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Pharmacology 201 > Other the Counter Pharmacology > Flashcards

Other the Counter Pharmacology Flashcards

1
Q

Why do OTC drugs not require a prescription?

A

They are safe to use when and as indicated. They have simple directions, few drug interactions and a large margin of safety.

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2
Q

Do they follow other drug regulations and protocols?

A

Yes they must pass clinical trials and be approved by HPFB/FDA. Many drugs start off as prescription drugs and later become OTC when data proves them safe enough for self management.

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3
Q

What are antihistamines.

A

Important antacid molecules that are antagonists of histamine receptors.

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4
Q

What are autacoids?

A

Autacids are not hormones, or neurotransmitters but rather are synthesized to act like hormones (locally) and brief in duration.

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5
Q

What kind of receptors are histamines and where are they located?

A

They are two types of receptors and both are GCPRS.
H1 is located all over smooth muscle tissue, endothelial cells, and the central nervous system.
H2 are located in the stomach/gastric mucosa.

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6
Q

What do H1 receptors do?

A

H1 receptors stimulate sensory nerves (causes the pain and itching). They also cause vasodilation, and endothelial call separation. This causes the redness and swelling. This is because the white blood cells have to squeeze into the extracellular space. Also they can cause tachycardia, and Bronco constriction.

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7
Q

What do H2 receptors do?

A

They stimulate gastric release from parietal cells. Parietal cells are those on the lining of the stomach, and are the main cells in mediating acid release. ECL cells in the body continually release small amounts of histamine. Since ECL is adjacent to parietal cells, the little bit of histamine binds to the receptors and increases the H+ content.

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8
Q

What are the uses of H1 antihistamines?

A

If it is a non-polar H1 antihistamine, it can cross the BBB and cause drowsiness, and allergy relief. These are known as first generation antihistamines.
If it is a polar H1 antihistamine, it will not cross the BBB. These are second generation and provide day time relief for allergies.
Many H1s are also anticholinergics, because they are structurally similar and have affinity for those receptors.

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9
Q

What are the uses of H2 antihistamines?

A

Regardless of their polar/ or non-polar properties, both block parietal cells.

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10
Q

What does H2 do to prevent acid release?

A

Blocks parietal cells. Though other food related triggers can overwhelm the antagonism.

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11
Q

If you want to completely reduce gastric acid release one should use a ______?

A

Antacid.

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12
Q

What are the names of first generation antihistamines?

A

Diphenhydramine, and Chloropheniramine.

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13
Q

What are the names of polar first generation antihistamines?

A

Cetirizine, and Loratadine.

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14
Q

What are the names of antacids?

A

Carbonate salts and Hydroxide salts.

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15
Q

What do antacids do?

A

Antacids directly neutralize the acids. For example tums or Gavison.

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16
Q

What are the effects go Mg and Al?

A

Mg - can act as a laxative
Al- causes constipations
When formulated together, they lower stomach acid without the side effects.

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17
Q

Although the antacids can completely prevent acid release, they cannot_____.

A

They cannot sequester or change the rate of acid release in the body.

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18
Q

If you have hyper secretion______?

A

Antacids can be overwhelmed and the drug will be used faster because of the increase in acid.

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19
Q

If you want a drug that will change the rate of acid release, you should use…?

A

A proton pump inhibitor.

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20
Q

What to PPI’s do?

A

They irreversibly inactive H+, K+ and ATPase which are common acid release pathways. The drug can reduce acid by 98%. The drug itself may have a short life but the mechanism works for an entire day. A proton pump takes 18-24 hours to make again.

21
Q

What are the names of H2 antihistamines?

A

Cimetidine and Ranitidine.

22
Q

What is the name of a PPI?

A

Omezaprole.

23
Q

What does NSAID stand for?

A

Non-steroidal inflammatory drugs

24
Q

Why is acetompetaphin not considered an NSAID?

A

They do not have anti-inflammatory properties.

25
Q

What are examples of NSAIDS?

