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OTC Flashcards

1
Q

Antihistamines used for allergy treatment are divided into 2 categories

A

1st generation

2nd generation

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2
Q

1st Generation Antihistamine. 4 examples

A

Dimetapp (brompheniramine)
Chlor-trimeton (chlorpheniramine)
Benadryl (diphenhydramine)
Tavist (clemastine)

the “amines”

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3
Q

2nd Generation Antihistamine. 4 examples

A

Zyrtec (cetirizine)
Allegra (fexofenadine)
Xyzal (levocetirizine)
Claritin/Alavert (loratadine)

the “ines”

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4
Q

1st Generation Antihistamine: Caution when used in patients with

A

narrow angle glaucoma, BPH and urinary retention

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5
Q

2nd Generation Antihistamine: Caution use in patients with

A

renal impairment, hepatic impairment (loratadine), allergy to hydroxyzine (cetirizine) and urinary retention (levocetirizine)

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6
Q

Diphenhydramine– the most

A

commonly used 1st generation OTC antihistamine; most sedating

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7
Q

1st Generation Antihistamine: It’s a ___ depressant so may cause

A

CNS depressant - causes drowsiness and sedation

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8
Q

1st Generation Antihistamine: Anticholinergic effects lead to

A

dry eyes, dry mouth, constipation, urinary retention

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9
Q

1st Generation Antihistamine: Should not be used in children younger than

A

6 years of age (diphenhydramine)

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10
Q

1st Generation Antihistamine: May cause ____ in children

A

excitability

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11
Q

1st Generation Antihistamine: Overdose symptoms include:

A

worsening of common anticholinergic and CNS side effects

Patients may also present with cardiac arrhythmias and hallucinations

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12
Q

1st Generation Antihistamine: Antidote for overdose

A

Physostigmine may be used for an anticholinergic overdose

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13
Q

2nd Generation Antihistamine: 2nd generation antihistamines have less ___ _____ than 1st gen

A

CNS depression

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14
Q

2nd Generation Antihistamine: 2nd generation antihistamines have less CNS depression however

A

higher dose may lead to sedation (loss of H1 specificity)

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15
Q

2nd Generation Antihistamine: Oral Liquid/ chewable tablet available for

A

children 2 – 6 years of age

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16
Q

2nd Generation Antihistamine: Toxicity with 2nd generation antihistamine is

A

unlikely

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17
Q

2nd Generation Antihistamine: Overdose symptoms:

A

mild CNS effects, agitation, restlessness, tachycardia, myalgia

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18
Q

Allergy Products: Combination medication available with a decongestant such as

A

pseudoephedrine

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19
Q

Pseudoephedrine may cause

A

restlessness, insomnia

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20
Q

Kept behind the pharmacy counter for patients ages 18 and up with identification due to potential for abuse. Pseudoephedrine has been used to manufacture

A

methamphetamine

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21
Q

Nasal Decongestants: 2 examples

A

Oxymetazoline

Phenylephrine

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22
Q

Nasal Decongestants: Phenylephrine: mechanism

A

constricts nasal blood vessels, decreases swelling in the nose to allow better inhalation

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23
Q

Nasal Decongestants: Phenylephrine: receptor

A

Alpha adrenergic agonists

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24
Q

Nasal Decongestants: Phenylephrine: Self treat for up to

A

3 days

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25
Q

Nasal Decongestants: Phenylephrine: Treatment for more than 3 days may cause

A

rebound congestion

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26
Q

Nasal Decongestants: Phenylephrine: Side effects include

A

increased BP, CNS stimulation such as insomnia/anxiety and rebound congestion

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27
Q

Allergic Rhinitis: 1st line treatment

A

Intranasal Steroids

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28
Q

Allergic Rhinitis: 1st line treatment is Intranasal Steroids such as

A

fluticasone

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29
Q

Allergic Rhinitis: 1st line treatment is Intranasal Steroids such as fluticasone. The effect is

A

Temporary relief of congestion, runny/itchy nose/ itchy and watery eyes

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30
Q

Allergic Rhinitis: Increased use of intranasal steroid may cause

A

slow growth rate in children (triamcinolone and budesonide)

