Is it ok for the nurse to recommend OTC drugs to a patient?

[Blackheartednurse]

Ok so one of my patients has suffers from constipation and is it ok to recommend him laxative OTC drugs like Metamucil or MOM?

[PatMac10,RN, RN]

Check your state's BON website and it's nurse practice act info.

It is within the practice of an RN in NC to recommend OTC drugs to a patient.

"Issue:

Registered Nurse (RN) authority to recommend over-the counter medications and non-prescriptive devices.

RN Role:

1.

May recommend the use of over-the-counter (OTC) pharmaceutical products (including dietary supplements and herbal remedies) and non-prescriptive devices for an identified health-related need of a client as part of her/his nursing practice.

2.

When making recommendations RN is accountable for having the knowledge to make such nursing care decisions safely and to monitor the outcomes of her/his actions.

3.

The practice of recommending over-the-counter pharmaceutical products and non-prescriptive devices must be consistent with the established policies of the system in which the registered nurse practices as well as consistent with the client's overall health-related plan of care.

LPN Role:

1.

Does not have the authority to independently recommend the use of over-the-counter products and non-prescriptive devices.

References:

G.S. 90-171.20 (7) & (8) - Nursing Practice Act

21 NCAC 36.0224 - RN Rule

21 NCAC 36.0225 - LPN Rule

10/96; 5/00; 4/07; 5/09 Page 1 of 1"

[anticoagulationurse]

I am in the habit of saying, "Well I am not a doctor so I cannot "prescribe", but some people use this or that OTC and notice improvement." Then I usually give a list and offer them some individual choices and follow up with, "Check with your pharmacist for any interactions with the OTC you choose."

[neutrophil]

When I was a med aide. We could in no way recommend anything. I remember once, the niece of a resident brought, Tylenol pm, otc. Told me, "give it to my aunt every night." I told her that as a med tech, I needed to get a doctors order before giving it. She was not happy. I faxed the doctor. Next day the order was. "Absolutely not!!! Do not give!!!"

I am now an LVN, sometimes a patient or family members will ask me of recommendations. I always tell them what I have seen used and what I would recommend. But I tell them that I would make a simple phone call to the doctor before taking something, or if they wanted me to fax the doctor. I never, ever say, "this is what you should take." I don't care if you are an RN, LVN. Though I medicate all of my family, and their friends, in the professional world, keep it professional. Let the doctor do the simple things. They get paid for it, (a little sarcastic humor).

[TheCommuter, BSN, RN]

Ok so one of my patients has suffers from constipation and is it ok to recommend him laxative OTC drugs like Metamucil or MOM?

I would tread carefully. Making a recommendation for an OTC medication such as Milk of Magnesia could harm the patient if you are unaware that he/she has a high serum magnesium level since mag levels aren't routinely screened. Recommending Tylenol could harm the patient if he/she has hepatic dysfunction of which we're unaware. Advising the patient to take Motrin could cause harm if he/she has GI ulcers or any potential for internal hemorrhage. OTC medications are not always as safe as we're led to believe.

[caliotter3]

I have been present and overheard a pharmacist speak to customers with disclaimers and requests that the customer see their physician. If a pharmacist is being cautious about this, you can bet I will be.

[caliotter3]

And BTW, working in home health, I have had family members attack me because I wanted to follow doctor's orders concerning any medication, much less an OTC medication being discussed that had not been previously ordered. I get somewhat perturbed inside when they insist that I am not to contact the doctor for medical advice or a valid order. Very common. I just do not like to be caught in the middle.

[gentlegiver, ASN, LPN, RN]

Remember even Herbal Teas can & do react with meds, so when I have a patient who's family bring in herbal teas to help with sore throats, sleep etc... I take them away from the patient until they are cleard by the DR. I then educate the patient & family on the medical history of teas and my reasoning for taking them. I have never had a problem when doing this.

[traumaRUs, MSN, APRN]

I would be very careful and defer to the provider.

I can't tell you how many times my (renal) pts tell me they were constipated and took MOM or mag citrate - neither of which are recommended for them.

[Meriwhen, ASN, BSN, MSN, RN]

I try not to recommend anything. If I do make a suggestion, it's always accompanied by "however, you should double-check with your doctor/pharmacist"

[Up2nogood RN, RN]

I would have your client refer to their physician. You can always encourage increasing water and fiber intake though.

[cb_rn]

If someone asks me about a recommendation I look at their prn list in the hospital - if they have docusate sodium ordered or prn dulcolax for constipation I give a spiel about "Here at the hospital the doctor has ordered you ____ on an as needed basis according to the dosage instructions. If you need to continue this med at home I would speak to him about whether he feels this is appropriate." If they are about to be discharged I let them follow up, if I'm going to see the doctor again before they leave, I tend to ask. I'm sure my share of doctors have rolled their eyes when I ask "What would you rather Patient XYZ use for pain relief on a regular basis, tylenol, motrin, or ASA?" for the eighth time on the eighth patient but I have had too many unexpected answers such as absolutely no tylenol or try ___ instead so I continue to ask