Pharmacy Over-the-Counter (OTC) Medications and Counseling 2 — Questions and Answers
Question 1: A patient with hypertension asks for an OTC decongestant for a cold. What is the best recommendation?
- Pseudoephedrine 60 mg — the most effective option
- Phenylephrine 10 mg — use with caution; consider non-drug options like saline rinse (Correct answer)
- Oxymetazoline nasal spray — safe for all hypertensive patients
- Any decongestant is safe if taken for only 1 day
Correct answer: Phenylephrine 10 mg — use with caution; consider non-drug options like saline rinse
Oral decongestants (both pseudoephedrine and phenylephrine) can raise blood pressure. If use is necessary, phenylephrine with close BP monitoring is sometimes used short-term, but saline irrigation and fluids are safer first options.
Question 2: Which OTC antacid contains calcium carbonate and may provide a supplemental calcium benefit?
- Magnesium hydroxide (Milk of Magnesia)
- Aluminum hydroxide (Amphojel)
- Calcium carbonate (Tums) (Correct answer)
- Sodium bicarbonate (baking soda)
Correct answer: Calcium carbonate (Tums)
Calcium carbonate (Tums) neutralizes gastric acid and also provides elemental calcium, making it useful as both an antacid and a calcium supplement.
Question 3: A patient is selecting an OTC laxative for occasional constipation. Which type of laxative is considered safest for long-term use?
- Stimulant laxatives (senna, bisacodyl)
- Osmotic laxatives like polyethylene glycol (MiraLAX) (Correct answer)
- Saline laxatives (magnesium citrate)
- Mineral oil
Correct answer: Osmotic laxatives like polyethylene glycol (MiraLAX)
Polyethylene glycol (PEG) works osmotically, drawing water into the colon, and is considered safe for long-term use. Stimulant laxatives can cause dependence with prolonged use.
Question 4: Which OTC product should be recommended for a patient describing symptoms of vaginal yeast infection (itching, thick white discharge, no fever)?
- Metronidazole vaginal gel (Metrogel)
- Clotrimazole or miconazole vaginal antifungal cream/suppository (Correct answer)
- Hydrogen peroxide douche
- Boric acid suppositories (prescription only)
Correct answer: Clotrimazole or miconazole vaginal antifungal cream/suppository
OTC azole antifungals (clotrimazole, miconazole) in 1, 3, and 7-day formulations effectively treat uncomplicated vaginal candidiasis. Metronidazole treats bacterial vaginosis, not yeast infections.
Question 5: A patient asks about OTC proton pump inhibitors (omeprazole). The recommended OTC course is:
- Take indefinitely for best heartburn prevention
- Take for 14 days, may repeat every 4 months if needed (Correct answer)
- Take only as needed, maximum one dose per week
- Take daily for 6 months minimum
Correct answer: Take for 14 days, may repeat every 4 months if needed
OTC omeprazole (Prilosec OTC) is labeled for a 14-day course of treatment, repeated no more than once every 4 months. Prolonged unsupervised use warrants medical evaluation.
Question 6: Aspirin therapy in children with viral illness should be avoided because of the risk of:
- Reye's Syndrome (Correct answer)
- Gray baby syndrome
- Kernicterus
- Stevens-Johnson syndrome
Correct answer: Reye's Syndrome
Aspirin use in children/teenagers with viral illnesses (influenza, chickenpox) is associated with Reye's syndrome — a rare but potentially fatal condition causing liver and brain damage.
Pharmacy Over-the-Counter (OTC) Medications and Counseling 2
A patient with hypertension asks for an OTC decongestant for a cold.
What is the best recommendation?