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Herbals / OTC Flashcards

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1
Q

DHEA

What is it?
Why is it used?

A

Naturally occuring steroid hormone

Raw material to make estrogen, progesterone, testosteron and cortisol

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2
Q

Lysine

Use?
Counseling

A

For cold sores and is recommended for those with HSV

Give on empty stomach

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3
Q

Lutein

Use?

A

Eye health

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4
Q

St.John’s wort

Use
ADE
Interactions

A

Depression

GI, dizzy, tired, dry mouth

450 inducer - can decrease birth control, decrease INR and cyclosporine levels

Can increase risk of serotonin syndrome because STW is a serotonin agent

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5
Q

SAM-e (s-adenosyl-L-methionin)

Use?
Caution?

A

Depression/osteoarthritis

May increase serotonin levels

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6
Q

Lithium oraotate

Brand
Use
ADE
OTC drug interaction

A

Symmetry, Serenity

Used for addiction, insomnia, mood swings, stress

Cognitive, weight gain, hypothyroidism, polyuria

NSAID’s increase lithium levels

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7
Q

Glucosamine sulfate

Use
Allergies
Caution

A

Osteoarthritis

May contain shellfish

Caution with diabetic patients

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8
Q

Chondroitin

Use
Caution
Time to effects
Drug interaction

A

Osteoarthritis

Caution with diabetic patients

2-3 months

May increase INR

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9
Q

Kava Kava

Use
ADE
Interaction

A

Anxiety, stress, insomnia

Hepatotox

Can cause CNS depression when mixed with alcohol

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10
Q

Valerian

Use

A

Insomnia

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11
Q

Chamomile

Use
Caution

A

Anxiety and as a bedtime tea

Anaphylaxis

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12
Q

Saw palmetto

Use
MOA

A

BPH

Noncompetitivley inhibits 5AR

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13
Q

Ma Huang (ephedra)

Use
ADE

A

Increase energy and for weight loss

Agitation, tremor, seizures, increase HR/BP

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14
Q

Ginseng

Use
Drug Interaction

A

Fatigue

Improve athletic performance , cognitive function, and immune function

May decrease blood glucose

Can induce 2C9 causing a decrease in INR

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15
Q

Ginkgo

Use
ADE
Drug interaction

A

Dementia, AD, asthma

GI, dizzy , may increase chance of stroke

Can inhibit platelet aggregation = increased bleeding

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16
Q

Prevagen

Use
ADE

A

Improve memory

CV events, seizures

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17
Q

Garlic (allium sativum)

Use
Drug interaction
Pgx

A

Prevention of atherosclerosis
High BP - weak evidence
Immune system - weak evidence
HLD - no evidence

May increase INR

450 inducer

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18
Q

Echinacea

Use
MOA

A

Respiratory tract infection and general immune system stimulation

May increase phagocytosis and promote lymphocyte activity

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19
Q

Goldenseal

Use
Drug interaction

A

Antimicrobial
Anti-inflammatory
Laxative
May induce contraction so never for pregnancy

May decrease INR

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20
Q

Fever few use

Butter bur use

A

Both used for migraine prophalaxis (NEVER treatment)

