Week 2 Flashcards
What are OTC drugs?
Drugs that do not require a prescription by a HCP.
They are considered safe to use without HCP supervision
Why should the nurse check if the patient is taking OTC meds in a safe way?
Because some patients done realize that you can OD on OTC meds.
What is a common reason for a patient to be taking too much or too little of an OTC?
Because sometimes the labels are too small and hard to read
What is the nurses responsibility in regard to OTC labels?
The nurse needs to ensure a patient can read and understand the label
What 6 things need to be on an OTC label?
APUSDI
- Active ingredients and amounts
- Purpose
- Uses/indications
- Warnings
- Dosage
- inactive ingredients
What are “specific warnings” on an OTC label?
Activities to avoid/side effects
What needs to be included in the dosage instructions of a OTC med?
How much, When, and how often
What major disease can ibuprofen interact with?
CHF
- it can increase fluid retention and worsen HF.
- Decreases the effectiveness of antihypertensives
What major disease can ASA Asprin interact with?
Asthma
- Can trigger an acute attack
- Linked to Reye’s Syndrome dangerous welling of liver and brain after recovering from viral infection
What dangerous health issue can be caused or made worse by the use of NSAIDS?
Stomach Bleeding or any bleeding conditions
What is Drug Literature and Why is it important?
Drug literature is information given to a patient about a new/current drug that they are prescribed.
-it is an important resource because patients don’t always remember or retain information about a drug told to them in the office/hospital
What advise can you give a patient about educating themselves about a new drug?
- Encourage them to research information beyond what you provide
- Be sure they use creditable sources
What does the OTC safety acronym SAFER stand for?
- Speak up
- Ask questions
- Find Facts
- Evaluate your choices
- Read Lables
What is CAM therapy?
Complementary and Alternative Therapy
What are CAM therapies used for?
To augment, supplement, or replace traditional medical therapies
CAM therapies include___
- Herbal Med’s
- Nutrition therapies
- Botanicals
What was the dietary supplement health and education act of 1994?
A federal act that regulated labeling and manufacturing of dietary supplements
What are dietary supplements?
Products that are intended to:
- supplement the diet
- Contain one or more dietary ingredient
- Intended to be taken PO
- Labeled as a dietary supplement
What are the Label requirements put forth by the Dietary supplement health and education act of 1994?
- Name of supplement
- Amount
- Nutrition label
- Ingredient list
- Name/place of manufacture
What is Cinnamon commonly used to treat?
- Bronchitis
- GI problems
- Anorexia
- DM
What is the recommended max dose of Cinnamon?
no more than 6g a week for no longer than 6 weeks
What is garlic commonly used for?
- Lower cholesterol
- lower BP
- Reduce heart disease
What is ginger commonly used for?
- Nausea
- Motion sickness
- Diarrhea
- Pain from OA/RA
What is ginko commonly used for?
- Asthma
- Bronchitis
- Fatigue
- Tinnitus
- Memory
- Decreased claudication
What are some common side effects of ginko
- HA
- Nausea
- Gi upset
- Dizziness
- INCREASED BLEEDING RISK IF ON BLOOD THINNERS
What are the uses for ginko?
- Immune system boost
- Increase sense of well-being
- Stamina
- Lower Glucose and BP
What are the side effects of ginko?
- HA
- GI symptoms
What is Hawthorn used for?
- Heart disease
- Digestive issues
- Kidney disease
What are the drug interactions common with hawthorn?
- Nitrates dizziness
- Antihypertensives hypotension
What is peppermint used for?
- Nausea
- Indigestion
- IBS
- Colds
- HA
- Pain
What is St. Johns Wort used for?
- Sleep
- Depression
- Wounds
- Nerve pain
What are the side effects of St Johns Wort?
- Photosensitivity
- Anxiety
- Dizziness
- HA/Fatigue
What drugs does St Johns Wort interact with?
- Antidepressants
- Birthcontrol
- Seizure meds
- Anticoagulants
What are some potential hazards of herbs?
- Patients may forget to mentions they are taking them during drug history questioning
- Severe Drug-Herb interactions
How often before surgery is it recommended to stop herbal use?