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31
Q

Allergic Rhinitis: Patients with use of inhaled corticosteroid should also

A

consult MD before use

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32
Q

Allergic Rhinitis: fluticasone may be used for up to

A

6 months

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33
Q

Allergic Rhinitis: budesonide may take up to

A

1 week to show improvement

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34
Q

Allergic Rhinitis: budesonide can be used for up to

A

2 weeks

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35
Q

naphazoline

A

Ophthalmic Agent

Decongestant

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36
Q

tetrahydrozoline

A

Ophthalmic Agent

Decongestant

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37
Q

Oxymetazoline

A

Ophthalmic Agent

Decongestant

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38
Q

Phenylephrine (ophtalmic formula)

A

Decongestant

use for up to 3 days

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39
Q

Nasal Decongestants: Phenylephrine (topical formula), use it Q

A

4 hours (short acting)

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40
Q

Nasal Decongestants: Phenylephrine (topical formula) use for up to

A

3 days

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41
Q

Nasal Decongestants: Phenylephrine (topical formula) Treatment for more than 3 days may cause

A

rebound congestion

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42
Q

Nasal Decongestants: Phenylephrine (topical formula) side effects

A

increased BP, CNS stimulation such as insomnia/anxiety and rebound congestion

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43
Q

Coricidin HBP is for treating

A

Cold and Cough

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44
Q

Coricidin HBP for Cold and Cough is specifically recommended for individuals with

A

high blood pressure by eliminating decongestants from the main ingredients

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45
Q

Cough Expectorant

A

Guaifenesin

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46
Q

Cough Suppressant

A

Dextromethorphan

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47
Q

Guaifenesin (Cough Expectorant) allows for

A

thinning and loosening of the mucus in airways

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48
Q

Guaifenesin S.E.

A

Dizziness, stomach pain, decreased uric acid, vomiting, rash, headache, and kidney stones

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49
Q

Guaifenesin signs of toxicity

A

vomiting, nausea

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50
Q

Dextromethorphan S.E.

A

increased heart rate, stomach pain, faint, dizzy, sedation, nervousness

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51
Q

Dextromethorphan signs of toxicity

A

sedation, hallucinations, detachment, euphoria

think mental status changes

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52
Q

Dextromethorphan: do not use with

A

MAOI’s

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53
Q

Guaifenesin and Dextromethorphan not for use in

A

Children under 4

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54
Q

Acetaminophen 2 main uses

A

Pain reliever/fever reducer

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55
Q

Acetaminophen: Metabolism and transport is in the

A

liver

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56
Q

Acetaminophen: MDD: for adults

A

4g in observational setting/3g limit OTC

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57
Q

Acetaminophen: Acetaminophen: MDD: for kids

A

50-75 mg/kg/day

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58
Q

Acetaminophen: bioavailability

A

88%

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59
Q

Acetaminophen: reaches highest plasma peak within

A

90 minutes

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60
Q

Acetaminophen: duration of effect

A

1.5-2.5 hours

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61
Q

You can use Decongestants for how long before seeing a PCP

A

7 days

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62
Q

congestion is caused by

A

Dilation of blood vessels

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63
Q

What are the two types of decongestants

A

Phenylephrine and Pseudoephedrine

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64
Q

Phenylephrine and Pseudoephedrine should be used with caution for people with HTN because

A

it raises BP

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65
Q

Phenylephrine has low oral

A

bioavailability

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66
Q

Phenylephrine S.E.

A

Restlessness, sleeping trouble, extreme nervousness, dizziness

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67
Q

Phenylephrine: Children dose vary depending on

A

form of medication: saline nasal spray is used more often

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68
Q

Pseudoephedrine biovailability is

A

very high, almost 100%

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69
Q

Pseudoephedrine S.E.

