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Fundies test 4-pillion lectures
12/12 over the counter drugs and prescription writing
53
Dentistry
Graduate
12/12/2013

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Cards

Term
Who oversees over the counter products?

Who oversees controlled substances, such as narcotics?
Definition
The Food and Drug Administration (FDA)

The Drug Enforcement Agency (DEA) and FDA
Term
What do histamine 2 receptor antagonists reduce?

Can children take them?
Definition
Acid in stomach (heartburn, acid indigestion, and sour stomach)

Not recommended for children <12 years of age
Term
Are food additives reviewed by the FDA?
Definition
No (ex: GNC)
Term
Which H2 receptor drug is least potent so used most often but is known to slow the metabolism of other drugs through Cytochrome P450 ( warfarin, theophylline, phenytoin=causes higher concentration, so a lot of drug-drug interactions)
Definition
Cimetidine
Term
What proton pump inhibitor is approved for the treatment of frequent heartburn in adults with symptoms of heartburn 2 or more days per week. Not intended for immediate relief of heartburn, since they take several days to become fully effective
Definition
Lamsoprazole (prevacid)
Term
Do (H2 receptor antagonist or proton pump inhibitors) work only after you eat a big meal?
Definition
proton pump inhibitor (inhibits H+ to be pumped in stomach)
Term
What is one of the most effective acne preparations. Apply sparingly once or twice daily. Decrease concentration or frequency if excessive skin irritation occurs. Pretty safe.
Definition
Benzoyl peroxide
Term
Why are antihistamines combined with pseudoephedrine or phenylephrine?
Definition
they are A1 agonist so they vasoconstrict (less fluid coming out of nose/decongestant)
Term
What alone relieve most symptoms associated with allergic rhinitis or hay fever
Definition
Antihistamines (H1 inhibitors)
Term
Of the following drugs which one is most likely to cause drowsiness?

Chlorpheniramine
diphenhydramine
brompheniramine
clemastine
Definition
diphenhydramine (benadryl)
Term
*Over the counter sale of products containing ______ is restricted because it can be used to produce methamphetamine
Definition
pseudoephedrine (only be sold in limited quantities to consumers after they provide photo identification and sign a logbook)
Term
What is most (mg) of acetaminophen or aspirin that you can take a day before toxicity?
Definition
4000 mg (4g)
Term
(acetaminophen or aspirin) is a quick way of committing suicide by putting you in to a seizure/coma?

(acetaminophen or aspirin) kills you by liver failure
Definition
aspirin

acetaminophen
Term
Ibuprofen and naproxen are more likely to cause what?
Definition
peptic ulcer
Term
Which of the following is an analgesic and antipyretic, but NOT an anti-inflammatory?

Aspirin
Ibuprofen
Acetaminophen
Naproxen
Definition
Acetaminophen
Term
Can Acetaminophen or Aspirin be given to kids? Why?
Definition
Acetaminophen

Aspirin associated to Reye's syndrome
Term
What individuals should NOT take aspirin or NSAIDS
Definition
individuals with peptic ulcers, or in those taking glucocorticoid drugs or anticoagulants --> risk of developing stomach ulcers
Term
For an antacid, (magnesium or aluminum hydroxide) causes constipation.

(magnesium or aluminum hydroxide) causes diarrhea
Definition
aluminum-constipation

magnesium-diarrhea

(usually given together=neutral)
Term
What is taken as needed (prn) to neutralize stomach acid?
Definition
calcium carbonate (tums)
Term
Can bismuth subsalicylate (pepto-bismol) be given with aspirin?

When should bismuth subsalicylate NOT be used?
Definition
No-can cause toxicity of salicylates (symptom: ringing of the ears)

Antidiarrheals should not be used if diarrhea is accompanied by fever > 101°F or if blood or mucus is present in stool.
Term
What drug is a synthetic opioid (acts on intestinal smooth muscle to decrease motility allowing for absorption of water and electrolytes=can cause constipation) that does not penetrate CNS (NOT a controlled substance)?
Definition
Loperamide (Immodium)
Term
What is found in cough medicine (antitussive) that has low addiction liability (schedule V opioid) that acts centrally to increase the cough threshold?
Definition
codeine
Term
What is the antitussive that is a nonopioid congener of levorphanol without analgesic or addictive properties but can cause hallucinogenic effects at very high doses.
Often is used with antihistamines, decongestants, and expectorants in combination products.
Definition
Dextromethorphan
Term
What are effective for the temporary acute management of rhinorrhea associated with common colds and allergies (decongestants)?
Definition
Topical sympathomimetics (alpha 1 mimetic- Oxymetazoline, Xylometazoline=longer acting, and phenylephrine)
Term
Topical decongestants should not be used for longer than _____ to prevent rebound nasal congestion.
Definition
3 days
Term
What oral decongestants have a prolonged duration of action but may cause more systemic effects, including nervousness, excitability, restlessness, and insomnia?

