Studied by 16 peopleHow do you convert pounds to kg
1kg = 2.2 pounds
What is the best dosage form for children
-Oral syringes with metric flow markings are preferred
-Use mL ONLY
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Acetaminophen dosing for children under 12
10-15 mg/kg every 4-6 hours as needed. Max: 2400 mg in 24 hours
Ibuprofen dosing for children under 12
5-10 mg/kg every 6-8 hours as needed, max: 1200 mg in 24 hours
Acetaminophen suppository dosage form for kids
80 mg, 120 mg, 325 mg
Acetaminophen oral suspension dosage form for infants and children
160mg/5mL
Ibuprofen oral suspension dosage form infants
50mg/1.25mL,
Ibuprofen oral suspension dosage form in children
100mg/5mL
What OTCs don’t need tamper resist packaging
dermatological, dentifrice, insulin or lozenge product
Drug Definition
Prevents, mitigates, cures, treat a specific disease
Are dietary supplements regulated as drugs
No
-No criteria for safety data
What is a health claim
FDA approved
Ex: “Adequate calcium and vitamin D as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life”
-Specific how the product helps a disease
What is a Structure-function claim
Doesnt need to be FDA approved
Ex. “support healthy cholesterol levels”
Ex. “may reduce high”
-How a nutrient or ingredient effects of the structure/body
What is required in the OTC drug label
-Name
-Address of manufacturer
-Net contents
-NDC
-Cautions and warnings
What is required in the OTC directions label
-Dosage for use and persons
-Frequency of dosing
-Duration of dosing
-preparation (ie.shake)
-Timing of dosing
What is included in the OTC Drug facts label
-API
-Purpose
-uses/indication
-specific warning & contraindications
-Questions? And phone number
-Directions
-Inactive ingredients
What are general OTC Labeling requirements
-Label on container and box
-Package insert and everything else counts as labeling
-The FDA must approve all text
What OTC medication are we concerned about for adults that have heart conditions
NSAIDs
What OTC medication are we concerned about for adults that have Delirium,dementia, cognitive impairment
1st generation antihistamines, H2 receptor antagonist
What OTC medication are we concerned about for adults that have falls, fractures
Proton pump inhibitor
What OTC medication are we concerned about for adults that have Gastric, duodenal
ASA (aspirin) > 325mg/day
NSAIDs
What OTC medication are we concerned about for adults that have Kidney dysfunction
NSAIDs
What OTC medication are we concerned about for adults that have Lower urinary tracy symptoms, BPH (large proastate gland)
1st generation antihistmatines
Anticolonergeics
What OTC medication are we concerned about for adults that have Osteoarthritis
NSAIDs: Renal failure, HPB, increase bleeding anticoagulant, cardiovascular disease
-*95% older adults who take NSAID develop PUD
What are OTC treatment options for Rhinorrhea
saline nasal spray
decongestants (Topical: baphazoline, oxymetazoline, phenylephrine, propylhexedrine; Oral: Pseudoephedrine)
1st generation antihistamine (Brompheniramine, chlorpheniramine, diphenhydramine)
When to follow up with PCP for Rhinorrhea
-sore throat>several days, fever/HA or nausea/vomitting
-symptoms worsen during nonrx.
-thick & colored nasal secretion persist,
Temp higher than 101.5, SOB, chest congestion, wheezing, rash, ear pain
Zinc side effects
Nausea, upset stomach. Diarrhea, irritation of oral mucose, distortion of tase, copper deficiency
When to start zinc use
within 24 hours of cold symptom onset
Zinc dosing
1 lozenge (13mg) every 2 hours while awake, initiate at first sign of cold
Zinc positive effects
reduces duration and severity of cold
Honey effectiveness
-Honey is better than placebo or no treatment
-Honey is about as effective as dextromethorphan
-Honey>diphendyhramine
What age groups can you use honey in and what dose
-Do not use honey in children under 1 year because of risk of botulism
-2.5-5mL in kids
-No studies in adults: start with 5mL, then 10mL, then stop
Honey positive effects
decrease in cough frequency
OTC drugs for Nonproductive cough
Oral antitussives
-Codeine
-Dextromethorpan
-Diphenhydramine
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Topical antititussives
-Camphor
-Menthol
OTC drugs for Productive cough
Expectorants: Guanifensin (limited efficacy, drink water instead)
Treatment course for acute cough
-Little evidence that oral antitussives and expectorants are effective at treating acute cough
-Start with nondrug measures first
What is a fever
elevation in core body temp above the daily range for an individual
Rectal fever temp
100.4; preferred age older than 6mo.
Oral fever temp
99.; avoid pt who are hyperventilating, not for children under 3 years
Axiliary fever temp
99.3; variation due to inappropriate placement
Tympanic fever temp
100; accuracy depends on proper placement
Nondrug measures for fever
Adequate fluid intake
-children increase by at least 1-2oz per hour
-adults: increase by at least 2-4oz per hour
Sponging or bath
-avoid isopropyl or ethyl alcohol due to alcohol toxicity
-Avoid ice water bath (induces shivering with causes increase in body temp)
-Lightweight clothing, remove blanket, maintain comfortable room temp
Fever exclusions for self care
-patient older than 6mo. With rectal temp 104+
-under 6 months with rectal temp 101
-risk for hyperthermia
-HIV, cancer
-CNS damage
-Children w/history of febrile seizures
-Fever that persist beyond 3 days with or without treatment
In children: if rash, refuse to drink fluid, lethargy, vomiting
Fever OTC treatments
Ibuprofen
Acetminophen
Ibuprofen dosing for a child
5-10mg/kg every 6-8hours
Max 4 doses daily
Avoid if less than 6 month old
Use 3 days max
-100mg/5mL
-50mg/1.25mL
Acetaminophen dosing for a child
-10-15mg/kg every 4-6 hours
-use 3 days max
-160mg/5mL liquid formulation
-max 5 doses per day
Mild eye irritation Drug and Nondrug measures
NonDrug:
-Cool, moist compress
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Drug
-Artificial tears/ointments
-Zinc sulfate solution
Corneal Edema First, second & third-line agents & regimens
Sodium Chloride Solution:
1st line: 2% solution 4x day
2nd line: 5% ointment @ night
3rd line: switch to 5% saline solution 4x daily & continue ointment
Allergic conjunctivitis First-line and other therapy
Ocular Lubricants are first line
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Other:
Ocular
Decongestants:Phenylephrine, Naphazoline, tetrahydrozoline, oxymetazoline, bromonidine
Antihistamines: Pheniramine , Ketotifen, Olopatadine
decongestant/antihistamine combination
Antihistamine-mast cell stabilizer
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Oral antihistamines
Combination eye+ oral
Eyedrop administration steps
-You can refrigerate the solution before administering it (the cold drops on the eye surface are easily detected) DO NOT refrigerate suspensions
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-Wash hands thoroughly and wash areas of the face around the eyes. Contact lenses should be removed unless the product is designed specifically for use with contact lenses
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-Tilt head back. When administering drops to children, have the patient lie down before placing drops in the eyes
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-Gently grasp lower outer eyelid below lashes and pull eyelid away to create a pouch
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-As soon as the drop is applied, release the eyelid slowly. Close your eyes gently for 3 minute and position the head downward as though looking at the floor. Minimize blinking or squeezing of the eyelid
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-Use a finger to put gentle pressure over the opening of the tear duct
\n -If multiple medications are indicated, wait at least 4 minute before instilling the next eye drop preparation.
Note
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