Over-the-Counter Drugs - Effects on the Body
Effects on the Body
OTC drugs can affect the body in many ways, depending on the type of medicine being taken, the condition being treated, and the general health of the user.
Allergy Medicines
Allergic reactions stem from the body's reaction to irritants from the environment. Breathing pollen grains or pet dander causes stuffy nose and cough in people who are allergic to these substances. Touching poison ivy or being stung by a bee produces itching and swollen skin. Allergies can also cause watery eyes, sore throat, and digestive problems. People with severe allergies—to peanuts or shrimp, for instance—can have life-threatening reactions if they consume even a tiny amount of those foods.
Because allergies are chronic, or lasting conditions, a large number of medicines have been developed to treat them. Pharmacies stock skin rash ointments, nasal sprays, liquid medicines, and pills. Many of the liquid and pill preparations are multi-symptom formulas with more than one active ingredient.
The Role of Histamines
Allergy symptoms are caused by histaminesPronounced HISS-tuh-meenz: chemicals released by the body during an allergic reaction; they cause: 1) an increase in gastric secretions, 2) the dilation, or opening up of capillaries, 3) constriction of the muscles around the airway, and 4) a decrease in blood pressure., which are chemicals that are produced by the cells of the immune system. Histamines are like warning signals that alert an individual to the presence of an allergen—the pet dander, the pollen, or the substance that's causing the allergic reaction. The release of histamines produces uncomfortable symptoms that are hard to ignore—symptoms such as inflammationA physical reaction to injury, infection, or exposure to an allergen characterized by redness, pain or swelling., sneezing, nasal congestion, and even dizziness or labored breathing.
Some allergy medicines contain antihistaminesDrugs that block histamine, a chemical that causes nasal congestion related to allergies., chemicals that work to stop the body's production of histamines. The most common OTC antihistamines are diphenhydramine hydrochloride and brompheniramine maleate. Taken at regular doses, these drugs may cause mild drowsiness as they relieve allergy symptoms. At higher doses, they can bring on severe anxiety, which is the feeling of being extremely overwhelmed, restless, and worried; insomnia, or difficulty sleeping; muscle tremors; and even hallucinations, which are visions or other perceptions of things that are not really present.
Some people are so sensitive to diphenhydramine that the standard dose can make them feel nervous and uncomfortable. It is possible to overdose on diphenhydramine, and the consequences can be very serious. An overdose can lead to coma or death if emergency medical treatment is not obtained.
Relieving Stuffy Nose, Headache, and Itching
Other allergy medications function differently, targeting the symptoms of an allergic reaction rather than blocking the production of histamines. Medicines containing decongestants work by widening nasal passages and thinning mucusA secretion released by the body to prevent germs and allergens from entering the bloodstream. in order to relieve a stuffy nose and headache. Common decongestants include pseudoephedrine hydrochloride and chlorpheniramine maleate. These ingredients can cause intense anxiety, hallucinations, convulsions, vomiting, and irregular heartbeat if taken in higher doses than what is recommended. The decongestant guaifenesin is a mucus thinner that has fewer dangerous side effects, but it will cause nausea and vomiting if taken at overdose levels.
Nasal sprays are another popular form of treatment for allergy symptoms. These should be used with care, following the directions on the bottle. Overuse of nasal sprays can produce a rebound effect, which causes even more swelling in the nasal passages than the original allergen would have produced. Overdoses of certain nasal sprays can bring on symptoms such as an irregular heartbeat and high blood pressure.
Some poison ivy creams and lotions contain hydrocortisone. Hydrocortisone is a synthetic drug that counteracts the body's response to an allergen. It reduces itching and swelling, but overuse may lead to skin irritation. Hydrocortisone does not prevent the spread of poison ivy, so it is not recommended for use on unaffected skin.
