Most OTC medication is generally considered to be safe enough that most persons will not hurt themselves accidentally by taking it as instructed. Many countries, such as the UK have a third category of pharmacy medicines which can only be sold in registered pharmacies, by or under the supervision of a pharmacist. However, the precise distinction between OTC and prescription depends on the legal jurisdiction. Medications are typically produced by pharmaceutical companies and are often patented. Those that are not patented are called generic drugs.

An anti-diabetic drug or oral hypoglycemic agent is used to treat diabetes mellitus. They usually work by lowering the glucose levels in the blood. There are different types of anti-diabetic drugs, and their use depends on the nature of the diabetes, age and situation of the person, as well as other factors.

Insulin is the only non-oral antidiabetic drug. It is the mainstay of treatment in type I diabetes, in which insulin production is impaired. In type II diabetes, it is used when oral medication has become ineffective.

Sulfonylureas were the first widely used oral hypoglycemic medications. They are insulin secretagogues, triggering insulin release by direct action on the KATP channel of the pancreatic beta cells. Seven types of these pills have been marketed in North America. Four, known as "first-generation" drugs, have been in use for some time, but not all remain available. Three "second-generation" drugs, are now more commonly used. They are stronger than first-generation drugs and have fewer side effects.

Sulfonylureas bind strongly to plasma proteins. Sulfonylureas are only useful in type II diabetes, as they work by stimulating endogenous release of insulin. They work best with patients over 40 years old, who have had diabetes mellitus for under ten years. They can not be used with type I diabetes, or diabetes of pregnancy. They can be safely used with biguanides and glitazones. The toxicity of these drugs on the whole is relatively low.

Meglitinides are related to sulfonylureas. The amplification of insulin release is shorter and more intense, and they are take with meals to boost the insulin response to each meal.

Repaglinide (Prandin) - The max dosage is 16mg/day. Take this drug 0 to 30 minutes prior before eating a meal. If a meal is skipped, then the medication should also be skipped.

Nateglinide (Starlix) - The max dosage is 360 mg/day, usually 120 mg three times a day (TID). It also follows the same recommendations as Repaglinide.

Biguanides reduce hepatic glucose output. Although it must be used with caution in patients with impaired liver or kidney function, metformin has become the most commonly used agent for type 2 diabetes in children and teenagers.

Thiazolidinediones, also known as "glitazones," bind to PPAR?, a type of nuclear regulatory protein involved in transcription of numerous genes regulating glucose and fat metabolism. They act as "insulin sensitizers" without increasing insulin secretion.

Alpha glucosidase inhibitors are "diabetes pills" but not technically hypoglycemic agents because they do not have a direct effect on insulin secretion or sensitivity. These agents slow the digestion of starch in the small intestine, so that glucose from the starch of a meal enters the bloodstream more slowly, and can be matched more effectively by an impaired insulin response or sensitivity. These agents are effective by themselves only in the earliest stages of impaired glucose tolerance, but can be helpful in combination with other agents in type 2 diabetes.

Many other potential drugs are currently in investigation by pharmaceutical companies. Some of these are simply newer members of one of the above classes, but some work by novel mechanisms. For example, at least one compound that enhances the sensitivity of glucokinase to rising glucose is in the stage of animal research.

The basic appeal of oral hypoglycemic agents is that most people would prefer a pill to an injection. Unlike all the oral drugs described in this article, insulin is a protein. Protein hormones, like meat proteins, are digested in the stomach and gut.

However, the potential market for an oral form of insulin is enormous and many laboratories have attempted to devise ways of moving enough intact insulin from the gut to the portal vein to have a measurable effect on blood sugar. One can find several research reports over the years describing promising approaches or limited success in animals, and limited human testing, but as of 2004, no products appear to be successful enough to bring to market

Asthma is a disease of the human respiratory system in which the airways narrow, often in response to a "trigger" such as exposure to an allergen, cold air, exercise, or emotional stress. This narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing, which are the hallmarks of asthma. Between episodes, most patients feel fine.