2-3 weeks
Natural does not mean ____
Safe
Legal OTC does not mean ___
Safe
What is a drug interaction?
An altered or modified action or effect of a drug as a result of interaction with one or more drugs/CAM
Is a drug interaction the same as an incompatibility or adverse reaction?
no
What is a drug incompatibility?
A chemical or physical reaction that occurs among two or more drugs
What is an adverse reaction?
an undesirable effect from a drug
What are the two types of Drug interactions?
Pharmacokinetic & Pharmacodynamic
How can absorption rates be altered by drug interactions?
- Increased GI emptying can decrease absorption reverse is also true
- Drugs that alter pH can decrease absorption of weak acid drugs
How can Antacids slow the absorption of drugs?
It will raise stomach pH
How can drugs that affect GI bacterial effect drug absorption?
If GI bacteria is Altered it can impact Pharmacokinetics
If Gi enzymes are inpacted by a drug how can it impact absorption?
It will reduce absorption and delay therapeutic response
What is the primary site of drug absorption?
Small intestines
Drugs that are absorbed in the stomach have a ____ absorption rate due to staying in the stomach longer
Increased
If a drug causes an increase in metabolism what interactions can occur?
- Drug elimination will increase
- If elimination is increased than drug plasma levels will decrease witch equates to reduced therapeutic drug action
How can a drug increase metabolism?
By stimulating liver enzymes
Other than prescription and otc drugs, What common substances can impact metabolism?
- ETOH
- Tobacco
- Natural/Herbal Products
What factors can be altered by a drug that will cause an impact to the excretion of other drugs?
- Renal Excretion
- CO
- pH
How can a drug interact and reduce -Renal Excretion?
If multiple drugs are taken that are excreted renally, than they kidneys will have reduced filtration due to increased drug levels in system
How can drugs that effect OC effect the excretion of other drugs?
If a drug decreases CO than blood flow to kidneys is reduced and will reduce excretion due to decreased GFR
How can diuretics effect drug excretion?
by promoting water and Na excretion and decreasing reabsorption of water Na and K
How can drugs that change urine pH impact the excretion of other drugs?
- If urine pH is high than weak acid drugs will be excreted faster
- If urine pH low than weak base drugs will be excreted faster
Why do patients who take diuretics often take potassium supplements?
Because diuretics decrease reabsorption of potassium so potassium needs to be replenished via supplement
Decreased renal or hepatic function ____ the overall free drug concentration
Increases
What is an Additive Drug effect interaction
When 2 drugs affecting different mechanisms can create a heightened effect
What additive effect does Nitroglycerin and Beta-blockers have?
They will add together to create severe vasodilation and Hypotension
What is a synergistic drug effect?
When 2 drugs work together and have a substantially greater effect than either drug working alone.
What is an antagoistic drug effect?
When one drug blocks the effect of another drug
What are some common symptoms of drug-drug interactions?
N/V, Dizziness, Lightheadedness, HA, heartburn
What are the most feared drug interactions?
Decreased BP & rapid/irregular HR
What is a drug-nutrient interaction?
An interaction between a drug and a food or supplement.
What are the four most common Drug-nutrient interactions?
- MAOI inhibitors & tyramine
- Coumadin & leafy greens
- Grapefruit
- Nutritional Deficiencies
How do MAOI inhibitors and tyramine interact?
Causes a hypertensive crisis due to tyramine’s vasoconstriction
How do coumadin and leafy greens interact?
Leafy greens have alot of vitamin K and this can reduce effectiveness of Coumadin An anticoagulant
What drugs does grapefruit interact with? how?
With over 40 drugs by inhibiting metabolism of the drugs
What is Kwashiorkor and how does it interact with drugs?
It is a protein deficiency and decreases protein binding abilities
What is marasmus
severe malnutrition
What is a photoallergic reaction?
When a drug undergoes activation in the skin by UV light to a compound that is more allergenic than the parent compound
What is a Phototoxic reaction
when a Photosensitive drug undergoes photochemical reaction within the skin to cause damage
How can drug induced photosensitivity interaction be avoided or decreased?
Sunscreen and protective clothing
