PHARMACOLOGY OTC

MEDICATION
PRESENTATION
Nikki Tacsik
Medications

Lactaid (lactase) Benadryl (diphenhydramine)

Lactaid (lactase)
General Information

■ Lactase is an enzyme that is normally produced by the body to breakdown lactose (milk
products)
■ Lactose intolerance
– Not an allergy
■ Can be self diagnosed
– Also, lactose tolerance test, breath hydrogen test, stool acidity test
■ No prescription needed
■ Cost: $9.79 for 32 caplet package
Lactaid (lactase)
Action & Uses
■ Used for people who wish to continue to consume milk or milk related products that
have the previous listed symptoms
– People with lactose intolerance
■ Lactase is an enzyme that breaks down lactose.
■ It converts the disaccharide lactose via hydrolysis into its monosaccharide components,
glucose and galactose.
Lactaid (lactase)
Side Effects and Drug Interactions
■ No major side effects of adverse effects
■ Most common: GI symptoms (abdominal pain/cramping, diarrhea, bloating, etc.)
■ No drug interactions reported
■ Galactosemics should not use Lactaid to take milk or milk products
– They should avoid milk or milk products entirely
■ Caution should be used in people with diabetes and penicillin allergies
– Lactaid can increase blood glucose levels
Lactaid (lactase)
Routes of Administration
■ Routes
– Drops
– Chewable tablets
– *Caplets
■ 1 caplet has 9000 lactase units
■ Directions for use: take 1-2 caplets with your first bite of dairy food, and if you
continue to eat dairy after 30-45 minutes take another caplet
Lactaid (lactase)
Patient Education & Alternatives
■ Important to remember to take the pill with dairy containing food
■ It does not cure lactose intolerance, only suppresses symptoms
■ It is not a drug, but it is a supplement (still important to tell your doctor!)
■ Not for patients with galactosemia
■ Caution in patients with diabetes and penicillin allergy
■ Alternatives: off brand lactase enzyme supplements, Equate dairy digestive
supplement…
Lactaid (lactase)
Alternatives (continued)
■ Lactaid or other non-dairy products
Benadryl (diphenhydramine)
General Information
■ No prescription needed
■ Cost: $4.44 for 24 count package
■ Type of antihistamine (receptor antagonist)
■ Metabolized in the liver
■ Excreted in the urine
Benadryl (diphenhydramine)
Action & Uses
■ Diphenhydramine…
– Acts as an allergy medication by non-selectively antagonizing central and
peripheral histamine H1 receptors
– Acts as an antitussive by suppressing the medullary cough center
– Possesses anticholinergic properties
■ Increase pupil diameter
■ Increased heart rate
■ Dilation of bronchioles
■ Decreased gastric motility and secretion, constipation
■ Vasoconstriction
■ Used for allergies, dystonias/Parkinson’s Disease, insomnia, pruitis, vertigo/motion
sickness
Benadryl (diphenhydramine)
Side Effects and Drug Interactions
■ Common reactions
– Drowsiness, dizziness, headache, constipation, hypotension, tachycardia,
diaphoresis, urinary retention, etc
– Think opposite of muscarinic receptors (so, flight or flight)
■ Serious adverse reactions
– Anaphylaxis, anemia, leukopenia, arrhythmias, seizures, toxic psychosis, heat
stroke, etc
■ Drug interactions
– Other sedatives, alcohol, diazepam, MAO inhibitors, pain meds
■ Benadryl should be used in caution with depression, COPD/asthma, and in people with
anticholinergic conditions (glaucoma, GI obstruction, urinary retention, etc).
Benadryl (diphenhydramine)
Routes of Administration and Dosing
■ Routes
– Capsule, tablet, solution, and also IV injection
■ 25 mg – 50 mg every 2, 4, 6, 8, hours, or nightly depending on reason for use
– Insomnia: every night as needed for sleep
– Motion sickness: every 4-6 hrs as needed (up to 300-400 mg/day)
– Allergic reactions: every 2-4 hrs as needed (up to 300-400 mg/day)
Benadryl (diphenhydramine)
Patient Education and Alternatives
■ Be cautious in patients with asthma/COPD, other anticholinergic conditions, and depression
■ Medication may make you drowsy
■ Don’t take with alcohol, other CNS depressants, etc
■ Look alike/sound alike drugs: dicyclomine, dimenhydrinate, dipyridamole
■ Alternatives
– Allergy: vistaril, antivert, atarax, etc.
– Insomia: ambien, trazadone, restoril, etc (*note: unisom, advil PM and other have
diphenhydramine in them)
– Vertigo: transderm scop, Dramamine (diphenhydramine), meclizine, etc.
References

■ Benadryl box
■ Epocrates Plus App. (2018). Epocrates, Inc.
■ Lactaid box
■ Rosenthal, L. D., and Rosenjack-Burchum, J., (2018). Lehne’s Pharmacotherapeutics
for Advanced Practice Providers. St. Louis, Missouri: Elsevier.