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OTC > OTC Exam 1 > Flashcards

OTC Exam 1 Flashcards

1
Q

What are special populations in OTC

A

Pregnant
Geriatric
Pediatric
Lactating

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2
Q

Who does the FDA recommend against self medicating with nonprescription products

A

Children less than 2 years old

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3
Q

What type of dosing is preferred

A

Weight based

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4
Q

What are exclusions for self treatment

A
  • OTC not available or recommended for child’s age group
  • disorder not self treatable because of age
  • rarity condition
  • could indicate more serious disorder
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5
Q

What are administration considerations

A

Taste and measuring device

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6
Q

What dosage forms are available for acetaminophen

A

Capsules
Tablets
Chewable tablets
Liquid
Suppositories
ODT

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7
Q

What dosage forms are available for ibuprofen

A

Capsules
Tablets
Chewable tablets
Liquid

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8
Q

What dose do acetaminophen chewable tablets come in

A

160 mg with score (80 mg sections)

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9
Q

What is the concentration of acetaminophen liquid

A

160 mg/5 mL

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10
Q

What is the infant concentration of ibuprofen

A

50 mg/1.25 mL (40 mg/mL)

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11
Q

What is the concentration of child’s ibuprofen

A

100 mg/5 mL

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12
Q

What pediatric antihistamines are available in chewable

A

Cetirizine
Diphenhydramine
Loratadine

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13
Q

What pediatric antihistamine is not available in a chewable tablet

A

Fexofenadine

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14
Q

What should miralax NOT be mixed in

A

Milk

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15
Q

What drugs are generally not recommended in pediatrics

A

Codeine
Promethazine
Quinolones
Tetracycline

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16
Q

Why is codeine not recommended in pediatrics

A

CYP2D6 enzyme converts it to morphine which could cause possible overdose for people who over-express this enzyme

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17
Q

Why is promethazine not recommended in pediatrics

A

Severe and potentially fatal respiratory depression

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18
Q

Why are quinolones not recommended in pediatric patients

A

Adverse effect on cartilage, bone, and muscle

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19
Q

Why are tetracyclines not recommended in children younger than 8

A

Stain teeth and weaken bones

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20
Q

What are the primary causes of accidental overdose in children

A

Iron and acetaminophen

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21
Q

What is the poison control number

A

1-800-222-1222

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22
Q

How does ABSORPTION change in the elderly population

A
  • increased GI secretions and motility
  • decreased surface area and blood flow
  • increased pH
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23
Q

How does DISTRIBUTION change in the elderly population

A
  • decreased total body water
  • decreased muscle mass
  • increased body fat
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24
Q

How does METABOLISM change in the elderly population

A
  • decreased hepatic blood flow
  • decreased enzyme activity
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25
Q

How does ELIMINATION change in the elderly population

A

Decreased renal function

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26
Q

What PK parameters change as you age

A

Absorption
Distribution
Metabolism
Elimination

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27
Q

What are the concerns with NSAID use in the elderly population

A

GI changes
Cardiovascular issues
Renal function concern

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28
Q

What are factors that pharmacists should consider in geriatric patients

A
  • Polypharmacy
  • Multiple chronic disorders
  • Alteration in senses
  • Cognition and memory changes
  • Dysphagia
  • Sensitivity to anticholinergic meds
  • Blurred vision
  • decreased Salivation
  • decreased Lacrimation
  • Urinary retention
  • Constipation

(Pharmacy School Sucks, At Least Dumb Bitches Can’t Make Us Cry)

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29
Q

What resource contains meds that cause adverse effects in the elderly

A

Beer’s criteria

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30
Q

What are screening tools used to adjust medications in the elderly

A

STOPP/START criteria

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31
Q

What should pregnant patients try first

A

nondrug therapy

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32
Q

Most medications cross what

A

The placenta

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33
Q

Most medications cross what

A

The placenta

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34
Q

What should pregnant patients never presume about an OTC medication

A

That it is safe for use during pregnancy

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35
Q

When is the best time for a breastfeeding mother to take a medication

A

Immediately after feeding or right before infant’s longest sleeping period

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36
Q

What should breastfeeding mothers be advised

A
  • use nonpharmacologic therapy if possible
  • take medication immediately after nursing/before infant’s longest sleep
  • counsel on potential side effects in the infant
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36
Q

