EOY Self-Care

Top 5 categories of OTC’s

Respiratory, oral care, GI, internal analgesics, eye care

Pharmacist care plan

Collect, assess, plan, implement, and follow up

SCHOLAR-MAC

A tool used by pharmacists to gather patient information, including Symptoms, Characteristics, History, onset, Location, aggravating factors, remitting factors (what makes it better), Other medications, Allergies, and conditions.

Colds and Allergies

Common conditions affecting the respiratory system, often treated with OTC medications. Symptoms include sneezing, congestion, and runny nose.

Allergic rhinitis symptoms

Bilateral - increasingly gets worse after awakening

Rhinorrhea - Runny nose

Itchy nose, throat, and eyes

Nasal congestion

Sneezing

Non-allergic rhinitis

Unilateral; constant day and night

Little to no sneezing

Rhinorrhea; posterior, watery or thick, and/or mucopurulent

No Pruritus

Sneezing/rhinorrhea/itching

INCS (preferred) or oral antihistamine

Sneezing/rhinorhea/itching + congestion

INCS or AH + decongestant

Exclusion for treatment

children >2 → children under 2 should be referred to physician for differential diagnosis

Symptoms of non-allergic rhinitis

Asthma, COPD, other respiratory disorders

SOB/Chest pains

AIDs or chronic immunosuppressants

Otitis media, sinusitis, bronchitis, or other infection

Non-pharmaceutical remedies

Pesticide for cockroaches

Air ventilation system

Wash sheets every week

Wash pets every week

Saline - neti pot to rinse nostrils

Avoid activities that involve disrupting dead plants

Be aware of air quality and plan outdoor activities when air pollution is low

Pharmaceutical remedies

Antihistamines

INCS

Decongestant

Pregnancy

Cromolyn → first choice, comp w/ lactation

Fluticasone → “prob” comp w/ lactation

Antihistamines → Diphenhydramine (highly sedating) and chlorpheniramine (Moderately sedating)

Children

Mast stabilizer: Cromolyn

INCS: Fluticasone furoate 2+

AH: Loratadine (non-sedating)

Top. DECONG. Oxymetazoline con 0.025%

Antihistamines Population avoids

Sedative → avoid in elders and children

Pregnancy → low risks

Lactation → contraindicated

Colds

Viral infections upper respiratory tract

Cold symptoms

Low energy

fatigue

aches

chills

headache

sore throat

sneezing, congestion, rhinorrhea

aches

fever

Last 1-2 weeks

Exclusions for treatment

Fever >100.4F

chest pain

SOB

Cardiopulmonary issues (asthma, COPD, CHF)

AIDS/Chronic immunosuppressants

Frail pts → advanced age

</= 3 mos

non-pharmaceutical remedies

increased fluid intake

steamy showers, humidifiers

Hot teas and warm chicken soup can sootheand rest to support recovery.

Breathe right nasal strips - enlarge anterior of nasal passage for temporary nostril relief

upright positioning to enhance nasal drainage

children→ bulb syringe to ease out fluids for decongestion

Saline nasal spray for mucous relief and saline gargles to soothe throat irritation.

Pharmaceutical

Decongestants

Local Anesthetics: temp relief of sore throat

Systemic Analgesics: pain relief/fever

Antipyretics: Fever

Decongestants

Oxymetazoline 0.05%/0.025%

Phenylephrine

Tetrahydrozoline

Oral decongestants considered “doping” product in sports

Local Anesthetic (2+)

Benzocaine

Dyclonine

Hydrochloride

Systemic analgesics

Aspirin

Acetominophen

Ibuprofen

Naproxen

Pregnancy

Top. DECONG - Oxymetazoline 0.05%

Aspirin: low doses no risk/high doses low risk

Avoid max strength or long-lasting drugs

Avoid combination drugs

Local anesthetics have risks but benzocaine menthol comp with breastfeeding

Special Pop.: kids

Avoid combination drugs

Avoid therapy children <2

Cough

Acute: <3 wks; common cold, acute sinusitis, may indicate underlying conditions such as asthma or COPD, bronchitis, irritants

subacute: 3-8 weeks; Post-infection, CHF w/ fluid overload

Chronic: >8 weeks; UAVS, asthma, GERD, COPD, chronic bronchitis

Cough; Antitussive

Unproductive

dry, hacking: viral, GERD, cardiac, meds cough, or irritation of the throat.

