1. Copyright © 2016 by Mosby, an imprint of Elsevier Inc.
Chapter 6
Self-Care: Over-the-Counter Products, Herbal Therapies, and Drugs for Health Promotion
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.

2. Copyright © 2016 by Mosby, an imprint of Elsevier Inc.
Overview
Self-care and OTC drugs
$18 billion spent on nonprescription remedies
Common influences
Friends
Advertisements
What do patients need to know about OTC products?
Can you think of any “wonder drug” claims you may have seen on TV or read about in the newspaper or magazines?
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.

3. Documenting Patient Health Care Practices
Nursing knowledge of products
OTC and prescription interaction
Container labels
Complementary and alternative medicine (CAM)
Why is it important for the nurse to include these drugs when obtaining an assessment for drug history?
Can you give a reason that patients may choose CAM (complementary and alternative medicine)?
What influence do culture and spiritual beliefs have on medical treatment?
Can you identify a CAM commonly practiced in a specific culture?
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.

4. Over-the-Counter Medications
OTC products are drugs that are thought to be safe and effective for use without instructions from a health care provider
Drug labels: OTC more complete and easier to understand than prescription
Common OTC drugs used
Widely available
Costs
Are OTC drugs less safe than prescription drugs?
What are some potential risks of OTC drugs?
Can you name a commonly used OTC drug that contains a combination product?
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Product Labeling
The U.S. Food and Drug Administration (FDA) requires that OTC product labels contain important information
Label characteristics
“Hidden” Ingredients: Table 6-1
Do OTC drugs require any type of regulation?
What types of information are included on the labels of OTC drugs?
What types of problems can “hidden” chemicals cause to a patient’s health?
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Patient Teaching
Key facts
Childhood considerations
Accurate measurement
Safety: child-resistant caps
Do OTC drugs have fewer side effects than prescription drugs?
What teaching information should be included with OTC drugs?
Name “knowledgeable resources” the patient can use to get answers to questions about OTC drugs.
What is a reason OTC drugs may be toxic to children?
Some OTC drugs may contain alcohol. This would be listed on the label.
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.

7. Complementary and Alternative Medicine, Including Herbal Therapies
Alternative medicine: herbal therapies, aromatherapy, chiropractic, acupuncture, massage, and homeopathy.
Complementary medicine: Alternative medicine along with standard medical care.
Integrative practices
How is complementary therapy different from alternative therapy?
What are some reasons consumers might use alternative forms of health care?
Why is there medical concern related to the use of herbs, supplements, and homeopathic therapies?
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.

8. Herbal Therapies and Supplements
Safety
Growing scientific studies
Since herbs are “natural” substances, are they considered safe for consumer use?
Can you identify reasons there is an increased use of herbs by consumers?
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Product Labeling
FDA does not require manufacturers to determine purity or potency of herbal products.
Dietary Supplement Health and Education Act of 1994
General statements about the product’s function in the body
Folk acceptance
Role of the healthcare provider
What type of statement can the maker of herbal supplements include on the label?
How are herbal preparations regulated in the United States?
If a patient requests advice in using herbal therapy, how should you respond?
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10. Concerns about Herbal Products and Dietary Supplements
Pros and Cons
Safety, purity, and effectiveness
Natural estrogens – phytoestrogens (flaxseed, red clover sprouts, and soy flour)
Time
Variability in each dose
Council for Responsible Nutrition
Refer to Tables 6-2, 6-3, 6-4
How does the manufacture of herbal products affect the strength of the product?
Why has the use of “natural” estrogen supplements increased?
Can you think of an herbal remedy that may be used to treat a condition that typically requires a prescription?
Why may one pill of an herbal product differ from another from the same container?
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Aromatherapy
Oils
Massage
Inhalation
What is the belief associated with aromatherapy?
What type of research supports the use of aromatherapy?
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.

12. Drugs for Health Promotion: Vitamins and Minerals
Common use
Self-care
Costs
When is the use of a vitamin or mineral supplement indicated?
When can the use of a vitamin or mineral supplement pose a risk?
Can you name a mineral commonly used by women?
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Pros and Cons
Lifespan considerations
Nutrition and deficiency
Vitamins: 50% to 150% of RDA
Dangers of overuse
Antioxidants
Lifestyles
If a patient overuses calcium, what effect does this have on the body?
How do antioxidants work within the body?
Are the benefits of vitamin products different depending on whether they are labeled natural or synthetic?
Can you identify a way you personally practice health promotion?
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Calcium
Reduces the risk of osteoporosis
Recommendation; At least 1200 mg daily
Vitamin D is important for calcium absorption
Administration considerations: Should be taken with food
What is a good food source of calcium?
Vitamin D is needed for calcium absorption.
In what natural source is vitamin D available to us?
Why is it best for calcium to be taken with meals?
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15. Folic Acid, Vitamin B, and Vitamin B12
Folic acid: prevention of fetal neural tube defects
Homocysteine: elevated levels in the blood are a risk factor for heart disease
High-risk populations
What patient population should receive adequate folic acid?
High levels of homocysteine levels in the body may lead to what risk factor?
Would a middle-aged male or an elderly male be at high risk for B complex deficiencies?
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Iron
Anemia
Female lifespan considerations
Excessive iron
Interactions
Which female requires less iron: the one who is menopausal or the one who is pregnant?
Too much iron can result in what type of damage to the body?
Which mineral competes with iron for absorption when they are taken together?
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17. Copyright © 2016 by Mosby, an imprint of Elsevier Inc.
Summary
Nursing Responsibilities
Ask about CAM and OTC drug use
Advise patients to stop use of any preparations 2 weeks before invasive procedures
Nurses need to specifically ask about the patient’s use of any of these.
Patients often do not mention use of any alternative therapies or preparations, since they do not require a prescription.
Many herbal preparations interact with OTC and prescription medications, especially anticoagulants.
Copyright © 2016 by Mosby, an imprint of Elsevier Inc.