OTC Products Flashcards
Os-Cal
- SEs
Ca+ carbonate + Vit D3
- Vit D = cholecalciferol = skin makes when exposes to sun. 3x more effective than Vit D2
- SEs: constipation
- Best take with meals
Iron Supplement
- Dose
- Administration
Avoid given with:
Abs is enhanced with: - ADEs
- Dose: 100-200 mg elemental iron QD
- Administration: empty stomach with water = best abs. If become irritated, can take w/ food, but NOT with cereal, milk, tea, coffee, eggs or fibers. Abs is enhance with Vit C.
ADEs
- Constipation, diarrhea
- Heart burn, GI distress
- Black stools
- Oral sol’n can temporary staining of teeth
Tylenol
- Indication
- Dose for children
- Hydrated:
- Dehydrated
- Max
- Liquid Dosage form
- Adult dosing
- Max Dose:
R strength 325mg
Extra strength 500 mg
ER 650mg
Acetaminophen
- Indication: pain/fever, analgesic/antipyretic
Dose for children: Max: 75mg/kg.d
- Well hydrated child: 15mg/kg Q4-6H
- Dehydrated: 10mg/kg Q4-6H
- Dosage form: 160mg/5mL
Adult dosing
- 650 mg PO Q4-6H.
- Max Dose:
R strength 325mg: 3250mg/day
Extra strength 500 mg: 3g/d
ER 650mg: 3900mg/d
NAC
Acetadote
- Indication
- Dosing
- Duration
N-Acetylcysteine
Acetadote: IV form
- Indication: tx tylenol toxicity. Level > 150 indicates tx
Dosing
- 1st dose: NAC 140mg/kg up to 14g
- Subsequent doses: NAC 70mg/kg Q4H x 17 doses
- Duration: Standard course is 72H
ASA
- MOA/Dosing
- ADEs
- CI
- DDI
- Overdose
MOA/Dosing
- Anti-inflammatory effect: 4g/d max
- Analgesic effect: 650-1000mg Q4-6H
- Antipyretic: same as above
- Platelet effects: 81-325mg/d.
ADEs
- GI: PUD/GI bleeding
- CNS: salicylism
- Central respiratory effects: depression or apnea
- Uric acid change
- Asymptomatic hepatitis
- Renal insufficiency
- Hypersensitivity
CI
- Rey’s syndrome
- Gout hypersensitivity of ASA
- Active PUD
- Aspirin induced fetal or neonatal toxicity
DDI
- Ibuprofen: inactivates ASA’s anticoagulation effects => compete for the same preceptor
Overdose
- Activated charcoal
- Na bicarbonate to increase pH
NSAIDs
- MOA
- ADEs
- C/I
- MOA: blocks cyclooxygenase COX 1 and COX2
ADEs
- GI: #1
- Renal adverse events
- Bleeding risk
- HA
- CNS effects
C/I
- PUD
- Renal insufficency
- Bleeding risk
- Hypersensitivity
- Avoid in 3rd trimester (Cat B in 1st and 2nd; Cat C in 3rd)
Meclomen
- Indication
Meclofenamate
- NSAID
Voltaren
Voltaren Gel
Diclofenac
Diclofenac gel
- NSAIDs
Arthrotec
- Indication
- Avoid in
Diclofenac 50mg + Misoprostel 200mcg
- NSAID
- Preg Cat X
Cytotec
- Preg Cat
- Indication
Misoprostel:
- Preg Cat X
Indications:
- Prevention of NSAID-induced gastric ulcers
- Medical termination of pregnancy
Pennsaid
- Form
Diclofenac
- Form: Topical Sol’n
Flector
- Form
- Duration
Diclofenac
- Form: patch Q12H. Apply to most painful area
Maxicam
- Dosing frequency
Isoxicam
- Long half life: QD
- NSAID
Feldene
- Dosing frequency
Piroxicam
- Long half life: QD
- NSAID
Motrin
Ibuprofen
Duexis
Ibuprofen 800mg + famotidine 26.6mg TID
Naprosyn
- Dose
Naproxen
- Dose 500mg Q12H
- Lowest cardiovascular risk
Nalfon
- Indication
Fenoprofen
- OA, RA, mild to moderate pain
Orudis
- Indication
Ketoprofen
- Dysmenorrhea
- OA, RA
Daypro
- Indication
Oxaprozin
- OA, RA
Lodine
- Indication
Etodolac
- Acute pain
- OA, RA
Relafen
Nabumetone
Indocin
Indomethacin
Clinoril
Sulindac
Tolectin
- Indication
- Class:
Tolmetin Na
- Indication: inflammation arthritis
