Best reply for medication queries

TazziRN, RN · Oct 22, 2006

You reply that generic and brand name meds have the same ingredients, but the generic is a lot cheaper. As for script versus OTC, the OTC meds usually have less drug than the script strength. Example: Zantac 75 mg is the OTC strength, but the script strength is 150.

scribblerpnp · Oct 22, 2006

With generic drugs, the "active ingredients" are the same, but the "fillers" may be different. This can change dosing at times (Some thyroid medication generic and brand are VERY different in dosing) and may even have some effect as to the effectiveness for some people.

TazziRN, RN · Oct 22, 2006

With generic drugs, the "active ingredients" are the same, but the "fillers" may be different. This can change dosing at times (Some thyroid medication generic and brand are VERY different in dosing) and may even have some effect as to the effectiveness for some people.

Really?? I'm in the ER, so of the meds that we give, generic and Rx are handled the same. We deal mostly with pain meds and abx.

jetscreamer101 · Oct 22, 2006

from what I understand, warfarin and coumadin can have slightly different effects, which can mess with you Protimes

CritterLover, BSN, RN · Oct 22, 2006

really?? i'm in the er, so of the meds that we give, generic and rx are handled the same. we deal mostly with pain meds and abx.

yes, the kinetics can be different. not so important for many meds, but can be a big issue for others (like dig). since the inactive ingredients are often different, the rate at which they are absorbed from the gi tract may vary.

think of the different oral forms of morphine -- ir, er, sr. the active ingredient is morphine sulfate, but the inactive ingredients alter how it is absorbed. the same is true for different brands of the same drugs, though not usually to the same degree.

GingerSue · Oct 23, 2006

and phenytoin is not to be switched for Dilantin because there are differences in formulations that can upset seizure control

(should not switch between generic and trade name formulations of

phenytoin because of differences in absorption and bioavailability)

santhony44, MSN, RN, NP · Oct 23, 2006

Also remind the patient that OTC does not mean totally safe! The recommended dosages are there for a reason, and if two is good, 6 or 8 is not better!

Additionally, it's a good idea to read all the ingredients of an OTC med. You could be taking, say, two different cold medications, and overdosing yourself on a particular ingredient, not realizing that it's in both.

A lot of people don't realize that you can kill yourself with Tylenol, or that taking adult-strength iron can be bad for children. The fallacy is that "if it's over the counter, it must be safe!" Nothing is safe for everybody. They also tend to not read the ingredients, just what the medication is supposed to do. I've seen people taking, for example, both Advil and ibuprofen and not having a clue that it's the same thing. I've seen this happen with prescription drugs too, of course, but I think it's a lot more common with OTC's.

goats'r'us, ASN, RN · Oct 23, 2006

woah! info overload!

i'd just tell them that the preparation may be slightly different between brands, but both panadol and generic paracetemol have the same amount of paracetemol in them, and the reason that i'm giving them generic over panadol is because generic is cheaper and therefore what we stock.

as for the difference between script and OTC, i'd just tell them that script meds need to be prescribed by a doctor for a number of reasons, such as needing to monitor the pt while on it, chance of side effect or interaction, strength or action of drug, some other reason that makes it unsafe for someone to just grab it off a shelf and swallow it down, while OTC tends to be safe enough to take with just a pharmacists advice.

i wouldn't have thought that either question would be particularly tricky.. am i missing something, or am i just uber-smart?