Additional Chapter 4 Notes

time-tested

CRITERIA TO BE CLASSIFIED AS OTC:

• It is __________ if it is already used for a long period and had been proven to work well.

active ingredients

CRITERIA TO BE CLASSIFIED AS OTC:

• It has been recognized to contain a.____________ (the one responsible for therapeutic and pharmacologic effect) with proven safety and efficacy even without professional supervision, as proven by b.______________________ (refers to an untoward reaction to a medication ex: jaundice, anemia, rashes, kidney damage, nerve injury, blurred vision, damaged hearing)

a = ?

adverse drug reaction (ADR) monitoring

CRITERIA TO BE CLASSIFIED AS OTC:

• It has been recognized to contain a.____________ (the one responsible for therapeutic and pharmacologic effect) with proven safety and efficacy even without professional supervision, as proven by b.______________________ (refers to an untoward reaction to a medication ex: jaundice, anemia, rashes, kidney damage, nerve injury, blurred vision, damaged hearing)

b = ?

bioequivalence

CRITERIA TO BE CLASSIFIED AS OTC:

• It is neither with ____________________ (the biochemical similarity of 2 or more drugs that share the same active ingredients and the desired outcomes for patients) problem nor classified as prohibited or regulated by DDB (Dangerous Drug Board) or as an internationally controlled drug product by the International Narcotics Control Board (INCB)

Patient Counseling

• process where healthcare professionals like pharmacists right after dispensing a product provide patients with essential information and guidance about their medications, about their conditions, and recommended lifestyle changes to ensure proper and safe use

• primary goal or objective is to improve medication adherence, patient understanding, self-management of their health, and overall treatment outcomes while preventing adverse drug effects and ensuring patient safety

Patient Medication Profile

• comprehensive record of the medications that a patient is currently taking

• includes prescription drugs, OTC drugs, dietary supplements, vitamins, and herbal remedies

Drug-drug interaction

a phenomenon where 2 or more medications taken together react with each other and alter the effectiveness or safety of one or more of them

Drug-food interaction

when food, beverages, or dietary supplements change how a drug affects the body, potentially altering its effectiveness or causing side-effects

Drug-disease interaction

occurs when a medication, or one condition either causes harmful effects or exacerbates a pre-existing disease in a patient like how some drugs raise blood pressure; dangerous for someone with already high blood pressur

bactericidal

antibacterial agents or substances that kill bacteria

bacteriostatic

antibacterial agents that prevent them from growing & reproducing

Alexander Fleming

introduced antibiotics in 1920, but developed in 1948

Antibiotic Resistant

• When bacteria have evolved to survive and multiply even when exposed to antibiotics that were once effective in killing them or stopping their growth

• previously treatable bacterial infections become very difficult and impossible to treat with standard antibiotics, making the infections longer lasting, more complicated, and potentially fatal

overuse and misuse

The _____________ of antibiotics are the primary drivers of antibiotic resistance and development of drug resistant pathogens

Presumptive Diagnosis

made based on history or clinical science, pattern of mortality and water temperature, especially if there is a history of the disease in that specific area

Etiology

investigation of the cause or origin of the disease

gram stain

Example of Etiology:

a. ____________ is a test that checks for bacteria at the site of a suspected infection such as your throat, lungs, genitals, skin wounds, or certain body fluids such as blood or urine.

b. _________ is to find germs such as bacteria or fungus that can cause infection. 

a = ?

culture

Example of Etiology:

a. ____________ is a test that checks for bacteria at the site of a suspected infection such as your throat, lungs, genitals, skin wounds, or certain body fluids such as blood or urine.

b. _________ is to find germs such as bacteria or fungus that can cause infection. 

b = ?

sensitivity test

• this checks to see what kind of medicine, such as antibiotics, will work best to treat the illness or infection

• should be done before antibiotics will be given to see if the patient is allergic to antibiotics containing penicillins

Causative microorganism

pathogenic microorganisms that cause disease, infections, or other conditions like bacteria, fungi, viruses, parasitic agents, or germs

bacteria

Common infectious diseases caused by ________ include: salmonella, tuberculosis, whooping cough or pertussis, chlamydia, or gonorrhea

viruses

Common infectious diseases caused by ____________ include: common colds, flu/influenza, COVID-19, stomach flu or gastroenteritis, hepatitis, or respiratory syncytial virus (RSV).

