TY - CHAP M1 - Book, Section TI - Therapeutic & Toxic Potential of Over-the-Counter Agents A1 - Clinard, Valerie B. A1 - Corelli, Robin L. A2 - Katzung, Bertram G. A2 - Vanderah, Todd W. PY - 2021 T2 - Basic & Clinical Pharmacology, 15e AB - CASE STUDYA 74-year-old man presents to his primary care provider for worsening shortness of breath, chest congestion, and symptoms of a severe cold (cough, rhinorrhea, nasal congestion, headache) over the past week. His past medical history is significant for heart failure, hypertension, and hyperlipidemia. His current medications include metoprolol succinate 100 mg daily, candesartan 16 mg daily, bumetanide 1 mg daily, potassium chloride 20 mEq daily, and rosuvastatin 20 mg daily. The patient reports excellent adherence with the prescribed regimen. When queried about the use of non-prescription medication and herbal and dietary supplements he admits to using several over-the-counter (OTC) medications over the past 5 days for his cold symptoms including Alka-Seltzer Plus Cold Formula (2 tablets every 4 hours during the day), Sudafed 24-hour (240 mg once daily), and Aleve PM (2 tablets at bedtime). His vital signs are as follows: afebrile, blood pressure 164/92 mm Hg, pulse 78 bpm, respiratory rate 18/min. On physical examination, an S3 gallop is heard; 3+ pitting edema is noted in his lower extremities, and a chest examination reveals inspiratory rales bilaterally. What medications do OTC “cold” preparations typically contain? Which of the OTC medications might have contributed to the patient’s current hypertension? Can any of these preparations exacerbate heart failure? SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1176472414 ER -