2.2 pharmacology

Question

Answer

Why can OTC medication selection be confusing for consumers?

Many products use the same active ingredients but are marketed differently

How can consumers best determine what an OTC product contains?

By reading the Drug Facts label

Why should consumers avoid relying on front-package marketing?

It may lead to taking unnecessary or extra medications

Which OTC category is often the most confusing for consumers?

Cough and cold products

What is guaifenesin classified as?

Expectorant

What is guaifenesin used to treat?

Productive cough

What is dextromethorphan classified as?

Antitussive

What is dextromethorphan used to treat?

Dry cough

What drug class is chlorpheniramine?

Antihistamine

What symptoms does chlorpheniramine treat?

Sneezing and runny nose

What drug class is phenylephrine?

Decongestant

What is phenylephrine used for?

Nasal congestion

What drug class is acetaminophen?

Analgesic and antipyretic

What is acetaminophen used to treat?

Pain and fever

What drug class is ibuprofen?

NSAID and antipyretic

What is ibuprofen used to treat?

Pain and fever

What medication class is primarily used to treat allergies?

Antihistamines

Approximately how long ago did many antihistamines become OTC?

About 15 years ago

Name an oral antihistamine now available OTC.

Loratadine (Claritin)

Name an OTC nasal steroid.

Fluticasone (Flonase)

What are the two main histamine receptor types?

H1 and H2

What do H1 receptors affect?

Smooth muscle contraction and capillary dilation

What do H2 receptors affect?

Gastric acid secretion

What drugs are typically referred to as antihistamines?

Drugs that block H1 receptors

What are drugs that block H2 receptors called?

H2 blockers

How do antihistamines work?

They compete with histamine for H1 receptors

What factor contributes to differences in antihistamine side effects?

Anticholinergic effects

What are anticholinergic effects?

Effects caused by blocking acetylcholine at receptors

List common anticholinergic effects.

Dry mouth, dry eyes, blurred vision, urinary retention, constipation

What is the anticholinergic effect level of chlorpheniramine?

Moderate

What is the sedative effect of chlorpheniramine?

Low

Why is chlorpheniramine suitable for daytime use?

Less drowsiness and more CNS stimulation

What is the anticholinergic effect level of diphenhydramine?

High

What is the sedative effect of diphenhydramine?

High

About what percentage of patients experience drowsiness with diphenhydramine?

About 50%

What other uses does diphenhydramine have?

Insomnia and nausea

What is the anticholinergic effect level of fexofenadine?

Low to none

What is the sedative effect of fexofenadine?

Low to none

What is an advantage of fexofenadine?

Longer acting with fewer side effects

What is the anticholinergic effect level of loratadine?

Low

What is the sedative effect of loratadine?

Low to none

What is an advantage of loratadine?

Longer acting with fewer side effects

What conditions are antihistamines commonly used to treat?

Nasal allergies, urticaria, and common cold symptoms

List additional uses of some antihistamines.

Motion sickness, Parkinson’s symptoms, vertigo, insomnia

Name two OTC nasal steroids.

Fluticasone (Flonase) and triamcinolone (Nasocort)

What condition is commonly treated with OTC heartburn medications?

Heartburn

When did esomeprazole (Nexium) become OTC?

2014

Which PPI was the first to become OTC?

Omeprazole (Prilosec OTC)

What are antacids used for?

Neutralizing gastric acidity

Name examples of antacids.

Tums, Gaviscon, milk of magnesia, Maalox

What is a benefit of antacids?

Available in many dosage forms

How do H2 receptor blockers work?

They competitively block H2 receptors in stomach acid-producing cells

Name an H2 receptor blocker.

Famotidine (Pepcid)

Which H2 blocker has a higher risk of drug interactions?

Cimetidine (Tagamet)

How do PPIs work?

They bind to the proton pump responsible for gastric acid secretion

Name two OTC PPIs.

Omeprazole and esomeprazole

What should patients do if they need daily PPI use for more than 14 days?

Consult a physician before continuing use