fungi

Common infections caused by _________ include: candida, like in yeast found in the skin, cryptococci or cryptocosses, aspergillosis, histoplasmosis, blastomycosis, or pneumocytis

pharmacodynamics

Drug Factors:

• the study of what the drug does to the body

pharmacokinetics

Drug Factors:

• the study of what the body does to the drug

Adverse effects

Drug Factors:

• harmful or abnormal results

• antibiotics: diarrhea, nausea, and vomiting, or dizziness

• interactions of these antibiotics are those that involve other drugs with low toxicity and efficacy ratio, which include anticoagulants like warfarin, anticonvulsants like phenytoin and phenobarbital, oral antibiotics, or oral antidiabetic drugs like tolbutamide

Drug-drug interactions

Drug Factors:

• experience unexpected side-effects example; mixing a sedative and an antihistamine, which slows reactions and makes driving a car or operating machinery dangerous

Topical antimicrobials (antiseptics)

AVOID THE USE OF:

• include bacitracin, mupirocin, gramicidin, fusidic acid, and gentamicin

Antimicrobial combinations

AVOID THE USE OF:

• amoxicillin + clavulanic acid which includes the beta-lactam amoxicillin and another example is trimethoprim-sulfamethoxazole combination

• considered for the treatment of serious gram-negative infections caused by Enterobacter cloacae or Pseudomonas aeruginosa and Serratia marcescens and certain gram-positive infections caused by Enterococcus species and Staphylococcus species

Prophylactic Antibiotics

AVOID THE USE OF:

• antibiotics you take to prevent infection

• 3 used in adult surgical prophylaxis, where weight-based dosing is recommended: cefazolin, vancomycin, gentamicin

Validated Prescription

prescription legal under all applicable laws issued to the person being tested by licensed healthcare providers authorized to issue such as prescription used for its intended purpose and as prescribed

Warfarin + Bactrim

EXAMPLE OF DRUG-DRUG INTERACTION:

• Bactrim contains sulfamethoxazole and trimethoprim that inhibits the cytochrome 2C9 - a primary enzyme that the body uses to break down warfarin. By blocking this enzyme’s action, concentration of warfarin will go up and the international normalized ratio will rise with it. The normal blood, when you take coagulants, when combined with warfarin and bactrim, will go up the normal range of viscosity.

Amiodrane + Levofloxacin

EXAMPLE OF DRUG-DRUG INTERACTION:

• corrected heart rate prolongation is a significant risk with amiodarone when used alone. If levofloxacin is added, the risk further increases

Phenytoin + Fluconazole

EXAMPLE OF DRUG-DRUG INTERACTION:

• Fluzonazole can significantly increase the concentrations of phenytoin and ultimately cause toxicity if not monitored appropriately

Ciprofloxacin + Calcium

EXAMPLE OF DRUG-DRUG INTERACTION:

• risk is lowering the absorption of ciprofloxacin when calcium is co-administered with it. Binding interactions are very common in practice. This is particularly true of some antibiotics like quinolone and tetracycline antibiotics.

non-steroidal anti-inflammatory drugs (NSAIDS) + warfarin (anticoagulant)

EXAMPLE OF DRUG-DRUG INTERACTION:

• OTC availability of NSAIDs to patients on anticoagulants need to be constantly reminded that they should not be taking NSAIDs that can significantly increase the risk of gastrointestinal bleeding when coupled with anticoagulants

2 years

Ordinary prescriptions are recorded in prescription books and kept for a.________, while dangerous drugs are kept for b.___________.

a = ?

1 year

Ordinary prescriptions are recorded in prescription books and kept for a.________, while dangerous drugs are kept for b.___________.

b = ?

Vit. C

a. Not taking antibiotics and acidic substances such as _________ at the same time is recommended to avoid reducing the effectiveness of the drug, causing insufficient drug dosage, giving bacteria the opportunity to change, causing resistance.

b. _______________ like citrus fruits and juices like orange and grapefruit or soda, chocolate, tomato products, of high acid content, which could decrease how much medicine is absorbed into your system for certain antibiotics.

a = ?

