1
Q
safety and efficacy of OTC drugs
A
- all are subjected to preclincal testing for safety
- post-market safety surveillance is also conducted
2
Q
grandparenting
A
new regulation don’t apply to products already on the market
3
Q
guidlines for using an OTC
A
- illness/symptoms are mild
- use shouldn’t exceed 2 weeks
4
Q
selection of appropriate OTC
A
- proven efficacy for the condition
- simplest ingredients
- list of ingredients and their amount
- come in appropriate dosage form
- known level of toxicity
5
Q
internal analgesics → acetylsalicylic acid (ASA; brand name = Aspirin)
A
- relieves pain (analgesic), fever (antipyretic), and inflammation (anti-inflammatory)
- ASA inhibits synthesis at prostaglandins, which are endogenous substances that enhance the mediation of pain and fever
- tinnitus (ringing in ears at high doses, bad for children)
- allergic reactions
- gastric irritation (ASA breaks down mucosal barrier in stomach)
6
Q
internal analgesics → acetaminophen (brand name = Tylenol)
A
- effective analgesic and antipyretic, not anti-inflammatory
- drug of choice in cases where ASA causes gastric irritation and inferable conditions in children
- inhibition of prostaglandin synthesis
- overdose can lead to fatal liver injury
7
Q
internal analgesics → non-steroidal, anti-inflammatory agents (NSAIDs) (Ibuprofen - brand name = Advil and naproxen = aleve)
A
- effective analgesics, antipyretics and anti-inflammatories
- reverse inhibition of the synthesis of prostaglandins
- gastric irritation
8
Q
topical analgesics
A
- minor sprains and overworked muscles
- voltarin (an NSAID) has proven efficacy
9
Q
antihistamines
A
- treatment of symptoms due to allergy
- block histamine receptors, thereby inhibiting the binding of histamine to its receptor, decreasing allergy symptoms
10
Q
antacids
A
- hold the pH of gastric contents at about 4
- neutralize gastric acid by an acid-base reaction
- systemic antacids - given orally and are absorbed by GI tract, leading to systemic alkalosis
- non-systemic antacids - aren’t absorbed and don’t cause systemic alkalosis
11
Q
decongestants
A
- cause constriction of blood vessels preventing the accumulation of fluid and thereby reducing congestion
- long-acting preparations are best
12
Q
cough suppressants
A
- centrally-acting → block processing of info in the medulla, reducing frequency of the cough; codeine (an opioid)
- peripheral cough suppressant → block the nerve endings in the throat and bronchioles inhibiting the stimulus to cough
13
Q
expectorants
A
- reduce the viscosity of the sputum by increasing secretions
- glyceryl guaiacolate
14
Q
sleeping aids
A
- main ingredient are an antihistamine that has sedative properties and an analgesic
15
Q
laxatives
A
- increases excretion of a soft-formed stool by increasing gut motility or hydration of the stool
- stimulant laxatives → increase motor activity of intestine and increase secretion of mucus, water and electrolytes into the intestine
- bulk-forming laxatives → swell in water to form an emollient gel or viscous solution that serve to maintain soft stool
16
Q
anti-diarrheal agents
A
- used to control diarrhea
- main concern with diarrhea is dehydration
- absorbents (Pepto) → add bulk to the GI tract and may absorb toxins
- loperamide → synthetic opioid that doesn’t penetrate into the CNS; inhibits gut motility by acting on opioid receptors in the GI tract, reducing peristaltic activity
17
Q
0.5% and 1% hydrocortisone
A
- topical anti-inflammatory used for exposure to poison ivy, insect bits, any anti-inflammatory condition that is treated topically
18
Q
sunscreens
A
- contains compounds such as para-aminobenzoic acid derivatives, benzophenone, and cinamic acids
- are absorbed into the outer layer of the skin and scatter UV energy, preventing it from reaching the lower layer of the skin
19
Q
increase in herbal drugs is due to
A
- desire of people to use natural products, which they believe are safer than conventional products
- manufacturers and retailers promote these products for financial gain
20
Q
allopathic medications
A
drugs used by mainstream medicine; have a DIN number from Health Canada
21
Q
herbal medications (homeopathics)
A
plant products sold as medicine (no DIN); often crude mixtures and evaluation is lacking
22
Q
phytopharmaceuticals
A
drugs obtained from plants, purified, and used at therapeutic doses with scientific evidence of efficacy and documented toxicity
23
Q
allopathic phytopharmaceuticals
A
full status as a drug and meet all requirements of a drug (full safety and efficacy evaluation; DIN)
24
Q
food supplement
A
a herbal product that is used at 1/4 of the proposed therapeutic dose
25
problems associated with herbals
- lack of efficacy and safety data
- lack of standardization
- intentional adulteration (addition of substances other than the herbal)
- questionable source
- drug interactions with allopathic medications
- confusing literature
26
St. John's Worts
- treat mild-moderate depression, and to heal wounds
- active ingredients are hypericin and hyperforin
- less effective than other antidepressants
- likely effective for mild to moderate depression
- can cause phototoxicity (sunlight causes a skin reaction)
27
aloe vera
- applied to skin topically to aid in healing of wounds/burns
- active ingredients are mannans and anthraquinones
- increase in micro-circulation of the skin
- possibly effective for cold sores and minor skin irritations
28
devil's claw
- recommended for a wide range of ailments, from migraines to kidney disease
- mainly used for treatment of inflammatory conditions
- active ingredients are glucoirioids