What should a breastfeeding mother avoid

A

Extra strength/long acting products
Combination products

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37
Q

What resource is an A to Z searchable database that summarizes known/possible side effects in pregnancy and possibility of passage through breast milk

A

Briggs

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38
Q

What drugs are safe for pregnancy for allergic rhinitis

A
  • chlorpheniramine
  • diphenhydramine
  • cromolyn
  • saline NS
  • flonase
  • zyrtec/claritin/allegra (2nd gen)

(Zack Catches Cute Cats And Dogs [on] Friday, Saturday)

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39
Q

What drugs are unsafe during pregnancy for congestion

A

Phenylephrine
Pseudoephedrine

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40
Q

What drugs are UNSAFE during pregnancy for pain, fever, and headache

A
  • aspirin (avoid high dose in 1st and 3rd trimesters)
  • excedrin
  • ibuprofen/naproxen (avoid in 1st and 3rd trimesters)
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41
Q

What drugs are UNSAFE during pregnancy for diarrhea

A

Loperamide
Pepto (bismuth subsalicylayte)

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42
Q

What drugs are UNSAFE during pregnancy for constipation

A

Castor oil
Mineral oil

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42
Q

What should be discouraged during lactation

A

Homeopathic and herbal remedies

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43
Q

What drugs are SAFE during pregnancy for constipation

A

Miralax
Colace/docusate
Fiber
Sennosides
Bisacodyl

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44
Q

What treatment options should lactating patients chose

A

Those with the shortest half life

45
Q

What is a major cause of poisoning (drug)

A

Acetaminophen

46
Q

What nonprescription products are most reported for potentially toxic exposures

A

Analgesics
Dietary supplements
Topical preparations
Vitamins
Antihistamines

(A TAD Vicious)

47
Q

What patient info does poison control ask for

A

Age
Weight
Medical history
Ongoing clinical effects

48
Q

Why have pediatric poisonings increased

A
  • use on nonstandard liquid measuring devices
  • caregiver misinterpretation on nonprescription medication labels
49
Q

What information about the toxin does poison control ask for

A

Name of drug/substance
Dose
Route of exposure
Time since exposure

50
Q

What information about treatment does poison control ask for

A
  • has the pt or caregiver offered anything to reverse poisoning
  • ask about excess water, forced vomiting, activated charcoal
  • if so, when and how long after the poison was ingested
51
Q

Even though ipecac syrup is approved for self treatment of ingested poisons, is does NOT

A

Improve outcomes for poisoned patients and use should be avoided

51
Q

What are approved agents for self treatment for ingested poisons

A

Activated charcoal and ipecac syrup

52
Q

What is activated charcoal mixed with to sweeten

A

Water/sorbitol

53
Q

What are adverse effects of activated charcoal

A

Vomiting
Black stools

54
Q

What should be done with activated charcoal before administering

A

Mix with water and shake vigorously

55
Q

Activated charcoal is sold as an OTC drug but is not available where

A

Not available in most homes, nor is it routinely recommended for home use by poison control centers

56
Q

What is the antidote for acetaminophen overdose

A

Acetylcysteine

57
Q

What is the antidote for several medications and poisons

A

Charcoal

58
Q

What is the antidote for scorpion poison

A

Centruroides antivenin

59
Q

What is the antidote for North American pit vipers (rattlesnake, copperhead, water moccasin, cottonmouth)

A

Crotalidae poluvalent immune fab, ovine

60
Q

What is the antidote for North American coral snake (eastern and texas)

A

Micrurus fulvius antivenin

60
Q

What is the antidote for opioids

A

Naloxone

60
Q

What is the antidote for iron

A

Deforxamine mesylate (desferal)

