Pharmacy Over-the-Counter (OTC) Medications and Counseling

Question 1

A patient with chronic kidney disease asks for a pain reliever. Which OTC medication should be recommended with CAUTION or avoided?

Accepted Answer

Ibuprofen (Advil)

Answer

NSAIDs like ibuprofen reduce renal blood flow by inhibiting prostaglandins and can worsen kidney function in patients with CKD. Acetaminophen (with dose adjustments) is generally preferred.

Question 2

Which OTC decongestant is restricted under the Combat Methamphetamine Epidemic Act (CMEA)?

Accepted Answer

Pseudoephedrine

Answer

Pseudoephedrine can be used to manufacture methamphetamine. CMEA requires it to be kept behind the pharmacy counter with purchase quantity limits and ID verification.

Question 3

Maximum daily dose of acetaminophen for a healthy adult is:

Accepted Answer

3,000–4,000 mg/day

Answer

The standard maximum is 3,000–4,000 mg/day for healthy adults (4 g/day per manufacturer, though many clinicians recommend ≤3 g/day for regular use); doses above this risk hepatotoxicity.

Question 4

An OTC first-generation antihistamine like diphenhydramine (Benadryl) is not recommended in older adults primarily because of:

Accepted Answer

Anticholinergic side effects including sedation, urinary retention, and confusion

Answer

First-generation antihistamines are on the Beers Criteria due to anticholinergic effects (sedation, confusion, urinary retention, dry mouth) — particularly risky in older adults.

Question 5

A parent asks which OTC cough-and-cold products are safe for their 3-year-old. You should tell them:

Accepted Answer

OTC cough/cold products are not recommended for children under 4 years old

Answer

The FDA warns against using OTC cough/cold products in children under 4 years due to risk of serious side effects; many experts recommend against them in children under 12.

Pharmacy Practice Test

Pharmacy Practice Test

Pharmacy Over-the-Counter (OTC) Medications and Counseling