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21
Q

SOY

Use

A

Decrease hot flashes and other postmenopausal symptoms

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22
Q

Yohimbe

Found where?
Use
Caution

A

Found in bark western to Africa

Impotence
Aphrodisiac
Body building

Heart attacks, seizures, GI problems, tachycardia

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23
Q

Evening primrose oil

Use
Drug Interaction

A

Eczema
Inflammation such as RA
Breast pain

May increase INR

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24
Q

Borage seed oil

Use
Caution

A

Skin conditions
Joint pain
Menopausal disorders

Liver damage and increased bleeding

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25
Cranberry Use Counseling
Prevention of recurring UTI's Don't drink large amounts because it can increase risk of kidney stones
26
Dong Quai Use ADE
Regulate menstrual cycles Help with menopausal difficulties Has anticoagulant activity Photosensitivity , diarrhea
27
Black cohosh Use ADE Time to effect Caution
Menopausal symptoms Liver failure 4-5 weeks May induce labor/miscarriage
28
CoQ10 Use MOA Drug interaction
Migraine PPX, decrease complications of heart surgery, statin myalgia, Produced by human body and is important for basic functioning of cells May decrease INR
29
Milk thistle Use Cautio
Used for liver problems, and gall bladder May lower blood sugar
30
Red Yeast Rice Use ADE
Lower cholesterol Statin ADE - when fermented it becomes lovastatin
31
Honey Use Age restriction?
Wound healing - As a moisture barrier Some antibacterial and antifungal activity Don't give to <1y.o
32
Cinnamon Use
Used for T2DM
33
Kratom Use
Has opioid-like effects - low doses are stimulant but high doses are a sedative Prohibited in some states
34
ADEK Uses
A - vision D- bones E- antioxidant K = clotting factor
35
Vitamin B's other names B1- B12
B1 = Thiamine B2 = riboflavin B3 = niacin B5 = Pantothenate B6 = Pyridoxine B7 = Biotin B9 - Folate B12- cyancobalamin
36
What is a B3 deficiency called? What are the symptoms?
Pellagra Marked by 3 D's - dementia, diarrhea, dermatitis
37
What labs are affected with B7?
Falsely Low tropnin and low TSH
38
Os- cal Generic Counseling
Calcium carbonate and Vitamin D3 Give with fod
39
What are the recommended daily calcium limits?
19-50 or 51-70M - 1G >51 F or >70 M - 1.2G
40
List elemental iron amount of... 1. Ferrous gluconate 2. Sulfate 3. Fumarate How can iron absorption be enhanced?
1. 12% 2. 20% 3. 33% Give with vitamin C
41
When do you start iron supplements in babies? What is the dose?
After 4 months and if they are breast-fed. If they are formula fed, they get enough iron. 4-6 months - 1mg/kg/d 6-12 months - 11mg/day 1-3 years - 7mg/day
42
Tylenol dosing for kids
15mg/kg Q4-6H MAX 75mg/kg/day
43
Max OTC tylenol dosing for adults
Reg strength - 3250mg/d Extra strength - 3g/d Arthritis - 3.9g/day
44
How is N-acetylcysteine supplied?
Inhalation Oral solution Effervescent tablet IV
45
What is the max dose of aspirin when on ticagrelor? What is the max dose in general?
81mg/d 4g/day
46
Aspirin ADE Contraindications Drug interaction Antidote for overdose
GI - PUD, bleed CNS - tinnitus Increase uric acid - so never give in gout patients Kids with viral illness, gout, active PUD Ibuprofen/naproxen can decrease aspirin effects so separate by >2 hours Give activated charcoal, IV dextrose, and/or sodium bicarb
47
Where do NSAID's work? What is the BBW?
Afferent arteries GI events (ulceration, bleeding). and CV events (edema and increase BP)
48
Diclofenac Brand/ROA/indication
Cambia packets for acute migraine attach Zorvolex tablets Arthrotec tablets with misoprostel Voltaren gel for pain Flector patch BID
49
What are two long acting NSAID's?
Meloxicam Piroxicam (feldene)
50
OTC max dose vs RX of ibuprofen
1200mg/day RX - 3200mg/day
51
Naproxen max dose OTC and RX
OTC - 600mg/day RX- 1500mg/day
52
Ketorolac Brand/ROA Max duration
Toradol tablets Acuvail eye drop Sprix nasal spray also IV/IM 5 days
53
Celecoxib Allergy Combo
Sulfa allergy Consensi - amlodipine + celecoxib
54
Capsaicin Brand Indication ROA
Zostrix Muscle/joint pain, neuropathic pain, post-herpetic neuralgia, diabetic neuropathy Topical Patch 0.025-0.05% (max 4/day) - can be cut
55
Fexofenadine Brand Counseling
Allegra Take on empty stomach and separate from orange/apple/grapefruit juice by 4 hours
56
Desloratadine Brand
Clarinex
57
What are 3 OTC decongestants?
Pseudeoephedrine Phenylephrine Oxymetazoline (afrin)
58
What are 3 OTN intranasal corticosteroids?
Triamcinolone (nasacort) Fluticasone Budesonide (rhinocort)
59
Triamcinolone Brand Indication
Nasacort >2 y.o for nasal decongestion and watery eyes
60
Budesonide Brand Age
Rhinocort >6y.o
61
Racepinephrine Brand Indication Contraindication ADE
Asthmanefrin OTC Temporary relief of SOB, wheezing for >4y.o MAOi within 14 days Nervousness, tachycardia
62
Primatene Mist Generic Indication/age Counseling
Epinephrine Temporary relief of intermittent asthma for >12y.o Prime and shake everytime
63
What would you give for a dry cough?
Dextromethorphan (delsym)
64
What would you recommend for a patient with respiratory infection and cough OTC?
Oral decongestant to stop postnasal drip that can trigger the cough
65
What are the components of swimmer's ears drops?
Isopropyl alcohol and anhydrous glycerin
66
Counseling ear drops for kids to adults
<3 y.o - pull down and back >3y.o - pull up and back
67
What is the onset for emollient stool softners?
Docusate or colace can take about 24-72 hours to work
68
Example of osmotic laxatives and onset
Magnesium citrate / sulfate PEG Lactulose Sorbitol Glycerin within 3 hours
69
Examples of stimulant laxative and onset
Senna Bisacodyl 6-12 hours
70
What is senokot-S
Senna + docusate
71
Miralax approved age
>17y.o But kids use it too
72
Pregnancy options for constipation
1. Bulking agents (psyllium) 2. Magnesium citrate 3. Stool softener - docusate
73
Bismuth subsalicylate Brand ADE Contraindication
Pepto-bismol tinnitus, stool/tongue black Avoid in salicylate allergy , taking coumadin, and greater than 3 weeks
74
Loperamide Brand Dose
Immodium Initial: 4mg PO single dose Titrate to 2mg PO after each loose stool Max Rx 16mg/day Max OTC 8mg/dat
75
Simethicone Dose
Adult : 40-125mg QID Infant: 20mg QID `
76
OTC option for head lice and age and counseling
Permethrin 1% >2 months and apply after washing hair and repeat every 9 days for 3 doses Pyrethrin 4% >2y.o and apply to DRY hair and repeat every 9 days for 3 doses
77
Oxytrol Generic Indication ROA / Dose ADE
Oxybutynin For women with OAB 3.6mg/day PATCH applied every 4 days anticholinergic so anti-sludge

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