objective 4.1

Question 1

medications that are legally available without a prescription
drugs thought to be safe and effective for people to use without instructions from a health care provider about how to use them

Answer 1

nonprescription meds or OTC products

Question 2

how do nonprescription differ from prescription drugs?

Answer 2

1. Label info more complete, often written in a style easier for consumers
   to understand
   2. Wider margin of safety
   3. Advertised directly to the consumer
   4. Widely available
   5. Dose may be lower than prescription
   6. These products are usually not covered by insurance

Question 3

can be sold in pharmacies, grocery stores, gas stations etc.
many versions and different names

Answer 3

OTC products

Question 4

what must product labelling include?

Answer 4

active ingredients/inactive ingredients
purpose(s)Uses
Storage info
Warnings/ adverse effects
Directions (dosage instructions)
contraindications

Question 5

what are the most common categories of nonprescription drugs?

Answer 5

Laxatives
Peptic acid disorder products ex. antacids
Analgesics
Cough & cold
antihistamines, expectorants, decongestants,
& antitussives
Vaginal antifungals
Smoking cessation products
Topical steroids

Question 6

what are the advantages of nonprescription drugs?

Answer 6

Convenient
Relatively safe
May free up physician’s time

Question 7

what are the disadvantages of nonprescription drugs?

Answer 7

May cause patient’s delay in treatment seeking
Cost due to no insurance coverage
MAY LACK IN PATIENT EDUCATION
Risk of toxicity if not used correctly
Lack of experience/knowledge of consumer re label
Small print on label

Question 8

what are alternative meds?

Answer 8

Herbal therapy
Aromatherapy
Chiropractic Care
Acupuncture
Massage
Homeotherapy

Question 9

what are complementary meds?

Answer 9

Alternative together with standard medical care
“Integrative Practices”

Question 10

why do ppl take CAM/OTC?

Answer 10

Seek products that will keep them in good health, also
think ‘natural’ must be good for you!
Tried regular treatments without success
Undesirable S/E from regular treatments
No known therapy for their problem
Someone shared their experience & successes
Seeking a nonprescription alternative
Regular treatments are in violation of pt’s religious or
spiritual beliefs
Cheaper and no prescription needed (good if no
insurance)

Question 11

what are examples of natural health products?

Answer 11

vitamin and mineral supplements
herbal remedies
homeopathic preparations
traditional Chinese Ayurvedic and other traditional medicines
probiotics
other products such as amino acids and essential fatty acids
numerous consumer products, such as certain toothpastes,
antiperspirants, shampoos, facial products, and mouthwashes.

Question 12

broad term for oral alternative medicines which include herbal supplements
intended to enhance the diet and includes other essential ingredients
come in various forms (tablets, capsules, softgels, gelcaps, liquids, and
powders); may also be found in nutritional, breakfast, snack, or health food bars;
drinks; and shakes

Answer 12

dietary supplement

Question 13

come from nature & includes leaves, bark, berries, roots, gums, seeds, stems
and flowers of plants
30% of all modern drugs are derived from plants
Aka phytomedicine; increase in demand… inexpensive and have better
cultural acceptability, are reasonably safe and effective, and have advantageous
compatibility and minimal adverse effects

Answer 13

herbs

Question 14

Belief that a disease can be treated by the administration of a microdose of a
substance thought to cause the physical signs of that disease
Thought to stimulate the immune defence

Answer 14

homeopathy

Question 15

Labour induction; reduce menopause symptoms; causes birth defects in
animals

Answer 15

blue cohosh

Question 16

Expectorant, antiulcer; only good in small doses; may cause Na retention
and K+ loss

Answer 16

licorice

Question 17

calming effect, used for anxiety , stress; can lead to possible liver toxicity
May increase the effects of barbiturates & alcohol

Answer 17

kava root

Question 18

Used for allergies, nasal congestion, asthma; possible cardiovascular and
stroke risks

Answer 18

ephedra

Question 19

Reduces menopausal symptoms; some considerations
noted

Answer 19

black cohosh

Question 20

anti-inflammatory, antispasmodic, anti-infective
Caution if allergy to ragweed, Produces sedation: caution
with sedatives or alcohol
Increased risk of bleeding with anticoagulants

Answer 20

chamomile

Question 21

Stimulates the immune system
used in treatment or prevention of colds & flu or UTI
Avoid if using hepatotoxic drugs (methotrexate), allergic to ragweed, progressive
autoimmune disorders
Possible interference with or counteraction to immunosuppressant drugs &
antivirals