- Class: SNAIDs
Toradol
Ketorolac
Celebrex
- MOA
- C/I
Celecoxib
- MOA: COX 2 selective = less GI SEs
- C/I: sulfonamide allergy
Zostrix
- Indication
- MOA
- ADEs
- Precaution
Capsaicin
- Indication: Pain due to RA, OA, post herpetic neuralgia, DM neuropathies
- MOA: deplete substances P
- ADEs: burning sensation
- Precaution: wash hand
1st Generation if Antihistamines
- Agents
- Indications
- SEs
Brompheniramine
Chlorpheniramine
Diphenydramine
Doxylamine
- Indications: allergic rhinitis, antiemetic, anaphylaxis
SEs
- Sedation
- Anticholinergic: hallucinations, blurred vision, agitation
- Worsen BPH, glaucoma
- Dizziness, resp depression
- Tachycardia, Torsades, SZ
2nd Generation of antihistamine
Fexofenadine - Allegra
Loratadine - Claritin
Desloratadine - Clarinex
Cetirizine - Zyrtec
Allegra
- Sedating
- Efficacy
Fexofenadine
- Least sedating
- Most effective agent
Claritin
- Sedating
- Potent
Loratadine
- Sedating at higher doses
- Less potent than allegra and zyrtec
Zyrtec
- Sedating
- Efficacy
Cetirizine
- Sedating at rec dose: most sedating
- Most effective agent
Debrox
Murine Ear
- Indication
- Dose
- Harmless SEs
Carbamide peroxide
- Used: earwax buildup by softening, loosening, and removing the earwax
- Dose: 5-10 drops in ear BID x 4d. Drop remain in ear for 15min
- May cause crackling sound in ears. This harmless effect is temp and due to med foaming and loosing the earwax
Swim Ear
Isoprolyl alcohol + anhydrous glycerins
- Use: dries/clears trapped ear-water
Ocean
SeaMist
Saline Nasal spray
- Nasal dryness/washing sinuses
Sudafed
- Indication
- Can buy
- Store
- Log
Pseudoephedrine
- Indication: decongestant
- Can buy: 3.6g/d or 9g per 30d. Mail order 7.5g
- Store: behind counter or locked in cabinet
- Log: customer ID, names, address, signatures x 2 yrs
Afrin
- Indication
- Dose
- Overuse
Oxymetazoline
- Indication: nasal decongestant
- Dose: 2 sprays/nostril BID 2-3d
- Overuse: may lead to rebound congestion
Neo-Synephrine
- Dose
- Indication
Phenylephrine nasal spray
- Dose: 2-3 sprays/nostril Q4H prn x 2-3d
- Indication: decongestant
Robitussin
- Indication
- Half life:
Guaifenesin (OTC)
- Indication: Expectorants
- Half life: shortest half life
Tessalon Pearls
- Indication
Benzonatate (Rx)
- Indication: antitussive for cough
Codeine
- Indication
Indication: night time cough (Rx)
Hydrocodone
- Indication
- Indication: Antitussive/Expectorants. For pain
- (Rx)
Delsym
- Indication
- Form
- Avoid in
Dextromethorphan
- Indication: Cough
- F: ER Q24H
- Avoid if pt also on MAOIs
Robitussin AC
- Indication
Guaifenesin with codeine
- Indication: cough suppressants
Hycotuss
- Indication
- CS
Hydrocodone + Guaifenesin
- Indication: cough suppressants
- CS II
Hycodan
- Indication
- CS
Hydrocodone + Homatropin
- Indication: cough suppressants
- CS II
Vituz
- Indication
- CS
Hydrocodone + chlorpheniramine
- Indication: cough, allergy, or cold sx
- CS II
Psyllium
- MOA
- Indication
- Max dose
Metamucil
- MOA: Bulk laxative
- Indication: constipation
- Max dose: 10g/d
Citrucel
- MOA
- Max dose:
Methylcellulose
- MOA: Bulk laxative
- Max dose: 6g/d
Fibercon
Calcium Polycarbophil
- MOA: Bulk laxative
Colace
- MOA:
- Max dose:
Docusate stole softener
- MOA: Emollient
- Docusate max: 400mg/d
Milk of Magnesia
- SE
- CI
Mg laxatives
SEs for all osmotic laxative
