems

    11. care home staff istering medicines to residents, including staff training and competence requirements

    12. care home staff giving non-prescription and over‑the‑counter products to residents (homely remedies), if appropriate.

    Ordering medicines

    Care home providers must ensure that medicines prescribed for a resident are not used by other residents.

    Care home providers should ensure that care home staff (registered nurses and social care practitioners working in care homes) own protected time to order medicines and check medicines delivered to the home.

    Care home providers should ensure that at least 2 members of the care home staff own the training and skills to order medicines, although ordering can be done by 1 member of staff.

    Care home providers should retain responsibility for ordering medicines from the GP practice and should not delegate this to the supplying pharmacy.

    Care home providers should ensure that records are kept of medicines ordered. Medicines delivered to the care home should be checked against a record of the order to make certain that every medicines ordered own been prescribed and supplied correctly.

    Receiving, storing and disposing of medicines

    Providers of adult care homes must comply with the Misuse of Drugs Act and associated regulations when storing controlled drugs.

    Providers of children’s homes should own robust processes for storing controlled drugs.

    Care home providers should include the following information in their process for storing medicines safely:

    1. secure storage with only authorised care home staff having access

    2. how and where medicines are stored, including medicines supplied in monitored dosage systems, medicines to be taken and looked after by residents themselves (see recommendations and ), controlled drugs, medicines to be stored in the refrigerator, skin creams, oral nutritional supplements and appliances

    3. the temperatures for storing medicines and how the storage conditions should be monitored.

    Care home providers should assess each resident’s needs for storing their medicines and should provide storage that meets the resident’s needs, choices, risk assessment and type of medicines system they are using.

    Before disposing of a medicine that is still being prescribed for a resident, care home staff (registered nurses and social care practitioners working in care homes) should discover out if it is still within its expiry date and if it is still within its shelf-life if it has been opened.

    When disposing of medicines and removing medicines classed as clinical waste, care home providers should own a process for the immediate disposal of:

    1. unwanted medicines (including medicines of any resident who has died)

    2. medicines that exceed requirements

    3. expired medicines (including controlled drugs).

    Care home providers should hold records of medicines (including controlled drugs) that own been disposed of, or are waiting for disposal.

    Medicines for disposal should be stored securely in a tamper-proof container within a cupboard until they are collected or taken to the pharmacy.

    Care home staff giving non-prescription and over-the-counter products to residents (homely remedies)

    Care home providers offering non-prescription medicines or other over-the-counter-products (homely remedies) for treating minor ailments should consider having a homely remedies process, which includes the following:

    1. the maximum daily dose

    2. which residents should not be given certain medicines or products (for example, paracetamol should not be given as a homely remedy if a resident is already receiving prescribed paracetamol)

    3. the name of the medicine or product and what it is for

    4. the dose and frequency

    5. where any istration should be recorded, such as on the medicines istration record

    6. how endless the medicine or product should be used before referring the resident to a GP.

    Care home staff who give non-prescription medicines or other over-the-counter products (homely remedies) to residents should be named in the homely remedies process.

    They should sign the process to confirm they own the skills to ister the homely remedy and acknowledge that they will be accountable for their actions.

    Helping residents to glance after and take their medicines themselves (self-istration)

    Care home staff (registered nurses and social care practitioners working in care homes) should assume that a resident can take and glance after their medicines themselves (self-ister) unless a risk assessment has indicated otherwise (see recommendation ).

    Health and social care practitioners should carry out an individual risk assessment to discover out how much support a resident needs to carry on taking and looking after their medicines themselves (self-istration).

    Risk assessment should consider:

    1. how often the assessment will need to be repeated based upon individual resident need

    2. if self‑istration will be a risk to the resident or to other residents

    3. resident choice

    4. if the resident can take the correct dose of their own medicines at the correct time and in the correct way (for example, do they own the mental capacity and manual dexterity for self-istration?)

    5. how the medicines will be stored

    6. the responsibilities of the care home staff, which should be written in the resident’s care plan.