The disorder is a chronic inflammatory condition in which the airways develop increased responsiveness to various stimuli, characterized by bronchial hyper-responsiveness, inflammation, increased mucus production, and intermittent airway obstruction. The symptoms of asthma, which can range from mild to life threatening, can usually be controlled with a combination of drugs and lifestyle changes.

Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children.[1] Susceptibility to asthma can be explained in part by genetic factors, but no clear pattern of inheritance has been found. Asthma is a complex disease that is influenced by multiple genetic, developmental, and environmental factors, which interact to produce the overall condition.

The most effective treatment for asthma is identifying triggers, such as pets or aspirin, and limiting or eliminating exposure to them. Desensitization is commonly attempted, but has not been shown to be effective. As is common with respiratory disease, smoking adversely affects asthmatics in several ways, including an increased severity of symptoms, a more rapid decline of lung function, and decreased response to preventive medications. Asthmatics who smoke typically require additional medications to help control their disease. Furthermore, exposure of both nonsmokers and smokers to secondhand smoke is detrimental, resulting in more severe asthma, more emergency room visits, and more asthma-related hospital admissions. Smoking cessation and avoidance of those who smoke is strongly encouraged in asthmatics.

The specific medical treatment recommended to patients with asthma depends on the severity of their illness and the frequency of their symptoms. Specific treatments for asthma are broadly classified as relievers, preventers and emergency treatment. The Expert panel report 2: Guidelines for the diagnosis and management of asthma (EPR-2) of the U.S. National Asthma Education and Prevention Program, and the British guideline on the management of asthma are broadly used and supported by many doctors. Bronchodilators are recommended for short-term relief in all patients. For those who experience occasional attacks, no other medication is needed. For those with mild persistent disease (more than two attacks a week), low-dose inhaled glucocorticoids—or alternatively, an oral leukotriene modifier, a mast-cell stabilizer, or theophylline—may be administered. For those who suffer daily attacks, a higher dose of glucocorticoid in conjunction with a long-acting inhaled ß-2 agonist may be prescribed; alternatively, a leukotriene modifier or theophylline may substitute for the ß-2 agonist. In severe asthmatics, oral glucocorticoids may be added to these treatments during severe attacks.

For those in whom exercise can trigger an asthma attack (exercise-induced asthma), higher levels of ventilation and cold, dry air tend to exacerbate attacks. For this reason, activities in which a patient breathes large amounts of cold air, such as cross-country skiing, tend to be worse for asthmatics, whereas swimming in an indoor, heated pool, with warm, humid air, is less likely to provoke a response.

Symptomatic control of episodes of wheezing and shortness of breath is generally achieved with fast-acting bronchodilators. These are typically provided in pocket-sized, metered-dose inhalers (MDIs—see the image to the right). In young sufferers, who may have difficulty with the coordination necessary to use inhalers, or those with a poor ability to hold their breath for 10 seconds after inhaler use (generally the elderly), an asthma spacer (see top image) is used. The spacer is a plastic cylinder that mixes the medication with air in a simple tube, making it easier for patients to receive a full dose of the drug and allows for the active agent to be dispersed into smaller, more fully inhaled bits. A nebulizer—which provides a larger, continuous dose—can also be used. Nebulizers work by vapourizing a dose of medication in a saline solution into a steady stream of foggy vapor, which the patient inhales continuously until the full dosage is administered. There is no clear evidence, however, that they are more effective than inhalers used with a spacer. Nebulizers may be helpful to some patients experiencing a severe attack. Such patients may not be able to inhale deeply, so regular inhalers may not deliver medication deeply into the lungs, even on repeated attempts. Since a nebulizer delivers the medication continuously, it is thought that the first few inhalations may relax the airways enough to allow the following inhalations to draw in more medication. Relievers include:

Short-acting, selective beta2-adrenoceptor agonists (salbutamol [albuterol], levalbuterol, terbutaline, bitolterol, pirbuterol, procaterol, fenoterol, reproterol). Tremors, the major side effect, have been greatly reduced by inhaled delivery, which allows the drug to target the lungs specifically; oral and injected medications are delivered throughout the body. There may also be cardiac side effects at higher doses, such as elevated heart rate or blood pressure; with the advent of selective agents, these side effects have become less common. Patients must be cautioned against using these medicines too frequently, as with such use their efficacy may decline, resulting in an exacerbation of symptoms which may lead to refractory asthma and death.

