chapter 13 OTC meds

Question 1

ASA

Answer 1

• ASA: cox 1: broad tissue distribution; cox 2: more specific tissue, less GI/renal involvement
  
  • analgesic, antipyretic, antiplatelet, and anti-inflammatory
  • don’t give to children-Reye syndrome

Question 2

Reye syndrome

Answer 2

• acute brain damage in children

- occurs after giving asa to kids

Question 3

Acetaminophen

Answer 3

• 3-4 g/24 hours
• aware of combination products (oxycodone)
• liver toxic
• inhibits prostaglandins in brain
• mucomyst given for OD

Question 4

NSAIDS

Answer 4

• ibuprofen, ketoprofen, naproxen
• cox 1 and cox 2 inhibitors
• max 2400 mg/24 hours
• analgesic, antipyretic, antiplatelet, anti-inflammatory
• GI ADRs
• ibuprofen decreases renal blood flow
• increased risk for CAD
• caution with renal disease patients

Question 5

antihistamines

Answer 5

• 1st line drugs for treating allergy
• 1st and 2nd generation available OTC
• increased lipophylic and BBB drowsiness

Question 6

decongestants

Answer 6

• sympathomimetic, vascontrictive drugs to reduce nasal congestion
• topical minimally absorbed
  
  • rebound congestion common if used>5 days
• systemic decongestants constrict vascular beds–increase BP, insomnia, increase HR; use with caution with pts with HTN and glaucoma
• restricted sales on methamphetamines
• very limited cough/cold meds for kids–many pediatric deaths

Question 7

antacids

Answer 7

• cations and ion compounds that neutralize gastric acid
• only dissolved antacids can react with stomach acid–tablets must be chewed
• interacts with most medications (i.e. tetracylcine-decreases bioavailability by 90%)

Question 8

Histamine 2 receptor antagonists

Answer 8

• inhibits gastric acid secretion by blocking histamine 2 receptors
• i.e. tagamet, zantac, pepsid
• rarely cause severe side effects
• cimetidine (tagamet) has most drug interactions
• can mask PUD

Question 9

PPI

Answer 9

• suppresses gastric acid secretion by inhibition of H+/K+/ATPase in gastric parietal cells
• 1 dose can suppress acid for 24 hours
• short term use only
• may alter absorption of pH dependent drugs (i.e. warfarin, diazepam)

Question 10

laxatives

Answer 10

• bulk forming: produce bulk in form of gel, metamucil, safest for longterm use
• stimulant: often abused–can lead to dehydration, loss of protein, K+ imbalance, tetany
• bisacodyl (dulcolax)
• anthraquinone stimulant laxative (i.e. senna, senekot)
• sufactant laxatives: docusate (colace), used for prevention, stool softner, works after 1-2 days
• Osmotic: PEG 3350 (miralax)-increases fecal water content by osmosis, non-habit forming
• magnesium hydroxide: osmotic saline laxative, well tolerated except for elderly

Question 11

OTC drug characteristics

Answer 11

• must be safe: benefits outweigh risk
• low potential for misuse/abuse
• can be labeled
• pt. able to self diagnose condition
• condition must be managed by pt.