Answer 21

echinacea

Question 22

Migraine Headaches
Inhibits platelet aggregation
Do not use concurrently with aspirin or warfarin

Answer 22

feverfew

Question 23

May lower BP, and blood lipids
Inhibits platelet aggregation
Do not use with aspirin or warfarin (anticoagulants)
Possible interference with hypoglycemic therapy
Monitor BP

Answer 23

garlic

Question 24

Antiemetic
Inhibits platelet aggregation
Do not use concurrently with aspirin or warfarin
At high doses possible interference with cardiac, antidiabetic and
anticoagulant drugs

Answer 24

ginger

Question 25

Antidepressant, not to be used with other antidepressants Numerous potential drug interactions results in decrease concentrations of many drugs May lead to serotonin syndrome if used with serotonergic drugs

Answer 25

st john's wort

Question 26

Used in AD, Improves blood flow to brain and extremities, improves brain tissue tolerance to hypoxia, alleviates vertigo and ringing in ears, may slow dementia Need to monitor for signs of bleeding, Avoid with pts with bleeding disorders, or if taking antiplatelet or anticoagulant agents

Answer 26

ginkgo biloba

Question 27

used for urinary symptoms associated with an enlarged prostate gland (also called benign prostatic hyperplasia or BPH), as well as for chronic pelvic pain, decreased sex drive, migraine, & hair loss May Change the effects of hormones in oral contraceptive drugs, patches or hormonal replacement therapies

Answer 27

saw palmetto

Question 28

Essential oils extracted from various parts of a plant, used to promote health and well being Some believe they can fight bacteria, viruses, bacterial toxins and fungi Thought to work by triggering hormones that govern bodily functions Molecules attached to O2 molecules in the lungs and circulate through the body Little research available Oils should never be swallowed or applied near the eyes Sage, DoTerra

Answer 28

aromatherapy

Question 29

From cow cartilage Eases aches & pains & Rebuilds cartilage

Answer 29

chondroitin

Question 30

From oyster shells Eases aches and pains, prevents collagen degeneration, rebuilds cartilage

Answer 30

glucosamine

Question 31

Pineal glands of cows Used for jet lag, menopause, ADHD, autism spectrum; regulates hormones and circadian rhythm Sleep and anti-aging remedy May inhibit sex drive in men

Answer 31

melatonin

Question 32

organic molecules needed in small amts for metabolism and other biochemical functions like growth and tissue repair in the body

Answer 32

vitamins

Question 33

are of equal importance-are inorganic elements found naturally in the earth

Answer 33

minerals

Question 34

are catalysts that stimulate chemical changes in other products. Vitamins and minerals enhance the function of enzymes, and are considered to be coenzymes.

Answer 34

enzymes

Question 35

Organic molecules needed in small quantities for normal metabolism and other biochemical functions such as growth and repair of tissue Need them in specific amounts daily Can come from plant and animal food sources

Answer 35

vitamins

Question 36

Not readily excreted in the urine and are stored in the body; daily ingestion not req’d Dissolvable in fat

Answer 36

fat-soluble vitamins

Question 37

what are fat-soluble vitamins?

Answer 37

A, D, E, K

Question 38

what do fat-soluble share?

Answer 38

Found in plant and animal food (table 9.2) Stored primarily in the liver Have a slower metabolism Excreted via feces Can reach toxic levels aka hypervitaminosis if excessive amounts are taken

Question 39

needs to be taken in from an outside source

Answer 39

exogenous

Question 40

From animal fats (liver, fats, eggs, fish liver oils) and carotenes (found in plants- green and yellow vegs. & yellow fruit) Essential for night and normal vision, Aids in cholesterol and steroid synthesis, Normal cell growth and differentiation Normal diet provides sufficient amount, may be used to satisfy normal body requirements or an increased demand in infants/ pregnancy Contraindications: known allergies to vitamin products or known current state of hypervitaminosis, excess amounts in pregnancy can be teratogenic

Answer 40

vitamin A

Question 41

Obtained from both endogenous synthesis and consumption of vit D2 containing foods (fish oils, salmon, sardines, herring, fortified milk, bread, ceral and animal livers tuna, eggs and butter) Mechanism of Action & Drug Effects: aids in regulation of calcium absorption and in utilization of calcium and phosphorus in the body; Derived from plants, UV light Indications: Used for supplementation, treatment of deficiency; Rickets is a vitamin D deficiency state; prevention of osteoporosis Contraindications: kidney insufficiencies, hyperphosphatemia, hypercalcemia

