Over-the-Counter Medications, Herbals, and Nutrition

Over-the-counter drugs refer to medicine for minor medical ailments issued to a consumer without a prescription from a healthcare professional. Examples include analgesics such as acetaminophen and ibuprofen, antihistamines such as diphenhydramine and loratadine, and expectorants such as guaifenesin. Herbal medicines are medicinal extracts from leaves, flowers, seeds, or stems of a plant used to maintain health, prevent, alleviate, or cure illnesses (Adams, Holland, & Urban, 2014, p. 98). Examples include garlic cloves, ginseng root, and echinacea leaves. Nutritional supplements, on the other hand, are products composed of one or more dietary ingredients such as minerals, vitamins, enzymes, and amino acids and are consumed alongside one's diet. Each medication and supplement has its rationale of use, benefits, and possible consequences of herbal-drug interactions, as discussed in this paper. 

Herbal Medications 

Garlic ( Allium sativum ), preferably administered to people with or prone to cardiovascular conditions such as stroke and heart attack due to its anticoagulant properties. The interactions between garlic and synthetic anticoagulants such as nonsteroidal anti-inflammatory drugs, warfarin, or heparin may lead to increased hemorrhage. It also interacts with anti-diabetic medications leading to the increased effects of low blood sugar. Patients may also develop bloating, skin rashes, unpleasant breath, and body odors with moderate to long term use of garlic (Adams, Holland, & Urban, 2014, p. 103). 

St. John’s wort ( Hypericum perforatum ) is mostly used as a dietary supplement to combat depression and insomnia. The drug interacts with HIV/AIDS drugs, asthma drugs, and opioids such as codeine, meperidine, methadone, dextromethorphan, tramadol, and methadone. It also interacts with drugs that lower neurotransmission levels, such as tranquilizers and sedatives. There is a likelihood of sunburns if one is exposed to sunlight while taking St. John’s wort (Adams, Holland, & Urban, 2014, p. 103) 

Aloe Vera ( Aloe barbadensis miller ), being a vital source of vitamins and antioxidants, is most commonly applied to the affected areas of skin to accelerate the healing of conditions such as sores, burns, and psoriasis. It interacts with anti-diabetes drugs, and this might lead to the lowering of blood sugar. It is also known to interact with digoxin leading to decreased levels of potassium in the body. Some people may experience mild burning or itching sensation while using aloe vera (Adams, Holland, & Urban, 2014, p. 99). 

Goldenseal ( Hydrastis canadensis ) is mostly administered as an immune system booster. It is known to interact with drugs that promote diuresis for example, chlorthalidone, chlorothiazide, metolazone or indapamide. An overdose of goldenseal may lead to hypotension, damage to the cardiovascular system, and paralysis (Adams, Holland, & Urban, 2014, p. 103). 

Ginseng ( Panax ginseng ) is used to improve the overall well-being and specifically for the management of hypertension, diabetes, and hyperlipidemia. It is known to interact with warfarin, water pills (diuretics), and drugs that slow brain activity (CNS depressants). The most common side effects of ginseng use include hypotension or hypertension, bleeding of the vagina, increased heartbeat, and insomnia (Adams, Holland, & Urban, 2014, p. 133). 

Echinacea ( Echinacea purpurea ) is a flowering plant species with a variety of alkylamides. These are compounds that help boost the body's immune system. It is used in the treatment of vulvovaginal candidiasis and colds. It interacts with certain antifungal drugs such as ketoconazole as well as anti-rheumatic drugs such as methotrexate. Side effects may include a feeling of unusual taste in the mouth, pain in the muscles, fever, nausea, and pharyngitis (Adams, Holland, & Urban, 2014, p. 103). 

Valerian ( Valeriana officinalis ) has aromatic, as well as diuretic characteristics. It is administered to combat insomnia and psychological stress. It has been known to interact with tranquilizers, sedatives, and hypnotics. Notable side effects include mouth dryness, stomach upset, drowsiness, insomnia, dullness, headache, and heart disturbances (Adams, Holland, & Urban, 2014, p. 103). 

