6/23/2011
Welcome to the
NASPA / NMA Student Pharmacist
Self-Care Championship
Sponsored by:
Welcome to the Opening Round!
NASPA / NMA Student Pharmacist
Self-Care Championship
Oh, My
Stomach!
SLEEPY TIME
My Eggo is
Preggo
Gentlemen,
lend me your
EARS
What’s the
Topic Al?
ACKNOWLEDGMENTS - Thanks to John Clark, Doctor of Pharmacy Candidate from University of Minnesota, Duluth for helping develop some of these questions!
1
6/23/2011
Opening Round
My Eggo is
Preggo
What’s the
Topic Al?
Oh, My
Stomach!
Gentlemen,
lend me your
EARS
(pregnancy related
questions)
(vitamins and herbals)
(Over the Counter
Topical Products)
100
100
100
100
100
200
200
200
200
200
300
300
300
300
300
400
400
400
400
400
500
500
500
500
500
SLEEPY TIME
Oh, My Stomach!
100
The two active ingredients in Zegerid
OTC™ are:
2
6/23/2011
Oh, My Stomach!
100
What are Omeprazole and Sodium
Bicarbonate?
Oh, My Stomach!
200
Docusate Sodium is this type of laxative.
3
6/23/2011
Oh, My Stomach!
200
What is Emollient ?
Also known as a stool softener, docusate sodium
works like a surfactant (think soap) to soften fecal
mass.
Oh, My Stomach!
300
Bismuth subsalicylate is
contraindicated in children less
than 12 years old because of the
development of what disease?
4
6/23/2011
Oh, My Stomach!
300
What is Reyes syndrome?
Reyes syndrome is a potentially fatal disease that has been
linked to aspirin consumption. It is a multi-staged disease in
which lethargy, persistent vomiting, and high fever
characterize the early stages. If left untreated, the symptoms
can progress to fatty liver, coma, multiple organ failure, and
even death.
Oh, My Stomach!
400
A patient comes to your pharmacy
complaining of severe abdominal
pain recently. This is what you
would recommend.
5
6/23/2011
Oh, My Stomach!
400
What is Refer to a physician?
Any patient that is having severe abdominal pain
should first be seen by a physician. Other exclusions
for self-treatment of GI disorders include, fever with
nausea and vomiting, paraplegia or quadriplegia,
symptoms persisting for greater than 2 weeks or
recurring over 3 months, daily laxative use, and
blood or pus in the stools.
Oh, My Stomach!
500
This is the total number of weeks per
year an adult can use OTC
omeprazole without consulting a
physician.
6
6/23/2011
Oh, My Stomach!
500
What is 6 weeks?
The current guidelines for OTC omeprazole use are no
more than 2 weeks of continued daily use every 4
months. Patients requiring frequent use of
omeprazole OTC should see a physician.
Gentlemen, lend me your EARS
100
This is the number of days in a row
Carbamide Peroxide can be used
safely for removing ear wax.
7
6/23/2011
Gentlemen, lend me your EARS
100
What is 4 days?
Carbamide Peroxide softens impacted cerumen due
to its foaming action. It releases hydrogen peroxide,
which serves as a source of nascent oxygen upon
contact with catalase. It should also not be used in
children under 12 years of age.
Gentlemen, lend me your EARS
200
This is the only FDA-approved OTC
treatment for water-clogged ears.
8
6/23/2011
Gentlemen, lend me your EARS
200
What is 95% isopropyl alcohol in 5%
anhydrous glycerin
(Swim Ear, Auri-Dri)?
The isopropyl alcohol acts as a drying agent while glycerin acts
as a humectant (increases solubility of alcohol and also
moisturizes). Patients should be referred after several days of
simultaneous use of ear-drying agents and prevention of exposure
to water with no relief.
Gentlemen, lend me your EARS
300
When administering ear drops to a
child less than 3 years old, you
should you pull their ears in the
following way.
9
6/23/2011
Gentlemen, lend me your EARS
300
What is down and back?
Children’s ear canals are shorter and at an angle. In
Adult administration, the earlobe should be held up
and back.