High acid foods

a. Not taking antibiotics and acidic substances such as _________ at the same time is recommended to avoid reducing the effectiveness of the drug, causing insufficient drug dosage, giving bacteria the opportunity to change, causing resistance.

b. _______________ like citrus fruits and juices like orange and grapefruit or soda, chocolate, tomato products, of high acid content, which could decrease how much medicine is absorbed into your system for certain antibiotics.

b = ?

Maintenance Drugs for High Blood Pressure

Examples:

• ACE inhibitors: benazepril, captopril/capoten, enalapril/vasotec, lisinopril, quinapril, fosinopril, ramipril, trandolapril

Maintenance Drugs for High Cholesterol

Examples:

• atorvastatin/lipitor, fluvastatin/lescol, lovastatin, pitavastatin/livalo, pravastatin/pravachol, rosuvastatin/crestor, simvastatin/zocor

Maintenance Drugs for Diabetes

Examples:

• sulfonylureas, meglitinides, metformin/biguanide, thiazolidinediiones/TZDs, alpha-glucosidase inhibitors (AGIs), dipeptidyl peptidase/DPP, bile acid sequestrants, dopamine agonists

Total Parenteral Nutrition (TPN)

Sterile Products:

• usually prepared in hospitals, it is administered through a needle or catheter that is placed in a large vein that goes directly to the heart called a central venous catheter

• It is a mixture of separate components which contains lipid emulsions, dextrose, amino acids, vitamins, electrolytes, minerals and trace elements.

Dextrose

starch based sugar made from refined corn, rice, or wheat

Quality control

• guidelines to make a high quality product and avoid defects

• product’s actual review during production to ensure that it is created to the highest standard

aseptic technique

set of practices that protects patient associated infections and protects healthcare workers from contact with samples like blood, body fluids, and body tissues

anteroom

clean area intended for personal use

buffer room

area where the laminar airflow workbench is found

Storage instruction

• takes into account elements like temperature, light, humidity

• provide information to the consumer on how they are going to store the pharmaceutical product, specifically if normal, room or other temperature. Can also be phrases like “Keep refrigerated

ISO Class 5 PEC

• high efficiency cleanroom provide significant particle protection for application requiring low particle concentrations

• requires numerous air changes allowing a limited number of maximum particle concentration limit per room

• conditions in the air particle count is no greater than a total of 3520 particles of 0.5 micrometer and larger per cubic meter of air that is supplied by HEPA filter

Examples of opium and its derivatives

heroin and morphine

Examples of Coca plant and its derrivatives

cocaine, alpha and beta eucaine, hallucigenic drugs like mescaline, acid diethylamide

Stethoscope

Example of Medical Devices:

• used to listen to internal body sounds; blood pressure monitoring

Electrocardiogram (ECG)

Example of Medical Devices:

• which records the electrical signal from the heart for different heart conditions

Electroencephalogram (EEG)

Example of Medical Devices:

• measures electrical activity in the brain with a small metal disc

Ultrasonography

Example of Medical Devices:

• uses sound waves to make pictures of organs, tissues, and other structure inside your body

X-Ray Machines

Example of Medical Devices:

• electromagnetic wave of high energy and very short wavelengths which is able to pass through many materials opaque to light

physical, mechanical, or chemical

The Medical Devices’ primary action is not through pharmacological, immunological, or metabolic means, but through other means like _____________ functions.

syringes, hypodermic needles. applicators, drug test, facemask, gloves, surgical sponges and catheters

single-use medical devices

ultrasound and CT scanners

example of Imaging Medical Devices

anesthesia medicines, patient monitors, or hemodialysis machines

Examples of Medical Equipment

Class 1 devices

Different classification of medical devices:

• not intended for use in supporting or sustaining life or for substantial importance in preventing impairment to human health

• may not present a potential unreasonable risk of illness or injury

elastic bandages or Inima Kids

example of Class 1 device

Class 2 devices

Different classification of medical devices:

• moderate to high risk to the patient or user

• 43% of medical devices fall under this category

wheelchairs and pregnancy test kit

Example of class 2 device

Class 3 devices

Different classification of medical devices:

• usually sustain or support life, like implanted or present potential, unreasonable risk of illness or injury

• 10% of medical devices fall under this category

pacemakers and implanted prosthetics.