Cough, Cold, and Flu Medicines
Irritating coughs have many sources. The most common reason for a cough is a post-nasal drip, or the draining of mucus from the nose down into the throat. The body reacts to this drip with a cough so that the mucus will not clog the trachea (TRAY-kee-uh) or move into the lungs. The trachea, commonly called the windpipe, is the tube in the throat that carries air to the lungs. Coughing also occurs when the body attempts to expel particles from the lungs or bronchial tubes. This kind of coughing is associated with several conditions: 1) bronchitis—an illness that affects the bronchial tubes in the lungs, leading to shortness of breath and coughing; and 2) pneumonia—a disease of the lung, usually brought on by infection, that causes inflammation of the lung tissue, fluid buildup inside the lungs, lowered oxygen levels in the blood, and difficulty breathing. Other coughs, known as "dry coughs," are simply a reaction to an irritation of the throat and can linger with no other symptoms present.
Persistent coughing—a cough that lasts for more than two weeks—may be a sign of a more serious problem, including pneumonia, tuberculosisPronounced tuh-burk-yuh-LOH-siss; a highly contagious disease of the lungs., or even lung or throat cancer. Over-the-counter cough medicines are designed for brief use. If a cough does not respond to an OTC product within a week, a doctor should be consulted.
When It's Good to Cough
A cough that brings mucus from the throat to the mouth is called a "productive cough." Productive coughs—while annoying—prove that the body is working as it should to protect the lungs. Patients with productive coughs should not try to suppress them, except perhaps at night in order to get uninterrupted sleep. Taking cough suppressants during the day may actually prolong the time it takes to get rid of a productive cough.
Since the majority of minor coughs stem from colds, allergies, or the flu, most multi-symptom products contain antitussives along with medicines to thin or eliminate mucus. The most popular antitussive in OTC cough syrups is dextromethorphan, which is usually combined with other active ingredients. Dextromethorphan taken at higher-than-recommended doses can produce an hallucinogenic experience. Its abuse as a recreational drug has led several pharmacy chains to place certain cough products behind the counter or demand proof that the buyer is over the age of eighteen. Recreational use of high doses of dextromethorphan can lead to physical and psychological addiction. Physical addiction occurs when the body
craves more of a drug; psychological addiction is the belief that a person needs to take a certain substance in order to function.
Flying Germs
Common colds are caused by viruses that pass easily from person to person through the air. The cold germ can also survive on surfaces such as doorknobs or light switches. So the virus can be passed if someone touches these germ-laden surfaces, then uses that finger or hand to touch one's eyes, nose, or mouth. When the virus invades the body, chemicals in the body's immune system attempt to fight off the infection. Symptoms such as stuffy nose, sneezing, sore throat, and cough are responses designed to keep the germs from reaching the bronchial tubes leading into the lungs. Cold symptoms that last for more than ten days, or that get worse rather than better over time, may indicate a more serious problem such as the development of bronchitis or pneumonia. A doctor should be consulted in such cases.
Influenza, or the flu, is also caused by a variety of viruses. The flu is highly contagious and usually occurs in winter, when people spend more time indoors. Its symptoms are often more severe than those associated with an ordinary cold. Patients develop fever, body aches, cough or sore throat, and sometimes nausea, vomiting, and diarrhea. All of these symptoms arise from the body's immune system response, so older people or those with immune deficiencies run the risk of developing complications, especially pneumonia. For this reason, older individuals and people with immune problems, such as cancer patients and people living with acquired immunodeficiency syndrome (AIDS), are encouraged to get annual flu shots.
The Multi-Symptom Trap
Colds and flu bring on a host of symptoms, so most OTC cold and flu medications contain several active ingredients. Each active ingredient targets a specific symptom. acetaminophenPronounced uh-SEE-tuh-MINN-uh fenn; a non-aspirin pain reliever, such as Tylenol. works on fever, body aches, and headaches. Dextromethorphan hydrobromide controls coughs. Pseudo-ephedrine hydrochloride and its related compounds are decongestants that open clogged nasal passages. Chlorpheniramine maleate is an antihistamine. Some "PM" or "overnight" remedies include alcohol. Some "stay alert" daytime remedies include caffeine. To complicate matters further, the liquid forms of these preparations contain sweeteners such as sucrose (SUE-krose; sugar) or the sugar substitutes saccharine (SAK-uh-rin) or aspartame (AH-spar-tame).