Gentlemen, lend me your EARS
400
Aspirin and OTC NSAIDS in toxic
amounts can cause this perceived
high pitched buzzing or humming
sound.
10
6/23/2011
Gentlemen, lend me your EARS
400
What is Tinnitus?
Tinnitus is considered a nonspecific and nonsensitive
clinical effect of salicylate toxicity.
Gentlemen, lend me your EARS
500
This is the accepted dosage range
for acetaminophen used for pain or
fever in infants and children?
11
6/23/2011
Gentlemen, lend me your EARS
500
What is 10-15 mg/kg per dose?
No more than 5 doses per 24 hours.
My Eggo is Preggo
100
A patient with a latex allergy should
use condoms made from this
material.
12
6/23/2011
My Eggo is Preggo
100
What is Polyurethane ?
Latex condoms are generally considered the best
choice, but polyurethane condoms are a good
alternative for a patient with a latex allergy.
Anecdotal evidence suggests that they are not as
comfortable as latex condoms.
My Eggo is Preggo
200
This is the earliest time that a
pregnancy test can detect a
pregnancy with high certainty
(>95%).
13
6/23/2011
My Eggo is Preggo
200
What is one week after a missed period?
Pregnancy tests can predict with 97% accuracy a pregnancy if
tested one week after a missed period, however women can
vary between a range of 6-12 days in terms of prime
sensitivity. The accuracy on the first day of a missed period is
around 90%. A pregnancy cannot be detected prior to
implantation, which generally occurs 6-12 days after
conception (hence the range of prime sensitivity).
Marketing 101
300
This is the amount a woman’s
resting basal body temperature
changes after ovulation AND when
and where the temperature should
be taken.
14
6/23/2011
My Eggo is Preggo
300
What is 0.4 to 1 degree Fahrenheit, in the
morning while lying in bed (before rising)?
A woman’s resting basal body temperature typically rises
between 0.4-1 degree Fahrenheit above normal after
ovulation. The best time to take resting basal body
temperatures is first thing in the morning before rising. Even
the slightest activity could raise your temperature enough to
cause a falsely elevated temperature.
My Eggo is Preggo
400
This medication prevents 75-89% of
pregnancies and is most effective if
taken within 72 hours of intercourse.
15
6/23/2011
My Eggo is Preggo
400
What is levonorgestrel?
From 0-12 hours, the number of pregnancies per 100
patients who used Plan B is about 0.5-1. That
number increases to about 4 after 61-72 hours and
drops off dramatically after that. Overall, the rate of
pregnancy is about 1/100 vs. 8/100 with no
contraception.
My Eggo is Preggo
500
This is a two-part answer: This is
the hormone that pregnancy tests
detect AND the time that the test
should be performed?
16
6/23/2011
My Eggo is Preggo
500
What is HCG (human chorionic
gonadotropin) and first morning urine?
First morning urine is more concentrated and more likely to yield
accurate results. Also, warm to room temperature urine is
most viable whereas cold urine may cause false negatives.
SLEEPY TIME
100
This is the adult dose for
diphenhydramine when used as an
OTC sleep aid.
17
6/23/2011
SLEEPY TIME
100
What is 25-50mg?
SLEEPY TIME
200
Kava is an herbal supplement that
should not be recommended as a
sleep aid due to concerns of causing
toxicity to this organ.
18
6/23/2011
SLEEPY TIME
200
What is the Liver?
Kava is a plant native to the South Pacific and is
advertised to promote relaxation. There is little
evidence to support use.
SLEEPY TIME
300
BONUS #1!!!
Do you feel lucky?
Please make a wager.
To the Bonus Question…
19
6/23/2011
SLEEPY TIME
400
If someone is unable to fall asleep,
this is a good sleep hygiene
technique the person should utilize.
SLEEPY TIME
400
What is?
Any of the following:
Leave the bedroom, a regular sleep pattern, comfortable
sleeping arrangements, relaxing activities before bed,
exercising (not late in the evening), use of bedroom for
sleep only, relaxation exercises, avoiding large meals for
dinner, no daytime napping, no caffeine after noon, and
avoidance of nicotine.
