Over-the-Counter Drugs

Over-the-Counter Drugs

When people are ill, often times they are able to seek relief from medications available at their local pharmacy without having to visit a physician for prescription medicine. Typically, the conditions are minor and not life threatening. People use nonprescription, or over-the-counter (OTC), drugs to treat less serious conditions that are either transient (will pass relatively quickly), such as the common cold, or chronic (lasting for a long time or recurring frequently), such as allergies.

There are over 100 thousand different OTC drugs. The Food and Drug Administration (FDA) classifies these drugs in over eighty categories such as allergy and cough/cold medications, pain relievers, aids for digestive problems, stimulants, sleep aids, and antibacterial drugs. There are also herbal remedies, which are not regulated by the FDA and which may or may not be effective at treating ailments.

Even though a drug is OTC rather than prescription, it can still have side effects. In fact, many OTC drugs have drug interactions with prescriptions and other OTC drugs. Interactions usually cause one of the drugs to work less effectively, but they can also have dangerous, even deadly, results. In fact, there are many OTC drugs that can aggravate certain medical conditions. In this and similar cases, that particular OTC drug should be avoided altogether. Furthermore, due to certain ingredients or for other reasons, many OTC drugs should be used only by adults and older children (generally over the age of twelve), unless it is a formula made especially for younger children. This is why the use of OTC drugs requires a careful reading of a drug's label and instructions so that a consumer will have a full understanding of the drug and its proper uses. If a person doesn't understand something on the package label, a pharmacist can usually help.

This chapter presents the most common OTC drugs, from pain relievers such as acetaminophen and aspirin, to cold and flu remedies, to more controversial remedies such as sleep aids and weight loss aids.

ACNE MEDICINE


Acne is an inflammatory disease of the oil glands of the skin. Both superficial (surface) acne and deep acne are caused by a combination of bacteria, hormones, and inherited tendencies.

Over-the-Counter Drugs: Words to Know

Acetaminophen:
A generic name for a compound that affects the brain and spinal cord, altering the perception of pain and lessening it.
Allergy:
A chronic condition in which an allergic reaction occurs when the immune system responds aggressively to a certain foreign substance.
Analgesic:
A drug that alleviates pain without affecting consciousness.
Antacids:
A medication used to neutralize up to 99 percent of stomach acid.
Antibiotics:
Drugs used to treat bacterial infections.
Antihistamine:
The drugs most commonly used to treat allergies.
Anti-inflammatory:
Chemical that counteracts inflammation.
Antiseptic:
A substance that prevents the growth of germs and bacteria.
Antitussive:
A type of cough medication that calms the part of the brain that controls the coughing reflex.
Aromatherapy:
A branch of herbal medicine that uses medicinal properties found in the essential oils of certain plants.
Arthritis:
Inflammation of the joints. The condition causes pain and swelling.
Astringent:
Something that tightens the skin.
Caffeine:
An organic compound that has a stimulating effect on the central nervous system, heart, blood vessels, and kidneys.
Carcinogens:
Substance that produces cancer.
Clinical trial:
A study that evaluates how well a new drug works, positive effects, negative side effects, and how it is best used.
Cortisone:
A hormone from the steroid family that originates in the adrenal cortex and is known for its anti-inflammatory properties.
Decongestant:
A compound that relieves a stuffy nose by limiting the production of mucus and reducing the swelling in the mucous membrane by constricting the blood vessels in the nose, opening the airways and promoting drainage.
Diarrhea:
An increase in the frequency, volume, or wateriness of bowel movements.
Echinacea:
A plant (also known as purple coneflower) that herbalists believe bolsters the immune system and treats certain ailments.
Endorphins:
Hormones that the brain produces that stop the sensation of pain from being transmitted from cell to cell.
Ephedra:
A type of plant (also known as Ma Huang) used to treat ailments, including bronchial problems, and as a decongestant.
Expectorant:
A type of cough medication that helps clear the lungs and chest of phlegm.
Feverfew:
An herb used to treat migraines.
Ginkgo biloba:
A tree (the oldest living kind of tree, in fact) whose leaves are believed to have medicinal value, particularly in aiding memory and treating dizziness, headaches, and even anxiety.
Ginseng:
An herb used as a kind of cure-all, with benefits to the immune system and aiding the body in coping with stress. Some also believe it aids concentration.
Hallucination:
A vision of something that is not actually there; can occur because of nervous system disorders or in response to drugs.
Hemorrhoids:
A form of varicose veins that occurs when the veins around the anus become swollen or irritated.
Ibuprofen:
The generic name for a type of analgesic that works in the same manner as aspirin but can be used in instances when aspirin cannot.
Indigenous:
Occurring naturally in an environment.
Insomnia:
Abnormal inability to get adequate sleep.
Insulin:
Hormone used to metabolize carbohydrates.
Interaction:
When two drugs influence the effects of each other.
Laxatives:
Drugs that alleviate constipation, the inability to have a bowel movement.
Metabolism:
Process by which substances are handled by the body.
Neurotransmitters:
A substance that transmits nerve impulses.
Nicotine:
An organic compound in tobacco leaves that has addictive properties.
Nonproductive cough:
A dry and hacking cough.
Organic:
Occurring naturally.
Osteoporosis:
A disease whereby, over time, bones mass (and therefore bone strength) is decreased.
Palpitation:
Rapid, irregular heartbeat.
Panacea:
A cure-all.
Phenylpropanolamine (PPA):
A chemical that disrupts the hunger signals being sent by the brain; it is often used in weight loss aids.
Phlegm:
Sticky mucus present in the nose, throat, and lungs.
Productive cough:
A cough that brings up phlegm.
Prostaglandin:
A hormone-like substance that affects blood vessels and the functions of blood platelets, and sensitizes nerve endings to pain.
Rapid-Eye movement (REM) sleep:
A deep stage of sleep during which time people dream.
St. John's Wort:
An herb used as an anti-inflammatory drug, to treat depression, and as an analgesic.
Side effect:
A secondary (and usually negative) reaction to a drug.
Stimulant:
Substance that produces temporary increase in ability.
Topical:
Designed for application on the body.
Toxins:
Poisonous substances.
Transient:
Passes quickly into and out of existence.
Vasoconstrictor:
A drug that constricts the blood vessels to affect the blood pressure.
Yeast infection:
A common infection of a woman's vagina caused by overgrowth of the yeast Candida Albicans.

During puberty, an increase in hormones causes oil glands on the face, neck, back, and chest to become stimulated. The glands produce large amounts of sebum, a fatty substance. Sebum normally flows out of the skin along the hair follicles. However, too much sebum, combined with skin debris, can form a plug in the hair follicle called a blackhead. Once the hair follicle becomes plugged, bacteria grow in it. This bacterial infection is called acne. In severe cases of deep acne, inflamed cysts may form; sometimes these cysts can cause permanent scars.

Acne can also occur in people who aren't experiencing puberty. Certain drugs, industrial chemicals, oily cosmetics, or hot, humid conditions can also cause it. Some people believe that stress can cause or worsen adult acne.

Acne is usually treated with OTC topical (applied on the body) drugs such as sulfur or benzoyl peroxide, which can be found in products such as Clearasil and Stridex medicated pads. Unfortunately, these ingredients can dry the skin too much. In particular, the FDA is currently studying the effects of benzoyl peroxide on skin that is exposed to the sun. Because the effects are unknown at this time, it is advisable to avoid unnecessary sun exposure and use sunscreen if treating acne with benzoyl peroxide.