OTC cold and flu medicines are formulated to treat the symptoms of these illnesses once they occur. Such remedies are not effective in warding off colds or flu and should not be taken as preventative measures. For years the herbal dietary supplement echinacea (eck-inn-AY-shuh; Echinacea purpurea and Echinacea angustifolia), derived from the purple coneflower, was thought to have cold-prevention properties. However, scientific tests have shown that the herb does nothing to prevent colds from occurring and has no effect on cold symptoms that already exist. Results of a study led by Dr. Ronald B. Turner of the University of Virginia School of Medicine were published in the July 28, 2005 issue of the New England Journal of Medicine. Turner's study evaluated the effects of treatment with echinacea or a dummy pill on 399 patients who had been infected with a cold virus. The researchers saw no benefit in using echinacea to treat the colds.
OTC Pain Relievers: The Big Three
The three most common over-the-counter pain relievers are aspirin, acetaminophen (Tylenol), and ibuprofen (Advil and Motrin). All three products work well to control minor headaches, muscle aches, menstrual cramps, arthritis pain, and fever. Doctors even recommend small daily doses of aspirin for people with heart problems. Although these products are valuable painkillers when used correctly, they can produce dangerous side effects when overused.
Aspirin and Acetaminophen Can Kill More Than Just Pain
According to Daniel Carr in a 2002 bulletin from the American Pain Society, about 22 percent of fatal poisonings in the United States each year involve an over-the-counter painkiller—especially aspirin and acetaminophen. Nearly nine out of ten of these deaths are suicides.
Acetaminophen overdose is one of the leading causes of calls to poison control hotlines every year. In a March 2004 article for the New York Times, William M. Lee noted that misuse of this drug leads to an estimated 56, 000 emergency room visits annually, with some 450 deaths—usually from liver failure. Symptoms of acetaminophen overdose establish themselves slowly, with little stomach upset. Sometimes, by the time the patient reports pain, the damage cannot be repaired. Multiple organ failure follows.
Aspirin overdose shows symptoms more quickly, but it can kill faster. It causes thinning of the blood, and at the same time it irritates the stomach lining. Internal bleeding begins, especially throughout the digestive system. toxicHarmful, poisonous, or capable of causing death. doses of aspirin work on the part of the brain that controls breathing. The rate of breathing can be slowed to dangerously low levels, resulting in death. Seizures, or sudden violent spasms or convulsions, may also occur.
As Pamela Grim noted in a 1998 Discover article, "This 'harmless' little pill can have deadly effects. … The kidneys, the liver, and the brain … can shut down forever, depending on the amount ingested. Patients can … crash and burn in the blink of an eye." If caught in time, aspirin overdose can be treated with activated charcoal to induce vomiting. Still, a patient will often face a long period of recovery from internal injuries.
Fatal overdoses of ibuprofen occur less frequently, but when they occur they are usually caused by kidney failure. Interestingly, one of the symptoms of ibuprofen overdose is headache and abdominal pain—exactly what the drug is designed to treat.
Sore Throat: Is It Strep?
Sore throats are common among children and adults. As with a cough, a sore throat can stem from post-nasal drip or from a minor infection. These kinds of sore throats usually subside after a few days, and the pain can often be relieved by gargling with a simple mixture of table salt, baking soda, and warm water.
The two main active ingredients in over-the-counter sore throat remedies are phenol (with or without menthol) and dyclonine hydrochloride. Sprays containing these substances act by temporarily blocking nerve irritation. Menthol-containing lozenges also act on nerve endings in the throat. Patients with diabetesA serious disorder that causes problems with the normal breakdown of sugars in the body. or allergies to artificial sweeteners should check the inactive ingredients in any sore throat preparation. Some products include sugar or artificial sweeteners to enhance the taste.
A sore throat accompanied by fever or nausea may be a sign of bacterial infection, particularly streptococcus (strepp-toe-KOK-uss), better known as "strep throat." Left untreated, strep throat infections can lead to rheumatic fever (roo-MAT-ik FEE-ver), a severe infection that results in fever, a rash, pain and swelling in the joints, and sometimes permanent damage to the heart valves. Strep infections cannot be treated with OTC drugs, but they do respond to prescription antibiotics, which are medicines that kill bacteria in the body. Doctors can test for strep by swabbing the throat and examining the sample for the presence of streptococcal bacteria.