20
6/23/2011
SLEEPY TIME
500
Melatonin is an endogenous
hormone produced by this gland.
SLEEPY TIME
500
What is the pineal gland?
Melatonin is a natural alternative for insomnia
that possibly helps with sleep latency. It is
generally well tolerated and does not seem to
have residual effects in the morning. It is
typically dosed 0.3-5mg 1-2 hours prior to
bedtime.
21
6/23/2011
What’s the Topic Al?
100
This is considered first-line
pharmacological therapy for head lice.
What’s the Topic Al?
100
What is Permethrin (Nix)?
Permethrin works by inhibiting sodium ion influx through
nerve cell membrane channels in parasites, resulting in
delayed repolarization. This ultimately results in
paralysis and death of the nits. Permethrin should be
applied to the affected area and left on for 10 minutes,
followed by rinsing of the area. It is ok to retreat in
one week if needed.
22
6/23/2011
What’s the Topic Al?
200
This nonprescription product used
for acne can actually make it worse
initially.
What’s the Topic Al?
200
What is Benzoyl Peroxide?
Benzoyl peroxide tends to be drying and irritating,
which is why it will initially make acne worse. It is
important to tell patients to continue to use it, as it
can take 2-3 weeks to see any effect. Patients
should start with lower concentrations once daily
and increase as needed. Some patients may benefit
from twice daily application.
23
6/23/2011
What’s the Topic Al?
300
This is the name of the substance in
Poison Ivy that causes sensitivity.
What’s the Topic Al?
300
What is Urushiol?
While 80% of the U.S. population is sensitive to this
compound, about 50% will present with a rash.
Urushiol is only released when the plant is
damaged and the typical rash will present about
10-15 minutes after contact. Hydrocortisone 1%
cream is among the most commonly
recommended over the counter products for the
treatment of poison ivy rashes.
24
6/23/2011
What’s the Topic Al?
400
This topical antifungal works by
distorting the hyphae and stunting
mycelial growth of tinea pedis
(athlete’s foot). Hint if this is too
difficult, John Madden would be
proud.
What’s the Topic Al?
400
What is tolnaftate (Tinactin®)?
Tolnaftate works to disrupt growth of tinea
pedis, whereas imidazoles (such as
miconazole) work by damaging cell wall
membranes of fungi.
25
6/23/2011
What’s the Topic Al?
500
This unconventional treatment for
warts can be found in the hardware
section of most stores.
What’s the Topic Al?
500
What is Duct Tape?
Limited data has shown that applying duct tape to warts
is as effective as other OTC preparations. Its mechanism
of action is unknown, but is thought to involve irritation
and also immuno-stimulatory mechanisms. Use should
be limited to six days. This treatment is not FDAapproved and there are no large controlled studies to
support its efficacy.
26
6/23/2011
Bonus #1
SLEEPY TIME
300
This sleep aid is in the pregnancy
category A.
Bonus #1
Natural Phytors
300
What is Doxylamine (Unisom
Sleeptabs)?
Doxylamine is safe to recommend for insomnia in
pregnancy
27
6/23/2011
This is the end of the
Opening Round.
Welcome to the Second Round
NASPA / NMA Student Pharmacist Self-care
Championship
No PAIN, No
Photo Finish
Gain
It’s Not John
Hancock, it’s
HERBie Hancock!
Cover Your
Cough!!!
As Seen on TV
ACKNOWLEDGMENTS - Thanks to John Clark, Doctor of Pharmacy Candidate from University of Minnesota, Duluth for helping develop some of these questions!
28
6/23/2011
Second Round
No PAIN No
Gain
Cover your
Cough!!!
(Congestion, Cough, and Cold)
It’s Not John
Hancock, it’s
HERBie Hancock”
(Herbal Products and Supplements)
Photo Finish
(name the item showin in
the picture)
As Seen on
TV
(name the product)
200
200
200
200
200
400
400
400
400
400
600
600
600
600
600
800
800
800
800
800
1000
1000
1000
1000
1000
No PAIN No Gain
200
This compound that is a part of many
people’s morning routines can both
treat AND cause headaches.