Why does it cause these effects?
Definition
Phenylephrine (Sudafed PE) Pseudoephedrine (Sudafed)

They are A1 agonists but in high doses it can get to the heart and effect B1
Term
What prevents ovulation and may inhibit fertilization or implantation (emergency contraceptive) when taken within 72 hours?
Definition
levonorgestrel
Term
What is a method for a clinician (the prescriber) to communicate with a pharmacist what he/she wants the patient to receive
Definition
Prescription (chart order in hospital)
Term
What should all be included in a prescription?
Definition
information about the drug to be administered
the formulation
the concentration
the reason it is being given
the duration of the prescription
refill information

(additional requirement for narcotics)
Term
What does this prescription mean?

Ampicillin 500 mg IV q6h x 5 days
Definition
500 mg of ampicillin delivered intravenously every 6 hours for 5 days
Term
What does this prescription mean?

Aspirin 0.6 g per rectum q6h prn temp over 101
Definition
rectal delivery (suppository-patient properly vomiting) that contains 0.6 grams of aspirin every 6 hours until temperature comes back down under 101
Term
1 grain (gr) = ___ g, ___ mg

15 gr = ___
Definition
1 grain (gr) = 0.065 grams (g), often rounded to 60 milligrams (mg)

15 gr = 1 g
Term
1 ounce (oz) = ___ mL
Definition
1 ounce (oz) by volume = 30 milliliters (mL)
Term
1 teaspoonful (tsp) = ___ mL

1 tablespoonful (tbsp) = ___ mL
Definition
1 teaspoonful (tsp) = 5 mL

1 tablespoonful (tbsp) = 15 mL
Term
1 quart (qt) = ____mL
Definition
1 quart (qt) = 1000 mL
Term
1 minim = ___ drop (gtt)
Definition
1 minim = 1 drop (gtt)
Term
20 drops = ____ mL
Definition
20 drops = 1 mL
Term
What do the following abbreviations stand for

ac
bid
cap
D5W
disp, dis
elix
g
gr
gtt
Definition
ac before meals
bid twice a day
cap capsule
D5W dextrose 5% in water
disp, dis dispense
elix elixir
g gram
gr grain
gtt drops
Term
What do the following abbreviations stand for

h
hs
kg
mEq, meq
mg
mcg
no
non rep
Definition
h hour
hs at bedtime
kg kilogram
mEq, meq milliequivalent
mg milligram
mcg, µg microgram (DO NOT USE mcg or ug) (write out microgram)
no number
non rep do not repeat
Term
What do the following abbreviations stand for?

OTC
OU
pc
PO
PR
prn
q
qam, om
qd
qh,q1h
Definition
OTC over-the-counter
OU both eyes
pc after meals
PO by mouth
PR per rectum
prn when needed
q every
qam, om every morning
qd every day (do not use) (write "daily")
qh, q1h every hour
Term
What do the following abbreviations stand for

q2h, q3h, etc
qhs
qid
qs
sup, supp
susp
tab
tbsp, T
tid
tsp
Definition
q2h, q3h, etc. every 2 hours, every 3 hours, etc.
qhs every night at bedtime
qid four times a day
qs sufficient quantity
sup, supp suppository
susp suspension
tab tablet
tbsp, T tablespoon (do not use)
(write out 15 mL)
tid three times a day
tsp teaspoon (do not use)
(always write out 5 mL)
Term
What is the schedule and potential for abuse for a drug that has No accepted medical use; lack of accepted safety as drug. (heroid, LSD)
Definition
Schedule I

high
Term
What is the schedule for a drug that is currently accepted medical use. Abuse may lead to psychologic or physical dependence. (cocaine, meperidine, morphine, oxycodone)
Definition
II
Term
What is the schedule for a drug that is currently accepted medical use. Moderate or low potential for physical dependence and high potential for psychologic dependence. (codeine combos, hydrocodone combos, secobarbital)
Definition
III
Term
What is the schedule for a drug that is currently accepted medical use. Limited potential for dependence (propoxyphene, butorphanol, midazolam)
Definition
IV
Term
What is the schedule for a drug that is currently accepted medical use. Limited dependence possible. (codeine)
Definition
V
Term
What are the requirements for schedule II prescriptions?
Definition
prescription must be ink
signed personally by prescriber
cannot be refilled
limit quantitiy
chronic use warrants suspension
Term
What are the requirements for schedules III and IV?
Definition
Prescriptions may be verbal can be refilled up to 5 times in 6 months
Term
What is required for prescription writing for opioids?
Definition
Must include patient's full address
write trade name, permit generic
make dosage units unalterable
no refills for schedule II
must include DEA #
Term
If a pregnant woman needs a drug in category B, would you prescribe it?
Definition
yes (A-no risk, B- no evidence of risk)
Term
If pregnant woman is very sick and needs a drug in category C, would you prescribe it?
Definition
yes (only if VERY sick and best drug available-risk cannot be ruled out, no evidence)
Term
If a pregnant woman is very sick and needs a drug in category D, would you prescribe it?
Definition
No (risk to fetus, X-definite risk)
Term
What are the 2 ways you can dose children?
Definition
Clark's rule (adult dose x weight/70kg)

by age (>12=100% ; 6-12=50% ; 2-6=25%)
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