Digestive Remedies: Antacids, Anti-Diarrhea Medicines, and Laxatives
Digestive system problems range from nausea and heartburn (a burning sensation in the stomach and esophagus) to diarrhea and constipation. In healthy people, most of these problems clear up in a day or two. More serious stomach problems include: 1) ulcers—the breakdown of mucus membranes, usually in the stomach; 2) cancers of the stomach or colon; and 3) irritable bowel syndrome (IBS)—an incapacitating condition, usually brought on by periods of extreme emotional stress, that causes abdominal pain and severe diarrhea, alternating with periods of constipation. These disorders require prompt medical treatment.
OTC Abuse and Eating Disorders
Another group of digestive ailments is connected with two psychological disorders: anorexia nervosa (an-nuh-REK-see-uh ner-VOH-sah) and bulimia nervosa (bull-EEM-eeh-yuh ner-VOH-sah). Men and women who suffer from these serious eating disorders have distorted views of their bodies. They see themselves as overweight no matter how thin they are. People with anorexia nervosa have an intense fear of gaining weight. As such, they deprive themselves of calories, either by eating too little or by abusing laxativesDrugs that help produce bowel movements.. The use of laxatives causes food to move through their systems before it can be digested fully. People with bulimia nervosa engage in long periods of bingeing on food, then force themselves to vomit before the food can nourish them. These patients may also abuse laxatives.
More about Laxatives: Rebound and Dependence
OTC laxatives are available as pills, liquids, or fibrous powders that are mixed with water or juice. Some of the active ingredients in laxatives include bisacodyl, docusate, magnesium hydroxide, psyllium, and senna, among others. Warning labels on these products caution users not to exceed the recommended dose and not to use the products for more than a week at a time, unless told to do so by a doctor.
Overdose or long-term use of laxatives can disrupt the body's chemistry and undermine the body's natural ability to eliminate waste. Laxatives are habit-forming if used daily and can be very dangerous in overdose. They can deplete the body's potassium supply, leading to an irregular heartbeat. At higher doses they frequently cause diarrhea, severe cramps, and dehydrationAn abnormally low amount of fluid in the body.. People using laxatives for occasional constipation are advised to drink plenty of water along with the medication.
Overuse of laxatives causes a rebound effect in the user. People who suffer from rebounding notice a worsening of the very symptoms that they sought to relieve with the use of a medicine. When laxatives are taken for too long a period of time or in larger-than-recommended doses, severe constipation may result after the medicine is stopped.
Anti-Diarrhea Meds
Anti-diarrhea medicines are often overused, but not for purposes of weight loss. Some people take them much longer than recommended as they try to end their diarrhea problems themselves, when they really should go to their doctor to find out what's causing the trouble. The active ingredient in the most often used OTC diarrhea remedies is loperamide hydrochloride. These medications should not be used for more than two days. If diarrhea persists beyond that period, or if a fever or blood in the stool develops, a doctor should be consulted. Loperamide should not be used in cases of suspected food poisoning from bacteria such as salmonella, e-coli, or shigella.
Taken as directed for a few days to treat mild diarrhea, most OTC diarrhea medicines are very safe. However, in cases of overdose, preparations containing loperamide hydrochloride, bismuth subsalicylate, or kaolin and pectin do present dangerous symptoms, including nervousness, drowsiness, and dizziness.
Antacids: They Aren't Candy
The most popular forms of antacid on the OTC market are chewable pills or tablets containing compounds of magnesium or calcium. Doctors may even recommend calcium-containing antacids for daily use in women who do not consume enough natural calcium in their diets. Taken in small, recommended doses, antacids are safe.
At overdose levels, though, they can cause both immediate and long-lasting problems. Antacids containing the ingredient simethicone can produce nausea, abdominal cramps, muscle aches, dehydration, and irregular heartbeat. Calcium-based antacids produce similar symptoms at overdose. These medicines carry another risk as well. Taken at high doses over a prolonged period of time, they can cause a buildup of calcium in the body that leads to painful calcium deposits in the kidneys known as kidney stones.
Because chewable antacids often look and taste like candy, children may want to eat them. Such medications should be kept in child-proof containers out of their reach. In case of an overdose, a doctor or poison control center should be contacted immediately.
Dietary Supplements: Vitamins, Minerals, and Herbal Drugs
"Dietary Supplements" is the catch-all term used to describe vitamins, minerals, and herbal drugs.