- possibly effective for arthritis and osteoarthritis
29
ginseng
- enhance memory, learning, productivity, and the immune system
- can also reduce blood sugar in diabetics
- active ingredients are ginsenosides and panaxosides
- possibly effective for thinking and memory, diabetes, erective dysfunction, and COPD
30
echinacea
- prevention and treatment of the common cold, for wound healing and as an anti-inflammatory agent
- active ingredients are echinacein, cichoric acid and caffeic acid
- can stimulate T-lymphocytes
- possibly effective for the common cold
31
valerian
- treatment of nervous tension and panic attacks
- active ingredients are valepotriates
- possibly effective for mild insomnia
32
vitamin
a substance essential for the maintenance of normal metabolic functions, but is generally not made in the body and therefore must be provided from an outside source (except vitamin D and K)
33
water-soluble vitamins
vitamin C and 11 vitamins in the B group
34
fat-soluble vitamins
vitamins A, D, E and K
35
vitamins as supplements
- increased requirements → necessary during growth, pregnancy, breastfeeding
- inadequate intake → bad diet
- disturbance in absorption → prolonged diarrhea, liver disease
36
nutritional approach to vitamin therapy
- one selects a diet aimed at supplying the RDA for each vitamin, or a multivitamin preparation which supplies the RDA of each vitamin
37
megavitamin approach to vitamin therapy
- excess water-soluble vitamins are excreted in urine
| - high doses of fat-soluble vitamins can accumulate in body fat and can cause severe toxic effects
38
vitamin A
- found only in animal products
- required for growth and development, normal structure of mucous membranes and epithelial cells
- administered in periods of increased requirement (infancy, pregnancy)
- deficiency can result in delay of growth and development, nigh blindness, dry skin
- excessive intake can result in dry itchy skin, vomiting, headache
39
vitamin D
- found in meat, fish and mushrooms
- increases absorption of calcium and phosphate from the intestine, regulation of blood calcium level
- used to help prevent osteoporosis
- deficiency can result in decreased absorption of calcium and phosphate from intestine, decreased blood calcium level
- excessive intake can result in elevated calcium levels in blood, excess removal of calcium from bone
40
vitamin E
- found in vegetable oils and some green leafy veggies
- essential for a number of biochemical reactions, including a role as an antioxidant, and protecting cells in the cardiovascular system
- useful in treatment of premature babies with an uncommon type of hemolytic anemia
- deficiency is rare
- excessive intake can inhibit platelet aggression and contribute to the anticoagulant effects of warfarin
41
vitamin B12
- found in meat and dairy
- synthesis of RBCs
- absorption decreases as we age → elderly increase intake
- alcohol abuse or malabsorption can lead to deficiencies
42
folic acid
- all food groups are rich in folate, but fresh greens veggies, liver and yeast are especially high
- synthesis of RBCs
- pregnant women increase intake to prevent neural tube defects
43
vitamin C
- found in fruits and veggies
- contributes to framework that holds cells together, required for formation on bone and teeth, antioxidant
- prevention and treatment of scurvy
- deficiency can result in scurvy
- excess intake results in diarrhea, formation of kidney stones
44
food additives
substances that are added to improve the appearance, texture and storage of food
45
intentional food additives
- substances that are added to improve appearance, texture and storage of food
- vitamins/minerals
- flavours
- colours
- preservatives
46
unintentional food additives
- substances that are added inadvertently as a result of the growing, manufacturing and storage processes of food
- often termed contaminants
- fertilizers
- pesticides
- heavy metals
47
safety of food additives
- regulations are more stringent for food additives than OTC drugs
48
determining toxicity of a food additive
- risk/benefit ratio must be carefully determined
- study toxicity in animals and then extrapolate the results to humans
- limitations are: exposure in humans is hard to replicate in animals, assumption of risk
49
rational use of food additives
- enhance or maintain quality of food
- should be used inly in quantities sufficient enough to obtain stated ends
- toxicological evaluation of additives should be undertaken
- special groups should be considered
50
current concerns with food additives
- mistrust of the use of additives
- exposure of children to additives
- natural additives can also be harmful
51
flavouring
- toxicity's are rare
| - mixtures of artificial flavours
52
colours
- organic dye added to give food an appetizing appearance
| - allergic reactions have occurred
53
texture agents
- high concentrations found in food
| - little to no toxicity
54
perservatives
- allows the delivery of food to distant destinations and ensures appropriate quality of the food
- benefits outweigh the risks
- antibacterials → smoke, can carry a small carcinogenic risk
- antibiotics → aren't used in Canada
- sodium nitrate → controversial, added to meat to give
a red colour
- antioxidants → prevent the oxidation and thus rancidity and discolouration of food
- water-soluble → added to reduce oxidation of
carbohydrates (fruit); citric acid
- lipid-soluble → prevents fats from oxidizing (chips)
55
sweeteners
- saccharin - restricted in Canada
| - aspartame - replaced saccharin
PHAR 100
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