Over the Counter Drugs

1. What are some of the reasons you should be familiar with OTC drugs?
2. Are herbal products drugs?
3. What is an analgesic? In what population, are NSAIDS contraindicated? What is the most common side effect of prolonged pirin use?
4. Should you advise a pregnant woman to take acetaminophen, ibuprofen or aspirin for pain relief?
5. What is the most common adverse side reaction to prolonged use of acetaminophen or acetaminophen overdose? What is the maximum amount of acetaminophen that could be taken per day? What is the maximum amount of acetaminophen for an alcoholic?
6. What are the common “ingredients” found in a cold remedy? How does each work to alleviate cold symptoms? What are side effects of the various drugs found in cold remedies?
7. What class of drugs are decongestant nose sprays considered? What is a major consequence of chronic users of decongestant nose sprays?
8. Explain the difference between a productive and non-productive cough. How should each be treated?
9. What is an expectorant? Name a common expectorant.
10. What is an antitussive? How do they “work”? What is the most effective antitussive (not available OTC)? Name some other antitussives. What should patients be taught about the various antitussives?
11. What is the only approved OTC sleep aid? As a nurse what should be done for patients who have insomnia? What are some side effects of diphenhydramine?
12. How do ophthalmic products “work”? Are they for short- term or long-term use?
13. How do OTC acne medications “work”? Name some of them. What caution should be used with benzyl peroxide?
14. What does the SPF of a sunscreen refer to? How should you advise patients to use a sunscreen? Some medications can increase the sensitivity to the sun. What are some of these medications?
15. What is a keratolytic agent?
16. What organisms are OTC products such as Bacitracin effective against?
17. What are topical steroids used for? What type of skin rashes should these products NOT be used on?
18. Why are there a number of different products included in hemorrhoidal products? What does each do?

1. What tragedy prompted the passing of the Kefauver-Harris Amendment? What does this amendment specify?
2. What are the two stages of drug testing? How does the first stage differ from the second stage? What is evaluated when testing drugs, ex. Toxicity,…? How long does the process take—for the first stage? For the second stage?
3. What is an investigational new drug (IND) status? When may a drug company apply for this status?
4. How many phases are there in the clinical trial?
5. What was the purpose of the Controlled Substance Abuse Act passed in 1970? Explain the schedule classification system.
6. Which schedule of drugs has the greatest potential for abuse? Which schedule has the least potential for abuse?
7. Under what schedule of drugs are benzodiazepines?

1. What labeling allows a herbal product to be marketed as a dietary supplement? Must a dietary supplement undergo testing for efficacy before it goes to market?
2. From which country does most of our information regarding herbal products come from? What is the name of the volume that is the most extensive and authoritative source on herbal products?
3. Compare the FDA with the DSHEA, in regards to safety of OTC products.
4. Discuss the different methods of delivery of herbal products.
5. What is black cohosh used to treat? What are the drug interactions with this product? Is it safe for short-term use or long-term use?
6. What is Echinacea used for? What may happen if people sensitive to ragweed take this product?
7. What is Feverfew used for? What risks and/or drug interactions are associated with its use?
8. What is ginger root used to treat? What are potential side effects/drug interactions with its use?
9. What is gingko used to treat? How does it work? Discuss potential side effects/drug interactions with its use.
10. What is goldenseal used to treat? In what population is its use contraindicated? What are the potential side effects of its use?
11. What is kava used to treat? How is Kava thought to exert its effect? What patient teaching should be included for patients taking this product?
12. What is another name for ma huang? What are the effects of ma huang? What class of drugs would ma huang be classified as?
13. What is St. John’s wort used to treat? How does it work? What are potential drug interactions with this product? What is serotonin syndrome?
14. What is saw palmetto used to treat? How does it work? What is the name of the prescribed drug that works similar to saw palmetto? What patient teaching should be given to pregnant women regarding this drug? What effect does the drug have on PSA levels in men? What relevance is this?
15. What is valerian root used to treat? How long does it take for valerian to exert its effects? What patient teachings should be included with use of this product?

