"THE HEART OF THE MATTER"
a special program of the National Emergency Medicine Association (NEMA)


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Week: 484.5 Guest: Angelo Voxakis, P.D. Topic: Over-The-Counter Analgesics Host: Richard Roeder Producer: Ed Graham

NEMA: This is a conversation on over-the-counter pain medications and how to choose between them with pharmacist Dr. Angelo Voxakis from the Hereford Pharmacy in Parkton, Maryland

NEMA: Dr. Voxakis, the shelves are filled with over-the-counter medications for pain control and though these drugs all have a similar goal or generally have a similar goal, they achieve that goal in a very different way. How is a person who's not a physician supposed to choose between aspirin, ibuprofen and acetaminophen?

Voxakis: That's what the man behind the counter is for. Basically anytime anybody has a question and you're buying anything over the counter, we encourage you to come talk to the pharmacist. That's what the health professional is there for, to answer your questions. He has the knowledge, utilize him. We encourage all of our customers - if you have any questions about over-the-counters, I don't hesitate to walk off the counter and explain to them. At our store, we try to educate our customers. Don't just look at the name brand. Flip it to the back. Read the actual active ingredients in it. Forget Madison Avenue. Look at what's in the medication. And you'd be surprised how many "me toos" are out there.

NEMA: Are there individuals in which a given over-the-counter analgesic works better one time and then another one works better for the same pain the next time or generally when people find success with a certain pain killer is that what's best for them to stick with?

Voxakis: Again you might think your symptoms are the same. They might be similar but not the same. Let's talk about nonsteroidal anti-inflammatories which the new drug out called Aleve, your Motrin, your Advil. Now you have to understand - Motrin, Advil, ibuprofen, Aleve are all in the same family. They're all similar medications so the questions is how should you handle it? We've had people on nonsteroidal medications for arthritis. They'll take one for a couple years. It's working fine and all of a sudden they feel it's not working so are they getting resistant to it? You don't know so therefore the simplest solution is switch them over to another nonsteroidal. Same thing with over-the-counters. Motrin might work for you for a while but then after a while you don't seem to be getting the same relief so you might want to go to an Aleve. I've seen people

within brands find the preference where one person says Advil works but Motrin doesn't and they're identical drugs.

NEMA: So in most cases, what you're going to have to do is with the guidance of your pharmacist, probably do some experimenting until you find what works best for you at that time anyway.

Voxakis: Experimenting with some knowledge. I don't like the word "experiment." I think with knowledge and help from your health professional, yeah, and if it works and like I tell people, if it works stick to it.

NEMA: I want to summarize with a question that we've discussed before but bears repeating. Is the expensive aspirin any better than the store brand aspirin?

Voxakis: In order for it to be what we call A-B rated, that means that it has to dissolve and give you the proper blood levels, generics have come a long way from 30 years ago. The generics now that you see out there, the store brands, are of excellent quality. They do comply with everything the FDA says. I have no problem recommending our store brand. In fact I encourage it. Also I use them.

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