Drug Therapy and Hazardous Substance Committee

Question 1

Name at least 3 factors associated with fatalities from over the counter cough and cold medications in children

Answer 1

Age younger than two years
Use of the medication for sedation
Use in a daycare setting
Combining two of more medications with the same ingredient
Failure to use a measuring device
Product misindentification
Use of products intended for adults

Question 2

What does Health Canada advise in regards to OTC cough and cold medications in children?

Answer 2

Health Canada advised against the use of all CCM formulations in children younger than 6 years of age, with caution being exercised when these formulations were used in children older than six years of age

Question 3

What is the one cough and cold treatment that may be beneficial?

Answer 3

Pasteurized honey in children >1 years old

Question 4

For what kind of organisms is azithromycin effective in treating?

Answer 4

Intracellular organisms (Azithromycin has a superior pattern of distribution to the intracellular compartment)

Question 5

Azithromycin should be avoided in which patients?

Answer 5

Patients with a high risk of bacteremia

Question 6

What is the mechanism of action for macrolides?

Answer 6

They inhibit bacterial protein synthesis by binding to the ribosome 50S subunit

Question 7

Name 4 incorrect practices that lead to antibiotic resistance?

Answer 7

1. Using antibiotics to treat viral infections
2. Under- or overprescribing
3. Inappropriate dosing
4. Prescribing the wrong treatment length

Question 8

Why does azithromycin use lead to increased pneumococcal resistance?

Answer 8

The long half-life of azithromycin results in subinhibitory concentrations at carriage sites over a period of several days and promotes the emergence of resistant strains

Question 9

In which two clinical situations should azithromycin be used for URTI/LRTI?

Answer 9

1. Can be used as second line treatment in cases of life-threatening beta-lactam allergy
2. When you are considering an atypical pneumonia

Question 10

When does folic acid exert its protective effect against neural tube defects?

Answer 10

Periconceptional period

Question 11

What is the safety reason against the use of folic acid fortification in the food supply?

Answer 11

High dose folic acid can mask the hematological signs of pernicious anemia

Question 12

How much folic acid do we recommend in order to reduce the risk of a pregnancy affected with NTD (not a recurrence)?

Answer 12

0.4 - 0.8 mg of folic acid per day

Question 13

How much folic acid do we recommend in order to reduce the risk of a pregnancy affected with NTD, that would be a recurrence?

Answer 13

0.8 and 4.0 mg of folic acid (optimal dose not found)