Another type of topical drug commonly used is keratolytic skin ointment. The ingredients in these ointments peel off the dead and hardened skin cells that form the skin surface and contribute to the sebum plug. This can cause soreness or redness, especially during the first few uses. Some OTC topical acne drugs also contain antibiotics to prevent or treat infection. Antibacterial soaps can be somewhat helpful, although they may cause irritation.

Mild cases of acne do not necessarily need to be treated with drugs. Regular washing and moderate exposure to sunlight will usually control the acne.

ANALGESICS (PAIN RELIEVERS)


Pain relievers, or analgesics, are familiar products found in most medicine cabinets. These products help consumers relieve headaches, muscle aches, fever, and other pain-related symptoms. With so many brand name products and different strengths and formulas, today's consumer has a variety of pain relieving products from which to choose. What follows are descriptions of the various pain-relieving agents available as OTC drugs.

Aspirin

Acetylsalicylic acid is known by a much more familiar nameaspirin. It is a common analgesic, or drug that alleviates pain without affecting consciousness. In the fifth century b.c., Greek physician Hippocrates, considered "the father of medicine," used powder extracted from willow tree bark to treat pain and reduce fever. The active ingredient, sodium salicylate, was discovered centuries later. This ingredient was the predecessor to aspirin.

IN 1897, GERMAN CHEMIST FELIX HOFFMAN DEVELOPED ASPIRIN WHILE TRYING TO FIND A WAY TO RELIEVE THE PAIN OF HIS FATHER'S ARTHRITIS. HE WORKED FOR A COMPANY CALLED BAYER.

Aspirin works by inhibiting the release of a hormone-like substance called prostaglandin. This chemical affects blood vessels and the functions of blood platelets and sensitizes nerve endings to pain. By limiting the prostaglandin, aspirin affects blood clotting, eases inflammation, and prevents the nerve ending at the site of the pain from becoming stimulated. It is used for headaches, muscle pain, arthritis, and to reduce fevers.

ASPIRIN FOR THE HEART?

The Bayer Company ran an advertisement for its aspirin in the 1920s that read, "DOES NOT AFFECT THE HEART." But Bayer was wrong; aspirin does affect the heart. Fortunately, aspirin has been found to be beneficial to the heart, and some of today's aspirin advertisements feature the American Heart Association's seal of approval.

It is estimated that Americans use 80 million aspirin tablets a day, and most are not taken for aches and pains. They are used to reduce the risk of heart disease. The FDA has approved the use of aspirin to treat serious cardiovascular conditions such as heart attack and stroke. It has been proven to reduce the risk of:

  • Strokes and heart attacks in those who have already had one.
  • Death or complications from a heart attack if taken at the first signs of one.
  • Recurring blockage in those who have had heart bypass surgery to clear blocked arteries.

The secret to aspirin's protective properties in relation to the cardiovascular system lies in aspirin's ability to reduce the body's production of prostaglandin, which causes blood platelets to stick together. This phenomenon can eventually lead to blocked blood vessels and clots. A blood clot in the brain causes stroke, while a blood clot in the heart causes heart attacks. By reducing the prostaglandin, the risk of heart attacks and strokes is reduced.

The American Heart Association believes that out of the nine hundred thousand lives lost each year to cardiovascular disease, five to ten thousand could be saved if more people used aspirin at the first signs of a heart attack (intermittent chest pain, shortness of breath, and fatigue). In the important first moments of a heart attack, aspirin provides "head start" therapy and a better chance for survival.

Because of its possible serious side effects, aspirin is not approved for daily use by healthy people who are not at risk for heart disease. For those who do need it, the recommended dose varies from 50 to 325 milligrams daily. Above all, aspirin should never replace a healthy lifestyle.

While it seems like a wonder drug, aspirin does have certain drawbacks. It can irritate the stomach lining, causing heartburn, pain, or nausea. Coating aspirin capsules helps reduce this irritation by preventing the release of the aspirin until it has passed through the stomach and into the small intestine; however, coating also slows the absorption of aspirin and increases the amount of time before it starts to work. Buffered aspirin reduces the acidity of the stomach's contents to lessen irritation. Taking aspirin with an antacid or after a meal will also reduce the stomach irritation. Because of these possible adverse effects, people should not take aspirin if they have a bleeding disorder, stomach ulcer, or gout (a painful disease of the joints, especially legs, hands, and feet).

Other side effects include the fact that high doses of aspirin may cause ringing in the ears. Furthermore, if children or adolescents infected with chicken pox or influenza (flu) are given aspirin, they could develop Reye's Syndrome, a sudden loss of consciousness that may cause death. Allergy sufferers should also watch their aspirin intake. If people are allergic to aspirin, they may have difficulty breathing or develop hives, itching, or swelling. Also, aspirin should not be given to someone directly before or after surgery because it decreases the blood's ability to clot, which could cause excessive bleeding.

People who consume a lot of alcohol need to be careful, tooliver damage and stomach bleeding can result when heavy drinkers use aspirin. Finally, aspirin should not be given to children under the age of twelve or to pregnant women, especially during the last three months of pregnancy since it could cause complications during delivery.

Acetaminophen

Acetaminophen is the generic (non-trademarked) name for the pain reliever found in brand name products such as Tylenol and Excedrin. It is also used to treat fever, headaches, and minor aches and pains. Acetaminophen works by affecting the brain and spinal cord, altering the perception of pain. Acetaminophen is similar to hormones that the brain produces called endorphins. These hormones stop the pain sensation from being transmitted from cell to cell. It reduces fevers by affecting the area of the brain that regulates temperature. Like aspirin, acetaminophen limits the production of prostaglandin in the brain. Aspirin affects prostaglandin production in the rest of the body as well, but acetaminophen only affects the brain. For this reason, acetaminophen does not reduce inflammation. It cannot affect swelling from arthritis, sprains, or muscle pain. It does have fewer side effects than either aspirin or ibuprofen (see below). Therefore, people with blood clots, ulcers, chicken pox, influenza, or gout can safely take acetaminophen instead of aspirin.

Individuals with liver disease should not take acetaminophen; in fact, an overdose of this drug can cause serious liver and kidney damage. Like other pain relievers, this drug should not be taken with alcoholic beverages. A risk of liver damage exists from combining large amounts of alcohol and acetaminophen. It should not be taken for more than ten days or by children under the age of twelve.

Ibuprofen

Originally available only by prescription, this drug has been available in lower strength as an OTC pain reliever since 1984. Ibuprofen can be used to treat headaches, muscle aches, arthritis, swelling, menstrual pain, and to reduce fevers. Like aspirin, it works by inhibiting production of prostaglandin, which aids blood clotting and makes nerve endings sensitive.

The possible side effects of using ibuprofen include drowsiness, heart-burn, upset stomach, nausea, vomiting, or dizziness. Taking the drug with food or milk often helps to avoid these problems. Pregnant women and people with diabetes or congestive heart failure should not take ibuprofen.

Ibuprofen is a stronger analgesic than either aspirin or acetaminophen and a better anti-inflammatory than aspirin. It can be found in brand name products such as Advil, Motrin IB, and Nuprin.

Ketoprofen and naproxen are pain relievers similar to ibuprofen. Ketoprofen has had OTC status since 1994; naproxen has been available over the counter since 1995. Ketoprofen and naproxen share side effects similar to those of ibuprofen, including heartburn and upset stomach.