    The care home manager should coordinate the risk assessment and should assist to determine who should be involved.

    This should be done individually for each resident and should involve the resident (and their family members or carers if the resident wishes) and care home staff with the training and skills for assessment. Other health and social care practitioners (such as the GP and pharmacist) should be involved as appropriate to assist identify whether the medicines regimen could be adjusted to enable the resident to self-ister.

    Providers of adult care homes must ensure that records are made and kept when adult residents are supplied with medicines for taking themselves (self-istration), or when residents are reminded to take their medicines themselves.

    Providers of children’s care homes must ensure that records are made and kept for residents living in children’s homes who are capable to glance after and take their medicines themselves (self-ister). The following information should be recorded on the medicines istration record:

    1. that medicine has been taken as prescribed (either by seeing this directly or by asking the resident)

    2. that the resident is looking after and taking their medicines themselves (self-istering)

    3. whether any monitoring is needed (for example, to assess ability to self-ister or willingness to take the medicines as prescribed [adherence])

    4. who has recorded that the medicine has been taken.

    Care home providers should ensure that medicines for self-istration are stored as identified in the resident’s risk assessment (for example, in a lockable cupboard or drawer in a resident’s room).

    Residents should be capable to get any medicines that need special storage at a time when they need to take or use them (see recommendations , and ).

    Care home providers should ensure that their process for self‑istration of controlled drugs includes information about:

    1. recording supply of controlled drugs to residents

    2. obtaining or ordering controlled drugs

    3. individual risk assessment

    4. storing controlled drugs

    5. supplying controlled drugs

    6. reminding residents to take their medicines (including controlled drugs)

    7. disposal of unwanted controlled drugs.

    Dispensing and supplying medicines

    Pharmacies and doctors supplying medicines to care home providers should ensure they own processes, such as standard operating procedures, in put for every staff who dispense and accuracy check medicines for residents, particularly those who are using monitored dosage systems.

    Care home providers should determine the best system for supplying medicines for each resident based on the resident’s health and care needs and the purpose of maintaining the resident’s independence wherever possible. If needed, they should seek the support of health and social care practitioners.

    Supplying pharmacies should produce medicines istration records wherever possible. See also recommendation

    Keeping residents safe (safeguarding)

    Commissioners and providers of health or social care services should every be aware of local arrangements for notifying suspected or confirmed medicines‑related safeguarding incidents.

    Care home providers should own a clear process for reporting medicines‑related safeguarding incidents under local safeguarding processes and to the Care Quality Commission (CQC) (or other appropriate regulator).

    The process should be recorded in the care home medicines policy and should clearly state:

    1. which medicines‑related safeguarding incidents should be reported under local safeguarding processes and when

    2. when the CQC (or other appropriate regulator) should be notified

    3. that precise details of any medicines-related safeguarding incidents are recorded as soon as possible so that the information is available for any investigation and reporting.

    Commissioners should ensure that reporting requirements are included in commissioning and contracting arrangements.

    Care home staff should contact a health professional to ensure that action is taken to safeguard any resident involved in a medicines-related safeguarding incident. They should follow a process agreed between health professional(s) and commissioners, which sets out who to contact in normal office hours and out‑of‑hours.

    Care home providers should record every medicines‑related safety incidents, including every ‘near misses’ and incidents that do not cause any harm, as a resident safety incident. Where there are notifiable safeguarding concerns these must be reported to the CQC (or other appropriate regulator).

    Local safeguarding processes should include the investigation of each report of a medicines-related safeguarding incident and should monitor reports for trends.

    Local safeguarding processes should include arrangements for feedback to care homes about reported medicines‑related incidents to promote sharing of experiences and learning.

    Care home staff should discover out the root cause of medicines‑related incidents.

    Care home providers should make certain that any training needed by staff to discover out the root cause of medicines‑related incidents is specified in contracts with commissioners.

