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Advanced pharmacology > OTC's herbals And Supplements > Flashcards

OTC's herbals And Supplements Flashcards

1
Q

Classification of an OTC

A

Safe, low potential for misuse, pt can self administer and diagnose w/o supervision

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2
Q

Hazards of OTC

A

Acetaminophen toxcity
Do not give infants or anyone under 4 decongestants
May be masking a serious illness

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3
Q

Adverse effects of OTC

A

GI upset, GI bleeding
Sedation with antihistamines
Impaired driving

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4
Q

Pharm tx for URI

A

Treat based on TYPE of symptoms and FREQ of symptoms

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5
Q

URI ( how to treat)

A

Mild and intermittent = antihistamine or decongestant

Moderate and freq and persistent = intranasal corticosteroid ( with or without antihistamine or decongestant)

Severe: intranasal corticosteroid with a antihistamine or decongestion ( consider oral steroid x 5)

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6
Q

Nasal decongestants : class, MOA, benefits, adverse, precautions, contraindication, preg

A

Sympathomimetic amine ( class)

MOA: stimulates beta receptors of smooth muscle and stimulates alpha receptors causing vasoconstriction

Benefits: reduces tissue edema and nasal congestion, promotes sinus drainage, opens Eustachian tubes

Adverse effects: tachy, increases IOP, urinary retention

Precaution: peripheral HTN, CVD, prostatic hypertrophy

Contraindications: mitral value prolapse, cardiac palpitations , severe HTN, severe CAD

Preg: C, not for nursing mothers

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7
Q

Types of nasal decongestants

A

Phenylinephrine ( Sudafed PÉ)
Pseudoephedrine ( Sudafed 12 hours)
Oxymetazoline ( Afrin)
Antihistamine + D ( AKA Allerga D, Claritin D)

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8
Q

Oral Antihistamines

A

1st generation : Tavist, Chlor-Trimetor, Benadryl ( more side effects)

2nd generation: Zyrtec, Claritin, Allegra ( less sedative s/e)

MOA: compete for histamine receptor ( H1) site, antagonize effects of histamine

Benefits: treats rhinorrhea, watery eyes, postnasal drip, sneezing

Adverse effects: dizziness , confusion, dry mouth , constipation

Precautions: lower resp disease, sleep apnea, bladder neck obstruction, elderly , pedi

Preg: B or C , not for nursing mothers

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9
Q

Intranasal corticosteroid

A

Examples: Flonase, Nasacort, Nasonex, Veramyst

No systemic side effects
Good for people who have had “ 6 weeks of hell”

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10
Q

Intranasal Mast Cell stabilizers

A

Cromolyn *
MOA: preventative agent, inhibits sensitized and mast cell degranulation that occurs after exposure to specific antigens

Drawbacks: must be nebulized ( may take months to see effects) 4-6 times a day

Adverse effects: nasal irritation, stinging, sneezing

Preg: B, lactation unknown

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11
Q

Antitussives ( Belsym)

A

Dextromethorphan

DO not supresses the cough during the day

MOA: centrally acting in medulla to elevate threshold for cough

Adverse: n/v dizziness
Precautions: pedi < 6
Contraindication: MAOI with 14 days
Preg: C

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12
Q

Expectorants

A

Guaifenasin
MOA: increases resp tract fluid secretions, reduces surface tension, loosens bronchial secretion

Benefits: used in the presence of mucus and congestion

Precaution : not use in children less than 12
Preg: C

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13
Q

Tylenol

A

MOA: no anti inflammatory activity , central inhibition of PG synthesis

Max dose of 4 g per day

Can use in pregnancy

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14
Q

Sleep aids

A

Sominex and Unisom

MOA: same as antihistamine
Adverse: sedation, dry mouth, constipation, blurred vision

Preg: B not recommended in lactation

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15
Q

Black Cohosh

A

Hot flashes and menopausal symptoms

Adverse: increased menstrual flow, GI upset, dizziness

Interaction: fertility agents, estrogens, oral contraceptives, progestin

Contraindication: abnormal fetal positioning, eclampsia

Preg: X

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16
Q

Coenzyme Q10

A

Acute MI, chronic systolic heart failure, mitochondrial disease

Adverse: well-tolerated,

Interactions: antihypertensives, warfarin

Preg: unknown

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17
Q

Cranberry

A

Recurrent UTI

Adverse : well tolerated

Preg: unknown

18
Q

Creatine

A

Non-hormonal performance enhancement

Adverse: weight gain from urinary retention

Interaction: cyclosporine

Contraindication: renal impairment

19
Q

Echinacea

A

Common cold or mild flu

Adverse: allergic reaction to plants ( sunflowers, daisies)

interactions: AID’s drugs, corticosteroids

Preg: unknown

20
Q

Garlic

A

Hypercholesterolemia

Adverse: GI

Preg: safe but data lacking

21
Q

Gingko Biloba

A

Dementia, memory impairment

Adverse: inhibits platelet aggregation

Interaction: anticoagulants

Preg: not reccomended

22
Q

Ginseng

A

Immune system enhancement, mental performace

Adverse: mild overdose : excitation, fidgeting, headache, inhibits platelet aggregation