- HyperMg
- HypoCa
C/I: renal failure
GoLytely
- MOA
Polyethylene glycol lavage sol’n
- MOA: osmotic laxative
Senokot
- MOA
Senna Extract
- MOA: stimulant laxative
Senokot-S
- MOA
Senna + Docusate
- MOA: stimulant laxative
Dulcolax
- MOA
- Form and OSA
Bisacodyl
- MOA: stimulant laxative
- PO: 6-12H
- PR: 1H
Visicol
- Indication
Na phosphate (Rx)
- Indication: Bowel prep
OsmoPrep
- Indication
Na phosphate (Rx)
- Indication: Bowel prep
Polyethylene glycol (PEG)
- GoLytely
- NuLytely, TriLyte
- HalfLytley, MoviPrep, Suclear
=> PEG preparation
- Indiction: Bowel prep
- GoLytely
- NuLytely, TriLyte: Sulfate-free
- HalfLytley, MoviPrep, Suclear: Low volume
PEG preparation
- Use PEG powder 17 gram
- Dissolve in 240mL water or juice
- May chill sol’n or mix w/ flavoring to improve taste
Prepopik
- Indication
- Direction
Na picosulfate, Mg oxide, anhydrous citric acid
Dose - smaller volume
- Two packets, each one is mixed with only 5 ounces of water
- Fill the supplied dosing cup with cold water up to 5 ounces line on the cup and pour in the contents of once packet of PREPPIE powder
- Drink five 8-ounce glasses of clear liquid after the 1st dose and 3 after the 2nd one
Constipation in kids
- Increase fluid, fruits, and vegetables (prune and pear)
- Need something to work FAST: glycerin suppositories
- Osmotic laxative: Miralax
- Docusate: help but take several days to work
- Stimulant: for rescue therapy when other tx fail
Constipation in pregnancy
- Safe to use
- C/I
- 1st line: pysllium
- Osmotic laxatives (Mg citrate): long term use = hyperMg, hyperPO4
- Stool softener
- Castor oil: Preg Cat X = uterine contraction/rupture
Pepto-bismol
- Indication
- Dose
- ADEs
- CI
Bismuth subsalicylate
- Indication: traveler’s diarrhea
- Dose: 2 tab PO QID
- ADEs: turn tongue and stool black
CI
- Salicylate allergy
- On coumadin
- Do not exceed 3 wks of use
Imodium
- Dose
Loperamide 2mg
Dose
- Initial 4mg PO for single first dose
- Titrate: 2mg PO after each loose stool
- Max: 16mg/d Rx. 8mg/d OTC
Sandostatin
- Indication
Octreotide
- Indication: diarrhea ass with carcinoid tumors
- Route: SC/IV/IM
Sandostatin LAR
- Dose
- Indication
Octreotide
- Dose: IM Q4W x 2 months
- Indication: diarrhea ass with carcinoid tumors
Gas-X
- Indication
Simethacone
- Indication: flatulence
DEET
- Indication
- Form
- Age
- Direction
N,N-diethyl-meta-toluamide
- Indication: inset repellent products
- Form: spray, lotion, towelette
- Age: kid over 2 months
Direction:
- Apply sunscreen prior to application of DEET
- Do not apply over cuts, wounds, or irritant skin
- Do not apply to hands or near eyes and mouth of young children
- Do not allow young children to apply this product
- Use just enough repellent to cover exposed skin and/or clothing. Do not use under clothing
- After returning indoors, wash treated skin with soap and water
- Wash treated clothing before wearing it again
- To apply to face, spray on hands first and then rub on face. Do not spray directly onto face
Nix
- Indication
- Age
- Clothes
Permethrin (OTC) 1%: 1st line
- Indication: head lice
- Age: FDA approved for children as young as 2 mo
- Clothes: Machine wash clothes, bedding, towels in hot water (130 degree), and dry them in a hot dryer (20 min). Items that can’t be washed can be vacuumed or put in a sealed plastic bag for 2 weeks.
