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MCPHS - OTC Exam I
MCPHS - Non Rx Exam I Stuff
| Question | Answer |
|---|---|
| Questions for Pt? | Type Problem? Who is Pt.? Age Pt (old/child)? Wt? When Started? Persistant/Intermittent? Inhibiting? Had Before? What makes Worse/Better? Other Med Conditions, Meds, taking anything else? Allergic to any OTC's? |
| How many OTCs do you suggest? | Serveral, and let Pt. pick., or see MD if needed. |
| What can pregnant pt do for pain? | only Acetaminophen for pain or fever. No NSAIDs in Late Pregnancy! |
| Nursing Pt. can not have? | No Aspirin or Salicylates for Nursing Mothers |
| What is OK for Nursing Pt.? | Most OTC's are ok for nursing other than Aspirin and Salicylates. |
| Geriatric Pt. with Glaucoma, bronchitis, emphysema, or urinary retention can not take which OTC? | Antihistimines |
| Geriatric Pt. with Heart Disease, HTN, Thyroid, diabetes can not take which OTC? | Decongestants |
| Delsym | Dextromethorphan 30 mg |
| Robotussin | Guaifenesin 100mg/5ml |
| Mucinex | Guaifenesin 600 mg |
| Afrin Mist | Phenylephrine (Nasal Decongestant) |
| Sudafed Tabs | Pseudoephedrine 30 & 60 mg |
| Bronkaid Dual Action | Ephedrine & Guaifenesin |
| Primatene Tabs | Ephedrine & Guaifenesin |
| Products Containing Trolamine | Aspercreme, Aspergel, Myoflex, Sportscreame |
| Products Containing Menthol | Absorbine Jr., Ben Gay SPA, IcyHot, Meneralice Gel |
| Products Containing ASA & Caffiene | Anacin & Bay Extra Strength Caps |
| Combo Products w/ ASA, APAP, & Caffiene? | Excedrin Extra Strength & Migrane |
| Robotussin A-C | Cod/Guaifenesin |
| Benadryl | Dipenhydramine (Antitussive) |
| Name the Antitussives? | Codeine, Dextromethorphan, Diphenhydramine, Camphor, Menthol, (Eucalyptol & Thymol) |
| Typical Dose of Codeine? | 10 mg/5 ml q. 4-6 (120 max) Not < 6 YO Increased seditive effects with Antihitamin. Preg Risk Factor C |
| Typical Dose of Dextromethorphan? | 10-20 mg q. 4 (240 mg/d max) |
| Typical Dose of Diphenhydramine | 25 mg q 4 (150) |
| Typical Dose of Guaifenesin? | 200 - 400 mg q. 4 (2.4) |
| What OTC for Pt's Allergic to ASA? | Choline Salicylate (Arthropan Liquid 870 mg/5ml = 650mg ASA) |
| What else can you give to Pt's Allergic to ASA? | Magnesium Salicylate (Doan's Pills, 377 mg = 325 mg ASA) |
| Which drugs Increase Tox w/ NSAIDS? | Digoxin, Lithium, Methotrexate |
| Which Drugs Increase Anticoagulation w/NSAIDs? | Coumodin |
| NSAIDs do what when taken with Antihypertensives? | Decrease their action |
| Can NSAIDs be taken with Alcohol regularly? | No, it increases GI bleeding |
| Name the Salicylate OTCs | Arthropan, Doan's, Nuprin, Motrin, Advil, Momentum, Aleve, Orudis, Actron (IBU's, Naproxen, & Ketoprofen products) |
| Name the Non-Salicylate NSAIDs | Ibuprofen, Naproxen, Ketoprofen |
| Some Brand Named Ibuprofens? | Motrin IB, Advil, Nuprin |
| Name a Naproxen OCT Brand? | Aleve |
| Name two Ketoprofen Brands? | Orudis, Actron |
| What is in Percogesic? | APAP & PhenylToloxymine (spelling?) |
| Arthropan smells like? | Fishy Odder - Liquid, so many people don't perfer it. Good for Pt.s Allergic to ASA |
| What should Pts with Renal problems avoid if they need pain med but allergic to ASA? | Doan's, it has Magnesium Salicylates |
| What is in Orginal Alka-Seltzer? | ASA 325 mg |
| What is in Alka-Seltzer Plus? | APAP 325 mg |
| Children's Tylenol Contains? | APAP |
| Children's Motrin Contains? | IBU |
| Ecotrin contains what ? | Enteric Coated ASA 325 mg |
| Name some ASA Brands | Alka-Seltzer, Ascriptin, Bayer, Bufferin, Ecotrin, St. Joseph's |
| Name some APAP Brands | Feverall, Infant's Pain Reliever, Panadol, Tempra, Tylenol |
| What is Side Effect of Pseudoephedrine? | It is a Stimulant (Not for Pt.s with Heart Conditions or HTN) |
| What is Side Effect of Dipenhydramine? | Sedative (Antihistamine, so Not for Pt's with Glaucoma |