ANTACIDS


The stomach is a very busy organ. It stores food, mixes food with gastric secretions, and empties food into the small intestine for digestion and absorption. Gastric acid helps with digestion and absorption of food, and it also kills bacteria found in the stomach. Acidity is measured using a pH value. The pH of gastric acid is extremely high, approximately 3 million times more acidic than the pH of blood. The stomach has a lining to protect it from this acid. The lining secretes mucus and bicarbonate, which form a barrier against the acid.

There are substances that interfere with this lining and cause the stomach to become irritated by the acid. These substances include medications, alcohol, and caffeine. Smoking and certain diseases affect the lining as well. When acid irritates the stomach, the result is heartburn, gas, indigestion, and sometimes ulcers. There are two main types of antacids to treat these problems: H2-antagonists and non-H2-antagonists. (H2 is a type of acid. The antacid types are called such because some people have an overproduction of acid.)

FROM BEHIND THE COUNTER TO OVER THE COUNTER

Many former prescription medicines can now be bought over the counter, such as Advil (pain reliever), Aleve (pain reliever), Monistat (treats yeast infections), and Tagamet HB (antacid). The FDA switches a prescription to OTC status if it determines that people can safely and effectively use the medicine after reading the medicine's package label and without physician instruction. The FDA also looks at how the medicine interacts with other drugs, how safe it is in high doses, and the risk of abusing this medicine before it approves a medication's OTC status. OTC drugs that used to be prescription medicines are usually sold in lower doses than could be prescribed by a physician.

NON-H2-ANTAGONISTS. Non-H2-antagonists were the first antacids to be available without a prescription. They work by neutralizing the gastric acid in the stomach. This makes it easier for the lining to protect the stomach. These antacids contain calcium carbonate, sodium bicarbonate, aluminum salts, or magnesium salts as their main ingredients.

Calcium carbonate takes longer to dissolve than the other ingredients but is more effective in neutralizing the acid. Calcium carbonate antacids are intended for short-term use only. Some people believe that the calcium in antacids can be used as a dietary supplement, but the amount of calcium that is absorbed by the body is actually very small.

Antacids that use sodium bicarbonate offer almost instant relief, but should not be taken by people who are on a low-sodium diet, have congestive heart failure, high blood pressure, cirrhosis, swelling, or kidney failure because of the sodium (salt) that the body absorbs from these antacids.

Aluminum salts dissolve very slowly and take longer to work. These antacids can cause constipation. They are often combined with magnesium salts, which cause diarrhea. Magnesium salts neutralize acid better than aluminum salts, but not as well as calcium carbonate or sodium bicarbonate, and they don't provide long-term relief. People with kidney failure should not use aluminum salt or magnesium salt antacids.

Some antacids have other ingredients such as aspirin or a chemical called simethicone, which relieves gas. Sometimes sodium bicarbonate antacids also contain alginic acid. This acid reacts to the sodium bicarbonate and makes a foam that treats heartburn.

H2-ANTAGONISTS. H2-antagonist antacids are now available without prescription. Originally designed to treat ulcers, they also work well for heart-burn, acid relief, and sour stomachs. These antacids work by blocking the formation of excess acid in the stomach. They do not neutralize the acid that is already there. These antacids should not be taken for more than two weeks.

Antacids in liquid form absorb faster than the other varieties, so they provide faster relief. Chewable tablets should be chewed thoroughly and work best if taken with water. Some interactions with other drugs may occur because the other drugs can bind to the antacids and will not get fully absorbed. Pregnant women should not use antacids unless recommended by their doctor.

ANTIBACTERIAL DRUGS


Antibacterial drugs work by attacking the bacteria that are causing the infection. Antibacterial medicine was first used in 1935. These early drugs were called sulfa drugs. They were so effective against a wide range of bacterial infections that they were included in the first aid pouches the U.S. Army supplied to soldiers in World War II (193945). The descendants of these early antibacterial drugs are called sulfonamides.

OTC antibacterial drugs such as Neosporin are intended to treat minor cuts and scrapes, and they contain one or more of three different antibiotics designed to treat specific types of microorganisms. Combinations of antibiotics give a broader range of treatment. Some antibacterial drugs also contain local anesthetics to alleviate the pain that can accompany infections. Other antibacterial drugs include antiseptics to prevent or slow down bacteria growth in the infected area. Mineral oil or lanolin may also be found in these drugs to speed the medication's absorption.

To further promote the effectiveness of antibacterial drugs, a person should keep the infected area clean, cool, and dry, and drink plenty of water (topical medicines are poorly absorbed by the skin if it is dehydrated). Antibacterial drugs can cause allergic reactions such as rashes and fever. These problems can often be resolved by changing to a different drug. Like many OTC drugs, antibacterial medications should not be used for more than seven days.

Cortisone

Cortisone is an organic (naturally occurring) compound from the steroid family (a group of fat-soluble organic compounds). It is a hormone that originates in the adrenal cortex (part of the adrenal glands, which are located one above each kidney), and is known for its anti-inflammatory properties. It was first introduced in 1948 as a treatment for rheumatoid arthritis. It provides relief from rheumatic fever, some kidney diseases, certain skin conditions, and allergies.

Available in many OTC creams and ointments, such as Cortaid, cortisone can cause problems with sodium, potassium, and nitrogen imbalances within the body and can sometimes cause swelling.

ANTIDIARRHEA MEDICINE


When the digestive tract is functioning normally, food and fluid pass from the stomach into the small intestine and colon. Cells that line the small intestine and colon absorb nutrients and water, then pass the waste along. If these cells become irritated, they cannot absorb the nutrients and water, as they should. The food and fluids then move through the colon too fast, which results in a watery stool called diarrhea.

There are a number of things that can irritate the cells lining the small intestine and colon. The most common culprits are allergies to certain foods and parasites or bacteria found in the food and water of some foreign countries. Stressful situations, poisons, blood pressure drugs, and drinking too much alcohol may also lead to diarrhea.

READ THE LABEL

The FDA has labeling guidelines for OTC drugs that make the packages easier to read and understand for consumers. The label must detail:

  • Active ingredients, or the primary ingredients.
  • The use, or the types of symptoms that the drug treats.
  • Directions, or the amount a person should take, how often it should be taken, and for how long.
  • Warnings, or possible interactions with other drugs or side effects the medicine may cause and what should be done if these things occur.

OTC antidiarrhea drugs, such as Imodium and Kaopectate, cannot cure diarrhea; rather they only control its symptoms. People who are experiencing diarrhea should try to rest, eat small amounts of food at a time, and avoid dehydration by drinking plenty of fluids. Antidiarrhea drugs should not be used for more than two days.

ANTIHISTAMINES AND ALLERGY DRUGS


The body's immune system protects the body from sickness and infection. To do so it must recognize and respond to any foreign substance it encounters. Histamine is an organic substance that plays an important role in the human body's response to injury or invasion. When an injury or allergic reaction occurs, the body releases histamine in response. An allergic reaction occurs when the immune system responds aggressively to a foreign substance. There are two main types of allergies; each is triggered by different substances. Perennial (year-round) allergies are usually a reaction to things such as animal dander, paint fumes, certain foods, drugs, dyes, or chemicals. Seasonal (occurring at certain times of the year) allergies are generally environmental. They are a reaction to pollens, trees, grass, ragweed, and mold spores.