examples of class 3 devices

Sodium Lauryl Sulfate (SLS)

COSMETICS:

• common sulfate that you spot on the label of your shampoos

parabens

COSMETICS:

• Chemicals under the methyl, propyl, and butyl are classes that fall under _________ (used as preservatives)

polyethylene glycol (PEGs)

COSMETICS:

• spotted as numbers like 100, 120, 30-37, etc

formaldehyde

COSMETICS:

• Formaline, formaldehyde, glyoxol, and chloroform indicate ______________

Diethalamine (DEA)

COSMETICS:

• used in skin care products 

drying alcohols

COSMETICS:

• Ethanol, methanol, and denatured alcohol are all ________________

petrolatum ingredients

COSMETICS:

• if an ingredient ends with -eth, they are ___________________

FD&C

COSMETICS:

• artificial dyes

abortus

Abortifacient came from the Latin words a._________________ (miscarriage) and b. ______________ (making)

a = ?

facient

Abortifacient came from the Latin words a._________________ (miscarriage) and b. ______________ (making)

b = ?

Abortifacient

causes miscarriage ranging from herbs to prescription medication

empty stomach

Anti-TB medication should be taken on an a.____________________.

Taken b.__________________ or c.________________ a meal, with a full glass of water.

a = ?

1 hour before

Anti-TB medication should be taken on an a.____________________.

Taken b.__________________ or c.________________ a meal, with a full glass of water.

b = ?

2 hours after

Anti-TB medication should be taken on an a.____________________.

Taken b.__________________ or c.________________ a meal, with a full glass of water.

c = ?

Category 2a

Instead of 5 months, HRE will be recommended for 9 months

30 minutes to 48 hours

In the ___________________ after eating a food that you are intolerant to, you will experience uncomfortable symptoms such as nausea, diarrhea, constipation, gas, or bloating.

Peripheral neuropathy

happens when the nerves that are located outside the brain and spinal cord are damaged. This condition causes weakness, numbness, and pain usually in the hands or feet

Arthralgia

describes joint stiffness, among its many causes are overuse, sprains, injury, gout, tendonitis, or a number of infectious diseases including rheumatic fever and chicken pox

Oliguria

A medical term for low urine output/how much is the volume of your urine. In the case of adults, this means less than 400 - 500 mL or around 2 cups of urine per 24 hours. The numbers depend on weight in terms of children and infants

Thrombocytopenia

condition that occurs when the platelet count in your blood is too low

Vitamin B6/Pyridoxine

Water-soluble vitamin found naturally in many food, it is also added in food or supplements.

Hyperuricemia

elevated uric acid level in the blood, The normal upper limit is 6.8 mL/dL, anything over 7 mL/dL is considered saturated and symptoms can occur

Nephrotoxicity

process that occurs when kidneys are damaged by a drug, chemical or toxin resulting in possible chronic kidney disease

Medication Adherence

defined by WHO as the degree to which the person’s behavior corresponds with the agreed recommendations from healthcare providers

Biotin

Examples of Oral HR:

• water-soluble vitamin found naturally in some food and supplements

• plays a vital role in assisting enzymes to break down fats, carbohydrates, proteins, and food

Calcium

Examples of Oral HR:

• most abundant mineral in the body

• found in some food, present in some medicines such as antacids, and available as dietary supplements

• Allows normal bodily movements by keeping tissues strong and flexible

Castor oil

Examples of Oral HR:

• well-known for its laxative properties, but can also be used for uterine contractions, lipid metabolism, antimicrobial activity, and stimulative laxative

Cod liver oil

Examples of Oral HR:

• contains fatty acids that prevent blood from clotting easily. This fatty acid also reduce pain and swelling

Cholecalciferol

Examples of Oral HR:

• medication used to treat and manage osteoporosis and Vitamin D defieciency

Cyanocobalamin

Examples of Oral HR:

• form of Vitamin B complex (Vitamin B12)

• used to treat Vitamin B12 deficiency, except in the presence of cyanide toxicity

Folic acid

Examples of Oral HR:

• form of folate (a Vitamin B complex that everyone needs)

• protects unborn babies against serious birth defects

Oral rehydration

Examples of Oral HR:

• used to treat dehydration caused by diarrhea