Green tea ( Camellia sinensis ), which has generally been used to increase mental alertness, treatment of warts of the genitalia, high cholesterol, and osteoporosis. Green tea interacts with dicoumarol, warfarin, and anisindione. Side effects may include anxiety, dizziness, bloating, and dryness of the mouth (Agbabiaka, Spencer, Khanom, & Goodman, 2018). 

Turmeric ( Curcuma longa ) is used in alternative medicine for the treatment of dyspepsia and inflammation. Turmeric interacts with apixaban, warfarin, and aspirin. The side effects associated with the use of turmeric include vomiting or nausea, loose stool, and stomach upset (Agbabiaka, Spencer, Khanom, & Goodman, 2018). 

Cranberry ( Vaccinium oxycoccus ) is acidic and has been used to treat bacterial infections of the urinary system. Cranberry interacts with dicumarol, anisindione, and warfarin. Nausea and vomiting are side effects associated with the use of cranberry. Other side effects include loose stool and stomach upset (Cassileth, Heitzer, & Wesa, 2009). 

Vitamins and Minerals 

Vitamin D is lipid-soluble, and other than being essential in facilitating the growth of cells and better functioning of the body's immune system, it has also been found to be vital for the metabolism of calcium and phosphates in the body. Continuous usage or overdose causes side effects including weight loss, hallucinations, and the weakening of bones (hypercalcemia). Vitamin D interacts with calcitriol and ergocalciferol (Adams, Holland, & Urban, 2014, p. 637). 

Vitamin A supplements contain pigments that are essential for vision. They also play a significant role in the development of epithelial cells (Adams, Holland, & Urban, 2014, p. 637). Side effects of this vitamin include sweating at night, severe migraines, severe vomiting, fatigue, peeling of skin on the palms and lips, double vision, and sharp feeling of agitation. Notable examples of drugs that interact with vitamin A include doxycycline, acitretin, tetracycline, etretinate, acitretin, and tretinoin. 

Vitamin C, popularly known as ascorbic acid, is used as an antioxidant (Adams, Holland, & Urban, 2014, p. 637). It also aids the body in iron absorption, a vital component for the formation of red blood cells. Examples of drugs that interact with Vitamin C include amphetamine and warfarin. Side effects may include symptoms such as loose stool, fatigue and nausea, and renal calculi (Soni et al., 2010). 

Vitamin E supplements play a vital role by inhibiting oxidation; hence are considered as anti-aging pills (Adams, Holland, & Urban, 2014, p. 637). Drug interactions for vitamin E include aspirin, apixaban, warfarin, and clopidogrel. Side effects include double vision, nausea, headache, loose stool, and stomach upset (Anastasi, Chang, & Capili, 2011). 

Folic acid is normally administered to cure symptoms associated with its deficiency. It may also prevent DNA mutations that could lead to cancer development. Possible drug interactions include methotrexate and sulfasalazine. Side effects include itching of the skin, and allergic reactions (Soni et al., 2010). 

Calcium gluconate is essential for the formation and maintenance of bones and is administered to patients with calcium deficiency. The most notable drug interactions are with digoxin. Side effects include bloating, dry skin, headache, and stomach cramps (Adams, Holland, & Urban, 2014, p. 644). 

Magnesium hydroxide is administered for the management of occasional stomach bloating and acidity. Side effects of abuse, or prolonged use of this mineral include colic in infants, abdominal upset, and hypermagnesemia. Notable drug interactions include magnesium oxide, calcium, vitamin D, furosemide, and cimetidine (Adams, Holland, & Urban, 2014, p. 644). 

Sodium phosphate is used to treat low phosphate levels in the body system. Side effects of an overdose or prolonged use of this mineral include symptoms of allergic hypersensitivity such as chest tightness, seizures, itchiness, and difficulties in breathing. Also, extreme thirst, fast heartbeat, and fatigue could be experienced. Sodium phosphate interacts with erdafitinib, burosumab, lactulose, and foscarnet (Soni et al., 2010). 

Potassium chloride is administered so to manage the effects of hypokalemia. Notable side effects for overdose or prolonged use include body numbness, bloated stomach, loose stool, difficulties in breathing, and slow heartbeat. Notable drug interaction is with cyanocobalamin (vitamin B12) (Adams, Holland, & Urban, 2014, p. 642). 