RID
- Indication
- Age
- Clothes
Pyrethrins
- Indication: head lice
- Age: FDA approved for children 2 y.o or older
- Clothes: same as above
How to apply RID shampoo
- Repeat
- Apply thoroughly to DRY HAIR.
- Let set for 10 min:
- Wash Out
- Comb out to remove lice, eggs, and nits from hair
- Repeat - use these products 3x: tx must be done in 9 day to kill any newly hatched lice.
Ulesfia
- Indication
- Form
- Age
- MOA
Benzyl EtOH lotion 5% (Rx)
- Indication: head lice
- Form: lotion apply in head for 10 min
- Age: > 6 mo
- MOA: Suffocating lice
Natroba
- Indication
- Age
- Direction
- Repeat
Spinosad - Rx
- Indication: topical head lice
- Age: > 4 y.o
Direction:
- Shake before use
- Applied to dry hair and scalp
- Rinse after 10 min
- If after 7 days there are still live lice, a second application is necessary
Ovide
- Indication
- Form
- Age:
- Counseling
Malathion lotion (Rx)
- Indication: topical head lice
- F: location
- Age: > 6 y.o
- Counseling: very flammable, keep medication and wet hair from heat sources such as hair dryers, heat, and open flames
Stromectol
- Form
- Weight
- Indication
Ivermectin - Rx
- 3mg PO
- Weight: > 15kg
- Used if all the other method failed. It kills lice within 24H
Sklice
- Indication
- Form
- Direction
Ivermectin lotion Rx
- Indication: lice
- Form: lotion
Direction
- Used on dry hair. Can use up to 1 tube to cover
- Allow lotion to stay on hair and scalp for 10 min after it has been applied
- Then rinse
- Use ONCE
Asthmanefrin
- Indication
Racepinephrine - OTC
- SOB
- Tightness of chest
- Wheezing due to bronchial
Oxytrol
- Indication
- Form:
- Dose
- ADEs
Oxybutynin patch for Women (OTC)
- Indication: overactive bladder
- Form: Patch
- Dose: 3.9mg/day patch is applied to the skin Q4d
- ADEs: anticholinergic ADEs
Ferro-Grand 500
Ferrous Sulfate + Ascorbic acid (Vit C)
Vitelle
Ferrous Sulfate + Ascorbic acid (Vit C)
Cambia
- Form
Diclofenac
- Form: Packet TID
Cataflam
- Form
Diclofenac
- PO
Zipsor
- Form
Diclofenac Potassium
- PO
Zorvolex
- Form
Diclofenac acid
- PO TID
Anaprox
- Form
Naproxen
- 550mg PO Q12H
Rexaphenac
- Form
Diclofenac (phenac = fenac)
- Cream
Vimovo
Naproxen + esomeprazole
Sprix
- Form
Ketolodac
- Spray
Acular
Ketolodac
- Form: eye drop
- Conjunctivitis
Acuvail
Ketolodac
- Form: eye drop
- Conjunctivitis
Karbinal
- Class:
- Form
- C/I
Carbinoxamine
- 1st Gen of Histamine
- Form: Sol’n
- C/I: in children
Alavert
- Indication
- Form
Loratadine
- Allergy
- ODT provides 24H
Tavist ND
- Form
Loratadine
- ODT provides 24H
Vicks Sinex
- Indication
Phenylephrine nasal spray
- Dose: 2-3 sprays/nostril Q4H prn x 2-3d
- Indication: decongestant
Nexafed
Pseudoephredrine
Dristan
- Indication
Oxymetazoline
- Decongestants
Allerest 12H
Oxymetazoline
- Decongestants
Fenesin
- Indication
Guaifenesin
- Indication: antitussive/expectorant
Mucinex
- Indication
- Half life
Guaifenesin
- Indication: antitussive/expectorant
- Half-life: longest
Tussionex
- Indication
- C-
Hydrocodone + chlorpheniramine
- Indication: cough and allergy
- C-II
Vituz
- Indication
- Form
- C-
Hydrocodone + chlorpheniramine
- Indication: cough/allergy
- Form: solution
- C-II
Correctol
Bisacodyl
- Constipation
Fleet Enema
- Indication
Na Bisphosphate Enema
- Constipation
- Work right away
Mylicon
Simethacone
- Indication: flatulence
Phazyme
Simethacone
- Indication: flatulence
Caldolor
Ibuprofen IV
Advil cold and sinus contains
Ibuprofen + pseudoephedrine