OTC drugs Flashcards
3 general types of drugs that are particularly problematic for OTC drugs
EtOH
anti-coag
CNS therapy
What are Oxymetazoline and Xylometazoline
topical long-acting decongestants similar to Sympathomimetics
drugs that interact with acetominophen and cause liver damage
CYP inducers (phenytoin, carbamazine, rifampin, phenobarbitol)
Azoles
Macrolides
Warfarin
ADE NSAIDs
Tinnitus + Gastritis/GI Bleeding + Renal Failure
DDI w/ NSAIDs
Warfarin Antihypertensive Rx (ARB + ACE-I / ɑ + β blockers) * all from PG interactions
conditions in which NSAID use should be cautioned
Renal Failure Gout (inhib Uric Acid elimination) Asthma (↑AA ---> Leukotrienes) CHF Elderly
OTC used for motion sickness
1st Generation anti-histamine [Diphenhydramine]
3 major components of Coricidin
Chlorpheniramine (Anti-Histamine) + Pseudoephedrine (Decongestant) + Dextromethorphan (Antitissuve)
Rhinitis Medicamentosa and Turbinate Hyperplasia are assc w./
prolonged use of topical decongestants (ex: affin and neosynephrine)
high dose causes: ↑warm feeling, ↑HR, ↑Dry Mouth/Throat, ↓Concentration
even higher dose causes PCP like effects : out-of-body + disorientation —> Addiction
dextromethorphan
how have manufacturers tried to prevent dextromethorphan abuse
formulated with /Guaifenesin (↑GI ADE to ↓dose) or Chlorpheniramine (↑toxicity)
where in the CNS does dextromethorphan work
medulla oblangata
instead of dextromethorphan what are mothers supposed to use for cough suppressant. whats the biggest concern
honey (not pasteurized –> botulism)
OTCs that affect BP
PEE comes out the TIP =
Phenylephrine, Ephedrine, Epi + Theophylline, Ibuprofen, Pseudoephedrine
OTC w/ ADE kidney stones
antacids (Inc Ca)
may cause anticoagulant probs + infectious diarrhea
Bismuth Subsalicylate [Pepto]
*↑salicylate toxicity from absorption of salicylate
ADE: paralytic ileus
loperamide
worry about chelation of other Rx + neutralize pH —> DDI
Magnesium Hydroxide/Sulfate
intox with 1st gen anti-histamines may cause
Hallucinations + Euphoria + anti-cholinergic effects
may cause cirrhosis + infectious diarrhea
loperamide
cause of death in huffing
Arrhythmia + Suffocation (Vomit Aspirate)
specific effect/toxicity seen in huffing
peroral/perinasal dermatitis
OTC DOC for analgesia in kids
acetaminophen
at what age are OTCs safe for use in kids
> 6 yo
OTCs that worsen glaucoma + ↓urinary retention in elderly
Decongestants [Pseudoephedrine]
OTCs that may lead to falls/fracturesin elderly
1st Generation Antihistamines