    Care home staff should give residents and/or their family members or carers information on how to report a medicines‑related safety incident or their concerns about medicines, using the care home provider’s complaints process, local authority (or local safeguarding) processes and/or a regulator’s process.

    Care home providers should ensure that every residents can use advocacy and independent complaints services when they own concerns about medicines.

    Identifying, reporting and reviewing medicines-related problems

    Commissioners and providers of health or social care services should ensure that a robust process is in put for identifying, reporting, reviewing and learning from medicines errors involving residents (see also recommendations –3).

    Health and social care practitioners should consider working with every relevant stakeholders to develop a locally agreed action plan, in line with other local and national strategies and governance arrangements, for improving the safety of residents and reducing medication errors in care homes.

    Care home staff (registered nurses and social care practitioners working in care homes) should report every suspected adverse effects from medicines to the health professional who prescribed the medicine or another health professional as soon as possible; this would generally be the GP or out-of-hours service. Staff should record the details in the resident’s care plan and tell the supplying pharmacy (if the resident agrees that this information can be shared).

    Supporting residents to make informed decisions and recording these decisions

    Health and social care practitioners (care home staff, social workers, case managers, GPs, pharmacists and community nurses) should ensure that care home residents own the same opportunities to be involved in decisions about their treatment and care as people who do not live in care homes, and that residents get the support they need to assist them to take a full part in making decisions.

    The health professional prescribing a medicine or care home staff should record a resident’s informed consent in the resident’s care record.

    Consent does not need to be recorded each time the medicine is given but a record of the istration should be made on the medicines istration record.

    Care home staff (registered nurses and social care practitioners working in care homes) should record the circumstances and reasons why a resident refuses a medicine (if the resident will give a reason) in the resident’s care record and medicines istration record, unless there is already an agreed plan of what to do when that resident refuses their medicines. If the resident agrees, care home staff should tell the health professional who prescribed the medicine about any ongoing refusal and inform the supplying pharmacy, to prevent further supply to the care home.

    Health and social care practitioners should identify and record anything that may hinder a resident giving informed consent.

    Things to glance out for include mental health problems, lack of (mental) capacity to make decisions, health problems (such as problems with vision and hearing), difficulties with reading, speaking or understanding English and cultural differences. These should be taken into account when seeking informed consent and should be regularly reviewed.

    Health professionals prescribing a medicine must:

    1. assess a resident’s mental capacity in line with appropriate legislation (for example, the Mental Capacity Act ) if there are any concerns about whether a resident is capable to give informed consent

    2. assume that care home residents own the capacity to make decisions

    3. record any assessment of mental capacity in the resident’s care record.

    Health professionals prescribing a medicine should review mental capacity, in line with the Mental Capacity Act and the Mental Capacity Act Code of Practice , when a resident lacks capacity to make a specific decision.

    How often they do this should depend on the cause, as this may affect whether lack of capacity fluctuates or is temporary.

    Health and social care practitioners should ensure that residents are involved in best interest decisions, in line with the Mental Capacity Act Code of Practice , and:

    1. talk to people who know them well, including family members or carers (informal or unpaid carers) and friends, as well as care home staff

    2. find out about their past and present views, wishes, feelings, beliefs and values

    3. involve them, if possible, in meetings at which decisions are made about their medicines

    4. deliver care and treatment in a way that empowers the resident to be involved in decisions and limits any restrictions to their care.

    Accurately listing a resident’s medicines (medicines reconciliation)

    The care home manager or the person responsible for a resident’s transfer into a care home should coordinate the precise listing of every the resident’s medicines (medicines reconciliation) as part of a full needs assessment and care plan.

    The care home manager should consider the resources needed to ensure that medicines reconciliation occurs in a timely manner (see recommendation ).

    Care home providers should ensure that the following people are involved in medicines reconciliation:

    1. a pharmacist

    2. the resident and/or their family members or carers

    3. other health and social care practitioners involved in managing medicines for the resident, as agreed locally.

