OTC Drugs-SC

Question 1

a-galactosidase (oral)
Category
Common OTC Uses
Key points for pt

Answer 1

Category: Miscellaneous GI gas product

Common uses: GI gas (due to gas producing food)

Key points:
>Take product with first bite of food
>Caution in diabetics: produces 2 to 6 grams carbohydrate per 100 grams of food
>Avoid in patients with galactosemia
>Possible allergic reaction for patients allergic to molds

Question 2

Acetaminophen
Category
Common OTC Uses
Key points for pt

Answer 2

Category: Analgesic and Antipyretic

Common uses:
>Cold and flu
>Dysmenorrhea
>Headache
>FeverPain 

Key points:
Brand Name: TylenolFDA
max of 4,000 mg per day (some manufactures 3,000 mg per day max)
Avoid in patients consuming 3 or more alcoholic beverages per day or with liver damage
May cause very serious skin rashes(rare)
Pregnancy: Human data suggests low risk Breastfeeding: Compatible
Pediatric dosing 10 to 15 mg/kg/dose Q4H to Q6H PRN*
Do not exceed 5 doses in 24 hours (maximum daily dose 75mg/kg/day not to exceed 4 grams daily)
*If age less than 2 or weight less than 24 pounds, consult pediatrician

Question 3

Activated charcoal (oral)
Category
Common OTC Uses
Key points

Answer 3

Category: Miscellaneous GI gas product

Common OTC Uses: Gi gas

Key points:
>Questionable efficacy, may be better for reducing smell
>May be alternative to simethicone
>No dosing in children age less than 12

Question 4

Adapalene (Topical)
Category
Common OTC Uses
Key points

Answer 4

Category: Acne product

Common OTC Uses: Acne

Key points:
>Acne may worsen in 1st week
>May take 12 to 18 weeks for full effect
>Increases sun sensitivity, use sunscreen
>Redness, scaling, and burning diminish after 1st month

Question 5

Aluminum acetate (Topical)
Category
Common OTC Uses
Key points

Answer 5

Category: Astrigent

Common OTC Uses: Contact dermatitis (weeping)

Key points:
>Dries and constricts tissue
>Has antimicrobial effects
>May be combined with antifungal for treatment of tinea pedis (athlete’s foot)

Question 6

Aluminum hydroxide (oral)
Category
Common OTC Uses
Key points

Answer 6

Category: Antacid

Common OTC Uses: GERD

Key points:
>Starts to work within 15 to 30 minutes (liquid faster than tablets)
>Diarrhea
>Avoid in acute kidney disease

Question 7

Antazolin (Ophthalmic)
Category
Common OTC Uses
Key points

Answer 7

Category: Antihistamine

Common OTC Uses: Allergic conjunctivitis

Key points:
>Limit OTC useto 3 days
>Contraindicated inpatients with glaucoma
>May be combined with ophthalmic decongestant for improved efficacy

Question 8

Aspirin (Oral)
Category
Common OTC Uses
Key points

Answer 8

Category:

• Analgeic
• Anitpyretic
• Salicylate

Common OTC Uses: 
Cold andflu
Dysmenorrhea
Headache
Fever, Pain 

Key points:
Avoid in children and teenagers due to risk of Reyes Syndrome
Take with food Risk of ulcer (increased in patients consuming 3 or more alcoholic beverages daily)
May cause upper GI discomfort
Do not use if patient has history of GI bleed
Avoid enteric coated version in patients wanting immediate relief
Watch dose: 81 mg is for heart protection only

Question 9

Balcitracin, polymyxin B (topical)
Category
Common OTC Uses
Key points

Answer 9

Category: Antiseptic

Common OTC Uses:

• Atopic dermatitis
• Infection prevention

Key points:
>Preferred over neomycin since some patients are sensitive to neomycin

Question 10

Benzocain (Topical)
Category
Common OTC Uses
Key points

Answer 10

Category: Anesthetic

Common OTC Uses:

• Canker sores
• Pain and itching due to vulvvaginal candidiasis

Key points;
>For canker sores, apply a small amount up to four times daily
>FDA recommends AGAINST use for teething pain and in children under age 2
>Rare but serious condition (methemoglobinemia)
>Treatment of vulvovaginal candidiasis should be focused on curing the infection with vaginal antifungal rather than masking symptoms with benzocaine