Do you have Any question? Click here to ask question.

Older, less selective adrenergic agonists, such as inhaled epinephrine and ephedrine tablets—both of which, unlike other medications, are available over the counter in the US under the Primatene brand. Cardiac side effects, although uncommon, occur more often with the less selective drugs. They also provide a shorter period of relief than the selective bronchodilators. Nowadays, they are usually avoided in patients with heart disease. In emergencies, these drugs were sometimes administered by injection. Their use in this situation has declined.

Anticholinergic medications, such as ipratropium bromide may be used instead. They have no cardiac side effects and thus can be used in patients with heart disease; however, they take up to an hour to achieve their full effect and are not as powerful as the ß2-adrenoreceptor agonists.

Prevention medication

Current treatment protocols recommend prevention medications such as an inhaled corticosteroid, which helps to suppress inflammation and reduces the swelling of the lining of the airways, in anyone who has frequent (greater than twice a week) need of relievers or who has severe symptoms. If symptoms persist, additional preventive drugs are added until the asthma is controlled. With the proper use of prevention drugs, asthmatics can avoid the complications that result from overuse of relief medications. Asthmatics sometimes stop taking their preventive medication when they feel fine and have no problems breathing. This often results in further attacks, and no long-term improvement. Preventive agents include the following.

Inhaled glucocorticoids (fluticasone, budesonide, beclomethasone, mometasone, flunisolide, and triamcinolone).
Leukotriene modifiers (montelukast, zafirlukast, pranlukast, and zileuton).
Mast cell stabilizers (cromoglicate (cromolyn), and nedocromil).
Antimuscarinics/anticholinergics (ipratropium, oxitropium), which have a mixed reliever and preventer effect. (These are rarely used in preventive treatment of asthma, except in patients who do not tolerate beta-2-agonists.)
Methylxanthines (theophylline and aminophylline), which are sometimes considered if sufficient control cannot be achieved with inhaled glucocorticoids and long-acting ß-agonists alone.
Antihistamines, often used to treat allergic symptoms that may underlie the chronic inflammation. In more severe cases, hyposensitization ("allergy shots") may be recommended.
Omalizumab, an IgE blocker; this can help patients with severe allergic asthma that does not respond to other drugs. However, it is expensive and must be injected.
Methotrexate is occasionally used in some difficult-to-treat patients.
If chronic acid indigestion (GERD) contributes to a patient's asthma, it should also be treated, because it may prolong the respiratory problem.

Alternative medicine

Do you have Any question? Click here to ask question.

Many asthmatics, like those who suffer from other chronic disorders, use alternative treatments; surveys show that roughly 50% of asthma patients use some form of unconventional therapy. There are little data to support the effectiveness of most of these therapies. A Cochrane systematic review of acupuncture for asthma found no evidence of efficacy. A similar review of air ionisers found no evidence that they improve asthma symptoms or benefit lung function; this applied equally to positive and negative ion generators. A study of "manual therapies" for asthma, including osteopathic, chiropractic, physiotherapeutic and respiratory therapeutic maneuvers, found no evidence to support their use in treating asthma; these maneuvers include various osteopathic and chiropractic techniques to "increase movement in the rib cage and the spine to try and improve the working of the lungs and circulation"; chest tapping, shaking, vibration, and the use of "postures to help shift and cough up phlegm". On the other hand, one meta-analysis found that homeopathy has a potentially mild benefit in reducing symptom intensity; however, the number of patients involved in the analysis was small, and subsequent studies have not supported this finding. Several small trials have suggested some benefit from various yoga practices, ranging from integrated yoga programs—"yogasanas, Pranayama, meditation, and kriyas"—to sahaja yoga, a form of meditation. A randomized, controlled trial of just 39 patients suggested that the Buteyko method may moderately reduce the need for beta-agonists among asthmatics, but found no objective improvement in lung function..

Cough medicine

A cough medicine is a drug used to treat coughing and related conditions. Dry coughs are treated with cough suppressants (antitussives) that suppress the body's urge to cough, while productive coughs (coughs that produce phlegm) are treated with expectorants that loosen mucus from the respiratory tract.