29
6/23/2011
No PAIN No Gain
200
What is Caffeine?
Caffiene is thought to aid in the absorption of pain
and headache medications. Also, if consistent
caffeine use is suddenly stopped, a rebound
headache can occur. Ingesting caffeine can reduce
and eliminate these withdrawal symptoms and thus
improve the headache.
No PAIN No Gain
400
This is the maximum daily dose of
naproxen for adults aged >65 years
of age.
30
6/23/2011
No PAIN No Gain
400
What is 440 mg
(220 mg every 12 hours)?
*400mg Naproxen base = 440mg Naproxen Sodium
The dose for adults and adolescents aged 12-65 is
220 mg every 8-12 hours (max 660 mg per day). This
reduced dose in the elderly is most likely due to the
fact that we tend to see decreased renal function in
older individuals and NSAIDS are well known to
potentially decrease renal function.
No PAIN No Gain
600
The “E” in “RICE” therapy.
31
6/23/2011
No PAIN No Gain
600
What is Elevation?
The acronym “RICE” stands for Rest injured area, Ice
application as soon as possible in 10 minute increments
three to four times daily, Compression applied with
elastic support or bandage, and Elevation of limb. This is
a common way to help with muscle pain.
No PAIN No Gain
800
This medication causes depletion in
substance P, aiding in muscle and
joint pain relief.
32
6/23/2011
No PAIN No Gain
800
What is a Capsaicin?
Substance P is a neuropeptide that is an
important element in pain perception. The
sensory function of substance P is thought to
be related to the transmission of pain
information in the CNS.
No PAIN No Gain
1000
A patient comes to your counter
complaining of a headache that has
severe, unrelenting pain that starts
behind their eye and radiates to
their temple. Name the type of
headache described.
33
6/23/2011
No PAIN No Gain
1000
What is a cluster headache?
Cluster headaches should always be referred to the
patient’s primary care physician.
Cover your Cough!!!
200
According to Federal law, this is the maximum
amount of pseudoephedrine that an
individual can purchase at one time.
34
6/23/2011
Cover your Cough!!!
200
What is 3.6 grams?
Due to the “Combat Methamphetamine Epidemic Act”
of 2006, a person can only purchase 3.6 grams of
pseudoephedrine per day or 9 grams per 30 days.
Cover your Cough!!!
400
This is the number of days can Topical
decongestants be used before
worrying about rebound congestion,
Medicamosa.
35
6/23/2011
Cover your Cough!!!
400
What is 3-5 days?
Cover your Cough!!!
600
These are two non-pharmacological
treatments that are recommended
for cough.
36
6/23/2011
Cover your Cough!!!
600
What are non-medicated lozenges or hard
candies, use of a humidifier, or hydration?
Lozenges and/or hard candies can reduce
irritation of the throat and humidifiers
increase the amount of moisture in the air,
which may help soothe irritated airways.
Cover your Cough!!!
800
A patient comes into your pharmacy
and claims that Emergen-C is the best
product EVER and that everyone with a
cold should use it. This amount of
Vitamin C per day when taken early in
the course of a cold may decrease the
duration of illness slightly.
37
6/23/2011
Cover your Cough!!!
800
What is one or more grams of vitamin C?
The clinical effects of large doses of vitamin C are
debatable. This may decrease the severity of illness
by around 20%, but super large doses (>4 g per day)
are known to cause diarrhea and other GI symptoms.
Cover your Cough!!!
1000
Name the medication and amount
that can be purchased OTC that is
used for cough which is available
without a prescription in 29 states.
38
6/23/2011
Cover your Cough!!!
1000
What is Codeine; no more than 200 mg per
100 mL;
Codeine is the gold standard antitussive because it acts
on cough receptors and is sedating (great for
nighttime cough!).
It’s not John Hancock, it’s HERBie Hancock!