Sodium bicarbonate is usually administered to combat indigestion and acidity. Side effects include nausea, stomach upsets, severe thirst, headache, and unpleasant taste. It interacts alprazolam, aspirin, ferrous sulfate, and amphetamine (Adams, Holland, & Urban, 2014, p. 642). 

Complementary or Alternative (CAM) Therapy 

Acupuncture may be deployed as an integral and alternative medicine to patients with chronic schizophrenia, a condition whose main symptoms include persistent physical pain and hallucinations. After 12 sessions of acupuncture therapy, a patient is likely to experience a better functioning of the body system since anxiety and paranoia symptoms are alleviated significantly. The alleviation augurs well for schizophrenia patients when acupuncture is complemented with conventional treatment. Few adverse reactions occur to patients when acupuncture is used as a complementary therapy (Alp, 2018). 

Common Nutritional Supplement 

Fish Oil (Omega-3) 

Omega-3 polyunsaturated fatty acids are found in oils extracted from fish and plants. Health professionals recommend these sources because the body does not manufacture them hence must be consumed in the diet. Omega-3 mode of action is by minimizing triglyceride levels in the blood. Conditions such as stroke, artery, and heart diseases are usually as a result of increased levels of triglycerides in the body. 

Overdose of fish oil may lead to allergic symptoms such as breathing difficulties, dizziness, itching of the skin, rashes, increased menstrual flow, nose bleeds, irregular heartbeat, and coughing up of blood. Some of these effects may fade away in the course of treatment as the body system adjusts to the medicine hence may not need any medical attention. Arrhythmias and liver disease are associated with drug interactions with omega-3 polyunsaturated fatty acids. Consequently, patients are advised not to take drugs containing aspirin, warfarin, apixaban, clopidogrel, and rivaroxaban alongside omega-3 (Cassileth, Heitzer, & Wesa, 2009). 

Conclusion 

Nutritional supplements, over-the-counter, and herbal medications are often used in cases of change in one's health. Dietary supplements are generally taken by people who believe in having a deficiency, thus risky contracting opportunistic diseases. It is, therefore, of great necessity to first consult a medical professional before taking a nutritional supplement. In some cases, a medical treatment rather than a dietary supplement could be necessary. The use of herbal medications for a health condition is generally influenced by the one's prevailing situation and the geographical location within which it first evolved. Its usage is majorly based on affordability and the excellent perception of its natural and non-toxic characteristics. It is of great necessity for consumers to be given science-based information on prescription requirements such as dosage, efficacy, and contraindications. Publicizing of information is achievable through global harmonization of legislation to guide responsible production, distribution, and use of herbal medications. 

References 

Adams, M., Holland, N., & Urban, C. (2014).  Pharmacology for nurses: A pathophysiologic approach  (4th ed.). Upper Saddle River, NJ: Pearson Education Inc. 

Agbabiaka, T. B., Spencer, N. H., Khanom, S., & Goodman, C. (2018). Prevalence of drug-herb and drug–supplement interactions in older adults: a cross-sectional survey. British Journal of General Practice ,  68 (675), e711-e717. doi:10.3399/bjgp18x699101 

Alp, H. (2018). Application of acupuncture in neuropathic pain.  Journal of Acupuncture and Meridian Studies ,  11 (4), 252. doi:10.1016/j.jams.2018.08.180 

Anastasi, J. K., Chang, M., & Capili, B. (2011). Herbal Supplements: Talking with your patients.  The Journal for Nurse Practitioners ,  7 (1), 29-35. doi:10.1016/j.nurpra.2010.06.004 

Cassileth, B. R., Heitzer, M., & Wesa, K. (2009). The public health impact of herbs and nutritional supplements.  Pharmaceutical Biology ,  47 (8), 761-767. doi:10.1080/13880200902991581 

Soni, M. G., Thurmond, T. S., Miller, E. R., Spriggs, T., Bendich, A., & Omaye, S. T. (2010). Safety of vitamins and minerals: Controversies and perspective.  Toxicological Sciences ,  118 (2), 348-355. doi:10.1093/toxsci/kfq293