61
Q

What is the antidote for black widow spider

A

Latrodectus mactans antivenin (LMA)

61
Q

What is the antidote to tricyclic antidepressants, cocaine, local anesthetic, and salicylates

A

Sodium bicarbonate

62
Q

What first aid antibiotic cream is used to prevent infection for minor cuts, scrapes, or burns than can be used for kids and adults 1-3x daily; greater than 7 days is not recommended unless directed by doctor

A

Bacitracin

62
Q

What is the chewable tablet strength for ibuprofen

A

100 mg

63
Q

What chewable antipyretic is 240 mg for 1.5 tablets

A

Tylenol

64
Q

What organization provides resources for the geriatric population

A

American Geriatric Society (AGS)

65
Q

What class of medication is generally avoided in geriatrics because it can increase BP, impair renal function, etc

A

NSAIDs

66
Q

What medications are called anticholinergic drugs and are used to treat allergic rhinitis but can cause confusion, urinary retention, and constipation in the elderly

A

Antihistamines

66
Q

What medication is used for gas and bloating and is rare since it can be dosed for 2 and under

A

Simethicone

67
Q

What is the drug of choice for pain, fever, and headache in all trimesters of pregnancy

A

Tylenol

68
Q

What is meant by nonpharmacologic

A

Treatment that is not medication

68
Q

What are the most frequent self care counseling topics by pharmacists

A
  • product selection for specific symptoms
  • potential drug-drug interactions
  • dosing/admin info
  • signs/symptoms that indicate when to seek medical advice
  • side effects and safety considerations
69
Q

What are key sections of a drug facts label

A

Active ingredient
Purpose
Uses
Warnings
Directions
Other information
Inactive ingredients

69
Q

What is meant by nonprescription

A

OTC

69
Q

What are most self care nonprescription products limited to

A

Mild illness and short duration

70
Q

Define self care

A

Independent act of preventing, diagnosing, and treating one’s own illness without seeking professional advice

71
Q

What are barriers to pharmacist assisted self care and barriers to patient engagement for self care

A
  • pt is seeking recommendation when medical care is needed
  • pt in a hurry to leave
  • pt erroneously considered nonprescription products to be overly safe
72
Q

What are self medication categories

A
  • nonprescription medications
  • nutritional dietary supplements
  • complementary and integrative health therapies and approaches

(CNN)

73
Q

What is required for prescription drugs

A
  • proof of Effectiveness
  • proof of Safety
  • Warnings about side effects or drug interactions

(SEW)

74
Q

What is allowed for prescription drugs

A

Disease treatment claims

75
Q

What is required for nonprescription drugs

A
  • proof of Effectiveness
  • proof of Safety
  • Warnings about side effects of drug interactions

(SEW)

76
Q

What is not allowed for nonprescription drugs

A

Disease treatment claims

77
Q

What is NOT required for supplements

A
  • proof of Effectiveness
  • proof of Safety
  • Warnings about side effects or drug interactions

(SEW)

78
Q

What is not allowed for supplements

A

Disease treatment claims

79
Q

OTCs do not _____ but they do_____

A
  1. Treat/cure anything
  2. Lessen symptoms
80
Q

What are the characteristics of nonprescription drugs

A
  • Low potential for misuse and abuse
  • can be used for Self diagnosed conditions
  • Adequately labeled
  • Do not require access to PCP for safe and effective use
  • Sales are not limited to pharmacies

(SAD Little Shit)

81
Q

Dietary supplements contain one or more of what ingredients

A

Vitamin
Mineral
Herb
Amino acid

(Very Much Hoeing Around)

82
Q

Dietary supplement claims are limited to what

A
  • function/structure
  • nutrition content

Ex. Good source of vit C, maintains bowel regularity, supports healthy immune system, builds strong bones

83
Q

What are concerns with supplements

A
  • may not contain ingredients on the label
  • may contain other ingredients NOT on the label
  • may be contaminated with rx drugs, heavy metals, other adulterants
84
Q