Antihistamine drugs used to treat allergies are called H1 blockers because they only block histamine on H1 receptors. H1 receptors are found mostly in the small blood vessels in the skin, nose and eyes. High levels of histamine in these receptors cause an allergic reaction, usually in the way of a stuffy nose or sneezing. Allergic reactions may include itching or swelling skin such as hives, eczema, itching from insect bites, or irritation of the eyes. Antihistamines are synthetic (human-made) drugs that block the action of histamine by replacing it at one of two sites where it binds to the receptor, which prevents reactions from occurring. This reduces the irritation in the eyes and nose, congestion and breathlessness in the lungs, and redness, itching, or swelling of the skin.

Antihistamines also pass from the blood to the brain where they cause general sedation (drowsiness) and depression of certain brain functions, such as the vomiting and coughing mechanisms. Since most antihistamines have this sedative effect on the brain, they are often used in sleep aid drugs (see section on sleep aids). They are also used to control nausea and motion sickness.

GRAPEFRUIT JUICE

Some people may know that drinking grapefruit juice when taking medication can help with the body's absorption of certain drugs. But a recent study at the University of California at San Francisco has shown that in some cases, grapefruit juice may actually decrease the absorption of drugs.

Grapefruit juice increases absorption of drugs by reducing the level of an intestinal enzyme known as CYP3A4. This enzyme breaks down drug molecules before they reach the bloodstream. A University of California study, however, found that an unknown substance in grapefruit juice activates a mechanism in the intestinal tract increasing the likelihood that certain drugs will not enter the bloodstream. Some of the drugs affected by this mechanism are those used to combat cancer, treat congestive heart failure, suppress organ rejection after a transplant, control high blood pressure, and treat allergy symptoms.

Depending on the drug, grapefruit juice may either increase or decrease levels of the drug in the bloodstream; thus, people may get too much or too little medication, both of which could be dangerous situations. In most cases, doctors recommend that people avoid taking drugs with grapefruit juice until more is known about how it affects drug absorption.

Some experts believe that antihistamines should not be available over the counter because of the drowsiness and sluggishness that is associated with their consumption. Other side effects include blurred vision, dry mouth, constipation, and light-headedness (all of which are particularly prominent in elderly users). Pregnant women and sufferers of chronic bronchitis, emphysema, and glaucoma should avoid antihistamines. Like many drugs, most antihistamines should not be taken with alcohol, antidepressants, or sedatives.

Antihistamines are not usually helpful in treating the common cold. They are sometimes used to treat fever, rash, and breathing problems that result from reactions to blood transfusions, and allergic reactions to drugs. Anti-histamines containing diphenhydramine are sometimes used in the early stages of Parkinson's disease.

These drugs should not be used for longer than seven days or by children under the age of six. Avoiding the substances that cause allergic reactions is usually the best treatment for allergies, when possible. If OTC allergy drugs do not help alleviate symptoms, allergy shots administered by a physician may be a viable alternative.

Decongestants

The lining of the nasal (nose) passages is called the mucous membrane. When infection, such as a cold or an allergic reaction, occurs, the blood vessels that supply the mucous membrane become enlarged and the mucous membrane swells. Fluid accumulates in nearby body tissue and mucus (the sticky substance secreted by the mucous membrane) is produced in larger amounts than usual. The result is a stuffy nose. Decongestants relieve a stuffy nose by limiting the production of mucus and reducing the swelling in the mucous membrane by constricting the blood vessels in the nose. This opens the airways and promotes drainage of nasal passages.

There are two types of decongestants: topical (applied to the body) and oral (taken by mouth). Topical decongestants are sprays or drops that are used directly in the nose, such as Neosenephrine. There are short- and long-acting topical decongestants that can provide relief from four to twelve hours; they usually start to work within a few minutes. Topical decongestants should not be used for more than three days because there is a risk of developing a problem called rebound congestion. When a person stops using a topical decongestant after using it for longer than recommended, the blood vessels in the mucous membrane will suddenly widen because they are no longer constricted by the drug. This causes congestion to occur all over again.

Oral decongestants, such as Drixoral, are taken through the mouth. Their effects are usually longer lasting than those of topical decongestants but they also take longer to yield noticeable relief. They are also more likely to cause side effects, such as increased heart rate and trembling, than topical decongestants. Both topical and oral decongestants should be used only by adults or children over the age of twelve unless advised by a doctor.

People with high blood pressure, diabetes, heart disease or an overactive thyroid should only use decongestants with their physician's approval. If a

person uses decongestants too frequently, she or he may develop problems, such as nervousness, insomnia, dizziness, headaches, or palpitations.

COLD AND COUGH/FLU MEDICINES


Contrary to popular belief, going outside on a cold day with wet hair does not cause a person to catch the common cold. Viruses, tiny diseaseproducing particles, are the culprits. Viruses can easily be transferred from person to person via the air (when a person sneezes, for example) or via objects such as door knobs and telephones. (That is why washing one's hands often helps cut down on the transmission of viruses.) The symptoms of a cold are a runny or stuffy nose, coughing, sneezing, and a sore throat. These symptoms usually last five to seven days. If the symptoms persist for seven to ten days and include fever, tiredness, and headache, it could be influenza (flu).

There is no cure for a cold or flu; the only medical option available is the treatment of the symptoms to provide a person with some relief. OTC cold and flu medicines, such as Nyquil, usually contain antihistamines, decongestants, and analgesics, such as aspirin or ibuprofen.

COUGH MEDICATIONS. There are two types of coughproductive and nonproductive. Productive coughs bring up phlegm (mucus produced by the mucous membranes in chest and lungs) and can often be treated by inhaling steam, which makes it easier to cough up the phlegm. If steam doesn't work, expectorants like Robitussin are used to help clear the phlegm from the chest and lungs. Nonproductive coughs are dry and hacking. This kind of coughing is treated with antitussives, which calm the part of the brain that controls the coughing reflex. Antitussives have a sedating effect on the brain and nervous system, so drowsiness and other side effects are common.

Most cough medicines are made up of active ingredients and flavorings added to a syrupy base. Some cough medicines contain active ingredients that work against each other, such as expectorants that produce phlegm and antitussives to suppress the body's ability to cough it up. A person must carefully read the label and choose a cough medicine that treats the kind of cough one has. Using the wrong type of cough medicine could cause the condition to worsen. If a cough lasts longer than two days or symptoms such as fever or blood in the phlegm are present, a physician should be consulted immediately.

Because many cough and cold remedies contain antihistamines, users should be certain that they are not taking another product containing antihistamines at the same time. Furthermore, cough and cold medicines should not be taken with tranquilizers or sedatives or for more than seven days. Sufferers of asthma, emphysema, glaucoma, heart disease, high blood pressure, or thyroid disease should avoid using these drugs. People with diabetes need to choose a sugar-free product. Most cold and cough remedies offer specific formulas for both adults and children.

HEMORRHOID MEDICINE


Hemorrhoids are a form of varicose (swollen or knotted) veins that occur when the veins around the anus become swollen or irritated. This is usually the result of prolonged back pressure from pregnancy or frequently sitting for long hours at a time. Hemorrhoids will cause itching, burning, pain, swelling, irritation, or bleeding around the anus. Constipation can make hemorrhoids worse.