Non-Pharm Antitussive

Salt gargles, soup, honey tea - sore throat, relieve coughing symptoms

Pharm methods antitussives

Codeine - contrain CNS depressants and CYP inhibitors/inducers

dextromethorphan - ContraIn CYP inhibitor

Diphenhydramine - may cause excitement; contrain High BP, thyroid issues, enlarged prostrate, ulcers, glaucoma

Chlophedianol - may cause excitement, sedation

Pregnant: coughs antitussives

Codeine: not in 1st trimester

Diphenhydramine: commonly used during pregnancy; excretion through breast milk can cause excitation in baby

Old ppl: Coughs antitussives

Start w/ lower dose and work way up

can cause excitability

Kids: coughs antitussives

Nonprescription cough/cold medicines should not be use <2

Cough: protussives

Productive

wet, chesty removing secretions

Non-Pharm protussives

Fluids: both warm and water to help thin mucus and promote drainage.

Humidifiers and steam inhalation to ease congestion.

These methods facilitate mucus clearance.

Pharm Methods; Protussives

guaifenesin - a expectorant that helps loosen mucus and phlegm in the airways.

guaifenesin: special populations

Pregnant: consult with/ doctor

Breastfeeding: consult with doctor before use.

Children: 4+

Elderly: generally safe

Fever

A temporary increase in body temperature, often due to infection or illness. It is a natural immune response that helps the body fight off pathogens.

Exclusion for treatment

pt >3 w/ rectal temp >/=104.0F

Pt <3 w/ rectal temp 100.4 F+

Children w/ repeated diarrhea

Child w/ stiff neck

Fever: Treatment plan

Re-take temp → non-drug measure ± antipyretics

Fever: Non-pharm therapies

Hydration

sponging/bath not routinely rec. for temp below 104

maintain comfortable room temp

wearing lightweight clothes

Fever: Pharm methods

ibuprofen: 6mos+; adults - 200 to 400mg every 4-6 hrs

Acetaminophen

Fever complications

Febrile seizures

hyperpyrexia

Headaches

can be caused by various factors such as tension, dehydration, or migraines. Treatment may include rest, hydration, and over-the-counter pain relievers.

HA: Treatment plan

wean off analgesic use if currently being used for HA

Diagnosed migraines → if they have underlying health conditions use acetaminophen; if no underlying conditions, use NSAIDs/solicylate, acetaminophen, etc

HA: Exclusion for treatment

Stiff neck

Severe and/or consistent HA

Age <8

Migraine symptoms but not yet diagnosed

Alcoholic

HA: Non-pharm methods

stress management

Physical therapy

massage-therapy

Chiropractors

adjunctive therapy

Maintain regular sleeping schedule

eating

exercising

cognitive therapy

Tension-Type HA

Bilateral

Diffuse ache, tightening, pressing, constricting

mild-moderate

Begins gradually

last 30 mins to 7 days

aggravated by stress, anxiety

May also exp seal tenderness, neck pain, and muscle tension

Tension type HA

acetaminophen or NSAIDs at onset

Migraine HA

Unilateral

throbbing, pulsating

moderate-severe

sudden

Last 4-72 hours

Aggravated by light, sound, and physical activities

May exp nausea, vomitng, aura

Migraine: Meds

Triptans

NSAIDs → take at onset to abort mild to moderate migraine HAs

Combo (triptan+acetaminophen or NSAID)

Sinus HA

Face, forehead, or periorbital area

pressure behind eyes or face, dull and bilateral pain

mild-severe

Begins simultaneous with sinus symptoms

Lasts days (resolves with sinus issues)

Aggravated by nasal congestion

May exp nasal congestion/discharge

Sinus HA: Meds

Oral/nasal decongestants

Analgesics

Acetaminophen

Analgesic/antipyretic

Contrain with hepatoxicity, liver disease

Ibuprofen & naproxen

nonsalicylate NSAIDs

analgesic/antipyretic

Aspirin

Salicylate NSAD

HA: Pregnancy

Acetaminophen recc

NSAIDs generally not recc

Low does aspirin works

HA: kids

Acetaminophen preferred

Ibuprofen preferred

age 2+

Avoid aspirin

Injury

Damage to body tissues or structures caused by external forces, often requiring medical attention or self-care measures.

Joint/muscle injury or pain from overexertion

RICE therapy and oral/top. analgesic

Top. analgesics - good for knee and hand arthritis

Diagnosis of osteoarthritis

Initiate non drug and drug therapies

Injury: Top, products

Diclofenac

Lidocaine

Counterirritants: methyl salicylate, menthol, methyl nicotinate, capsicum preparations

Nausea & vomiting

common side effects of various medications, often requiring supportive care and antiemetic treatments.