Vitamins and Minerals
Vitamins are compounds that are necessary for proper nutrition but, in most cases, cannot be produced by the body. The usual means of obtaining vitamins is from eating healthy foods. When people do not eat well, for whatever reason, they may need to supplement their vitamin intake. Marion Webb reported in the April 12, 2004 edition of the San Diego Business Journal that 40 percent of Americans consume at least one vitamin pill a week. As with other OTC drugs, it is wise to consult a doctor before beginning vitamin use.
The major vitamins include A, C, D, E, K, B-12, and seven B-complex vitamins. The body only requires small amounts of these nutrients to function properly. Fat-soluble vitamins such as A, D, E, and K are stored in fatty tissues. It is very difficult to deplete these stores of vitamins and very easy to suffer an overdose from their pill forms. Vitamins C, B-12, and the B-complex vitamins are water soluble. They exit the body quickly by way of the urine and must be replaced more often. This can be done by eating fresh fruits and vegetables, whole grains, beans, nuts, vitamin-fortified breakfast cereals, and meat.
Minerals, too, are substances derived from the diet that aid the body in its functions. Important minerals include calcium for bone strength, iron for maintaining red blood cell levels, and magnesium, which is essential for nerve and muscle action, bone formation, and enzymeSubstances that speed up chemical reactions in the body. activity. Experts say that the best way to receive sufficient amounts of these nutrients is to eat foods containing them—dairy products and cheese for calcium, meats for iron, and green, leafy vegetables, nuts, and whole grains for magnesium.
More Is Not Better
It is possible to overdose on vitamins and minerals. Some specific symptoms are listed below.
- Too much vitamin A can cause headache, fatigue, nausea, diarrhea, dry skin, hair loss, bone pain, and enlargement of the liver and spleen. Extremely high overdoses cause swelling in the brain.
- Too much niacin (a B-complex vitamin) may result in liver damage.
- Too much vitamin D can bring on muscle weakness, excessive thirst and urination, digestive disturbances, bone pain, and high blood pressure.
- Too much vitamin E can cause abdominal cramps, nausea and vomiting, diarrhea, and reduced absorption of other vitamins.
- Too much calcium can lead to diarrhea and the production of kidney stones.
- Too much iron can cause nausea, abdominal cramps, constipation, diarrhea, and liver damage.
- Too much magnesium can result in nausea, vomiting, diarrhea, dizziness, muscle weakness, and heart damage.
- Too much zinc leads to problems absorbing other vitamins.
The Herbal Craze
In the 1970s, many Americans became interested in alternative medicine, including the medical use of herbs. (An entry on herbal drugs is available in this encyclopedia.) Herbal preparations have been used by cultures worldwide for thousands of years to treat conditions ranging from arthritis pain and menstrual cramps to depression, memory loss, and anxiety. Most herbal dietary supplements are bottled the same way as OTC medicines and vitamins, with the active ingredients highly concentrated into pills. This, however, is not the way native cultures consume herbs. The doses in OTC herbals are much higher than those found in the leaves and teas consumed by those who first discovered the benefits of these products.
The San Diego Business Journal estimated that in 2004, herbal dietary supplements were a $4 billion-a-year market in the United States. Anyone of any age can purchase them. However, some of the products warn that they should not be used by children under the age of twelve.
Herbals: Safety Issues
Many people who use herbal supplements are not aware that these products do not meet the same FDA requirements as medicines. Technically, herbal supplements are considered foods. Their labels are carefully worded so they don't imply that they will relieve any specific symptoms. Highlighting the many unknowns connected with herbal drug use, California congressman Henry Waxman noted in Nutrition Action Healthletter in 2003: "The dietary supplement market is the Wild West. … There are no requirements that a company prove anything about either the safety or the effectiveness of its products before they go to market."