There are two ways to treat hemorrhoids using OTC drugs. There are creams and suppositories that relieve most of the symptoms. These drugs usually consist of a soothing agent that contains an antiseptic, an astringent (such as bismuth, witch hazel, and zinc oxide), or a vasoconstrictor (shrinks blood vessels). These ingredients reduce swelling, burning, and itching, and restrict blood supply to the area. Some also contain a local anesthetic (pain blocker) to ease the pain. These drugs may cause irritation or a rash. The second method of treatment is to relieve constipation, which makes hemorrhoids more uncomfortable, with laxatives. Laxatives soften waste to ease its passage through the intestines.

Neither treatment actually shrinks the hemorrhoids. They simply provide relief while the problem corrects itself naturally. OTC hemorrhoid drugs are available in ointments, suppositories, and medicated pads with witch hazel, such as Tucks. Severe or persistent hemorrhoids may need to be removed surgically. If a person has hemorrhoids, it is a good idea to see a doctor as the hemorrhoids could be a sign of a more serious bowel disorder.

LAXATIVES


When people's bowels do not move as often as usual and the waste becomes hard and difficult to pass, they have constipation. Other symptoms may include lower back pain, a distended stomach, or a headache. Constipation is usually the result of limited water intake or a diet that is lacking in fiber. Fiber naturally provides bulk, which makes the waste soft and easy to pass. A diet that includes more fruits, vegetables and whole grain breads will provide more fiber. Also, certain diseases and drugs such as narcotic analgesics, antidepressants and antacids that contain aluminum may cause constipation. Lack of exercise may be a contributing factor as well.

Constipation is commonly treated with OTC drugs called laxatives, which stimulate bowel muscles or affect waste consistency. Laxatives are also used to prevent pain for people suffering with hemorrhoids or after childbirth or abdominal surgery. Laxatives should only be used for short-term therapy (no longer than a week) and should not be used to achieve weight loss. Overuse of laxatives is dangerous and can lead to severe deficiencies in vitamins and minerals. People can also develop a dependency on laxatives if they are used for too long; this can lead to chronic constipation.

There are two main types of OTC laxatives, and both affect the large intestine. Bulk-forming laxatives, such as Metamucil, absorb water, increasing the volume of waste in the bowel and making it softer and easier to pass. These laxatives produce results within twelve to seventy-two hours. Stimulant laxatives, such as Ex-Lax and Senokot, use senna to make the bowel muscle contract, which speeds the passage of waste through the intestine. Overuse of stimulant laxatives can cause dehydration, severe cramping, and loss of protein and potassium. Products such as Doxidan contain both a stimulant laxative and stool softener.

FDA APPROVAL

By law, all new drugs have to be proven effective and safe before the Food and Drug Administration (FDA) will approve them. Even with FDA approval, however, no drug is completely safe; there is always a risk of a bad reaction. The FDA must weigh the risks against the benefits when deciding to approve a new drug.

The process begins with the drug's sponsor, which is usually the manufacturer. The sponsor submits studies called new drug applications (NDAs) that show the effectiveness and safety of a drug. The NDA is supposed to tell the whole story about the drug, including what happened in the clinical trials; what components make up the drug; the results of studies on animals; how the drug behaves in the body; and how it is manufactured, processed and packaged. The clinical trials are especially important because they demonstrate how effective the drug is. (A clinical trial allows researchers to fully understand a drughow it works, positive effects, negative side-effects, and how it is best used. People allowed to participate in drug trials usually share certain characteristics that make them appropriate for that specific trial. Furthermore, the trials usually take place under the supervision of a physician at a hospital, treatment center, or a university.) The human studies provide information that will be used for the drug's professional labeling, which is the guidance that the FDA approves for using the drug.

NDAs for drugs with the greatest potential benefit have priority over other NDAs. For example, all AIDS (acquired immunodeficiency syndrome) drugs have the highest priority, as well as drugs that offer significant advances over current therapies for any disease.

When the FDA analyzes a drug, the decision to approve it is based on two questions:

  • Do the studies provide enough evidence of effectiveness?
  • Do the results show that the product is safe (that the benefits outweigh the risks) when used according to the proposed labeling?

The FDA's review will have one of three outcomes. The FDA may tell the sponsor that the drug is approved. The drug is then placed on the market as soon as the manufacturer has production and distribution systems in place. The FDA may also tell the sponsor that the drug will be approved if minor changes are made, or that the drug cannot be approved because of major problems. At that point, the sponsor can either amend (change) or withdraw the NDA or ask for a hearing.

The approval process can be sped up for some promising experimental drugs. These drugs can be used in unrestricted studies that not only tell researchers more about the drug but that also make treatment available to people who have exhausted all available forms of treatment. These studies are used for drugs that treat serious or life-threatening diseases for which there is currently no viable treatment.

OTC drugs used to be approved using the same standards as prescription drugs. The FDA now classifies an OTC drug by treatment category (laxative, analgesic, etc.) and evaluates the ingredients. An OTC drug does not require specific approval as long as it meets the standards that the FDA has determined for the drug's category.

Laxative users should visit their doctors if they experience nausea, vomiting, bleeding, dizziness, or weakness while using OTC laxatives. Children under six should not use laxatives unless they have been so advised by their doctor.

PMS MEDICINE


Premenstrual Syndrome (PMS) is the name given to a group of physical and emotional symptoms that women may experience prior to the start of menstruation each month. The symptoms usually begin seven to fourteen days before the onset of menstruation and can last until twenty-four hours after menstruation ceases. It is estimated that over 40 percent of women experience some symptoms of PMS.

The symptoms and their intensity can vary. Physical symptoms include headache, cramps, backache, bloating, constipation, and diarrhea. The emotional symptoms may include irritability, lethargy or tiredness, and quick mood swings. OTC drugs for PMS, such as Pamprin and Midol, treat the physical symptoms using analgesics to help relieve the pain and diuretics to reduce the bloating.

SENNA

The leaves and fruit of the senna plant, a member of the pea family, are used in herbal medicine as a potent (strong) laxative. Like other herbal remedies, people who use it should be well informed about its negative effects. Senna, also called Cassia, can cause cramps, nausea, heart palpitations, or severe diarrhea. Long-term use of senna can flush out important minerals. One of the minerals at risk is potassium, which keeps the heart beating normally. Potassium can be found in potatoes, squash, bananas and orange juice, but laxatives prevent the mineral from being absorbed. Low levels of potassium over an extended period may cause heart problems, even death. Women who are pregnant or nursing should avoid senna, since the drug passes directly through their breast-milk and can give a nursing infant diarrhea.

The best way for women to treat PMS is to avoid stress, exercise regularly, and watch their diets. A diet high in protein, complex carbohydrates, and vitamin B can help lessen the symptoms of PMS. It also helps to avoid salt (which helps the body retain water), coffee, tea, chocolate and cola (which contain caffeine and can contribute to headaches).

YEAST INFECTION MEDICINE


A yeast infection is a common infection of a woman's vagina caused by overgrowth of the yeast Candida Albicans. This yeast is naturally present in the vagina, but it multiplies rapidly when there is a change in the pH or hormone balance. This rapid growth can also be caused by antibiotics or steroid therapy. Women with diabetes often experience yeast infections because the yeast also grows quickly when their blood sugar level is high. The symptoms of a yeast infection are itching, burning, and redness in the pubic area.

OTC yeast infection drugs, such as Vagisil, treat the symptoms, while drugs such as Monistat actually kill the yeast. Available in suppository form, these drugs can cause negative interactions with oral contraceptives (birth control pills) and antacids and should not be used by pregnant women.