Cough suppressants

Cough suppressants may act centrally (on the brain) or locally (on the respiratory tract) to suppress the cough reflex.

Centrally acting suppressants include dextromethorphan (DXM), noscapine, ethyl morphine, and codeine.

Do you have Any question? Click here to ask question.

Peripherally acting substances include local anaesthetics, which reduce the sensation of nerves in the throat, and demulcents, which coat the esophagus. Although it is commonly believed that cough medicines must coat the throat to be effective, there is no evidence that it is possible to control coughing by this means.

One might think it unwise to suppress the cough reflex (the mechanism for expelling mucus from the respiratory tract) but severe coughing may lead to lung irritation, causing a vicious cycle. The cough reflex is also very strong and cannot be completely suppressed. However, dry cough (without mucus production) or cough that is exhausting and preventing sleep should be treated with supressants.

Recent studies have found that theobromine, a compound found in cocoa, is more effective as a cough suppressant than prescription codeine. This molecule suppresses the "itch" signal from the nerve in the back of the throat that causes the cough reflex. It is possible to get an effective dose from dark chocolate, which contains more cocoa than milk chocolate. Theobromine was also free from side effects in the blind tests.

Expectorants

An expectorant is a medicine or herb which increases the expulsion of tracheal or bronchial mucus through expectoration or coughing. In over-the-counter preparations, guaifenesin is often used. Herbal expectorants include the following:

Aniseed (Pimpinella anisum),
Balm of Gilead (Populus gileadensis),
Balsam of Peru (Myroxylon perierae),
Balsam of Tolu (Myroxylon toluifera),
Blood Root (Sanguinaria canadensis),
Coltsfoot (Tussilago farfara),
Comfrey (Symphytum officinale),
Elder Flower (Sambucus nigra),
Elecampane (Inula helenium),
Garlic (Allium sativum),
Golden Seal (Hydrastis canadensis),
Grindelia (Grindelia camporum),
Hyssop (Hyssopus officinalis),
Iceland Moss (Cetraria islandica),
Irish Moss (Chondrus crispus),
Liquorice (Glycyrrhiza glabra),
Lobelia (Lobelia inflata),
Lungwort (Sticta pulmonaria),
Marshmallow (Althaea officinalis),
Mouse Ear (Hieracium pilosella),
Mullein (Verbascum thapsus),
Pleurisy Root (Asclepias tuberosa),
Senega (Polygala senega),
Skunk Cabbage (Symplocarpus foetidus),
Squill (Urginea maritima),
Thuja (Thuja occidentalis),
Thyme (Thymus vulgaris),
Vervain (Verbena officinalis),
White Horehound (Marrubium vulgare),
Wild Cherry (Prunus serotona).

Cough drops

Do you have Any question? Click here to ask question.

Cough drops are tablets which people can suck to soothe the throat or to alleviate excessive coughing. They are usually relatively small, sweetened, and contain medicine that helps to reduce pain or irritation. The occasional use of "lozenge" (first used in 1530, according to the Oxford English Dictionary) is due to the original lozenge shape of cough drops. Popular brands of cough drops include Fisherman's Friend, Halls (cough drop), and Ricola.

Controversy

In 2002, researchers at the University of Bristol (Schroeder & Fahey) published a study in the British Medical Journal indicating that some cough medicines are no more effective than placebos.

Many cough mixtures contain both an expectorants and a suppressants -- even though an expectorant requires the action of a cough to expel mucus. Many believe this supports the idea that cough supression is just a placebo effect. However, in practice the two active ingredients combine to provide less coughing, but more productive coughs.

Diarrhea & its Treatment & theDrugs

Diarrhea (AmE) or diarrhoea (CwE) is a condition in which the sufferer has frequent and watery, chunky, or loose bowel movements (from the ancient Greek word d?a???? = leakage; lit. "to run through"). In the Third World, diarrhea is the most common cause of death among infants, killing more than 1.5 million per year.