After nearly thirty years of unregulated human use of herbal supplements, drug researchers began to pinpoint the dangers of specific substances. In 2004, for instance, the FDA banned the use of the natural supplement ephedra, also called ma huang (ma-HWANG), in any product sold in the United States. Ephedra has been used in China for thousands of years as a treatment for asthma (AZ-muh), a lung disorder that interferes with normal breathing. It contains substances very similar to amphetaminesPronounced am-FETT-uh-meens; stimulant drugs that increase mental alertness, reduce appetite, and help keep users awake. that can have a powerful stimulating effect on the heart. (A separate entry on amphetamines is available in this encyclopedia.) The FDA's ban came after research revealed that numerous deaths and injuries were linked to the use and abuse of the herbal supplement.
According to the Nutrition Action Healthletter, other herbal dietary supplements have been shown to produce serious side effects as well. For example, echinacea can cause stomach cramps, skin irritations, and other allergic reactions. Guarana (gwah-rah-NAH; Paullinia cupana), a plant that contains natural caffeine, causes the same symptoms as caffeine in use and overdose. Caffeine affects the brain, digestive system, heart and breathing rates, kidneys, body temperature, and other body functions.
St. John's wort may cause upset stomach, rash, fatigue, or restlessness. It should not be used in combination with any other psychoactive substancesMind-altering; a psychoactive substance alters the user's mental state or changes one's behavior., including antidepressants, caffeine, anti-anxiety medicines, or drugs for attention-deficit/hyperactivity disorder (ADHD)A disorder characterized by impulsive behavior, difficulty concentrating, and hyperactivity that interferes with social and academic functioning. or schizophreniaA mental disease characterized by a withdrawal from reality and other intellectual and emotional disturbances.. St. John's wort also reacts badly with certain prescription heart pills, drugs for high cholesterol (kuh-LESS-tuh-rol), oral contraceptives (birth control pills), blood thinners, and antacids.
Weight Loss Preparations
Obesity and its related health problems were major concerns for doctors and patients in the early twenty-first century. Obese individuals weigh at least 20 percent more than their ideal body weight. The CDC's Division of Nutrition and Physical Activity (DNPA) noted that in 2005, more than 60 million Americans were obese. And since the 1980s, obesity has become more and more of a problem for children in the United States. According to the DNPA's "Overweight and Obesity" home page, "the percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are considered overweight."
Weight gain usually occurs when people eat too much and/or exercise too little. In some cases, however, obesity is linked to serious health problems. The condition can be hereditary, which means it is passed on genetically from parent to child. It can also be a result of hormone imbalances. Whatever the cause, overweight or obese individuals face higher risks of heart trouble, high blood pressure, and diabetes than people who maintain an ideal weight.
Over-the-counter fad diet products rarely, if ever, fulfill their promises. Still, the diet pill industry reaps huge profits. In 2004, Forbes magazine estimated that Americans spend about $27 billion each year on "miracle" diet pills, powders, and other products. But weight loss is one health problem for which no quick fix exists. Through its food pyramid and other programs, the U.S. Department of Agriculture urges Americans to seek realistic weight loss solutions. The food pyramid shows the types of foods one should include in his or her daily diet, including dairy, grains, fruits, vegetables, meats, and beans. In 2005, the famous food pyramid was revised to include a little stick figure running up a flight of steps. This is a reminder that a balanced diet and daily exercise are the most effective ways to achieve a healthy personal weight.
OTC Pills and Herbals for Weight Control
Weight loss pills and herbal supplements both work by speeding up the body's metabolismThe process by which food is converted to energy that the body uses to function.. Diet pills generally contain some kind of amphetamine, and herbal supplements rely on plants that either contain caffeine or mimic caffeine's behavior in the body. Individuals who take diet pills may notice a "speedy" or "peppy" feeling, even at normal doses. In overdose, FDA-approved diet pills can cause agitation, anxiety, insomnia, hallucinations, heart palpitations, and high blood pressure. In 2004 the FDA banned the sale of the herbal weight loss supplement ephedra. Producers of herbal supplements have responded by creating a vast array of ephedra-free items for sale over-the-counter.
The manufacturer's label on most diet pills recommends using the products only for a few months. Some people ignore this important warning and continue taking the pills. Diet pills can be habit-forming and may produce withdrawalThe process of gradually cutting back on the amount of a drug being taken until it is discontinued entirely; also the accompanying physiological effects of terminating use of an addictive drug. symptoms when discontinued. The most frequent withdrawal symptom is rapid weight gain. People who begin a program of OTC diet pills may find themselves hooked on the pills both physically and psychologically as they convince themselves that they will become obese again if they quit.