A

Restlessness, vomiting, nervousness, stomach pain, fast heartrate, dizziness

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70
Q

Analgesics and Antipyretics. 2 main uses

A

Treatment of acute pain and temporary fever relief

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71
Q

Acetaminophen carries a black box warning for

A

hepatotoxicity if daily limit dose is exceeded

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72
Q

Acetaminophen toxicity symptoms include

A

nausea, vomiting, hepatotoxicity and renal impairment

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73
Q

Acetaminophen toxicity is due to

A

increased formation of reactive intermediate NAPQI

74
Q

Acetaminophen toxicity is due to increased formation of reactive intermediate NAPQI. NAPQI is detoxified by

A

glutathione at therapeutic doses

75
Q

Acetaminophen toxicity: ____ may be given as an antidote within 8 hours of ingestion

A

N-acetylcysteine (NAC)

76
Q

Naproxen group

77
Q

Ibuprofen group

78
Q

Ibuprofen: Children dosing based on

A

weight and age

79
Q

NSAIDs carry a boxed warning for

A

GI bleeding, ulceration, perforation as well as MI and stroke

80
Q

NSAID: Avoid use in patients with

A

renal disease (CrCl less than 30ml/min)

81
Q

NSAID: signs of overdose include

A

stomach pain, nausea and vomiting

82
Q

NSAID: increased risk for bleeding with a___

A

age over 60

83
Q

NSAID: increased risk for bleeding with P___

84
Q

NSAID: increased risk for bleeding with c____

A

corticosteroids

85
Q

NSAID: increased risk for bleeding with more than

A

3 alcoholic drinks a day

86
Q

NSAID Long-term use may increase risk of

A

MI or stroke

87
Q

Aspirin has a unique property:

A

antiplatelet

88
Q

Aspirin is mainly used as

A

heart protectant in patients with MI risk

89
Q

Aspirin: Should not be used in

A

patient less than 18 years of age who are recovering from chicken pox or flu (Reye’s syndrome – progressive encephalopathy)

90
Q

Aspirin Toxicity presents with

A

hyperventilation, tachypnea, nausea and vomiting, tachycardia

91
Q

Aspirin: Phase 1 Toxicity

A

Tachypnea and hyperventilation

92
Q

Aspirin: Phase 2 Toxicity –

A

Adults may experience increased metabolic acidosis, children may experience pure metabolic acidosis

93
Q

Aspirin: Phase 3 Toxicity –

A

potassium and bicarbonate depletion, dehydration, cerebral/non-cardiogenic pulmonary edema

94
Q

Aspirin: Toxicity treatment includes

A

correcting life threatening complications, allowing patient to hyperventilate to maintain alkemia as well as activated charcoal within 1 hour of ingestion

95
Q

Combination Pain Medication: Limit no more than 2 days per week use to prevent

A

medication induced rebound headache

96
Q

Antacids work by

A

neutralizing stomach acid

97
Q

Antacids SE

A

Constipation, calcium in antacids can lead to nausea, vomiting, mental status changes, kidney stones, plus alkalosis

98
Q

Certain antacids like, Alka-Seltzer, contain

A

aspirin which can lead to bleeding or formation of ulcers; be aware of salicylate allergy

99
Q

if taken in excess, Magnesium containing antacids-can lead to

A

confusion, low blood pressure and irregular heartbeat

100
Q

Antacids: Aluminum is an ingredient in certain formulations. Excess consumption can result in

A

muscle weakness, pain in stomach, bloody or tarry stools.

101
Q

For antacids with Aluminum and sodium, watch out for

A

renal impairment

102
Q

For antacids with sodium, watch out for

A

hypertension, heart failure

103
Q

Antacids: Prolonged use may cause

A

acid rebound

104
Q

Antacids: can significantly reduce the absorption of

A

many prescription medication

105
Q

H2 receptor blockers work by

A

decrease excess acid /reversibly bind histamine and gastric parietal cells- decrease acid secretion when eating and when not eating in dose-dependent manner

106
Q

H2 receptor blockers time of onset

A

30 - 90 minutes

107
Q

H2 receptor blockers duration

A

several hours

108
Q

H2 receptor blockers: when is it taken

A

first meal of the day, may take before evening meal, or even at bedtime

109
Q

Four main H2 receptor blockers:

