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In the United
States, any substance that can be considered a medication is tightly
controlled by the Food
and Drug Administration (FDA). Pharmaceutical companies who
manufacture these drugs must go through strict testing and lengthy
trial periods for each product they hope to market. Some substances
that are sold or prescribed in other countries have not received
FDA approval and therefore are not available here. Even if a drug
is available in the U.S., you may not see it on store shelves if
it requires a doctor's prescription. Your local pharmacist should
be able to tell you the availability of a specific medication.
Prescription
vs. Over The Counter
The FDA determines
whether medicines are prescription or nonprescription. The term
prescription (Rx) refers to medicines that may be obtained only
under a doctor's order. Nonprescription - also called over-the-counter
(OTC) -- drugs are medicines that the FDA decides are safe and effective
for use without a doctor's prescription.
Over-the-counter
medications commonly can be found on the shelves of drugstores,
supermarkets and variety stores (such as WalMart or Kmart), and
include analgesics, or painkillers, such as aspirin, acetaminophen
(Tylenol), ibuprofen (Motrin), naproxen sodium (Aleve); digestive
aids, such as antacids and laxatives; some mild sleep aids; and
treatments for colds, influenza and similar viral infections, which
are typically various combinations of analgesics, antihistamines
and decongestants.
A prescription
from a doctor is required for stronger pain relievers, all antibiotics
(necessary in the treatment of bacterial infections), and psychologically
oriented drugs, such as tranquilizers and antidepressants.
Once a doctor
has given you a prescription, you can present it to your local pharmacy
to purchase your prescribed medication. Sometimes, the status of
a prescription drug will change. For example, ibuprofen was originally
a prescription only medication, but the FDA relaxed its stance and
now has deemed this analgesic, in lesser strengths, as suitable
for over the counter sales.
Generic
vs. "Brand Name"
In addition
to earning FDA approval, pharmaceutical companies obtain a patent
for each new drug they develop. This means that for a set number
of years the company holding the patent on a substance is the only
one entitled to manufacture and market it. For this reason, new
drugs are usually expensive. They are generally marketed to the
public under a brand name, to attract name recognition and
customer loyalty. After the patent for a drug expires, any company
may manufacture it under FDA approved guidelines, which increases
competition, reduces the cost of purchasing the drug, and makes
the drug available from non-brand name sources. These non-brand
name drugs are called generic drugs. The generic version
of a drug is always less expensive.
For example,
ibuprofen was developed by McNeil-PPC, Inc. and sold under the brand
name Motrin. Now that the patent held by McNeil has expired, one
can find many generic versions of ibuprofen on store shelves (often
sold with the store's name on it and called "store-brand", although
it is still considered generic). They are less expensive than the
Motrin brand, yet they contain the same chemical ingredients, which
must be listed on the label.
Both prescription
and over-the-counter drugs are sold as generic and brand names.
When your doctor is prescribing a drug, you may want to ask him
about its generic equivalent. If you choose to have the prescription
filled generically, you must request that the pharmacist do so.
Some Insurance plans that cover the cost of prescription drugs will
pay only for generic drugs unless the physician indicates that a
brand name drug is required.
The
Role of the Pharmacist
A pharmacist
is licensed by law to fill prescriptions for controlled substances,
and has had to undergo strict training. Therefore, he or she is
a valuable resource when seeking medication. The pharmacist can
advise on side effects of a drug and whether or not it should be
taken in conjunction with other drugs, or substances such as alcohol.
He can also offer advice or make recommendations regarding over-the-counter
medications.
Pharmacies,
the section of a store where the pharmacist dispenses prescription
drugs, can now be found in all manner of stores. At one time, these
were located only in drugstores that commonly sold health aids and
little else. Now, drugstores are frequently huge emporiums selling
everything from shampoo to beach chairs. Usually, they are "chain
stores," such as Walgreens and Eckerds, although smaller local drugstores
can still be found. Pharmacies may also be found in variety stores
(i.e. WalMart) and supermarkets.
Natural
or Herbal Remedies
One area that
has managed to elude the FDA is the field of "natural medicinals."
These are remedies largely derived from botanicals such as herbs
or roots. While many of them may be beneficial, they have not undergone
the intense scrutiny and government testing required of standard
medications. These products are generally found in health food stores,
whose staff can be helpful in providing information about them.
Some, such as the mood elevator, St. John's Wort, or the cold preventative,
echinacea/goldenseal, have become so commonly used that many mainstream
manufactures, like Bayer with their One a Day brand vitamins, are
now adding them to their product lists.
Many traditional
physicians regard natural remedies with suspicion for two reasons.
One, because a patient might disregard the standard therapy for
a condition in favor of an untested or unmonitored one. And, two,
simply because there is no regulation or standard place on these
products by the government. For patients interested in pursuing
a natural approach to health care there is the field of homeopathic
medicine, whose practitioners may be MD's, but usually are not.
  
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Medication