Answer 41

vitamin D

Question 42

Made up of tocopherols Come from plant and animal sources Mechanism of Action & Drug Effects: Antioxidant and essential to diet, believed to protect polyunsaturated fatty acids, a component of cellular membranes Indications: premature infants at greatest risk of complications from deficiency, helps decrease the damage caused by free radicals in the body, protection from UV radiation Contraindications: allergy

Answer 42

vitamin E

Question 43

Synthesized by the intestinal flora (endogenous supply) Mechanism of Action & Drug Effects: essential for blood clotting, Deficiency is rare Indications: deficiency states, Deficiency states can be seen in newborns due to malabsorption because of decreased bile; given an IM injection on admission to nursery, used to reverse excessive anticoagulation if the patient has evidence of bleeding, used to reverse warfarin effects Containdications: Allergy

Answer 43

vitamin K

Question 44

include the B complex vitamins and Vitamin C (ascorbic acid) Plant and animal food sources Dissolvable in water Not stored in the body Excreted via urine

Answer 44

water-soluble vitamins

Question 45

Can result in beriberi or Wernicke’s encephalopathy Can be caused by poor diet, extended fever, hyperthyroidism, liver disease, alcoholism, malabsorption and pregnancy and breastfeeding. Normal serum levels 0.75-222 nmol/L Mechanism of Actions & Drug Effects: required for carbohydrate metabolism & other metabolic pathways, plays important role in GI, Cardio and PNS Indications: treatment of metabolic disorders, deficiency state, used as dietary supplement to prevent or treat deficiency in cases of malabsorption (induced by alcoholism, cirrhosis, or GI disease) Adverse Effects: Rare but hypersensitivity, nausea, restlessness, pulmonary edema, cyanosis, cardiovascular collapse can occur

Answer 45

vitamin B1

Question 46

Deficiency results in cutaneous, oral and corneal changes Essential for tissue respiration (release of energy) Mechanism of Action & Drug effects: important for tissue respiration, & in carbohydrate catabolism, Vit B6 needs this vit for activation, needed for RBC maintenance Indications: Deficiency rare though can occur in those with long standing infections, liver disease, chronic infections, alcoholism or malignancy and those taking probenecid, can be used to treat acne, anemia, migraine headaches Adverse Effects: safe & effective, no adverse effects reported , Can discolor urine to yellow-orange in large doses

Answer 46

vitamin B2

Question 47

A dietary deficiency will produce symptoms known as pellagra; include various psychotic disorders, crusting erythema and desquamation of the skin, diarrhea, inflammation of mucosa Mechanism of Action & Drug Effects: Needed for tissue respiration and metabolism of proteins, carbohydrates, protein and lipids (fig 9.1) Indications: prevention & Treatment of pellagra, Can be used for certain types of dyslipidemia, beneficial effect in peripheral Vascular disease Contraindications: liver disease, severe hypotension, arterial hemorrhage and active peptic ulcer disease

Answer 47

vitamin B3

Question 48

Deficiency can lead to Anemia (sideroblastic anemia), Neurological disturbances, seborrheic Dermatitis, Convulsions Vit B6 deficiency can be caused by uremia, alcoholism, cirrhosis, hyperthyroidism, malabsorption syndromes and heart failure Mechanisms of Action & Drug Effects: necessary for many metabolic functions in the body such as protein, carbohydrate and lipid utilization Indications: Treat deficiency, seizures unresponsive to normal therapy, morning sickness during pregnancy and metabolic disorders may respond to B6 therapy

Answer 48

vitamin B6

Question 49

Important for fat and carbohydrate metabolism and protein synthesis, growth, cell replication, hematopoiesis and nucleoprotein and myelin synthesis Mechanism of Actions & Drug Effects: oral absorption of B12 requires the presence of an intrinsic factor (glycoprotein secreted by gastric parietal cells) A complex is then formed which is absorbed by the intestines Fig 9.3 Contrainidications: drug allergy, sensitivity to chemical element cobalt Indications: deficiency states Caused by malabsorption or poor dietary intake