A

Cimetidine, Famotidine, Nizatidine, and Ranitidine

tidines are H2 blockers

110
Q

H2 Blocker: Famotidine: SE

111
Q

H2 Blocker: Ranitidine: SE

112
Q

H2 Blocker: Nizatidine: SE

A

rare but bleeding can happen along with abdominal pain

113
Q

H2 Blocker: Cimetidine: SE

A

dizziness, rashes, and rarely gynecomastia

114
Q

Proton Pump Inhibitors work by

A

Blocks gastric H,K ATPase which leads to inhibition of acid secretion

115
Q

Proton Pump Inhibitors are used for

A

GERD, ulcers, NSAID induced ulcers

116
Q

Proton Pump Inhibitors: SE:

A

fever, headache, diarrhea, constipation, and vomiting

117
Q

Proton Pump Inhibitors: Excess use can lead to:

A

sweating, blurred vision, fast heartbeat, vomiting, confusion

118
Q

Proton Pump Inhibitors: how much should you use the OTC

A

usually 14 day course treatment at a max of 3 times a year

119
Q

Proton Pump Inhibitors end in

120
Q

Laxatives SE:

A

electrolyte imbalance, diarrhea, abdominal discomfort and cramping

121
Q

Loperamide SE:

A

drowsiness, dizziness, fatigue, and constipations

122
Q

Pepto-Bismol (Bismuth) has Salicylate in adult version, can lead to

123
Q

Children’s Pepto (Bismuth) =____ is only active ingredient

124
Q

Children’s Pepto (Bismuth) SE

A

constipation, bleeding issue

125
Q

Children’s Pepto (Bismuth) : excess leads to

A

nausea, vomiting, mental changes

126
Q

Bismuth: Avoid concomitant use with

A

salicylate containing products, PUD, bleeding disorders, aspirin allergies

127
Q

Bismuth SE

A

black stools and black tongue

128
Q

Bismuth: high doses can cause

129
Q

Bismuth may be used for ___ eradication regimen

130
Q

Metamucil Fiber- SE

A

gas/cramping

131
Q

Epsom salt+Magnesium Citrate- helps soften stool however, excess magnesium can lead to

A

vomiting, flushing, and pain

132
Q

Methyl Salicylate with menthol

A

Topical!

pain killer

133
Q

benzocaine

A

Topical!

pain killer for mouth

134
Q

benzocaine: Risk of

A

methemoglobinemia with use in infants

135
Q

Clotrimazole and Miconazole are in what group and what do they treat

A

Topical Antifungals (tinea pedis, tinea cruris, tinea corporis, candidiasis (vaginal yeast infections))

136
Q

Clotrimazole directions

A

Athletes foot apply to affected areas twice daily for 4 weeks
Vaginal yeast infection apply daily for 7 days
Ringworm apply to affected areas twice daily for 4 weeks

137
Q

Miconazole directions

A

Athletes foot apply to affected areas twice daily for 4 weeks
Ringworm apply to affected areas twice daily for 4 weeks
Vaginal yeast infection : Cream - 2% apply for 7 days, 4% apply for 3 days
Vaginal yeast infection : Suppository – 100 mg for 7 days, 200mg for 3 days and 1,200mg for 1 day
Vaginal products may compromise condom and diaphragm integrity and make them ineffective

138
Q

Selenium Sulfide is in what group

A

Topical Antifungal

139
Q

Terbinafine

A

Topical Antifungal

140
Q

Selenium Sulfide, uses

A

think S for Scalp
Anti-infective agent of scalp and skin
Used to relieve itching and flaking of the scalp with dandruff
Used to treat tinea versicolor (fungal infection of the skin resulting in discolored patches)

141
Q

Neosporin, what group?

A

Topical Antibiotics

142
Q

Bacitracin, what groups?

A

Topical Antibiotics

143
Q

Neosporin is made up of 3 things

A

Polymyxin B, neomycin, bacitracin

144
Q

Neosporin and Bacitracin (topical abx) 3 facts

A

Self treat up to 7 days
1-3 applications a day
application size: tip of your finger

145
Q

Neosporin is different from Bacitracin because

A

it kills bacteria instead of just stopping the growth

146
Q

Topical Corticosteroids: Properties:

A

anti-inflammatory, immunosuppressive, and vasoconstrictive

147
Q

Low potency Topical Corticosteroids

A

Desonide, fluocinolone acetonide, hydrocortisone

148
Q

Mid-potency Topical Corticosteroids

A

Triamcinolone acetonide, mometasone furoate

149
Q

High potency Topical Corticosteroids

C____, d____, f___, f____,h____, h____

A

Clobetasol, desoximetasone, fluocinonide, flurandrenolide, halcinonide, halobetasol propprionate

