ketotifen fumarate; antihistaminic effect

Use: temporary relief of itching due to pollen,ragweed, grass,animal hair and dander

Age: >3 yo

use bID

conjunctivitis

most are viral; some bacterial

antioxidants

-Vitamin C(500mg), E(400IU), A (25000 IC or 15 mg beta carotene)

minerals: zinc oxide (80mg) and cupric oxide (2mg)

for AMD

Contain: vitc-500mg; e-400IU; A-25000 IU or 15mg beta carotene

zinc oxide-80mg; cupric oxide-2mg

for AMD

Contain: vitc-500mg; e-400IU; A-25000 IU or 15mg beta carotene

for AMD

Contain: vitc-500mg; e-400IU; A-25000 IU or 15mg beta carotene

demulcents

emollients

all are water soluble, liquid polymers

-act like mucin to coat surface of irritated mucous membranes and protecting underlying cells & viscosity therefore retained in eye

-Artificial tear or lubricant solutions

lipis, fats or oils

-as ointment

-help to replace substances from sebaceous glands

-All are applied to the inner part of lower eyelid

-BEST HS bc may cause blurred vision

cellulose derivatives

dextran 70

gelatin

polyols:glycerin, PEGs, Propylene glycol, polysorbate 80

Polyvinyl alcohol

-Lanolins

-mineral oil

-petrolatums

-white ointment

-waxes: white, yellow

not to be used without recommendations by MD

-hypertonic NaCl soln or oint

-2 to 5% NaCl

muro-128

occurs as we get older, can't see things close- due to inability of eye muscles to bend lens of eye

-aren't strong enough bc lens is so stiff

vision is blurred due to inability of the optics of the eye to focus

-may be due to irregular toric or curvature of lens or cornea

H20 content: high

O2 permeability: high

--> irritant to eye-->Benzalkonium:no

Soaking/disinfection: yes

Wetting soln: no/yes (to prevemt dryness)

photophobia: less (partic at night)

Rigid gas permeable lens

-made of polymers; not as flexible; smaller; fits over cornea & takes longer to get used to

-sharper vision

-Low H20 content

-Low h20 permeability

Benzalkonium-yes

Soaking/disinfection- yes

wetting soln- yes

photophobia-more

for softlens

-special container w/ disc

-neutralizes any oxide left in soln after cleaning

Subtilisin

Pancreatin

Papain

cellulose derivatives

sorbic acid and derivatives

assoc w/ improper cleansing of lenses

-product recall ReNu Moisture Loc- a no rub cleaning soln for soft lens

4 day use, then consult MD

>12 yr

Similasan Earache

-Chomomilla

-mercurius

-sulphur

-pulsatilla

Hyland Earache +Belladona

Host characteristics: genetic

Oral Cavity environment:

-pH 6.7-6.9 (SALIVA)

-Presence of Ca+2,PO4-3,F

-Gingival inflammation

-Xerostomia (drymouth)-nothing to dilute bacteria

Bacterial envir: aerobic and anaerobic bacteria

-mostly gram + strep cocci usually resp for tooth decay

to show where plaque remains

-Oragel Plaque Revealing Rinse

form Calcium fluorapatite

-Fl replaces hydroxyl grp and strenghtens teeth

-most effective method

-water supplies 0.7 to 1.2 ppm (1ppm)

-Fluorosis

Scope

Cepacol

-Antiplaque/antigingivitis rinses

-chronic ingestion >2ppm: "mottled teeth"-y/yb teeth

-chronic ingestion >10ppm: deposition in soft tissues and skeletal system. bone is harder but more brittle-- > chance of fracture

-Acute toxicity: GI irritation, N,V

-Lethal dose 70-140 mg/kg

-Antidote-calcium (milk)

local anesthetic product

-Benzocaine (5-20%)

wound cleanser/debriding agent

-hydrogen peroxide

sweet oil (olive oil)

-not recog as efficacious

Sodium fluoride products (4)

ACT

Tom's of Maine Natural Anti-cavity Rinse

Listerine Tooth defense and smart rinse

Phos-flur

cellulose derivatives w/ electrolytes

-Oasis Dry Mouth

-Biotene Dry Mouth products

-OraMoist- disc attached to roof of mouth - dissolves and replaces moisture

Fluoride:

-NaF

-Na monofluorophosphate

-Stannous fluoride

not FDA approved drugs

-h202

-carbamide peroxide

antiplaque/antigingivitis products

-Total

wound cleanser/debriding agent

-carbamide peroxide

murine earigate and earigate just for kids

:isotonic sea water

dry mouth

-leads to increase caries formation

-salive substitutes (cellulose derivatives with electrolytes)

local anesthetic product

-Benzocaine (5-20%)

oral protectant for canker sores/aphthous ulcers

-2-octyl cyanoacrylate

local anesthetic product

-Benzocaine (5-20%)

increased 'substantivity'

