OTC Drugs

Question 1

Both Prescription and OTC drugs are regulated by the FDA

Answer 1

ok

Question 2

The FDA has a Non-Prescription Drug Advisory Committee that makes the decision to grant over- the counter status

Answer 2

ok

Question 3

What has to be on the label for OTC drugs?

Answer 3

• Product Name
• Active Ingredients
• Purpose
• Uses
• Warnings
• Directions
• Other Info
• Inactive Ingredients

Question 4

Acetaminophen side effects

Answer 4

Liver toxicity

Question 5

Acetaminphen interactions

Answer 5

Azoles, Macrolides, Warfarin, CYP inducers, These drugs cause hepatotoxicity on their own

Question 6

Recall the fundamental difference between 1st gen antihistamines and 2nd gen

Answer 6

1st- cross the BBB, produce sedation and potential anticholinergic effects.

2nd Generation antihistamines- Act only in the periphery

Question 7

Dextromethorphan can be toxic even in recommended doses to pts who are deficient in

Answer 7

CYP 2-D 6

Question 8

Acid reducers should be used for less than 2 weeks and not in children under 12 yp

Answer 8

ok

And omeprazole (prilosec) shouldn’t be used in ppl under18

Question 9

Which of the 1st gen antihistamines is the most sedating

Answer 9

diphenhydramine (benadryl)

Question 10

Oxymetazoline can only be used for 3 days—-Afrin—–because of the risk of rebound congestion. You can use xylometazoline (the long acting form) instead

Answer 10

ok

Question 11

Acetaminophen can give rise to hepatic toxicity when consumed in high concentration, this toxicity may be exacerbated bythe concurrent consumption of drugs that induce CYP

Answer 11

ok

Question 12

NSAIDS like advil can interact with

Answer 12

Warfarin by way of their affect on prostaglandins and to diminish the activity of anti-hypertensive drugs with have an affect on prostaglandins.

May also worsen gout

Question 13

What is Bisacodyl

Answer 13

An OTC constipation medicine that can cause electrolyte imbalance

Question 14

What is Magnesium Hydroxide

Answer 14

An OTC constipation medicine that may not only cause electrolyte imbalance but may chelate concurrent drugs and alter bioavailability by neutralizing pH.

Question 15

Bismuth Salicylate (pepto)

Answer 15

OTC diarrhea medication.

Things to watch out for: Anticoagulation (salicylates inhibit prostaglandins)

Question 16

Loperamide (immodium)

Answer 16

OTC anti-diarrheal drug that leads to electrolyte imbalance, fluid loss, etc…

Question 17

Know that caffeine is found in analgesics, menstrual products, and stimulants

Answer 17

ok

Question 18

Cimetidine and Nazatidine are

Answer 18

Acid reducers

Question 19

Cimetidine and Nazatidine dosing

Answer 19

Use for no more than 2 weeks and not in kids under 12.

Question 20

Omeprazole. What is it and whats important about its dosing

Answer 20

Acid reducer (prilosec)…should only be used for up to 2 weeks and in no one under the age of 18

Question 21

What is the big “non-sedating” anti-histamine

Answer 21

Zyrtec (cetirizine)

Question 22

Chlorpheniramine?

Answer 22

Sedating antihistamine (chlor-trimeton)

Question 23

Diphenhydramine?

Answer 23

Sedating antihistamine (1st gen) known as benadryl

MAY CAUSE ANTICHOLINERGIC EFFECTS!!!! Remember those?

• Anti-sludgeBBB
• Insomnia
• Hallucinations and Cognitive dysfunction
• CV issues

Question 24

Guaifenesin

Answer 24

mucolytic

Question 25

Psuedoephedrine

Answer 25

Alpha Adrenergic agonist which means that it reduces vasodilation

Question 26

What types of drugs cause rebound congestion or rhinitis medicamentosa

Answer 26

Topica nasal decongestants like Afrin

Question 27

What is dextromethorphan

Answer 27

A non-narcotic antitussive that works in the cough center of the medulla oblongata. Usually produces no sedative or addictve effects?

Question 28

What group of ppl can experience toxicity via dextromethorphan at even normal doses?

Answer 28

Populations deficient in CYP 2D6.....white europeans | Dry mouth, Tachycardia, inability to concentrate

Question 29

In supra-pharmacologic doses, dextromethorphan can become addictive. In order to discourage addiction, what is it often co-formulated with?

Answer 29

Guaifenisin....will produce nausea, vomitting, and diarrhea if taken in high doses.

Question 30

Cough and cold products labeled only for those over what age

Answer 30

6

Question 31

Common OTC agents affecting BP

Answer 31

Ephedrine, Epinephrine, Ibuprofen, Phenylephrine, Pseudoephedrine, Theophyline EEIPPT

Question 32

In the 12-17 age range, what sex is more likely to get high using cough syrup?

Answer 32

Females Males after that (18-25)

Question 33

Doxylamine, Diphenhydramine, and Chlorpheniramine....Abuse

Answer 33

Yeah, these are all first generation anti-histamines so they are sometimes used to produce hallucinations and euphoria in high concentrations.

Question 34

3 methods of stomach acid modification

Answer 34

- neutralize stomach acid content with an antacid - block histamine H2 receptor stimulation of all acid secretion - Block the final effect of acid secretion the proton pump

Question 35

DOC for pain relief in kids

Answer 35

acetaminophen because of the concerns over aspirin and reye's syndrome

Question 36

Senna

Answer 36

Laxative

Question 37

Orlistat

Answer 37

wt loss drug