What is complementary medicine

A

Can be used WITH standard medical care

Ex. Acupuncture to help cancer treatment side effects

85
Q

What is alternative medicine

A

Used in place of standard medical care

Ex. Herbals, special teas, massage

85
Q

What is an RX to OTC switch

A

OTC marketing of a drug that was once an rx drug for the same indication with the same:

  • strength
  • dose
  • duration of use
  • dosage form
  • route of admin
85
Q

What are the benefits of OTC switch

A
  • cost (save consumers money on dr visits)
  • beneficial to drug companies who are about to lost patent rights and generic competition
85
Q

Why do patients most often seek OTCs

A
  • Pain
  • Cough, cold, flu, sore throat
  • Allergies/sinus problems
  • Heartburn/indigestion
  • Constipation, diarrhea, gas
  • Minor infection
  • Skin problems

(Some Hoe Called Mia A Cat Person)

86
Q

Why are patients utilizing self care at an increasing rate

A
  • cost to see PCP
  • aging population uses more OTCs
  • more women in population (more likely to use OTC)
87
Q

What are the concerns with OTC labeling

A
  • Inappropriate use when patients have limited reading skills or language barriers
  • part of label covered by anti-theft tags
  • small font type
  • drug product reformulation (Kaopectate example)

(Please, I Suck Dick)

88
Q

What does QuEST stand for

A

Qu: quickly and accurately assess the patient

E: Establish that a pt is an appropriate self care candidate

S: Suggest appropriate self care strategies (plan)

T: Talk w/ the patient (key info about lifestyle and OTC therapy)

89
Q

SCHOLAR MAC

A

Symptoms
Characteristics
History
Onset
Location
Aggravating factors
Remitting factors

Medications
Allergies
Conditions

90
Q

What are exclusions to self care

A
  • symptoms Require medical referral
  • pt Not appropriate candidate
  • Symptoms too severe/long lasting
  • Effective OTC therapy N/A
  • OTC Dosages/duration is inadequate to treat the condition
  • Previous OTC treatment was ineffective after adequate trial

(Please SEND Rach)

91
Q

How should a pharmacist make a recommendation when we cannot help the patient

A
  • determine who to refer to and urgency
  • be specific about where and when the treatment should take place
92
Q

What patients would not be appropriate self care candidates

A
  • OTC meds not indicated
  • Previous OTC therapy ineffective
  • Minor but persistent symptoms, cause not easily identifiable
  • Symptom specific exclusions
  • Health status/history
  • Pharmacist in doubt of medical condition

(Maybe Put Some New People Here)

93
Q

What are self care strategies

A

Nondrug therapy
OTC
Refer to PCP or ED
No treatment

94
Q

What are counseling points for self treating patients

A
  • Reason for self treatment
  • Description of medication or treatment
  • proper Admin
  • what to Expect
  • How soon to see results
  • Precautions
  • Adverse effects/management of them
  • General treatment guidelines
  • appropriate Follow up
  • Other important info (storage)
  • When to seek medical attention

(Went And FORAGED Plenty Herbs)

95
Q

What are the 5 core components of PPCP

A

Collect
Assess
Plan
Implement
Follow up: monitor and evaluate

96
Q

What PPCP step correlates w/ each part of QuEST

A

Qu - collect/assess
E - assess
S - plan
T - implement/follow up

97
Q

What are nonverbal cues to demonstrate good listening

A

S - squarely face the pt
O - open posture
L - lean toward pt
E - eye contact
R - relax

98
Q

What are patient barriers to communication

A

Education level
Health literacy level
Misconceptions of pharmacist role
In a hurry
Aging
Visual/hearing difficulties

(How Many Elephants In A Van)

99
Q

What are pharmacist barriers to communication

A
  • attitude towards counseling
  • lack of pt communication training
100
Q

What are pharmacy/corporate barriers to communication

A

Lack of privacy
Low financial resources
Large # of patients per pharmacist

OTC (31 decks)

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