N/V causes

GI tract disorders

CNS disorders

Other: cardiac diseases, diabetes, disease

N&V treatment plan Adults

Motion sickness → non-pharmacist then AHs

Pregnancy sickness → Non-pharm. methods, vitamin B6 and doctor if no improvements

Related to food → adjust diet, hydration; then H2RAs, antacids, etc

Drug-induced → recc. talk to HP

Non-pharm N/V

Avoid reading while moving

Focus line of vision straightforward

Avoid excess food/et before travel

avoid areas of excessive heat

avoid iron containing supplements

sugar → 5:1 water:cola syrup ratio

ginger

breathing exercises

acupressure techniques (bands, etc)

N&V treatment plan kids

Motion sickness → non-pharm then AHs

Dehydration; restlessness/irritability, tachycardia, weight loss, dark urine, sunken fontanellei→ medical referral

episodic N/V → phosphorated carbohydrate

N/V Motion sickness meds

sedative/anticholinergic

meclizine

cyclizing - bonine for children

diphenhydramine

dimanhydrinate

Doxylamine

Pyridoxine

N/V: Overeating

antacids

H2 blockers

bismuth subsaliylate → pepto bismol

phosphorylated carbohydrate solution: 15-30 ml every 15 min no more than 5 doses an hour; 2+ 5-10ml every 15 min

N/V pregnancy; non-pharm.

Multivitamins at least one moth b4 preg

eat plain foods → dry toast, crackers

get up from bed slowly

eat small meals

carbonated drinks/fruit juice

no greasy foods

N/V: Pregnancy; meds

Doxylamine

1st line → Pyridoxine; high doses inhibit lactation

Bismuth subsalicylate; for lactating

ginger → warfarin (avoid)

AHs: dimenhydrinate, diphenhydramine

N/V old ppl

careful with AHs

sugar solution

avoid acupressure bands

N/V: rehydration

pedialyte

sugar drink ratio 3:1

<10kg → 60-120 ml after vomiting episode

for >10kg → 120-240 ml after vomiting episode

Kids → 50-100ml/kg per 3-4h

try to replace 30-50% fluid lost w/n 24h → 15ml every 5 min for teens+; 5 ml for kids → start 10 min after episode

Constipation - defined

Bowel movement that differs from normal

Constipation: Pathophysiology

Primary constipation and secondary constipation

Primary constipation

Slower than normal transit or defecatory disorder

Secondary constipation

Structural abnormality, neurological, psychological obstruction

Constipation - causes

insufficient fiber

not using bathroom when body says

opioid use

structural → injury, tumor

Psychological → depression, stress

Lack of exercise

Constipation non-pharm

Fiber intake → 25/d for females and 38/d for males; incorporate moe fruits and grains

Exercise

Hydrate

Establish regular bathroom times

Constipation - pharm

bulk laxative

Hyperosmotic agent

Emollient

Saline laxative

Lubricant agents

Stimulant agents

Bulk laxative

Fiber product

12-24 hrs

6+

Methycellulose

Psyllium

Polycarbonil → calcium containing avoid in pts with renal disease

hyperosmotic

Brings water into colon via osmosis

Glycerin → 15-30min, 2+

PEG3350 → 12-24h

Emollients

Preventive measure, take with opioids

2+

If taking when constipated already → take with stimulant agent

Docusate

Saline Laxative

Usually for procedures

hydrate

Magnesium sulfate

Magnesium hydroxide

Stimulant agents

intestinal motility

Senna

Bisocodyl

Constipation: Kids

>2 yrs → 5mg/d fiber

6-12 yrs → bulk laxative, decussate, magnesium hydroxide

Constipation: Old

Bulk

PEg3350

Constipation: Pregnant

Bulk

Diarrhea: Exclusions for treatment

children with signs of dehydration, severe abdominal pain, pregnant, persistent vomiting, chronic diarrhea

Diarrhea: Pharm treatments

Loperamide

Bismuth subsalicylate

Digestive enzymes

Diarrhea: ORS

<10kg: 60-120mL per vomiting/diarrhee

>10kg: 120-240mL per vomiting/diarrhea

50-100ml/kg of ORS over 4-6 hours to rehydrate

Diarrhea: Special Population

Kids → ORS

Old/PRegnant → refer to HCP

Heartburn: Exlcusions

frequent >/+3mos

Difficulty eating solid foods

Unexplained weight loss

Stomach pain

SOB/chest pains

Heartburn Pharm treatment: Mild

OTC Histamine 2 Receptor antagonist (H2RA) such as ranitidine or famotidine and antacids

Heartburn Pharm treatment: Moderate

High dose H2RA and antacids

Heartburn pharmacy treatment: >/+ 2 weeks

Proton pump inhibitor for 14 days if improvement seen take every 4 mos and use H2RA as needed

Heartburn: Pregnant

Magnesium

Famotidine comp

Heartburn: Kid

Antacids

famotidine

Heartburn: Old

Avoid H2RAs

Anorectal: Exclusions

<12 yrs

Familial history colon cancer

bleeding

non-hemorroidal

GI disease conditions affecting anal region

Anorectal Pharm treatment

Local anesthetic

Vasoconstrictors

Astringents

Corticosteroids

Anorectal: Local anesthetic

Quick relief

Benzocaine

Dibucaine