Motion Sickness Pills
Motion sickness, sometimes known as vertigo, does not affect everyone. For those who suffer from it, however, a car ride or an airplane flight can trigger a variety of uncomfortable symptoms, including sweating, dizziness, an increased heart rate, nausea, vomiting, and trembling. The disorder seems to be hereditary, passed down from parent to child. It stems from the way unpredictable movement affects an organ in the inner ear that controls balance. Anxiety about the symptoms can make the condition worse.
People who suffer mild cases of motion sickness can usually control the symptoms by breathing fresh air and by concentrating on a fixed point on the horizon. The symptoms end quickly when the car, boat, or plane trip ends.
OTC motion sickness pills contain antiemetics (an-tee-ih-MEH-tiks), compounds with the same active ingredients as antihistamines. Antiemetics are drugs that reduce nausea and vomiting. The FDA has approved two antiemetics for use in motion sickness medicines: dimenhydrinate (Dramamine) and meclizine hydrochloride (Antivert). It is important to note that the FDA has not approved the use of meclizine hydrochloride in children under twelve years of age.
Bad Trips
From time to time, abusers of motion sickness medicine appear in clusters in various parts of the United States. At high doses, dimenhydrinate can cause intense and long-lasting hallucinations. It also affects the memory center in the brain, so sometimes the abuser cannot recall what has happened during the experience. Dimenhydrinate hallucinations are often frighteningly real to the user. The hallucinations may be visual, making everything seem liquid or producing visions of monsters, insects, or snakes. They may also manifest themselves as distorted sounds. Some users have even reported hearing voices. At very high doses, dimenhydrinate causes paranoiaAbnormal feelings of suspicion and fear., difficulty breathing, convulsions, and coma.
Once the symptoms of a dimenhydrinate tripAn intense and usually very visual experience produced by an hallucinogenic drug. begin, it can take up to twelve hours for them to subside. The other motion sickness medicine available over the counter is a nondrowsy formula called meclizine hydrochloride. Like dimenhydrinate, overdoses of meclizine can cause hallucinations, muscle tremors, blurred vision, difficulty breathing, and in worse cases, convulsions and coma.
Users of motion sickness preparations need to take certain precautions. The drugs do not work after motion sickness symptoms start, so it is necessary to take the medication at least fifteen to thirty minutes before the bothersome motion begins. The pills usually work for eight to ten hours. Pregnant women and nursing mothers should consult a doctor before taking these drugs.
Sleep Aids
Over-the-counter sleeping pills are intended for use by people who usually fall asleep easily. Every box of OTC sleep aids bears the warning: "For occasional use only." Individuals who suffer from a recurring inability to fall asleep—or stay asleep—should consult a doctor. Since one of the main causes of insomnia, or the inability to sleep, is pain, some OTC sleep aids contain analgesicsPain relievers or the qualities of pain relief. as well as active sleep-inducing compounds. Other products are formulated to bring on sleep during colds and flu.
The most common OTC sleep aids are antihistamines, including diphenhydramine hydrochloride and doxylamine succinate. These are the same ingredients in cold and allergy formulas that cause mild drowsiness. In long-term use or abuse as sleep aids, both compounds can actually make insomnia worse. In addition, they can increase agitation and nervousness in the user. As with other OTC drugs, it is important to treat only the symptoms of insomnia, and not medicate for cold, flu, or pain if those problems are not present.
Stimulants
Just as people sometimes have trouble falling asleep, others sometimes have trouble staying awake. OTC stimulants usually contain caffeine and are designed for occasional use only. Even at recommended doses, OTC stimulant products can cause nervousness and irritability. With regular use, OTC stimulants become habit-forming. Users quickly develop a toleranceA condition in which higher and higher doses of a drug are needed to produce the original effect or high experienced. to these drugs. Extreme drowsiness and lack of energy may occur when OTC stimulants are discontinued.
Overdose symptoms of OTC stimulants include nervousness, insomnia, irregular or rapid heartbeat, convulsions, and coma. Stimulants that come in time-release preparations should never be crushed and consumed as powder. This increases the possibility of overdose and possibly fatal poisoning.
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