Treatment of diarrhea

Keep hydrated. This is the most appropriate treatment in most cases of minor diarrhea.
Try eating more but smaller portions. Eat regularly. Don't eat or drink too quickly.
Intravenous fluids or a "drip": Sometimes, especially in children, dehydration can be life-theatening and intravenous fluid may be required.
Oral rehydration therapy: Taking a sugar/salt solution, which can be absorbed by the body.
Opioids and their analogs should not be used for infectious diarrhea as they are said to prolong the illness and may increase the risk of a carrier state. Opioids are the most effective antidiarrheals available. Their principal method of action is to inhibit peristalsis. Loperamide, also known as Imodium, is the most commonly used antidiarrheal. Loperamide is chemically related to the drug meperidine or Demerol, but does not cross the blood-brain barrier and does not appear to induce tolerance or dependence. Other opioids used to control diarrhea (in increasing order of strength) are: Lomotil (diphenoxylate with atropine); Lonox (difenoxin with atropine); codeine; opium tincture (laudanum); and morphine. The most potent opioids are generally reserved for chronic diarrhea (e.g., from complications of AIDS).
Antibiotics: antibiotics may be required if a bacterial cause is suspected and the patient is medically ill. They are sometimes also indicated for workers with carrier states in order to clear up an infection so that the person can resume work. Parasite-related diarrhea (e.g. giardiasis) require appropriate antibiotics. Antibiotics are not routinely used, as the cause is rarely bacterial and antibiotics may further upset intestinal flora and worsen rather than improve the diarrhea. Clostridium difficile-associated diarrhea and pseudomembranous colitis is often caused by antibiotic use.

Do you have Any question? Click here to ask question.
Dietary manipulation: especially avoid wheat products with celiac disease.
Hygiene and isolation: Hygiene is important in limiting spread of the disease.
It is claimed that some fruit, such as bananas, mangoes, papaya and pineapple may have positive effects on this condition. Bananas have the merits of being easily obtainable, and they are unlikely to have any other significant unwanted side effects. Bananas are thought to be "binding," as is mucilage, which you can obtain in capsule form. Mucilage can also be used as cereal for babies, as it is easily digested. The high acid content of pineapple may make this food a bad choice for people suffering from chronic diarrhea.

Nasal spray

Nasal sprays are used for the nasal delivery of a drug or drugs, generally to alleviate cold or allergy symptoms. Although delivery methods vary, most nasal sprays function by instilling a fine mist into the nostril by action of a hand-operated pump mechanism. The three main types available are: antihistamines, corticosteroids, and topical decongestants.

Excessive histamine function is the primary cause of allergic reactions in people. Histamine is a chemical naturally produced by the body which creates an inflammatory effect to help the immune system remove foreign substances. Antihistamines work by competing for receptor sites to block the function of histamine, thereby reducing the inflammatory effect. Astelin (Azelastin hydrocholoride) is the only local antihistamine available as a nasal spray. It is available by prescription only and has gained popularity with sufferers of allergic rhinitis.

Steroidal nasal sprays, also available only by prescription, use the anti-inflammatory effect of a corticosteroid to reduce swelling and congestion in the nasal passages and sinuses. Examples include Nasonex, Flonase, Nasacort, and Rhinocort. They generally take a week to ten days to reach their maximum effectiveness, and are considered safe for extended use.

Decongestant nasal sprays such as Afrin (Oxymetazoline hydrochloride), which are available over-the-counter in the United States, work to very quickly open up nasal passages by constricting blood vessels in the lining of the nose. With prolonged use these types of sprays can damage the delicate mucous membranes in the nose, ironically causing an increased inflammatory effect known as rhinitis medicamentosa, or the "rebound effect". As a result, decongestant nasal sprays are advised for short-term use only.

Saline sprays are also common and are typically unmedicated. A mist of saline solution is delivered to help moisturize dry or irritated nostrils.

It is not uncommon for a doctor or allergist to prescribe several types of nasal sprays in combination with each other or with other drugs. For example, a decongestant spray is often advised for the first few days of treatment with an antihistamine or steroidal spray. The quick-acting effects of the decongestant allow for better initial delivery of the other sprays.

Do you have Any question? Click here to ask question.