Interactions: anticoagulants , anti-platelets
Preg:avoid

23
Q

Melatonin

A

Mild insomnia, jet lag

Adverse: headache, depression, tachy

Preg: should be avoided

24
Q

Saw Palmetto

A

Adjunct for BPH

well tolerated

Interactions: androgens, 5-alpha reductase

Contra: UTI, prostate CA

Preg: avoid in preg

25
Q

St. John’s Wort

A

Adjunct for depression and seasonal affective disorder

Adverse: GI irritation, sexual dysfunction

Interaction: induces CYP34A, MAOI, warfarin, SSRI;s

Contra: AIDS/HIV, MAOI, SI
Preg: not reccomended

26
Q

Valerian

A

Occasional treatment mild insomnia or anxiety die to restlessness or nervousness of non-psychotic origin

Adverse: paradoxical reaction (agitation)
Interaction: sedatives, hypnotics, ethanol, anxiolytics

27
Q

Nutrient - Drug interactions

A

Food may effect
- drug absorption, metabolism, excretion,
Drug may affect nutrient status

28
Q

Influence of Diet on Drug Absorption

A

Drug absorption can be decreased, delayed, accelerated or increased by food

Food changes gastric ph
Food may bind with medication, decreasing absorption

29
Q

Influence of diet on drug metabolism

A

The rate of the drug metabolism is affected by nutrient intake

  • low carb high protein diet may increase drug -metabolizing enzymes
  • antioxidant vegetables may increase the activity of drug - metabolizing enzymes

Grapefruit and P450

  • inhibits CYP 3A4
  • increases levels of ccb, statins, tacrolimus

Food and P450:
- Veggies, caffeine, charcoal broiling may lead to therapeutic failure

30
Q

Influence of Diet on Drug Excretion

A

Some food can change urinary PH

Foods that alkalinize the urine
- milk, veggies, citrus fruits

Foods that Acidify the urine
- meat, fish, cheese, eggs

31
Q

Drug - food incompatibilities

A

Warfarin - Vit K containing foods

MAOI- tyramine-containing foods ( fermented pickles)

Metronidazole: alcohol

Caffeine : accelerates absorption up to 20X
Alcohol: enhances drug solubility

32
Q

Influence of drugs on nutrients

A

Drug induced nutrient depletion
- antacid therapy or potassium therapy can decrease folic acid, iron, vit B

Phenytoin reduces folic acid

Loop diuretics affect sodium, calcium, potassium

33
Q

Fiber

A

Decreased constipation, CAD, better glucose control , improved lipid levels

34
Q

Vitamins A, C, D, K

A

A= vision, bone growth, immune, reproduction

C ( ascorbic acid) = humans cant synthesize vitamin C, inadequate intake may lead to scurvy , smokers are at risk, does not decrease URI’s,

D = Bone health , need 400 IU day

K= need for blood clotting

35
Q

Vitamin B

A

B1= thiamine = alcoholics are at high risk for Wernicke’s encephalopathy

B2 ( riboflavin) = may decrease headache

B3 ( niacin) : used to treat hyperlipidemia

B12 : could lead to megablastic anemia

36
Q

Folate

A

Critical to the production of new cells
Found in green leafy veggies, fruits, dried legumes

Deficiency Occurs in pregnancy

Preg: 600mcg day

37
Q

Minerals

A

Calcium = need for muscle contraction, bone health, heat health

Iron = need for oxygen transport, pt will develop microcytic-hypochromic anemia

38
Q

Fatty acids

A

Must be consumed ( nuts)
Heart health
Children with autism or ADD may benefit to omega three

39
Q

Plant sterols

A

Compete with cholesterol in the intestine

Can lower LDL

40
Q

Pre / Pro / Symbiotics

A

Reduces antibtiocs associated diarrhea

May improve IBD and necrotizing enterocolitis

Advanced pharmacology (12 decks)

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