Flashcards in 65 OTC Deck (57):
What are the 3 classification of drugs? And, what law/year came up with that?
1. Prescription/legend-Durham Humphrey Amendments FDC act-1951
2. OTC- Durham Humphrey
3. Vitamins, minerals, and herbs- Dietary Supplement Health and Education- 1994
When is FDA involved for dietary supplements and herbals?
Only if safety concerns
What drug category falls under safe use w/minimal supervision?
What category of drugs are regulated by FDA?
Does testing for efficacy for dietary/herbs exist? safety?
2. left to the manufacturer
What drug category has ongoing testing efficacy and ongoing?
Give 3 reasons for why we should be familiar with OTC agents?
1. Effective in treating common ailments
2. May worsen existing conditions or interfere with prescriptions
3. misuse/abuse may produce complications
What is a category I agent?
Useful and safe
What is a category 2 agent?
Unsafe or not useful
What is a category 3 agent?
What OTC category does brompheniramine and chlorpheniramine belong to?
H1 antihistamines- 1st gen-allergies
What OTC category does clemastine belong to?
H1 antihistamine-allergy- 1st gen
What OTC category does cetirizine and fexofenadine and loratadine belong to?
2nd Gen H1 antihistamine- allergy
What OTC category does dextromethorphan belong to?
antitussive- with codeine
What OTC category does oxymetazoline and xylometazoline belong to?
What OTC category does guaifenesin belong to?
expectorants- reduce pulmonary mutants
What OTC category does benzoyl peroxide belong to?
acne vulgaris treatment
What OTC category does bismuth subsalicylate belong to?
miscellaneous antidiarrheal prepartions
What OTC category does polycarbophil, psyllium, and methyl cellulose?
bulk-forming laxative for constipation
What OTC category does Mg OH and polyethylene glycol belong to?
Osmotic laxative- for constipation
What OTC category does glycerin and bisacodyl belong to?
irritant laxative- for constipation
What OTC category does cyclizine and meclizine belong to?
antiemetics- prevent or treat motion sickness
What OTC category does diphenhydramine belong to?
A few- sleep aid, anti emetics etc.
What OTC category does doxylamine belong to?
sleep aids- for insomnia
What OTC category does nicotine polacrilex belong to?
What OTC category does naphazoline and tetrahydrozoline belong to?
ophthalmic vasoconstrictors- for bloodshot eyes
What OTC category does orlistat belong to?
weight loss- for obesity
What does it mean when a prescription only agent is now available as OTC?
demonstrated that it is safe for general use
What does the FDA keep systematically reviewing ?
OTC products for efficacy and safety- categories 1 and III-- remember II was already proven to be unsafe
What are the 3 hidden drugs found in analgesics?
antihistamines, caffeine, sympathomimetics
What is the hidden drug found in antitussives?
What are the 3 hidden drugs found in cold/allergy medications?
alcohol, aspirin and sympathomimetics
What is the hidden drug in dermatologic OTC?
What are the 2 hidden drugs in menstrual OTCs?
antihistamines and caffeine
What OTC classes have antihistamines as a hidden drug?
analgesics and mestrual
What OTC classes have local anesthetics as hidden drugs?
dermatologic and antitussives
What are the 5 guidelines for use of OTCs?
1. select simplest formulation
2. select therapeutically effective dose
3. product appropriate for symptoms
4. recommend generic product
5. be wary of gimmicks
What are 3 ways products are made different by (gimmicks)?
1. adding other ingredients that don't contribute
2. brand names selected to suggest specific uses or strength
3. special formulation- may or may not be helpful
What happens due to the fact that the public gets generally overwhelmed by differences?
Will use the one that is most heavily advertised
What are excipients?
T_F- excipients are only found in OTC and not prescription drugs?
Are excipients approved by FDA?
yes - 100s used
What might excipients affect?
dissolution and absorption of drug
T-F-- CaSO4 increased phenytoin levels and lactose decreased phenytoin levels?
False- other way around
What are the alka-seltzer plus cold & sinus tablets active ingredients? inactive ingredients?
1. aspirin, phenylephrine
2. aspartame, docusate sodium
What are the active ingredients to sudafed?
What are the active ingredients of advil PM?
What is the active ingredient of afrin nasal spray?
Review avoidable cost to healthcare from Drug-drug interactions-
135 billion /year from ADRs
10-20% of those are from drug-drug
What drug-drug interactions prevent absorption?
1. chelation- cations/antibiotics
2. non-absorbable form- iron/H2 antagonist
3. non-specific binding- bile acid sequestrants
What are the 3 receptor interactions agonists and antagonists?
1. beta antagonist + beta2 agonist
2. methotrexate + folic acid
3. alpha1 +beta2 agonist
What is a common drug-drug interaction of catecholamines?
What is a major drug-drug with antihistamines
What is a major drug-drug with tetracyclines?
What are 2 particularly dangerous interactions with warfarin?
NSAIDS and Macrolides
What are the 2 particularly dangerous interactions of ACE inhibitors?
K supplements, spironolactone