1. Name some of the etiologies of shock. Understand how each of them can lead to hypotension.
2. Describe the structure of catecholamines. What are some of the properties of catecholamines? How must catecholamines be administered? Why must they be administered in a certain manner?
3. With which receptors does epinephrine act as an agonist? For what types of shock is epinephrine used? What are some adverse drug reactions associated with this drug?
4. What receptors does norepinephrine act on? What are the uses for this drug? Is this an appropriate drug for use in anaphylactic shock? Why or why not? What are adverse drug reactions seen with this drug?
5. What receptors are activated with dopamine? What determines which receptors are activated? How is dopamine administered? What are potential side effects of this drug?
6. What is the primary use of dobutamine? How does it exert its effect? What are the adverse drug reactions associated with this drug? What are nursing implications?
7. For any of the drugs used to treat shock or hypotension, an assessment of what parameter is essential before administration? What is the recommended route for administration of these drugs? Discuss how each of the drugs used to treat the various types of shock affect the following: Heart rate? Heart rhythm? Cardiac output?

1. What is the underlying imbalance in Parkinson’s disease patients? What is the triad of symptoms seen in patients with this disease? What are other characteristics seen with Parkinson’s patients?
2. What is the goal of therapy for Parkinson’s patients? What two major categories of drugs are used to treat Parkinson’s?
3. Name 3 ways that dopaminergic drugs work. What are the 5 classes of dopaminergic drugs?
4. What is levodopa? How does it work? When can patients expect to see some effect? What are some of the side effects of levodopa?
5. What is carbidopa? How does it work? What is the common combination, carbidopa/levodopa Parkinson’s medication? What is the first symptom to usually disappear with use of the combination carbidopa/levodopa medication? Because it may decrease the effectiveness of the medication, patients taking this combination drug, should be cautioned to NOT eat a diet high in what? What are some of the side effects Sinimet?
6. What should Parkinson’s patients taking Sinimet know about vitamin B-6? Protein? Alcohol use?
7. What is COMT (catechol-O-methyltransferase)? When in the course of treatment of Parkinson’s patients are COMT inhibitors used? What are important nursing implications for this class of drugs? What are side effects associated with this class of drugs?
8. What is MAO-B? How do MAO-B inhibitors work in treating Parkinson symptoms? What is an important nursing implication for patients taking an MAO-B inhibitor (about its metabolites)? Why should the combination of selegiline and meperidine be avoided?
9. How do the dopamine agonists work in treating Parkinson symptoms? What are some differences between ergots and nonergots? What are side effects of dopamine agonists?
10. How does the antiviral, amantadine (Symmetrel) work? What are some of the side effects of this drug? What is livedo reticularis?
11. How do anticholinergic drugs work? In what population of Parkinson patients, do you see anticholinergic used more often? Why? What symptom seen in Parkinson’s patients are they most effective in treating? What are some of the side effects seen with anticholinergic drugs? What are nursing implications for these drugs? What patient teaching is necessary with anticholinergics?
12. Compare the anticholinergics, Congentin and Benadryl. Which has a longer duration of action? Which is used primarily to induce sleep?
13. What is a drug holiday? Describe the end-of-dose phenomenon. How can end-of-dose phenomenon be remedied? Describe the on-off phenomenon.
14. Antipsychotics can induce Parkinson-like syndrome. Why does it occur? What are the symptoms of this syndrome? What can be used to treat this syndrome? What is Zyprexa? What is an advantage of using Zyprexa?

1. What causes tuberculosis (TB)? How is it spread? What is the primary site of infection? What are other sites of infection?
2. Is a person who is diagnosed with an inactive case of TB treated with medications?
3. What are multiple drugs used simultaneously to treat TB? What is isoniazid (INH)? What is its mechanism of action? What is a major life-threatening risk factor associated with this drug? Why is peripheral neuritis sometimes seen in patients taking INH?
4. What is rifampin? How does it work? What is the most common non-life threatening side effect is seen with this drug? What patient teaching should be done with rifampin because of the non-life threatening side effect? What patient teaching should be given to women using oral contraceptives and taking rifampin?
5. What are pyrazinamide and ethambutol? What is a life-threatening risk with use of these drugs?
6. What is streptomycin? Why is it used in the treatment of TB? How is it administered? What are nursing implications for this drug?
7. Explain DOT. What does the CDC recommend as far as treatment for TB?

