For 2013, NCPIE has been invited to serve as Column Coordinators in the Pharmacy Today
  One-to-One column to bring pharmacists and other healthcare providers valuable counseling tips 
aimed at enhancing communication with patients. Pharmacy Today is the monthly medication 
therapy management (MTM) magazine of the American Pharmacists Association.

National Drug Facts Week (NDFW) – January 28- February 3, 2013) is a health observance week for
teens that aims to shatter the myths about drugs and drug abuse. Through community-based events and
activities on the Web, on TV, and through contests, NIDA is working to encourage teens to get
factual answers from scientific experts about drugs and drug abuse. 

A survey of parents finds just one-third are very concerned about the misuse of prescribed narcotic
pain medicine by children and teens in their community, according to a national survey of more than
1,300 parents with children ages 15 to 17 was conducted by the University of Michigan Mott
Children’s Hospital.  Only one-fifth are very concerned about the misuse of these drugs in their
own families.

According to the findings, 38 percent of black parents, 26 percent of Hispanic parents, and 13
percent of white parents are very concerned about the misuse of narcotic painkillers in their own
families. Misuse of these medicines has been shown to be three times higher among white teens than
black or Hispanic teens, according to the researchers. They found 41 percent of parents favor a
policy that would require a doctor’s visit to obtain refills on these medications. About half said
they do not support a requirement that unused pain medicines be returned to a doctor or pharmacy.

According to the survey, 66 percent of respondents strongly support requiring parents to show
identification when they pick up narcotic painkillers for their children, and 57 percent strongly
support policies that would ban obtaining prescriptions for the medicines from more than one doctor.

“Recent estimates are that one in four high school seniors have ever used a narcotic pain medicine.
However, parents may downplay the risks of narcotic pain medicine because they are prescribed by a
doctor,” Sarah Clark, Associate Director of the Child Health Evaluation and Research Unit at the
University of Michigan, said in a news release. “However, people who misuse narcotic pain medicine
are often using drugs prescribed to themselves, a friend or a relative. That ‘safe’ prescription
may serve as a readily accessible supply of potentially lethal drugs for children or teens."

You have flu symptoms, so you've been getting some relief for the past two days by taking a cough
and flu medicine every few hours. Late in the day, you have a headache and you think about grabbing
a couple of acetaminophen tablets to treat the pain. Stop right there.

What you may not realize is that more than 600 medications, both prescription and over-the-counter
(OTC), contain the active ingredient acetaminophen to help relieve pain and reduce fever. Taken
carefully and correctly, these medicines can be safe and effective. But taking too much
acetaminophen can lead to severe liver damage. Acetaminophen is a common medication for relieving
mild to moderate pain from headaches, muscle aches, menstrual periods, colds and sore throats,
toothaches, backaches and to reduce fever. It is also used in combination medicines, which have
more than one active ingredient to treat more than one symptom.

‘Tis the Cold and Flu Season
The National Institutes of Health (NIH) says that Americans catch one billion colds per year and as
many as 20% of Americans get the flu. Moreover, 7 in 10 Americans use OTC medicines to treat cold,
cough and flu symptoms. Consumers looking for relief from a cold or the flu may not know that
acetaminophen comes in combination with many other medications used to treat those symptoms. If you
are taking more than one medicine at a time, you may be putting yourself at risk for liver damage.
Symptoms of acetaminophen overdose may take many days to appear, and even when they become
apparent, they may mimic flu or cold symptoms. The current maximum recommended adult dose of
acetaminophen is 4,000 milligrams per day.  To avoid exceeding that dose:

•don't take more than one OTC product containing acetaminophen, 
•don't take a prescription and an OTC product containing acetaminophen, and 
•don't exceed the recommended dose on any product containing acetaminophen. 

Advice from FDA:  When you are at the store deciding which product to buy, check the 'Drug Facts'
label of OTC cold, cough and flu products before using two or more products at the same time. If
you’re still not sure which to buy, ask the pharmacist for advice.

Note:  NCPIE, like the FDA, is a member of the Acetaminophen Awareness Coalition (AAC), a diverse
group of leading health and consumer organizations. AAC’s outreach campaign, "Double Check, Don't
Double Up," is all about the safe use of acetaminophen. Visit www.knowyourdose.org for more
information. 

FDA has issued new dosing recommendations for sleep aids containing zolpidem. The new
recommendations are based upon new data that shows that when taken at night, blood levels of
zolpidem remain high enough in the morning to impair activities that require alertness, such as
driving. The new guidelines halve the dosage for women because the new data showed that their
bodies take longer to eliminate the drug. 

FDA urges drug manufacturers and health care providers to follow the new dosing instructions, which
apply to brand name and generic drugs containing zolpidem:

•Ambien® 
•Edluar™ and Zolpimist®; 5 mg for women, 5 mg or 10 mg for men 
•Ambien CR®: 6.25 mg for women, 6.25 mg or 12.5 mg for men 

Additionally, manufacturers of these drugs have been instructed to follow the new guidelines and
print new patient information drug labels containing the new recommendations. 

The recommended doses of Intermezzo®, a lower-dose zolpidem product approved for
middle-of-the-night awakenings, are not changing. At the time of Intermezzo's approval in November
2011, the label already recommended a lower dosage for women than for men.