| Topical Counterirritant Analgesic Catagories? | A = Heat (rubbing), B = Cooling on Application, C = No Heat (Vasodialation), D = Heat (w/out Rubbing) |
| Cat. A (Heat by Rubbing) Actives? | Methyl Salicylate, Allyl Isothiocyanate, Ammonia Water, and Turpentine Oil |
| Cat B (Cooling) Actives? | Camphor & Menthol |
| Cat. C (No Heat/Cooling) Actives: | Methyl Nicotinate, Histamine Dihydrochloride |
| Cat. D (Heat w/out Cooling) Actives? | Capsaicin products |
| "RICE" tx for Join Pain Stands for What? | Rest, Ice, Compression, Elevation (above Heart) |
| Fluoroquinolone Antibiotics can do what? | Cause Tendon Rupture (Not for Pt's who workout alot, or suffer from Bursitis or Tendinitis) |
| What is the cause of a Hang Over Headache? | Acetaldehyde (Tox Metabolite of Ethyl Alcohol) |
| Acetylsalicylic Acid is called what? | Asprin (ASA) |
| Which drugs interact with Asprin | Warfarin, Valproic Acid, Sulfonylurea agents (Glipizide & Gliburide), Uricosuric agents (Probenecid), Methotrexate, Alcohol |
| NSAIDs interact with which drugs? | Digoxin, Beta-Blkrs, ACE Inhib, Lithium, Methotrexate, Warfarin(Coumodin), Alcohol |
| Special Precautions w/Asprin and Pt's with? | Chronic Alcohol Use, Asthma, Nasal Polyps, Pregnancy, Children w/Viral Infections (Not <15 YO) |
| Acetaminophen (APAP) facts? | Not an NSAID, 325 mg normal strength, Non-Antiplatelet, Safe for Pregnant Pt's. 30 tabs = Brain Damage, 60 = Fatal, No GI Irritation, 2x Oral Dose = Rectal Dose |
| What effect does high doses of Dextromethorphan do to Pt's? | Acts like LSD, may cause hallucinations, it is widely abused by kids. Dextromethorphan is shorter acting than Codiene as a Cough Surpressent (Antitussive). |
| What is an Expectorant? | Increases Resp. Tract Secretion. Guaifenesin is only FDA approved Expectorant. |
| What do Antitussives do? | They surpress cough. They work on CNS, not a troat coater! |
| What does Pectin do? | It coats the throat. Used in cough drops. |
| Can Expectorants and Antitussives be taken together? | Yes, no problem |
| Pt w/gergling cough, over wt., high cholesterol, What do you suspect? | CHF |
| What effect can Lisinopril do for Coughs? | Lisinopril (Zestril) can cause Pt's to Cough |
| What Side Effect can Guaifenesin have? | Nausia, HA, Upset Stomach |
| What does PineTar, Potassium Iodine, Terpin Hydrate do? | They are older Expectorants taken off the market after DESI Laws. |
| What is the TX for Fever & Pain in Children? | APAP or IBU (ASA not Recomended <15 YO ) |
| Epinephine (Primatine Mist) Has what side effects? | Alfa, Beta-1 = Tachycardia but, Beta-2 is Brokodialation = good effect |
| Dyspnea means what? | It is pain while breathing with tightness in chest. Experienced by Asthma sufferers |
| Asthma sufferers have what kind of cough? | chronic non-productive |
| How many hospitalized and how many deaths caused by asthma | 1/2 million hospitalized each year, and 5428 died in 1998 |
| Which sex experiences more asthma as a child? | Males but, later the ratio is approx equal as both sexes age |
| What percent of childhood asthma sufferers still experience Sx's when they get older? | 30%, and 15 million world population have asthma. 5 million are children in the USA |
| What is Atopy? | Genetic trait for hypersensitivity to environmental allergens which predispose for Asthma. 30-50 % US Pop are Atopic. (2nd Hand Smoke increases risk) |
| Nyquil is what kind of product? | "shot-gun" Contains 1000 mg APAP, 25 % Alcohol, 15 mg Dextromethorphan (cough surpress), 30 mg Pseudoephedrine (Decongest/stimulant), 6.25 mg Doxalimine Succinate (AntiHistamine) |
| What does PAR and SAR stand for concerning Allergies? | SAR = Seasonal Allergic Rhinitis, PAR = Perenial Allergic Rhinitis |
| How much of Pop in US have PAR and SAR allergies? | 10 - 30 % and it is caused by pollens, molds, mites, pet dander, chemicals... |
