Second-generation antihistamines: the OTC debate

Some side effects and effcts on physical activity of second-generation antipsychotics: A study in children and adolescents

Background:

This study was designed to investigate the metabolic adverse effects (AEs) of second-generation antipsychotics (SGAs) and their relationship with physical activity and non-metabolic AE in children and adolescents.

Materials and Methods:

After exclusion of patients with metabolic syndrome, 62 patients (34 children, 28 adolescents) of both genders who were candidates for SGA therapy were selected. Metabolic parameters included fasting blood glucose (FBG), triglyceride (TG), blood pressure (BP), and waist circumference (WC); non-metabolic AEs and physical activity were evaluated at baseline, 1 month, and 3 months after starting the treatment.

Results:

Mean of post-treatment FBG and TG were significantly higher than the baseline values (P < 0.0001). Compared to the baseline value, significantly more patients developed abnormally high (AbH) FBG at the end point (P = 0.02). There was no significant difference in the frequency of patients with AbH-FBG either at the baseline or at the end point (P > 0.05). The frequency of patients with AbH-TG at the end point was not significantly higher than those with baseline AbH-TG (P = 0.10). Although no patient was obese at baseline, 11 (18%) patients developed abdominal obesity at the end point (P < 0.0001). There was no significant difference in the frequency of non-metabolic AE (P > 0.05). There was no significant correlation between metabolic and non-metabolic AE (P > 0.05). Frequency of inactive patients was significantly more than the baseline value (P-0.008), and abdominal obesity was significantly more prevalent in less active participants (P = 0.03).

Conclusion:

The present study showed the AE of SGA on FBG and TG, but no effect on BP and WC. We also found that children are more prone to develop abnormally high FBG.

Implications of a switch from prescription to over-the-counter status for allergy drugs

Several drugs for the treatment of allergic conditions, previously available only by prescription, can now be purchased over-the-counter (OTC). The OTC availability of allergy drugs has the potential to increase patient access to these medications. At the same time, OTC availability transfers a number of decisions from the health care provider to the patient and might alter the role of the physician in allergy management. For example, patients must correctly self-diagnosis that their symptoms are due to an allergy, and identify the appropriate type of allergy medication to use. OTC drug availability has economic implications for the patient and physician, as well as for the health care insurance and pharmaceutical industries. Therefore, although OTC access to allergy medications facilitates treatment of allergies by consumers, more research is required to understand the true public health and economic impacts of OTC availability of these drugs.