Non-Prescription Drug Alerts

Erin Stromley
Pharmacy Extern

Seattle health officials are warning physicians not to prescribe NSAIDS such as ibuprofen for children with chickenpox. NSAIDS are suspected to increase the risk of severe cases of group-A strep--the "flesh-eating" bacteria that causes necrotizing fascitis. The CDC has researchers studying the association between NSAIDS and group-A strep. To be safe, parents should be advised to avoid giving NSAIDS to children with chickenpox.

Patients with hypertension can probably use a short course of the nasal decongestant pseudoephedrine (Sudfed) without increasing their blood pressure. If the patient's blood pressure is under control and if the patient isn't using an antihypertensive which can increase the effects of pseudoephedrine (methyldopa (Aldomet), reserpine or guanethidine) go ahead and tell him or her that it's all right to use pseudoephedrine.

Fasting can lead to an increased risk of acetaminophen toxicity. The maximum daily dose for acetaminophen is 4 grams (8 extra-strength tablets). Studies have shown that severe liver toxicity can occur after only a moderate overdose (4 - 10 grams/day) when patients had not eaten. Patients who are unable to eat due to a sore throat, vomiting or a tooth abscess should be warned to carefully monitor the amount of acetaminophen they are taking to relieve their pain.

Be sure patients with home nebulizers are diluting their medication with the correct saline. Using the wrong type can lead to bronchitis. Bacteriostatic saline contains benzyl alcohol which is irritating to the lungs. Contact lens saline contains buffers which can also irritate the lungs and cause bronchitis. Multi-use bottles of saline can easily get contaminated and cause an infection. Patients need to be using the small unit-dose packages of saline or a can of Broncho-Saline which dispenses 1cc at a time.