Over the counter medications Flashcards
1
Q
are generics as good as brand names?
A
yes - they are the same thing
2
Q
what must you consider when taking OTC? (3)
A
- risk vs benefit
- interactions
- evidence of effectiveness
3
Q
do you ask someone about OTC meds when taking a standard med history?
A
YES YES YES
4
Q
what is the same in generic vs brand names
A
the active ingredient
5
Q
where do generic and brand names differ?
A
inactive ingredients
6
Q
which is less expensive, generic or brand name?
A
generic
7
Q
what type of med names are capitalized vs lower case
A
Brand Names Capitalized
generic name lowercase
8
Q
if you want to prescribe someone specifically the brand name, can you just write the script as the generic?
A
NO - dont be lazy, put the brand name!
9
Q
5 types of OTC drugs include
A
- pain and fever
- cold meds
- allergy meds
- GI meds
- misc OTC
10
Q
pain and fever OTC include (2)
A
acetaminophen, NSAIDs
11
Q
cold meds OTC include (3)
A
- cough suppressant
- expectorant
- histamine-1 (H1) blocker/decongestants
12
Q
allergy OTC include
A
- H1 blocker
- decongestants
13
Q
GI OTC meds include
A
- antidiarrheals, laxatives, antacids
- histamine-2 (H2) blockers/proton pump inhibitors
14
Q
administration options for OTC meds
A
oral, rectal, transdermal
15
Q
acetaminophen med effects
A
- analgesic
- antipyretic
16
Q
max adult/ped dose acetaminophen and when is it normally given
A
4000mg adult, 75mg/kg Q4H normal
17
Q
most common analgesic in US =
A
acetaminophen
18
Q
1 toxic exposure reported to poison control
A
acetaminophen
19
Q
antidote for acetaminophen OD
A
N-acetylcysteine
20
Q
acetaminophen OD are (4)
A
- common
- silent
- deadly (potentially)
- treatable
21
Q
what meds are includes in NSAIDs
A
- acetylsalicylic acid (ASA)
- ibuprofen
- naproxen
22
Q
NSAIDs effects (3)
A
- anti-inflammatory
- anti-pyretic
- analgesic
23
Q
Acetylsalicylic Acid dose, what is it given for, given as
A
dose: 81-325mg
Treats: acute coronary syndrome & ischemic stroke
Given as: oral, liquid, suppositories, creams/lotions
24
Q
common side effect of Acetylsalicylic Acid
A
GI upset & GI bleed
25
ASA toxicity could result in
1. acid base abnormalities
2. acute resp distress syndrome
3. hypoglycemia
4. ototoxicity
5. hyperthermia
6. hallucinations
7. seizures
26
do you give kids ASA?
NO ARE YOU KIDDING ME
27
PEARL
chronic salicylate toxicity often confused with sepsis - especially in elderly
28
ibuprofen OTC strength, prescribed strengths, dosed every ___ hours and has a max dose of ____ mg
OTC strength: 200mg
Prescribed: 4,6,800mg
Q6-8H
max daily = 3200mg
29
naproxen OTC strength, prescribed strengths, dosed every ___ hours and has a max dose of ____ mg
OTC: 220mg
prescribed: 500mg
Q12H
max daily = 1000mg
30
NSAIDs risks
1. CHF exacerbation
2. HTN worsened
3. upper GI bleed
4. renal impairment
5. hepatotoxicity
31
what meds are all considered equally efficacious in relieving pain
aspirin, ibuprofen, naproxen
32
what type of meds contain caffeine
HA meds
33
excedrin =
acetaminophen + ASA + caffeine
34
why is caffeine put in an analgesic?
acts synergistically with other ingredients to magnify their analgesic effect (umm pamprin?!?)
35
difference in excedrin XS and excedrin migraine
no silly goose they are the same
36
guafensen actions
1. expectorant
makes mucous thinner to improve clearance of secretions
37
dextromethorphan actions
1. suppress cough reflex
38
cough drops actions
1.active ingredient is menthol
suppress cough by increasing salivation and providing anesthetic effect
39
oral decongestants are used to relieve
cold (URI/allergy)
40
sympathomimetics =
acts via vasocontriction
41
examples of sympathomimetics
1. Pseudoephedrine (ppl made meth so now behind counter)
2. phenylephrine
42
oral preps can ____ BP and ____ HR
increase 2x
43
oral preps are contraindicated in patients with
1. heart disease
2. HTN
3. Dysrhythmias
4. BPH
44
intranasal sympathomimetics =
nasal decongestant
45
what are nasal decongestants used for
relieve cold and allergy symptoms by constricting dilated arterioles in the nasal mucosa
46
nasal decongestant are (slow/rapid) onset with (many/few) adverse side effects
rapid, few
47
therapy for nasal decongestants are limited to ___. why?