150
Q

Topical Corticosteroids directions

A

Apply a thin layer to skin 1-4 times daily depending on specific agent
Generally should not be used for more than 4 weeks (Halobetasol, flurandrenolide tape, Clobetasol is only 2 weeks)

151
Q

2 Topical Antihistamine

A

Diphenhydramine topical

Calamine Lotion

152
Q

Diphenhydramine topical- application and SE

A

Apply 3-4 times a day

S.E.: skin rash, sunburn, sensitivity to sunlight and sunlamps

153
Q

Calamine Lotion- application and SE

A

3-4 times a day

S.E.: skin irritation

154
Q

Levonorgestrel, what group

A

Emergency Contraceptives

155
Q

Levonorgestrel: Indication: to prevent pregnancy following unprotected intercourse within

156
Q

Levonorgestrel: Avoid use if

A

pregnancy is confirmed

157
Q

Levonorgestrel: Available only by prescription for

A

women <17 years old

158
Q

Levonorgestrel: If vomiting occurs within 2 hours,

A

repeat dose

159
Q

Levonorgestrel: Adverse effects:

A

heavier menstrual bleeding, nausea, lower abdominal pain, fatigue, headache, breast tenderness, dizziness

160
Q

Oxytrol: Indication: treatment of

A

overactive bladder in women with symptoms of urinary urgency and frequency for at least 3 months

161
Q

Oxytrol: This is NOT intended for

A

men, women < 18 years of age, UTI, stress incontinence (urine loss due to cough, laugh, sneeze).

162
Q

Oxytrol: ____ should be consulted prior to use

163
Q

Oxytrol: Directions:

A

apply one patch to abdomen, hips or buttocks every 4 days; rotate site

164
Q

Oxytrol: Adverse reactions:

A

(anticholinergic effects) sleepiness, confusion, dry mouth, constipation, blurred vision

165
Q

Pediculides: Indication:

A

treatment of head, pubic, and body lice

166
Q

Pediculides: Active ingredients:

A

permethrin (NIX); pyrethrins combined with piperonyl butoxide (RID)

167
Q

Pediculides: Avoid: if

A

allergic to ragweed
children <2 years
near eyes, nose, mouth, or vagina

168
Q

Pediculides: Adverse effects:

A

itchiness and redness at application sites

169
Q

Nicotine Transdermal Patches: Dose initiated usually mimics number of cigarettes smoked /day

A

1 pack/day - > 21mg patch for 6 weeks, then step down to next dose every 2 weeks

170
Q

Nicotine Transdermal Patches

A

Adverse effects include: local skin reactions (erythema, itching, burning), headache, and sleep disturbances (insomnia, abnormal/vivid dreams).

171
Q

Nicotine Gum and Lozenges: Do not use lozenge if

A

allergic to soya (soy beans)

172
Q

Nicotine Gum and Lozenges: Avoid nicotine products if

A

less than 18 years old

173
Q

Nicotine Gum and Lozenges: directions

A

Gum and lozenge should be “parked” between cheek and gums and allowed to dissolve slowly to minimize swallowing the nicotine.

174
Q

Nicotine Gum: adverse effect

A

jaw soreness, hiccups, dyspepsia, throat and mouth irritation, nausea, vomiting, lightheadedness

175
Q

Nicotine Lozenge: adverse effect

A

mouth irritation, nausea, hiccups, cough, heartburn, headache, sore throat, dizziness.

176
Q

Nicotine Gum and Lozenge MDD

177
Q

Clobetasol, what group

A

High potency Topical Corticosteroids

178
Q

desoximetasone, what group

A

High potency Topical Corticosteroids

179
Q

fluocinonide, what group

A

High potency Topical Corticosteroids

180
Q

flurandrenolide, what group

A

High potency Topical Corticosteroids

181
Q

halcinonide, what group

A

High potency Topical Corticosteroids

182
Q

halobetasol propprionate, what group

A

High potency Topical Corticosteroids

Pharm (23 decks)

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