A

Aspirin, Advil/Ibuprofen and Naproxen.

26
Q

How do NSAIDS work?

A

They block the autacoids known as Prostaglandins. Prostaglandins are synthesized by the COX enzyme. The NSAIDS inhibit the enzyme. It should be noted that Aspirin does this irreversibly, whereas other NSAIDS do this reversibly.

27
Q

How come NSAIDS can cause stomach ulcers?

A

Prostaglandin lines the stomach. NSAIDS prevent prostaglandin synthesis. Since the stomach now has no protective lining ulcers can form.

28
Q

What therapeutic effects to NSAIDS cause?

A

They are effective at being anti-inflammatories, analgesics, and antipyretics (preventing fevers).

29
Q

What does Acetaminophen do?

A

Weakly inhibits COX 1 and COX2. It treats mild/moderate pain, and can be used in conjunction with an anti-inflammatory.

30
Q

Why can Acetaminophen be toxic?

A

When Acetaminophen is metabolized with the CYP 450 enzyme, it can form a toxic compound known as NAPQI. NAPQI causes liver damage. If you have glutathione in the body, it neutralizes the NAPQI hence preventing the damage.

31
Q

Why does Alcohol and Acetaminophen have bad drug interactions?

A

Ethanol induces CYP 450 and 2E1, which reduce the glutathione levels.

32
Q

What are the new requirements for Acetaminophen?

A

Use the lowest effective dose.
Don’t mix with alcohol.
Do not exceed 4 grams without a 24 hour period.
Don’t use longer than 5 days, or 3 if you have a fever.

33
Q

What are local anesthetics?

A

Drug that provides local and short term relief.

34
Q

What do the local anesthetics do?

A

They work by preventing the nervous system from feeling pain. Anesthetics like codeine, lidocaine, and bupivacaine, block the major proteins involved in nerve activity. Essentially the drug depolarizes it.

35
Q

What are local anesthetics used for?

A

Minor surgical procedures, dental or medical.

36
Q

What forms can you get the local anesthetic in?

A

It is a treatment of neuropathic pain ( IV or oral) and available OTC as a topical gel for minor irritations or burns.

37
Q

What is Pseudoephedrine used for?

A

It is a nasal decongestant and allergies suppressant.

38
Q

How do they work?

A

It is a drug that binds to alpha receptors that help cause vasoconstriction of nasal mucus membrane and reduce tissue edema, which allows for more air flow.

39
Q

What are the side effects of Pseudoephedrine?

A

Since the drug binds to alpha and beta receptors, taking the drug can cause vasoconstriction in other areas of the body. Increased contractions, especially in the heart can cause tachycardia, and hypertension.

40
Q

What are Antitussives?

A

They are cough suppressant drugs. Coughs are produced because we have receptors in pulmonary area that send signals to the cough centre in the brain when they are stimulated or irritated.

41
Q

What is Dextromethorphan?

A

An OTC Antitussive that is a non-opioid derivative of morphine. It has minimal overlap with opioid Pharmacodynamics.

42
Q

How does Dextromethorphan work?

A

This drug works by binding to sigma receptors in the cough centre. At high doses it can be an NDMA antagonist (cause hallucinations) and can cause an OTC high.

43
Q

Is Menthol an Antitussive?

A

Yes, it binds to transient receptors and depolarizes channels which lead to sensation of feeling cold. It tricks the mucus lining into feeling less irritated and itchy.

Its decongestant effect is placebo.

44
Q

What does sucrose do as an antitussive?

A

Increases cough threshold and helps you secrete mucus during couching.

45
Q

What is an expectorant?

A

These drugs help promote the secretion of sputum during coughing.

46
Q

What is an example of an Expectorant?

A

Guaifenesin

47
Q

What does Guaifenesin do?

A

Increases volume of pulmonary secretions, decreases viscosity and increases coughing efficacy by easing burden. This happens by helping cilia to work and get it out.

48
Q

Combination Therapy

A

Benylin

Neocitran

Pharmacology 201 (20 decks)

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