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Over the counter drugs
April final
47
Pharmacology
Undergraduate 2
04/17/2012

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Cards

Term
Over the counter drugs
Definition

: Drugs which can be purchased 

without a prescription. Usually limited toxicity 

and self-limiting symptom

Term
Safety
Definition

Toxicity tests

– Prescription drugs

Term
Efficacy
Definition

More Difficult

– Use clinical trials  - Often not conducted. 

Term
Advertising
Definition
Cannot claim a cure
Term
Conditions for use of O T C
Definition

– Illness is mild

– If symptoms become worse,  see Physician

– Not more than 2 weeks

– Adverse events - Stop the drug

Term

Role of the Health Professional

Watch out for

Definition

Self medication may not allow       

diagnosis and condition worsens. 

-Drug interactions

-Toxicity  of  OTC products.

Term
3 characteristics of Acetylsalicylic acid
Definition

Analgesic 

• Antipyretic

• Anti-inflammatory.

Term
Mechanism of Acetylsalicylic acid
Definition

Inhibits cyclo-oxygenase I and II 

-Prostaglandins are involved in mediation of 

pain, inflammation and fever

Term
Toxicity of Acetylsalicylic acid
Definition

Gastric irritation, tinnitus (large doses),

Reyes syndrome in children with fever.-rare event. 

Allergic reactions are rare, but do occur –Tartrazine.

– Recent use to inhibit platelet aggregation.– Prevent 

thrombi formation – Low dose ASA.

Term

3 characteristics of Acetaminophen

 
Definition

Analgesic 

• Antipyretic

• NOT anti-inflammatory

Term
Mechanism of Acetaminophen
Definition
Inhibits Cyclooxygenase I and II
Term
Are acetaminophen and ASA equal in efficacy?
Definition
Yes
Term
Does acetaminophen irritate the GI system?
Definition
No
Term
Overdose of acetaminophen results in: 
Definition
Fatal hepatic Necrosis.
Term
Why is acetaminophen the drug of choice in children?
Definition
No Reyes syndrome
Term
In what way is Ibuprofen equal to ASA and acetaminophen?
Definition
Analgesic and antipyretic
Term
Is Ibuprofen anti-inflammatory?
Definition
Yes
Term
Which drug is new to the Canadian OTC market?
Definition
Naproxen
Term
What are the uses of Naproxen?
Definition
Main use is an anti-inflammatory but it can also be used as an analgesic and an antipyretic. 
Term

Cold preparations, anti-histamines

5 properties

Definition

Not a cure

May alleviate symptoms if there is an allregic component. 

May have anti-cholinergic properties

May cause drowsiness - older drugs

Minimal evidence for their use in colds. 

 

Term

Cold preparations

decongestants

Definition

Alpha agonsits - phenylephrine (local application) and pseudoephedrine (oral). There are many other compounds

Use in children under 6 is not approved

Cause vasoconstriction and hence decongestion. 

Doses may alter blood flow and pressure in the hypertensive. 

Doses too low to be effective. 

Local application can lead to rebound congestion. 

Term

Cough suppressants: 

Names

Dose

Efficacy

Definition

Codeine or dextromethorphan (drug of choice) - both effective cough suppressants, suppress the cough center in the medulla. 

Doses too low in preparations to be effective

Term
Expectorants
Definition

Glyceryl guaiacolate  limited value

– No evidence of efficacy

– Used to reduce viscosity of bronchial 

secretions ??

Term

Name 3 analgesics and antipyretics

How are they used best?

Definition

ASA Acetaminophen Ibuprofen

Best used as single agents

Term

Consumers Union - Recommended for Cold 

therapy.  

Definition

Rest,  fluids, Analgesics, antipyretics 

– Chicken soup ?  

Term
Antitussives
Definition

Suppress cough

– Codeine and dextromethorphan (preferred)

– Effective in sufficient  doses. Suppress the 

cough center – Receptors. 

– Best prep is Dextromethorphan as a single 

agent.

– Contain alcohol. 

– Large placebo response.

Term

Sleep aids

contain

Names

Definition

Contain an analgesic and a sedating 

antihistamine 

Acetaminophen and diphenhydramine  

– Large placebo effect.

– Change life style and sleep habits – more 

important than drugs.

Term
Hay fever preps - should combinations be used?
Definition
No
Term
What is the drug of choice with Hay fever preps?
Definition

An H1 antagonist is the drug of choice

– But do not alleviate all symptoms as histamine is not 

the only cytokine released.

Term
Decongestants and hay fever preps
Definition
Used with caution
Term
How may children respond to H1 antagonists?
Definition
Paradoxically with excitation
Term
Hay fever preps and tolerance
Definition
Tolerance may develop to sedative effects and to anti-hitaminic effect, change products. 
Term

For Treatment of minor skin inflammatory 

conditions.

Definition

Calamine lotion- cooling and temporary relief

– 0.5% hydrocortisone Ointment or cream

Most effective - will reduce inflammation, 

Term
UV C 200-290 nm
Definition
Absorbed by ozone
Term
UV B 290-320 nm
Definition

sunburn, tanning and 

cancer

Term
UV A 320-400 nm
Definition
Photosensitivity
Term
Function of sunscreen: 
Definition
Sunscreens scatter or absorb light
Term
SPF= 
Definition

Min erythema dose protected/min 

erythema dose unprotected.

Term

Laxatives 

• Stimulant Cathartics

Definition

Castor oil--- stimulate the intestinal muscle to 

increase contractions

– Increase secretion of water into stools

– Problems--- Excess loss of electrolytes and 

water  especially in the elderly

Term

Laxatives

Saline Cathartics

Definition

 

– Magnesium Sulfate   Retain water in fecal 

mass by osmotic forces.

Term
Which two classes of laxatives should not be used?
Definition
Stimulant and saline cathartics
Term
Drugs of choice in laxatives
Definition

Bulk Forming Laxatives

– Methylcellulose—form an emollient gel in 

water and maintain a soft stool.

Term
What are emollient laxatives and when are they used?
Definition

– Dioctyl Sodium Sulfosuccinate (Colace)  

function as a surface active agent to allow 

water to penetrate fecal mass. 

– Often used for drug induced constipation.

Term

Antidiarrheal agents

Adsorbents

Definition

ATTAPULGITE  (clay)--- Add bulk to the G. I. Tract  

and may adsorb bacterial toxin. (Kaopectate)

Term

Antidiarrheal agents

Loperamide 

Definition

Antidiarrheal

– Synthetic opioid – does not enter CNS

– Inhibits peristaltic activity- acts on opioid receptors in 

the GIT but not in brain.

– Often used for Traveler’s diarrhea

Term
Drug interactions with OTC
Definition

Antihistamines with CNS depressaants 

including alcohol.

• Decongestants and Monoamine Inhibitors

• ASA and anticoagulants.

• Aluminum antacids decrease absorption of 

some drugs.

• Mineral oil as a laxative decreases 

absorption of drugs.

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