200
Ingesting even one teaspoonful of
Oil of Wintergreen can put you at
risk for what type of toxicity.
39
6/23/2011
It’s not John Hancock, it’s HERBie Hancock!
200
What is Salicylate toxicity?
In its pure form, methyl salicylate contains 7g of
Salicylate (87 baby aspirins). Most oil of wintergreen
products contain 10-60% methyl salicylate. This
product is indicated for topical use only.
It’s not John Hancock, it’s HERBie Hancock!
400
This commonly used herbal
supplement has benzodiazepinelike effects.
40
6/23/2011
It’s not John Hancock, it’s HERBie Hancock!
400
What is Valerian root?
Products of valerian metabolism are believed to
bind to receptor sites similar to
benzodiazepines. This ultimately influences
gamma-aminobutyric acid (GABA) affinity in
the CNS. If discontinuation of Valerian is
desired, it should be tapered.
It’s not John Hancock, it’s HERBie Hancock!
600
A dietary/herbal supplement that
meets these standards may carry
what mark.
41
6/23/2011
It’s not John Hancock, it’s HERBie Hancock!
600
What is The “USP Verified” Mark ?
These Standards are:
• Contains the ingredients listed on the product label, in
the declared strengths and amounts
• Does not contain harmful levels of contaminants
• Will break down and release ingredients in the body
within a specified amount of time
• Has been made under Good Manufacturing Practices
(GMPs)
It’s not John Hancock, it’s HERBie Hancock!
800
This OTC supplement is considered
a disease-modifying treatment for
osteoarthritis.
42
6/23/2011
It’s not John Hancock, it’s HERBie Hancock!
800
What is Glucosamine sulfate?
Glucosamine is a precursor molecule, which is important
for maintaining elasticity, strength, and resiliency of the
cartilage in movable joints. It also has anti-inflammatory
properties and is used to decrease pain in individuals
with osteoarthritis. Glucosamine sulfate (not HCl)
should be used, because the sulfate form has positive
data from large studies to support its efficacy.
It’s not John Hancock, it’s HERBie Hancock!
1000
BONUS #2!!!
Do you feel lucky?
Please make a wager.
To the Bonus Question…
43
6/23/2011
Photo Finish
200
Photo Finish 200
What is a nebulizer?
44
6/23/2011
Photo Finish
400
Photo Finish
400
What is an enema bulb?
45
6/23/2011
Photo Finish
600
“So I have this Friend…”
600
What is a butterfly bandage?
46
6/23/2011
“So I have this Friend…”
800
Photo Finish
800
What is a light therapy machine?
47
6/23/2011
Photo Finish
1000
Photo Finish
1000
What is a wetness alerting device?
48
6/23/2011
As Seen on TV
200
“BLANK in. Mucus Out.”
As Seen on TV
200
What is Mucinex®?
49
6/23/2011
As Seen on TV
400
“Apply directly to forehead!”
As Seen on TV
400
What is HeadOn?
50
6/23/2011
As Seen on TV
600
“Because your period is more than a
pain.”
As Seen on TV
600
What is Midol?
51
6/23/2011
As Seen on TV
800
“With BLANK I can “lovetheair””
As Seen on TV
800
What is Zyrtec®?
52
6/23/2011
As Seen on TV
1000
“BLANK in the PM for a BM in the AM“
As Seen on TV
1000
What is Doxidan?
53
6/23/2011
Bonus #2…and the topic is:
It’s not John Hancock, it’s HERBie Hancock! - 1000
This is the only medication listed by
the Natural Medicines Database as
“possibly safe” and “possibly
effective” for the prevention of
colds and influenza
Bonus #2…and the topic is:
It’s not John Hancock, it’s HERBie Hancock! - 1000
What is Panax (American) ginseng?
The highest rating on NMDB is “likely safe” and “effective”
and no natural treatments fall into this category.
According to these ratings, American ginseng is more
likely to be effective than Echinacea, vitamin C, and zinc.
NMDB still does not recommend using American ginseng
for cold and flu prevention. Conventional medicine
doesn’t have a lot to offer for cold prevention in general.
54