Question 11

Benzoyl peroxide (topical)
Category
Common OTC Uses
Key points

Answer 11

Category: Acne product

Common OTC Uses: Acne

Key points:
>Avoid in very sensitive skin
>Increases sun sensitivity, use sunscreen
>Start low (2.5%) to minimize side effects; increase if desired results not achieved and patient tolerates treatment
>Full benefit may take 4 to 6 weeks
>Several potential drug interactions

Question 12

Bisacodyl (oral)
Category
Common OTC Uses
Key points

Answer 12

Category: Laxative (stimulant)

Common OTC Uses: Constipation

Key points:
>May cause abdominal cramping due to mechanism of peristalsis stimulation
>Often produces bowel movement in 6 to 12 hours

Question 13

Bismuth oral)
Category
Common OTC Uses
Key points

Answer 13

Category: Salicylate

Common OTC Uses:

• Diarrhea
• Dyspepsia
• Nausea

Key points:
>Avoid in children and in patients with renal failure
>May cause stool and tongue to turn black
>Risk of salicylate toxicity, neurotoxicity with extended use
>Not recommended inchildren under 12
>Drug interaction with warfarin

Question 14

Budesonide (intranasal)
Category
Common OTC Uses
Key points

Answer 14

Category: Corticosteroid

Common OTC Uses:

• Allergic conjunctivitis
• Allergic rhinitis

Key points:
>May start at full dose and titrate down
>Works best after atleast 1week of continued therapy
>Budesonide,fluticasone,and triamcinolone maybe used in children**but approved age varies byproduct
**Although OTC products for allergies exist for pediatric patients, patients under age 12 should first be evaluated by PCP

Question 15

Caffeine (oral)
Category
Common OTC Uses
Key points

Answer 15

Category: Diuretic

Common OTC Uses: Water retnetion (due to menses.)

Key points:
>Most women do not experience any true sodium or water retention and do not experience weight gain
>Swelling and bloating are caused by a fluid shift
>May cause nervousness, tachycardia, insomnia

Question 16

Camphor (oral)
Category
Common OTC Uses
Key points

Answer 16

Category: Antitussive, Counterirritant

Common OTC Uses: Cough

Key points:
Vapors stimulate sensory nerve endings causing local anesthetic sensation
>Little clinicalevidence >Toxicics of wallowed(4tspof5%camphor)
> For topical formulations, use on intact skin only, wash hands after applying, and do not apply heat
>Do not use in patients age less than 2

Question 17

Capsaicin (topical)
Category:
Common OTC Uses
Key points

Answer 17

Category: Conterirritant

Common OTC Uses: Musculoskeletal pain

Key points:
>Decreases nerve impulses by depleting substance P
>Use on intact skin only, wash hands after applying, and do not apply heat

Question 18

Carbamide peroxide (otic)
Category:
Common OTC Uses
Key points

Answer 18

Category: effervescent debriding agent

Common OTC Uses: excessive cerumen (ear wax)

Key points:
>Place 5 to 10 drops in ear canal, allow it to remain for several minutes
>Cerumen remaining after treatment may be removed with gentle, warm water irrigation, administered with oticbulb syringe
>May be repeated daily for up to 4 days

Question 19

Cetizizine (oral)
Category:
Common OTC Uses
Key points

Answer 19

Category: antihistamine (2 generation)

Common OTC Uses:

• Allergic rnx
• Allergic rhinitis
• Congestion (due to cold and fever)

Key points:
>Less sedation and less anticholinergic than 1st generation antihistamine
>Cetirizinestill causessome drowsiness(~10%of patients)
>Should not be used OTC in pregnant or lactating patients Brand Name: Zyrtec

Question 20

Chlorpheniramine (oral)
Category:
Common OTC Uses
Key points

Answer 20

Category: Antihistamine (1st generation)

Common OTC Uses: AAA AND 2 KEY POINTS
>Allergic conjunctivitis
>Allergic rhinitisAllergic dermatitis
>Congestion (due to cold or flu)Contact dermatitis

Key points:
>Highlylipophilic molecule that readily crosses the blood‐brainbarrier (causingsedation)
>Sideeffectsincludedrowsiness,dizziness, urinaryretention,constipation, blurredvision, tachycardia, dryeyes, dry mouth, dry nose, dry vagina
Do not use in pregnancy, lactation, premature infants, glaucoma, geriatric patients, patients with enlarged prostate, and patients on MAOI’s