OTHER COMMON OTC DRUGS


There are certain OTC drugs that are somewhat controversial in nature because they are known to be addictive (habit-forming) or because they have been linked to abuse and misuse, such as sleep aids and diet pills. There are other OTC drugs that a person might not naturally recognize as being an actual "drug," such as caffeine, which is considered a drug that, when misused, can have dangerous effects.

Caffeine and Caffeine-Based Stimulants

Caffeine is classified as a drug by the FDA. An organic (natural) compound, caffeine has a stimulating (speeds up or excites) effect on the central nervous system, heart, blood vessels, and kidneys. Caffeine can also make a person feel more alert and less tired. It can also cause irritability, nervousness, jitters, headaches, anxiety, and insomnia (sleeplessness). Consumed in excess, caffeine can cause heart palpitations, diarrhea, and vomiting. Some research studies have suggested that caffeine plays a role in the development of birth defects, ulcers, breast disease, diabetes, heart disease, osteoporosis, and high blood pressure. Girls, in particular, should avoid consuming caffeine if they are experiencing PMS (Pre-menstrual Syndrome) as it can make the symptoms worse.

HOW MUCH CAFFEINE?

Doctors recommend a daily caffeine intake of no more than 200 mg (milligrams) or less. How much caffeine is in what you eat and drink?

  • Chocolate cake1 slice     30 mg
  • Cola12 oz     45 mg
  • Ice tea5 oz     100 mg
  • Coffee6 oz     175 mg

Some OTC drugs have caffeine, too:

  • Anacin     64 mg
  • Excedrin     130 mg
  • NoDoz     200 mg

Because caffeine is found in many common products, it can be easy to consume too much of it. Coffee, tea, many soft drinks, chocolate, and many medications, such as pain relievers and weight loss aids, all contain caffeine. To help maintain alertness and prevent sleep, people often use OTC stimulant products containing caffeine. However, because of the side effects that accompany the excessive use of caffeine or any kind of stimulant, these products are intended for short-term use only.

Why do people use OTC stimulants to stay awake if they can drink coffee or have a caffeinated soft drink? Compared to caffeinated beverages, the caffeine used in brand name products such as Vivarin and NoDoz tends to be less irritating to the stomach than that which is found in coffee.

Nicotine and Nicotine-Replacement Products

Like caffeine, nicotine is also considered a drug. Nicotine is an organic compound found in tobacco leaves. These leaves are used to make cigarettes, chewing tobacco, and other tobacco-based products. Since nicotine is addictive, regular smokers tend to become addicted to nicotine. And, in spite of the fact that many people use tobacco on a regular basis, nicotine is highly toxic (poisonous) in large doses, which can cause vomiting, nausea, headaches, stomach pains, convulsions, paralysis, and even death. In fact, nicotine is toxic enough that it is a component in some insecticides.

The very thing that causes smokers to become addicted to smoking, however, can be used to help them quit. Smoking provides a steady supply of nicotine, which causes smokers' bodies and brains to crave nicotine when they cease smoking. Often these cravings are so strong they make smokers very likely to start smoking again after they attempt to quit. Ironically, nicotine is used in nicotine replacement therapy (NRT) products. NRT products are temporary aids that are used on a regular schedule; they provide the body with nicotine but do so without necessitating the user to smoke. Over time, these products, which are available in many forms, including the patch, pills, and chewing gum, help lessen nicotine cravings and also help smokers move away from the actual habit of lighting up a cigarette or chewing tobacco. All of this contributes to the diminishment of withdrawal symptoms. In many of the products, the dosage of nicotine is gradually decreased to help smokers wean themselves off nicotine.

Sleep Aids

When people don't get enough sleep, they often feel tired, overwhelmed, and stressed out. In fact, too much stress could even be the reason they aren't getting enough sleep.

There are several types of sleep disturbances. Sleep disturbances fall under the sleep disorder category of insomnia, which is a difficulty falling or staying asleep or a disturbance in sleep that causes individuals to feel as though they did not get an adequate amount of sleep. Transient insomnia lasts only a few days and doesn't require treatment. This is usually the result of a temporary worry or discomfort from a minor illness. If people have chronic, or long lasting, lack of sleep, they need to see doctors instead of trying to treat the problem themselves. Chronic sleeplessness could be caused by psychological (mind-related) problems, such as severe anxiety or depression, or by a physical disorder.

Most OTC sleep aids work by interfering with the chemical activity in the brain and nervous system by limiting communication between the nerve cells. This reduction in brain activity allows a person to fall asleep more easily. Many sleep aids use the antihistamines diphenhydramine and doxylamine to depress brain function. (Antihistamines are drugs that relieve the symptoms of allergies or colds.) With this in mind, anyone taking antihistamines should not be taking sleep aids containing the same ingredient and vice versa. Sominex and Unisom are two examples of brand name sleep aids that contain antihistamines.

MANY PEOPLE THINK THAT DRINKING WARM MILK WILL HELP THEM GET TO SLEEP. IN FACT, WARM MILK CONTAINS A CHEMICAL CALLED TRYPTOPHAN THAT MAY ACTUALLY DISTURB SLEEP INSTEAD OF PROMOTING IT.

GETTING TO SLEEP NATURALLY

Here are some ways to promote sleep without using medication:

  • Watch caffeine intake, and avoid consuming caffeine late in the day or at night.
  • Avoid strenuous exercise for two to three hours before bedtime.
  • Skip bedtime snacks.
  • Try to go to bed at the same time each night.
  • Minimize light and noise at bedtime.
  • Do something relaxing before bedreading, lounging, or taking a bath.
  • Stop worrying! Try writing worries down to clear your mind before going to bed.
  • Don't use bed for studying or watching TV.

Transient insomnia, which lasts less than three weeks, is treatable with OTC sleep aids, which should be used only when lack of sleep is affecting a person's general health. The purpose of the sleep aids is to reestablish the habit of sleeping, and their effectiveness is reduced rapidly after the first few nights; this means that they work best for a limited time. OTC sleep aids should not be used for more than seven to ten days or by children under the age of twelve.

Sleep aids, by virtue of their purpose, may cause drowsiness, slowed reactions, and slurred speech. Most people who use them are asleep within an hour of taking them. However, the sleep induced by sleep aids is not the same as the sleep one experiences when falling asleep naturally. Because of this, then, people taking sleep aids often feels less rested than if they had fallen asleep naturally. One reason for this may be that these drugs suppress rapid eye movement (REM) sleep, the stage of sleep during which people have dreams. All stages of sleep are important to awakening in the morning feeling rested.

Non-antihistamine sleep aids can be addictive if taken regularly for more than a few weeks or in large doses. This is a danger, as the effects of all OTC sleep aids will diminish after a few nights' use. This may prompt a user to take more than the recommended dose. When people who exceed the recommended dose stop taking these drugs after becoming dependent upon them, they may experience sleeplessness, anxiety, seizures or hallucinations. They may also have nightmares or vivid dreams because the amount of REM sleep suddenly increases again.

Some analgesic (pain-relieving) or anti-fever drugs can also induce sleep. These are most effective if pain is keeping a person from falling asleep. People should avoid these drugs if they have are allergic to aspirin or acetaminophen.

Weight Loss Aids

OTC weight loss aids are designed to suppress (restrain) the appetite. The main ingredient in weight loss drugs such as Dexatrim or Acutrim is phenylpropanolamine (PPA). PPA disrupts the hunger signals being sent by the brain and gives people a dry mouth, which makes food taste bland and unappetizing. The effectiveness of weight loss aids, particularly PPA, is a highly debated issue. One study showed that people using PPA lost only five pounds more than those who were not using the drug at all. Furthermore, PPA has been shown to be effective for only three months.

