Interactions

[rafhelp]

I find identfying drug interactions a difficult topic in practice. What I wanted to ask is how does identifying OTC drug interactions differ from identifying POM drug interactions in practice.

What i know is that serious drug - drug interactions are flagged on the PMR system when labelling and that these kind of interactions were taught at university and can be found in the BNF. But what OTC medicines. For example if i take two different drugs to the pharmacist and ask if its ok for the patient to take both at the same time, for most people is it just something that comes with practice. Because they know they dont interact as they have been asked this before or do you have to look at it the same way as you would a POM to POM interaction.

Do you know of any good sites or literature that can help with dealing wit drug interactions. Also are drug interactions a favourite type of questions the exams?

[bambalec]

learn through practice. If you are picking up two OTC medicines and you think they interact, look it up. You have the BNF, PIL, SPC's and stockley's (if your place keeps a copy)

drug interactions will come up in the open and closed book

don't just focus on drug-drug interactions; keep mind open for drug-disease and drug-food interactions

[crit care]

having an understanding of the active ingredients in each of the OTC products and in which patient groups they need to be avoided in will help...it comes with experience and practice

[Pharmanaut]

Watch out for implied conditions due to presence of a drug....
Patient has salbutamol inhaler; Ibuprofen (NSAID) use with caution or contraindicated (depending on patient reaction to them)

[rafhelp]

what would you say are the most common drug interactions or drug-disease interactions to watch out for in relation to only OTC medicines in practice. I am aware it depends on the community but im sure there are some which are common to all practices.

I heard about st johns wart causing some problems but i have not seen this recently being sold, is it still available?

[crit care]

i think it is still available, but don't know how commonly available it is...

as for your OTC there is a book..symptoms in the pharmacy..gives comprehensive details of all ailments in community, what they are, how they are managed, when to refer, treatments, contraindications, counselling points etc. quite useful..well it was for me, being hospital trained, and not really being up to date with my OTC for pre reg!

hope that helps

[kl06229]

having an understanding of the active ingredients in each of the OTC products and in which patient groups they need to be avoided in will help...it comes with experience and practice

That's what I do whenever I'm thinking of interactions in OTC medicines, since I'm crap at remembering brand names anyway. The big ones that I can think of to watch for are NSAIDs, decongestants, cystitis relief sachets, weak opioids, hyoscine (in travel sickness remedies) and H2 antagonists.