Toxic drugs over the counter?

[bigbaldguy]

Just doing some research on NSAIDs. It seems like some of the most toxic like acetaminophen are over the counter while seemingly less toxic ones like meloxicam are prescription. Anybody know why this is?

 

[mycrofft]

Tylenol is not a NSAID but I get ya.

I read somewhere that acetaminophen was discovered about the time as they discovered how to synthesize ASA. Supposedly it was not promoted due to many hepatic related deaths (and one must remember that in the late 1800' and early 1900's, there were many chemicals, drugs, food additives and diseases affecting the public which challengd the liver). Didn't hear much about Tylenol until they started giving it to pregnant and post partum mothers in the late Sixties. (Is it coincidental that neonetal jaundice seems to have increased since then?).

Meloxicam is also sold for veterinary use as Rx only and is mucho expensive (as many vet Rx are). Maybe they don't want a human to animal black market?

Well, consider the OTC NSAIDS:

ASA (aspirin): potential for stomach bleeds and primary toxicity. Pediatric marketed products mostly gone now due to Rye's Syndrome.

Ibuprophen (Motrin, Advil): as above, was for a time the #1 prescribed medicine in America. Never cleared for regular use at Rx dose (800 mg po up to TID) beyond thirty days. Initially not recognized as antipyretic, and scattered patient reports of dizziness and alterd LOC finally acknowledged as a rare side effect.

Naproxen (Naprosyn, Alleve): as above but not OTC as long and supposed to have fewer side efects and it lasts longer.

All except ASA were prescription, then released as half-strength OTC's. They were relaeased as OTCs because their patents were threatened and OTC offers great profit.

 

[bigbaldguy]

From wiki at http://en.wikipedia.org/wiki/Paracetamol

"Though acetaminophen is used to treat inflammatory pain, it is not generally classified as an NSAID because it exhibits only weak anti-inflammatory activity.

Paracetamol is part of the class of drugs known as "aniline analgesics"; it is the only such drug still in use today.[50] It is not considered an NSAID because it does not exhibit significant anti-inflammatory activity (it is a weak COX inhibitor)."

Very interesting. I just assumed it was lumped in with NSAID class drugs. I've officially learned something today....that doesn't happen very often. I think I better go have a lie down while my brain recovers.

 

[mycrofft]

And elevate and ice.

 

[Anonymous]

Anybody know why this is?

Politics, same reason marijuana is illegal and alcohol legal I suppose.

 

[mycrofft]

For the love of all that's holy, let's not go THERE!!!!h34r:

 

[lightsandsirens5]

For the love of all that's holy, let's not go THERE!!!!h34r:

What he said......

 

[silver]

Tylenol is one of the quintessential landmark examples of pharmaceutical marketing, because of its historic context. Evidence based medicine and drugs are like non-existant in the eyes of drug companies. In fact the heaviest marketed drugs are likely to be the least evidence based. This more or less explains why its over the counter now. They saw the potential and gained the success.

If anyone is interested in how marketing and the politics of pharma play a role in drugs here is a quick read.
http://www.pharmedout.org/RxDrugMarketing.pdf

 

[Farmer2DO]

(Is it coincidental that neonetal jaundice seems to have increased since then?).

Probably not.

Meloxicam is also sold for veterinary use as Rx only and is mucho expensive (as many vet Rx are). Maybe they don't want a human to animal black market?

There already is. I've worked significantly in animal health (dairy), and the exact same drug used on people has the price jacked a lot when you package it for animals. We used human drugs all the time.

ASA (aspirin): potential for stomach bleeds and primary toxicity. Pediatric marketed products mostly gone now due to Rye's Syndrome.

Several professors have said that ASA likely wouldn't be approved for OTC use if it was developed today.

Politics, same reason marijuana is illegal and alcohol legal I suppose.

For the love of all that's holy, let's not go THERE!!!!h34r:

Why not? We're talking about pharmacology, right? Why not talk about recreational pharmacology too?

 

[Achilles]

Why not? We're talking about pharmacology, right? Why not talk about recreational pharmacology too?

It's also medicinal.

 

[mycrofft]

Consider what's available OTC in some other countries....everything.

And some stuff we had OTC here used to include cocaine, opiates, arsenic, strychnine, dexedrine, radium salts (yes, actual stuff), and devices such as fluooscopes (as in shoe stores) and various electrical discharge devices that were more likely to harm your pocketbook but probably could kill someone with an arrythmia or who decided to try to juice it up a bit.

Consider internal herbals and "folk remedies". Vaginal potassium permanganate crystals to induce abortion (severe burns), sassafrass tea made from the essential oil (a carcinogen), melaleuca oil (unstable as an oil and breakdown products include carcinogens), kombucha "tea" (potential anaphylactogen), and megadoses of St John's Wort (interacts with meds), just to name a handful. Deemed dietary supplements, rarely banned (although it is much harder to get a good cup of sassafrass tea nowadays and it is rarely if ever named in rootbeer ingredients anymore).

And last week a mother filed suit about her daughter succumbing to an arrythmia exacerbated by Monster caffeine drinks.

 

[bigbaldguy]

Consider what's available OTC in some other countries....everything.



Consider internal herbals and "folk remedies". Vaginal potassium permanganate crystals to induce abortion (severe burns),

My mother a nurse of 60 years has told me some horrifying stories about young women in El Paso where she worked going to Mexico for abortions before it was legal here in the states. Awful awful stuff. Chemicals, coat hangers, you name it.

Frightening what you can still walk up to a counter in some countries and order without a prescription. I believe it's Belize where the pharmacist can actually write you a prescription for anything you want. I was on a cruise and needed antibiotics and the pharmacist writes me the script then filled it. Then he tried to talk me into a few other things, several of which are controlled substances here in the US.

 

[mycrofft]

How convenient. One-stop shopping.

 

[lightsandsirens5]

I suppose this might be a good time to point out that all drugs are toxic. Just depends on the dose.

 

[mycrofft]

Yeah. I'm trying to google the safe dose of radium PO PRN AD LIB.:rofl:*

*Not laughing, screaming in pain


EDIT: Actually, I am guessing enough people used the old crazy-available meds so sparingly that most did not experience acute effects. However, the life span was around 68 for women and 70 for men, with many dead kids/babies helping pull the av. lifespan to the left.

 

[bigbaldguy]

I suppose this might be a good time to point out that all drugs are toxic. Just depends on the dose.

Oxygen isn't














*hurls himself behind a row of sand bags laughing manically.

 

[mycrofft]

If you're well enough to unleash this sort of hot-mess gate to Hell, you're darn well ready to moderate again.

 

[lightsandsirens5]

Oxygen isn't














*hurls himself behind a row of sand bags laughing manically.

 

[akflightmedic]

Oxygen isn't .

http://en.wikipedia.org/wiki/Oxygen_toxicity

 

[mycrofft]

http://en.wikipedia.org/wiki/Oxygen_toxicity

He knows, he knows. You're only buttressing his insanity plea.

"Wiseass!"