Another factor working against PPA is that low doses of it are not very effective, and high doses can cause nervousness, nausea, insomnia, headaches, and high blood pressure. Elevated blood pressure can lead to an increased risk for stroke and other cardiac problems in individuals predisposed to these ailments. Because all of these side effects will worsen with time, PPA is not to be used for more than three months, and it should not be used by anyone under the age of eighteen or over the age of sixty. Weight loss aids containing PPA should not be used in conjunction with cold and cough medicines, as many contain PPA as well, thus putting too much PPA into the consumer's system at once.

The FDA recently banned 111 other ingredients in OTC weight loss aids because their effectiveness could not be proven. These ingredients include

alcohol, vitamin C, caffeine, sodium, and yeast. The FDA is still investigating PPA.

HERBAL MEDICINE


Many of today's drugs are derived from plants. Medicinal herbs are parts of plants that are used to treat illnesses and improve health. They have become ingredients in cosmetics, foods, teas, detergents, and even veterinary remedies. There is some controversy over the benefits of herbal medicines, and their effectiveness and safety have not been proven.

Herbal remedies are available in teas, syrups, decoctions (tough plant material that is boiled), tinctures (herbs steeped in alcohol and water), tonic wines, capsules, compresses, oils, ointments, creams, lotions, inhalants, and

eyewashes. In general, herbal medicine is untested and unregulated. It can also have harmful interactions with similar synthetic (human-made) drugs. Always check with a physician before taking any herbal medicine.

Echinacea (Purple Coneflower)

Echinacea (pronounced ek-i-NAY-sha), known commonly as purple coneflower because of its color and shape, can be found growing on road banks, prairies, fields and dry, open woods of North America. Native Americans and early settlers used it to treat fevers, wounds, toothaches, sore throats, mumps, smallpox, measles and snakebites, which is why it is also called snakeroot. Echinacea boosts the body's immune system to help it fight off disease and has antibacterial properties as well. Early herbalists used the root of Echinacea to cleanse and heal wounds and also to treat skin disorders like boils and abscesses.

Studies have shown that Echinacea stimulates production of white blood cells, which fight infection, and increases the level of T-cells and other components of the immune system. Echinacea also improves the migration of white blood cells to attack foreign organisms and toxins. Furthermore, it inhibits an enzyme that destroys the natural barrier between healthy tissue and harmful organisms. Echinacea has mild antibiotic properties that are effective in treating staph and strep infections. In animal experiments, it has proven to be effective in inhibiting the growth of tumors.

Today's herbalists use this plant to treat viral, bacterial, and fungal infections such as colds, flu, and kidney infections. Echinacea helps the body defend itself against flu and may help reduce the runny nose and sore throat that accompany the flu. It can be helpful in treating tonsillitis, inflamed gums, and some forms of arthritis. Some herbalists recommend Echinacea for the treatment of chronic fatigue syndrome, indigestion, gastroenteritis, and for weight loss. It is applied externally to treat skin conditions such as burns, insect bites, ulcers, psoriasis, acne, and eczema, and there is even some evidence that it is helpful in treating allergies.

Echinacea is usually available as a tablet or tea. People who suffer from multiple sclerosis, AIDS, tuberculosis, or who are pregnant or nursing should not use Echinacea because it could trigger overactive autoimmune responses (the production of antibodies that attack the body's own cells and tissues). There are no other known side effects.

AROMATHERAPY

Aromatherapy is the use of fragrant, concentrated oils from parts of plantssuch as their flowers, fruit, stalks, roots, and barkfor the purpose of improving a person's physical and emotional well-being. It is believed that aromatherapy has been used to increase well-being for thousands of years. The Egyptians were probably the first to use essential oils. These oils occur naturally in plants and are extracted from the flowers and leaves. They are believed to improve healing ability and have a beneficial effect on the human mind. Research has shown that they are effective in treating anxiety and depression by stimulating nerves that are linked to the parts of the brain that control emotions.

Essential oils should never be used internally. They are commonly used for massage, added to hot bath water, or used in a vaporizer.

Ephedra (Ma Huang)

Ephedra (also known by its Chinese name Ma Huang) has been cultivated in China over the last 5,000 years. The dried young stems of the herb ephedra are used to treat sinusitis, colds, asthma, hay fever, and other allergies. It appears to have antibacterial properties and is the source of the synthetic (human-made) drug ephedrine, which is often used in decongestants. However, in traditional Chinese medicine the entire plant is used, not just the isolated compound of ephedrine. The Chinese have used ephedra at the first sign of a cold or flu and to treat arthritis and fluid retention.

Ephedra indirectly stimulates the central nervous system. It is effective for treating asthma because it relaxes the airways. It also raises blood pressure, so people with hypertension (elevated blood pressure) or coronary thrombosis (a blockage in a vein or artery of the heart) should not use ephedra. People who are currently taking certain types of antidepressants or have glaucoma should not use ephedra either. Other possible side effects include

headaches, irritability, restlessness, nausea, sleeplessness, and vomiting. Only adults and children over six years of age should use ephedra, and it is intended for short-term use only, because people can become dependent on it. Because of the possible side effects, ephedra is restricted in the United Kingdom, Australia and New Zealand. (Ephedra has not applied for FDA approval in the United States so its use is still unrestricted in most states.)

Feverfew

Feverfew is also known as featherfew or bachelor's buttons. It was first brought to the United States as an ornamental (decorative) plant. Clinical trials have shown that it is effective in the treatment of migraine headaches and reduces the frequency and severity of other headaches. Feverfew limits the release of the chemicals serotonin and prostaglandin in the body, which are believed to be the sources of migraine headaches. It also slows the production of histamine, so the inflammation that constricts the blood vessels in the head is reduced.

Feverfew is also known for offering relief from depression, nausea, and the pain of arthritis. Tea made from the herb is used to stimulate appetite and improve digestion and kidney function. It has been proven to lower blood pressure and cause less stomach irritation than aspirin or other pain relievers. It is believed to be helpful in treating dizziness, tinnitus (ringing in the ears), symptoms of premenstrual syndrome, asthma, and coughs.

Chewing fresh leaves of feverfew may cause mouth ulcers or loss of taste in the mouth, and pregnant women or people who are using anticlotting drugs should not take this herb.

Garlic

Although most people think of garlic as a seasoning, it is also known as nature's most versatile plant because of its medicinal uses. A member of the onion family, garlic is used to treat a wide range of health problems. It has been used for thousands of years to treat wounds, infections, tumors, and intestinal parasites. Today, clinical trials have shown that garlic lowers cholesterol and blood pressure, kills bacteria like antibiotics, and is an effective blood thinner, which reduces the risk of heart attacks and strokes. The National Cancer Institute is studying garlic as a treatment for stomach, skin, and colon cancer. Garlic is even used externally to treat corns, warts, calluses, muscle pain, and arthritis.

Garlic contains a chemical called amino acid allicin that is released when the bulb is crushed. This chemical gives garlic its strong odor and is responsible for garlic's antibacterial properties. Garlic also contains compounds of sulfur, vitamin A, and vitamin C, which combine to make it a strong antioxidant. Antioxidants protect the body at a cellular level from damage and disease.