| Cromolyn does what? | Prophylaxis Tx for Allergies, prevents Sx's |
| When does Cromolyn start to work? | 3 - 7 d to start to work, then takes 3 -4 weeks for full benefits of supporting mast cell stability |
| Side Effects and Dose of Cromolyn | Low Side Effects, but Sneezing, burning or stinging nasal passages Norm Dose: 1 spray ea nostril 3-6 x d |
| Types of Wetting Agents? | Saline, Propylene Glycol, Polyethylene Glycol (Non-Therapuetic Agents) |
| How do S&SX's differ b/w allergies and colds? | Allergies have Itchy EYES and Palate, Post Nasal Drip, Red EYEs, No Chills, No Sore Throat, No Fever, No Coughing, No Aches and Pains (...like colds do...) |
| Name Local Anesthetic Tx for common Cold | Benzocaine, Dyclonine, Phenol are used in Lozenges, troches, mouthwashes, sprays |
| AntiSeptic Agent to Tx Comm Colds | Cetylpyridinium Cl, Hexylresoreinol, Eucalyptol, Thymol Not good for Tx of Viral |
| Antihistamines have what kind of effects? | Anticholenergic that effect the CNS (such as sedating effect) |
| Most Sedating Antihistamine? | Diphenhydramine & Doxylamine |
| Least Sedating Antihistamines? | Chlorpheniramine & Brompheniramine |
| What is another name for Chlorpheniramine? | Chlor-Trimenton |
| What is another good alternative to Benydryl (Diphenhydramine)? | Loratadine (Claritin or Alavert) |
| Coricidin HBP is used by teens for what purpose? | They use it to get high. It contains Chlopheniramine (Antihistamine) & Dextromethorphan 30 mg, but some types like Cold & Flu also contain APAP. Teens take 5x -75x normal dose OD'ing on APAP which is Hepatotoxic |
| Topical Decongestants can do what when used too often? | Rebound Nasal Congestion (Use only for 3 - 4 d) "Rhinitis Medicamentosa" is med term for rebound effect |
| Is >1 gm of Vitamine C good to prevent colds? | No, it causes kidney stones, diarrhea, GI distress |
| Is Vit C good to reduce duration of colds? | Yes, some studies show it reduces the duration of colds |
| Is Zinc approved by FDA to TX colds | No, but some studies show it helps, but no real conclusive evidence |
| Two types of FDA recognized Topical Antitussives? | Camphor & Menthol (Camphor is Toxic if taken internally) |
| How much Camphor is toxic? | 5 mls 20% soln can be fatal to children (For External only) |
| What is replacing Pseudoephedrine in many OTC's | Phenylephrine (10 mg q. 4 Hr. *NMT 60 mg/d) |
| What is typical dosing for Pseudoephedrine and what is it used for? | Pseudoephedrine (60 mg q. 4-6 Hr. *NMT 240 mg./d) Best Decongestant |
| Side Effects of Systemic Decongestants? | Pseudoephedrine & Phenylephrine are Stimulants and may cause BP to Rise, HTN, restlessnes, insomnia, anxiety, tremors... |
| What is dextromethorphan used for and what is it compared to? | AntiTussive and is comparable to Codiene but does not last as long |
| What is typical dose of codiene? | 10 mg/5 ml 1-2 tsp q. 4-6 Hr. for cough syrup (risk cat c) |
| What is Pregnancy Risk Cat A? | A is OK |
| Preg Risk Cat B? | B is Prob Safe |
| Preg Risk Cat C? | C is ques. but useful |
| Preg Risk Cat D? | Very ques, but also poss useful |
| Preg. Risk Cat. X? | Bad, Do not Use if Pregnant. Birth Defects.... |
| What is in Anacin? | ASA & Caffiene |
| What is Ascriptin? | ASA & Mg Buffer |
| Ecotrin ? | Enteric Coated ASA |
| Ibuprofen brands? | Advil & Motrin |
| Aspercreame? | Trolemine Sal. |
| Robitussin AC Contains? | Codiene & Gauifenesin |
| Chlor-Trimenton | Chlorpheniramine |
| Tavist? | Clemastine (antihistamine) another alt to Benadryl |
| Dose of Chlorpheniramine? | 4 mg q 4-6 hr. (Chlor-trimenton) |
| Benadryl dose? | 25 mg q. 4 hr. (NMT 150 mg/d) Diphenhydramine |
| Nasalcrom? | Chromolyn |
| Ascriptin contains what? | ASA & Mg++ (Buffered) "Maloxx" |
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