3 days - rebound congestion (rhinitis medicamentosa)
48
Oral histamine-1 blockers =
antihistamines
49
antihistamines target
1. sneezing
2. rhinorrhea
3. itchiness of eyes and nose preventing histamine release
50
antihistamines are separated into
first and second generation
51
first generation antihistamines include
1. diphenhydramine
2. chlorpheniramine
3. brompheniramine
4. clemastine
5. doxylamine
(benadryl, Dimetapp, etc)
52
first gen antihistamine cause
drowsiness - dont give to treat allergies
53
nyquil combination cold med is composed of
Acetaminophen - 650mg
Dectromethorphan - 30 mg
Doxylamine - 12.5mg
NO DECONGESTANT
54
dayquil severe is composed of
Acetaminophen - 325 mg
Dextromethorphan - 10mg
Guafensin - 200 mg (not in normal dayquil)
phenyleprine - 5mg
No antihistamine, no sedation
55
nyquil severe is composed of
Acetaminophen - 650mg
Dectromethorphan - 20 mg
Doxylamine - 12.5mg
phenylephrine - 10mg
56
should cold meds be given to kids 4 and under?
no
57
should cold meds be given to kids 4-6
only if approved by doc
58
all cold meds are a mix of
pain, cough, decongestant, and antihistamine
59
cold meds vary by
1. combination
2. strength
60
second gen antihistamine =
allergy meds!
61
2nd gen antihistamines include
1. fexofenadine
2. loratadine
3. desloratadine
4. cetrizine
(Zyrtec, allegra, claritin, etc)
62
when are allergy meds most effectively used?
prophylactically
63
are allergy meds used for URI's
not usually
64
diarrheal meds (list em)
1. loperamide
2. bismuth subsalicyte
65
loperamide (what does it do)
slows peristalsis
66
actions of bismuth subsalicylate
1. antacid
2. antimicrobial
3. gastroprotective
4. anti-secretory
5. anti-inflammatory
67
what are common meds that contain bismuth subsalicylate?
pepto and kaopectate
68
pepto-bismol commonly causes what and is a mistake often in ERs lol
black tarry stool, oopsie its not a GI bleed its just my pepto
69
when do you want to avoid taking an anti-diarrheal?
suspected bacterial gastroenteritis
70
constipation med action
stimulate peristalsis
71
constipation meds (list em)
1. senna compounds
2. bisacodyl
3. aloe vera
4. cascara
72
bulk forming agents (fiberrrrr)
high fiber content
1. methylcellulose
2. psyllium hydrophilic mucilloid
73
how do bulk forming agents work?
pulls water into the intestines
74
stool softener action
reduce surface tension of stool enhancing fat and H2O absorption
75
stool softeners are used
prophylactically
76
stool softeners are known to be (more/less) effective than other agents
less
77
what is the primary stool softener med?
docusate sodium
78
enema meds active ingredient
sodium phosphate, mineral oil, bisacodyl
79
how do enemas work
introduce fluids into the intestines through the rectum, fluid softens stool and enema nozzle breaks apart stool - very productive
80
primary components of antacids
magnesium hydroxide, aluminum hydroxide, calcium carbonate
81
action of antacids (2)
1. neutralize gastric acid
2. reduce acid delivery to duodenum
82
role of antacids
1. treat heartburn (primary)
2. treat mild GERD
83
what are meds used for GI upset?
histamine 2 receptor blockers
84
how do histamine 2 receptor blockers work to help with GI upset
inhibit acid secretion by blocking H2 receptors on parietal cells
85
H2 receptor blockers effective for (2)
1. mild esophagitis
2. GERD
86
OTC H2 receptor blockers (3)
1. cimetidine
2. femotidine
3. nizatidine
87
what is another type of med used for GI upset?
proton pump inhibitors
88
how do PPIs work
blocks acid secertion by irreversibly binding to and inhibiting the hydrogen potassium ATPase pump on parietal cell membrane
89
PPIs pros (compared to H2 blockers)
1. stronger acid suppression
2. faster control of symptoms
3. higher ulcer healing rates
90
PPIs are more effective in preventing NSAID-_____ ____ _______
NSAID induced GI toxicity
91
PPI (list em)
1. omeprazole
2. lansoprazole
3. esomeprazole
92
name some misc OTC meds
1. vitamins
2. Zinc
3. Melatonin
4. Saw palmetto
5. Omega 3 fish oil
6. probiotics
93
what vitamins are fat soluble
ADEK
94
ADEK vitamins are toxic in ___ ____
high doses
95
what vitamins are water soluble
BC
96
is there a toxicity concern for water soluble (BC) vitamins
not generally