-ability of product being used as antimicrobial to stay on the tissues to continue to act

local anesthetic product

-Benzocaine (5-20%)

local anesthetic product

-Benzocaine (5-20%)

antiplaque/antigingivitis rinses

-Listerine

Benzyl alcohol

phenol products

10% docosanol- apply immediately & 5x/d

-prevents virus from entering epithelial cells

karaya gum: poligrip, fasteeth

carboxymethylcellulose- effergrip

Peroxides- efferdent

Perborates- polident

*not classified as otc drugs

wound cleanser/debriding agent

-carbamide peroxide

2 weeks of continous tx

(objective of tx: relief of pain/discomfort w/ pH goal in stomach 3.5)

Antacids:

Relief-

Duration-

neutralize stomach acid

-Take after meals

relieft in 5 mins

Duration: 30-120min

aluminum hydroxide

calcium carbonate

magnesium oxide, hydroxide or silcates

sodium bicarbonate

PPI

Take:

Relief:

Duration

before meals

relief 120-180 m

duration 12-24 h

adhere to mucosal wall and provide physical protection against acid

-bismuth cmpds (take AFTER meals)

***can't neutralize acid***

heartburn

sour stomach

upset stomach

1. rapidity of action: Antacids (solns>susp>tabs)>H2 blockers>PPIs

2.taste

3.cost

4. dose size

5. other illness

H-2 Blockers

Take:

Relief:

Duration:

prevent acid secretion

take b4/after meals

relief:30-60 mins

duration:6-10 hr

PUD:

-Duodenal ulcer (4-6 wks healing time)

-gastric ulcer (6-8 wks healing time)

 GERD

Gastritis

Hiatal Hernia

Zolliger-Ellison syndrome- gastrin producing tissue in other areas of GI

Hyperphosphatemia- commin in chronic kidney dialysis pts; USE Aluminum hydroxide antacids

rapid relief- soluble & taken as soln

AEs: systemic alkalosis, High Na content causes salt & h20 retention leading to edema

CI: pts on salt-restricted diets & htn pts

sodium bicarbonate

APAP

NOT ANTACIDS

-Combined w/ antacids allowing them to claim heartburn relief sx's

-float on top of the gastric contents: blocking gastro-esophagel sphincter & preventing acid reflux

*contain sodium bicarb or salts of aluminum & mg in their formulation as the antacid

may have cytoprotective action; not a true neutralizer

AEs:

1. may cause constipation due to astringent action

2. may impart black color to tongue, oral mucosa & feces bc of formation of bismuth sulfide

3. avoid in pts w allergies, children after chx pox or flu, or pts on anticoagulants

contains 40% elemental calcium

AEs:

1. may cause constipation, diarrhea, flatulence

2. rebound acidity

3. milk-alkali syndrome:rare today

Interactions: reduces absorption of tcns, quinolones, atenolol, iron, & increases serum concentrations of quinidine due to increased renal reabsorption

Don't take for >2wks

" pregnant/nursing

keep out of reach of children

if abd pain persists, call md

do not use in children <12 yo

Alka seltzer original, extra, gold

Bromo seltzer

Gaviscon tablets/liquid

For FREQUENT Heartburn (2 or more days/week) in pts >18 yo

-take 1 daily w/ h2o 30-60 mins before eating first substantial meal of the day x 14 days

-may repeat regimen every 4 months (notify MD if worsens or >4 months)

-may take 1-4 days for max benefit

if amt of Na from inactive and active in the recommended dose is >5mg , product label must state sodium content

>140mg must bear warning: do not use if on Na-restricted diet unless directed by MD

constipation

delayed gastric emptying

hypophosphatemia

pts. w/ comprised renal fx absorb aluminum ion, resulting in deposition in the CNS causing encephalopathy

many absorp interactions

Antacid dose: 5-10ml

laxative: 15-30ml

calcium glycerolphosphate & magnesium stearate

-dietary supplement

-claims include prevention of acid formation but no proof of efficacy; not approp. recommendation for heart burn

10mg famotidine, Calcium carbonate, magnesium hydroxide

-designed to counter fast acting claim of all antacids

Antacid

-aluminum hydroxide

-sodium bicarbonate

-magnesium oxide, hydroxide, silcate

-calcium carbonate

GI Drug (class & drugs) taken before or after meals.

relief:30-60 mins

duration 6-10 hours

h2 blockers

-cimetidine

-famotidine

-nizatidine

ranitidine

GI Drug (class & drug) taken before meals

-relief: 120-180 mins

duration: 12-24 h

Mucosal protectives

-bismuth compounds