Answer 49

vitamin B12

Question 50

Deficiency can result in scurvy; characterized by weakness, edema, gingivitis and bleeding gums, loss of teeth, anemia, subcutaneous hemorrhage, bone lesions, delayed healing of soft tissues and bones and hardening of leg muscles Mechanism of Actions & drug Effects: very important for metabolic activities within the body, including collagen syntheses & maintenacnce of connectoive tissue; tissue repair, maintenacen of bones, teeth and capillaries and folic acid metabolism, Essential for erythropoiesis, enhances iron absorption Adverse Effects: megadoses produce nausea, vomiting headache and abdominal cramps and will acidify urine

Answer 50

vitamin C

Question 51

Essential nutrients… act as building blocks for many body structures and thus are necessary for a variety of physiological functions. needed for intra­cellular and extracellular body fluid electrolytes Minerals are necessary for muscle contraction and nerve transmission and are required components of essential enzymes. Elements that are required in larger amounts are called macrominerals; those required in smaller amounts are called microminerals or trace elements

Answer 51

minerals

Question 52

is the most abundant mineral element in the human body (2% of body weight) Highest concentration is in bones and teeth Reduces risk of osteoporosis > 50 yrs should have 1200 mg/daily Fortified OJ is one of the best sources as well as milk & dairy products, fortified cereals and salmon & sardines! Best if taken with food; requires Vit D for efficient absorption _______ products bind with tetracyclines, making the antibiotic inactive.

Answer 52

calcium

Question 53

is one of the principal cations present in the intracellular fluid essential part of many enzyme systems associated with energy metabolism It is required for muscle contraction and nerve function. used for treatment of magnesium deficiency and as a nutritional supplement in TPN and multivitamin preparations. Also given to prevent preterm labor and as an anticonvulsant in magnesium deficiency induced seizures, management of cardiac dysthymias, and treatment of constipation

Answer 53

magnesium

Question 54

Essetnail for proper function of all biological systems (stored in many sites throughout the body- spleen, liver, bone marrow) Woman and Children most likely to develop anemias- require the highest amt of iron Iron is essential for the production of hemoglobin, which is required for transport of oxygen Dietary sources include: meats vegtables, grains beans, dried fruits, and eggs. Orange juice can assist in absorption Should not be taken with calcium Constipating

Answer 54

iron

Question 55

Is a water souble B complex vitamin Dietary sources include: dried beans, peas, oranges and green vegs. Essentail for normal erythroposis Protects against neural tube defects in the developing fetus (recommended to start taking 1 month before pregnancy) Taking with vit B6 and B12 can help decrease risk of heart disease

Answer 55

folic acid

Question 56

Effects can be felt within seconds to minutes of smoking, vaporizing or dabbing cannabis. These effects can last up to 24 hours. If you eat or drink cannabis, these effects can occur within 30 minutes to 2 hours and can last up to 24 hours

Answer 56

medical cannabis

Question 57

Cannabis contains hundreds of chemical substances, known as cannabinoids. Cannabinoids have effects on cell receptors in the brain and body; and can change how those cells behave and communicate with each other.

Answer 57

cannabis sativa

Question 58

responsible for the way your brain and body respond to cannabis, including the high and intoxication.

Answer 58

THC

Question 59

is another cannabinoid, but does not produce a high or intoxication

Answer 59

cannabidiol CBD

Question 60

Some of the short-term effects on your brain from cannabis can include what?

Answer 60

confusion sleepiness (fatigue) impaired ability to: ◦remember ◦concentrate ◦pay attention ◦react quickly anxiety, fear or panic Short term effects on your body can also include: if smoking, damaged blood vessels caused by the smoke decrease B/P and an increase HR

Question 61

Long-term cannabis use can harm your...?

Answer 61

memory concentration intelligence ability to think and make decisions

Question 62

what are the uses of medical cannabis?

Answer 62

Relieving symptoms and side effects of cancer treatments Pain a/w cancer progression and treatments Loss of appetite a/w cancer treatments Nausea and vomiting, again a/w cancer progression and treatments PTSD (FDA approved) Childhood epilepsy (FDA approved) 72 controlled clinical studies evaluating the therapeutic effects of cannabinoids, present an interesting therapeutic potential as anti-emetics, appetite stimulants in debilitating diseases (cancer and AIDS), analgesics, and in the treatment of MS, SCIs, Tourette's syndrome (TS), epilepsy, and glaucoma (See Table 5 from link) Palliative care