2.3 pharmacology

Question

Answer

What two types of medications make up much of the OTC pain and fever aisle?

Analgesics and antipyretics

What are analgesics used for?

Pain relief

What are antipyretics used for?

Fever reduction

What are the main OTC analgesics available?

Acetaminophen, ibuprofen, naproxen, and aspirin

What is the most widely used non-opioid analgesic?

Acetaminophen

What abbreviation was historically used for acetaminophen?

APAP

Why is the abbreviation APAP falling out of favor?

It may cause confusion and medication errors

Why can acetaminophen overdose occur unintentionally?

It is included in many combination products

What is a major risk of exceeding the recommended daily dose of acetaminophen?

Liver toxicity

What does NSAID stand for?

Non-steroidal anti-inflammatory drug

How do NSAIDs differ from acetaminophen?

They also treat inflammation

Which OTC drugs are NSAIDs?

Ibuprofen, naproxen, and aspirin

How many NSAIDs are available in the US?

23

Do most NSAIDs require a prescription?

Yes

When was aspirin first marketed?

1899

What effects does aspirin have?

Pain relief, fever reduction, and anti-inflammatory effects

What adverse effects are associated with aspirin?

GI intolerance, bleeding, and renal impairment

Why were other NSAIDs developed after aspirin?

To reduce side effects

How do ibuprofen and naproxen compare to aspirin?

They are generally better tolerated

What is a key safety concern with acetaminophen?

More than 4 g daily can cause liver failure

Why must patients monitor combination products containing acetaminophen?

Risk of overdose

What special property does aspirin have related to the heart?

It inhibits platelet aggregation

Why is aspirin recommended at the first sign of a heart attack?

It reduces platelet aggregation

Why is 81 mg aspirin used for cardiac protection?

Low-dose antiplatelet effect

What is a benefit of naproxen compared to other NSAIDs?

Longer duration allowing less frequent dosing

What is nicotine replacement therapy (NRT)?

OTC products used to help with smoking cessation

Why do prescribers sometimes write prescriptions for NRT products?

To allow insurance billing

Are NRT products available without a prescription?

Yes

Where are NRT products commonly kept in pharmacies?

Behind the pharmacy counter or front cashier

Is one NRT product more effective than others?

No

What improves the success of smoking cessation with NRT?

Behavioral counseling

What is a unique feature of the nicotine transdermal patch?

Stepwise dose reduction over time

Which nicotine dosage form is best for acute symptoms?

Gum

How does nicotine gum onset compare to cigarettes?

30 minutes vs 10 minutes

Which nicotine form can also be used for acute symptoms?

Lozenge

Which NRT forms require a physician order?

Nicotine nasal spray and nicotine inhaler

What are the prescription-only NRT brand names?

Nicotrol NS and Nicotrol inhaler

What is a dietary supplement?

A product intended to complement the diet

What ingredients may dietary supplements contain?

Vitamins, minerals, herbs, botanicals

What percentage of modern drugs are derived from plants?

About 30%

What is herbal medicine?

The practice of using plant components to heal

Why did herbal medicine fall out of favor historically?

Shift toward Western medicine in the early 20th century

What is alternative medicine?

Therapies not traditionally emphasized in Western medicine

Give examples of alternative medicine.

Herbal medicine, acupuncture, massage, chiropractic

When was the Office of Alternative Medicine established?

1992

What is the current name of the Office of Alternative Medicine?

The Center for Complementary and Alternative Medicine

What is complementary medicine?

Alternative medicine used alongside Western medicine

What is the major regulatory difference between supplements and drugs?

Supplements do not need proof of efficacy

Who is responsible for supplement safety?

The manufacturer

What organization began certifying supplements in 2002?

US Pharmacopeia

Is US Pharmacopeia certification required?

No

What change occurred in 2007 regarding supplement manufacturing?

FDA required good manufacturing practices

What must manufacturers demonstrate under GMP?

Identity, purity, strength, quality, and lack of contaminants

Why is the belief that supplements are safe incorrect?

They can cause adverse and toxic effects

Why is nondisclosure of supplement use a concern?

Potential drug interactions

What can supplement-drug interactions cause?

Unwanted side effects

What is St. John’s Wort commonly used for?

Depression, anxiety, sleep disorders

What is a major safety concern with St. John’s Wort?

Many drug interactions

What is ginkgo commonly used for?

Memory loss prevention

What does current research show about ginkgo?

Lack of efficacy

What is garlic commonly used for?

Cardiac health

What is a safety concern with garlic supplements?

Increased bleeding risk

What is echinacea commonly used for?

Immune system stimulation

Does echinacea shorten colds?

No

What supplement has strong evidence and an FDA-approved drug?

Omega-3 fatty ac