1. Name the two categories of fungal infections. How is each treated?
2. When is amphotericin B used? What are the drawbacks of using this drug? What are nursing implications for this drug?
3. How do the azole antifungal medications work? What are nursing implications for this drug?
4. What type of infections is nystatin used for? How should a patient be instructed to use this drug for an oral Candida infection?
5. When should amantadine be given for treatment of flu symptoms? What is another use for amantadine, other than for treatment of flu? What are some of the side effects of amantadine?
6. What is a potential fatal side effect of Valtrex, if given to immunocomprimised patients?

1. How does metoclopramide, Reglan, work? What receptors are involved? Discuss some of the uses for metoclopramide? What are some of the adverse reactions seen with this drug?
2. The antispasmodics are used in the treatment of what syndrome? What are some of the side effects of this category of drugs?
3. Name the four major categories of antidiarrheals. How do they work? Name advantages, disadvantages of each of the categories.
4. What is the most effective antidiarrheal? Why is atropine added to the OTC antidiarrheal, Lomotil?
5. Where is lactobacillus kept? How does it work?
6. Name the five major categories of laxatives. How do they work? Name advantages, disadvantages of each of the categories. What patient teachings are necessary with the various laxative categories? What are the nursing implications?

1. An accumulation of what metabolic byproduct causes gout? What causes the pain associated with gout?
2. What are the five drugs used to treat gout? Which drugs are used for acute attacks? For chronic gout?
3. What is the most common side effect of colchicine? What can be done to manage side effects? Is colchicine an effective drug for pain relief?
4. What are the common side effects associated with indomethacin use? What are some of the advantages of using indomethacin for treatment of gout attacks?
5. Indomethacin is contraindicated in patients having what condition? Is indomethacin an effective drug for pain relief?
6. What is the most serious side effect of allopurinol use? What are the symptoms?
7. What patient teaching should be included with allopurinol use?
8. How does probenecid work to decrease gout attacks?
9. What are the side effects associated with sulfinpyrazone use? How can these be minimized?
10. What drug to drug interaction is known with sufinpyrazone? How should it be monitored?

1. Where would the majority of calcium be found in the body?
2. What types of cells are responsible for the breakdown of bones? For the building bones?
3. What classes of drugs used to treat osteoporosis are available in the US? How do each of the classes of drugs work?
4. Your patient is 58 years old and does not take any estrogen. How many milligrams of calcium should she have per day?
5. What types of calcium are available for intravenous use? Which form of calcium has the most elemental calcium in it? What can be done to maximize calcium absorption?
6. What is a side of effect of calcium supplementation (especially calcium carbonate)? What can be done for this side effect?
7. What is the potential risk of biphosphonates use? How can this risk be minimized? What patient teaching should be included with biphosphonates?
8. What patient teaching should be included for patients taking SERMs (selective estrogen receptor modulators)?

1. What are the sources of estrogens available for therapeutic use?
2. What effect does estrogen have on the development and maturation of the young female? What stimulates the initiation of menstruation?
3. What are some uses for estrogen replacement therapy?
4. What hormone must be included with estrogen if taken by a woman with an intact uterus? Why?
5. How does a contraceptive containing estrogen and progestin work to prevent fertilization?
6. What is the difference between hormone replacement therapy and contraceptives?
7. What are some of the side effects of hormone therapy? How can these side effects be minimized?
8. What is the one risk factor that contributes greatly to the increased incidence of deep vein thrombosis in contraceptive users?
9. A patient normally takes her birth control pill at 8 AM each morning. It is now noon, and she realizes that she forgot to take her pill for that morning. What would you advise her to do?