    Commissioners and providers of health or social care services should ensure that the following information is available for medicines reconciliation on the day that a resident transfers into or from a care home:

    1. date and time the final dose of any ‘when required’ medicine was taken or any medicine given less often than once a day (weekly or monthly medicines)

    2. details of other relevant contacts defined by the resident and/or their family members or carers (for example, the consultant, regular pharmacist, specialist nurse)

    3. resident’s details, including full name, date of birth, NHS number, address and weight (for those aged under 16 or where appropriate, for example, frail older residents)

    4. known allergies and reactions to medicines or ingredients, and the type of reaction experienced

    5. medicines the resident is currently taking, including name, strength, form, dose, timing and frequency, how the medicine is taken (route of istration) and what for (indication), if known

    6. GP’s details

    7. changes to medicines, including medicines started, stopped or dosage changed, and reason for change

    8. other information, including when the medicine should be reviewed or monitored, and any support the resident needs to carry on taking the medicine (adherence support)

    9. what information has been given to the resident and/or family members or carers.

      Providers should ensure that the details of the person completing the medicines reconciliation (name, occupation title) and the date are recorded.

    Ensuring that records are precise and up to date

    Health and social care practitioners should ensure that records about medicines are precise and up-to-date by following the process set out in the care home medicines policy (see recommendation ).

    The process should cover:

    1. recording information in transfer of care letters and summaries about medicines when a resident is away from the home for a short time

    2. recording information in the resident’s care plan

    3. recording information in the resident’s medicines istration record

    4. recording information from correspondence and messages about medicines, such as emails, letters, text messages and transcribed phone messages

    5. what to do with copies of prescriptions and any records of medicines ordered for residents.

    Care home providers must follow the relevant legislation to ensure that appropriate records about medicines are kept secure, for an appropriate period of time, and destroyed securely when appropriate to do so.

    Training and skills (competency) of care home staff

    Care home providers must ensure that designated staff ister medicines only when they own had the necessary training and are assessed as capable.

    Care home providers must ensure that staff who do not own the skills to ister medicines, despite completing the required training, are not allowed to ister medicines to residents.

    Care home providers should set up an internal and/or external learning and development programme so that care home staff can acquire the necessary skills for managing and istering medicines. The programme should meet the requirements of the regulators, the residents and the training needs of care home staff.

    Care home providers should consider using an ‘accredited learning’ provider so that care home staff who are responsible for managing and istering medicines can be assessed by an external assessor.

    Care home staff must own induction training that is relevant to the type of home they are working in (adult care homes or children’s homes). Every care home staff (including registered nurses as part of their continuing professional development) involved in managing and istering medicines should successfully finish any training needed to fulfil the learning and development requirements for their role.

    Care home providers should ensure that every care home staff own an annual review of their knowledge, skills and competencies relating to managing and istering medicines. Care home providers should identify any other training needed by care home staff responsible for managing and istering medicines.

    If there is a medicines-related safety incident, this review may need to be more frequent to identify support, learning and development needs.

    Health professionals working in, or providing services to, care homes should work to standards set by their professional body and ensure that they own the appropriate skills, knowledge and expertise in the safe use of medicines for residents living in care homes.

    Over the Counter Medications

    Medically reviewed on May 7, by L. Anderson, PharmD.

    In the U.S., there are more than 80 classes of over-the-counter (OTC) medications, ranging from acne medicines to weight loss products.

    OTC drugs are medications that are safe and effective for use by the general public without seeking treatment by a health professional.

    Favorite examples include pain relievers love acetaminophen(Tylenol) and ibuprofen (Advil, Motrin), cough suppressants such as dextromethorphan (Robitussin) and antihistamines love loratadine (Claritin 24H).

    What is a excellent over the counter medicine for allergies

    These drugs are generally located on shelves in pharmacies, grocery stores, and even in gas stations. OTC medicines treat a variety symptoms due to illness including pain, coughs and colds, diarrhea, heartburn, constipation, acne, and others.


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