This herb also stimulates the body's natural defenses. Garlic increases the activity of white blood cells and other components of the immune system. In fact, garlic is reported to be more effective than penicillin in the treatment of typhus disease. Garlic also helps the body fight off strep, staph bacteria, and the organisms responsible for cholera and dysentery. Many people use garlic to help prevent colds, flu, and other infectious diseases. Studies have shown that garlic stimulates the liver's production of detoxifying enzymes that the body uses to protect itself from carcinogens (cancer-causing agents) and other toxins.

Garlic may even have anti-cancer properties. It may prevent cells from turning cancerous by helping the body remove toxic substances. Many people believe garlic boosts immunity. The National Cancer Institute reported in 1992 that people who ate large amounts of garlic and onions seemed to have lower chances of getting stomach cancer.

Research has shown that garlic reduces "bad" cholesterol, or LDL, levels while raising the level of HDLs, or "good" cholesterol. Garlic is beneficial in any and all formsraw, dried, oil, or in prepared pill formbut must be used for at least two or three months before its good effect on cholesterol becomes evident, and it may even raise cholesterol a bit at first, but it has none of the side effects of other cholesterol-lowering drugs. Garlic is also used as a blood thinner and to reduce blood clots and improve circulation. It lowers blood pressure by slowing the body's production of hormones that raise blood pressure. There have been clinical trials that show garlic can be used to effectively manage mild hypertension.

Garlic is even used to treat diabetes, urinary infections, acne, asthma, sinusitis, arthritis, ulcers, and respiratory infections like bronchitis, although its effectiveness has not been proven. It is used as a dietary supplement to maintain good circulation, reduce fat levels in blood, help resist infection, and balance out blood sugar and pressure. In large quantities, however, garlic can cause upset stomach.

Ginkgo Biloba

Ginkgo is indigenous (native) to China, Japan, and Korea. It is the oldest living tree species, and geologists (scientists who study the origin and structure of the earth) believe it has been around for 150 to 200 million years. Studies have shown that ginkgo helps prevent many health problems throughout the entire body.

Gingko increases blood flow through the network of blood vessels that carry blood and oxygen to the body's organs, including the brain. It boosts oxygen levels in the brain, which improves short- and long-term memory and increases reaction time. It is sometimes used to treat people with Alzheimer's disease and other problems with memory, absentmindedness, confusion, depression, headache, and difficulty with concentration. It is also used to treat tinnitus, dizziness and anxiety. Some people take ginkgo to combat mental fatigue and lack of energy.

The increased blood flow to other organs can improve circulation in the hands and feet, reduce swelling, and treat hemorrhoids, varicose veins, and chronic arterial blockage. It can help with complications from strokes and skull injuries. Gingko may be able to relax constricted blood vessels and reduce the amount of cholesterol that turns into plaque, which hardens the arteries. Furthermore, studies have proven that ginkgo helps improve eyesight by increasing the blood flow to the retinas, which slows their deterioration and increases vision. It also improves hearing in elderly patients. It is being tested as a potential treatment for asthma, toxic shock syndrome, and to help prevent transplanted organs from being rejected.

Ginseng (Panax)

This sweet-smelling herb is native to China, Russia, North Korea, Japan and some areas of North America. The name panax comes from the Greek word panacea, which means, "all healing." Ginseng has been used in various forms for more than seven thousand years, and it has known widespread use since the eighteenth century. Wild ginseng is rare, so the plants are cultivated (grown with the help of man). Ginseng roots are called Jin-chen, which means "like a man" because they are shaped like the human body. These roots can live for over 100 years.

Vitamins A, B6, and the mineral zinc are all found in ginseng. It also contains steroid-like ingredients that help balance and counter the effects of stress. Studies from China show that these ingredients increase production of proteins and activity of the brain's neurotransmitters. These actions help with memory and concentration, which can be impaired by inadequate amounts of blood supplied to the brain. Studies from Russia and London indicate that ginseng improves concentration and endurance.

Ginseng is often used as a tonic for people who are weakened by disease, old age, or stress. It is believed to help invigorate those who feel fatigued and are having difficulty working and concentrating. Siberian ginseng has been used since the 1930s to combat stress. It increases energy, stamina, and helps the body defend itself against infections and environmental toxins. Ginseng has both a soothing and stimulating effect on the central nervous system. Many people use this herb to improve mental performance, learning, memory, and sensory awareness. Too much ginseng, however, can cause sleeplessness.

Ginseng should not be used by people who have acute inflammatory disease or bronchitis, since the herb can actually make these problems worse. Pregnant women should not take ginseng.

St. John's Wort

St. John's Wort comes from a bushy perennial plant with yellow flowers that is native to Europe and the United States. Some people believe its name comes from early Christians who named it after St. John the Baptist and collected it on June 25, St. John's Day. Others believe its name comes from the Knights of St. John of Jerusalem, who used it to heal wounds during the Crusades (military campaigns undertaken by European Christians in the eleventh, twelfth, and thirteenth centuries). St. John's Wort has been used for centuries as a nerve tonic and has a wide range of other medicinal uses. Red extracts from the herb's blossoms are used externally as an anti-inflammatory to treat burns, wounds, and joint problems. It soothes burns by lowering the temperature of the skin. St. John's Wort is being tested to determine how effective it is in the treatment of immune deficiency problems. This herb has antiviral and antibacterial properties and is even being studied as a possible treatment for AIDS.

Today, St. John's Wort is commonly used as a mild antidepressant. Studies have shown that it can be effective in treatment of people suffering from mild to moderate depression. Reports show there was some improvement in the sadness, helplessness, hopelessness, anxiety, headaches, and exhaustion experienced by people with mild depression when taking St. John's Wort, and without any reported side effects.

The active ingredient in St. John's Wort is hypericin, which increases the theta waves in the brain. These waves usually occur while a person is asleep and are associated with meditation, pleasure, and increased creative ability. The herb also contains monoamine oxidase, which affects the brain's sera-tonin. Both of these chemicals act similarly to the synthetic chemicals in prescription drugs used to treat depression. St. John's Wort should never be taken with other antidepressants, and it is not effective in treating severe depression. It is best to discuss symptoms with a doctor to determine if, and at what level, one is experiencing depression.

St. John's Wort is also used to repair nerve damage and reduce pain and inflammation, such as menstrual cramps and arthritis. It also affects the secretion of bile to soothe the digestive system. In folk medicine, the blossoms of St. John's Wort are used to treat ulcers, gastritis, diarrhea, and nausea. The oil of the plant is sometimes applied to sprains, bruises, and varicose veins to relieve inflammation and promote healing.

This drug should not be used by women who are pregnant or nursing, or by people who are taking antidepressants such as Prozac. Long-term use (more than four to six weeks) of St. John's Wort may cause photosensitivity, which is an increased sensitivity to sunlight. It may also cause constipation, and fair-skinned people may be more susceptible to sunburns.

FOR MORE INFORMATION


Books

Adderley, Brenda D. Doctor's Guide to OTC Drugs. Warner Books, 1998.

Hill, Clare. The Ancient and Healing Art of Aromatherapy. Ulysses Press, 1998.

Leber, Max, et al. Handbook of Over-The-Counter Drugs and Pharmacy Products. Celestial Arts, 1995.

Ody, Penelope. Home Herbal. London: Dorling Kindersley Limited, 1995.

Sifton, David W. The PDR Guide to Over-the-Counter Drugs. Ballantine Books, 1998.

Web sites

Food and Drug Administration. [Online] http://www.fda.gov/ (Accessed September 10, 1999).

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