Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care, 20th Edition

Written and peer reviewed by experts in practice and academia, the 20 th edition of the Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care is an authoritative resource for students and for health care providers who counsel and care for patients undertaking self-treatment—nonprescription drugs, nutritional supplements, medical foods, nondrug and preventive measures, and complementary therapies. Its goal is to develop the knowledge and problem-solving skills needed to assess a patient’s health status and current practice of self-treatment, to determine whether self-care is necessary or appropriate, and, if appropriate, to recommend safe and effective self-care measures. Key Features: Enhanced content in all chapters from the previous edition with up-to-date information beneficial to all health care providers and students Updates to the universal objectives to complement the content in the chapters focused on medical disorders Abstracts for each online chapter providing concise introductory material focused on key features of each chapter. Up-to-date content on nonprescription medications including indications, dosages, interactions, current evidence, medical conditions and prescription to nonprescription reclassifications Quick-reference tools such as treatment algorithms (including exclusions for self-treatment), drug product tables, patient education sidebars, and product administration illustrations Two new comprehensive patient cases for each disorder-related chapter Concise Key Points section at the end of each disorder-related chapter, summarizing critical information Cover Contributors and Copyright Editor-in-Chief Associate Editors Contributors Authors Reviewers Copyright Notice Foreword Preface Chapter Content Chapter Features Acknowledgments Chapter 1: Self-Care and Nonprescription Pharmacotherapy The Expanding Definition of Self-Care Understanding Today’s Self-Care Consumer Self-Care Changes Driven by Health Care Reform and Changes in Pharmacy Practice The Current Self-Care Marketplace Nonprescription Medications Dietary Supplements Complementary and Integrative Health Therapies Legislative and Regulatory Issues Affecting Self-Care Educating the Public About Safe Medication Use: Collaborations Be MedWise and Boy Scouts of America Up and Away Know Your Dose OTC Medicine Safety Campaign The Future of Self-Care: A Changing Marketplace and Advancements in Technology Expansion of the Self-Care Marketplace Technology Roles for the Pharmacist and Student Pharmacist in Self-Care Practice Key Points Chapter 2: Pharmacists’ Patient Care Process in Self-Care Pharmacists’ Patient Care Process (PPCP) PPCP in Self-Care: The Five Steps Step 1: Collect Step 2: Assess Medication Assessment Patient History and Risk Assessment Preventive Care Assessment Exclusions for Self-Treatment Step 3: Plan Medication-Related Problems Goals of Therapy Patient Engagement Care Continuity Step 4: Implement Step 5: Follow-up: Monitor and Evaluate PPCP in Self-Care: The Core Patient-Centered Care Specific Core Components Collaborate Communicate Document Efficient Use of PPCP in Self-Care QuEST/SCHOLAR-MAC Special Populations and PPCP in Self-Care Pediatric Patients PPCP Considerations for Pediatric Patients Collect Assess Plan and Implement Follow-up: Monitor and Evaluate Geriatric Patients PPCP Considerations for Geriatric Patients Collect Assess Plan and Implement Follow-up Pregnant Patients PPCP Considerations for Pregnant Patients Collect Assess Plan and Implement Follow-up Lactating Women PPCP Considerations for Lactating Women Collect Assess Plan and Implement Follow-up Case 2–1 Case 2–2 Case 2–3 Case 2–4 Key Points for PPCP in Self-Care Chapter 3: Exploring Cultural Aspects of Self-Care Definitions Rationale for Exploring Cultural Aspects of Self-Care Demographic Changes in the U.S. Population Health Disparities Culturally Appropriate Health Care and Workforce Diversity Concepts of Working Across Cultures Stereotyping and Generalization Acculturation Models of Cultural Competence Barriers to Self-Care Fear and Mistrust of Health Care Providers Language Barriers Literacy and Health Literacy Sociocultural Framework for Self-Care Practices General Description of Beliefs in Different Population Groups Risks of Self-Medication and Suboptimal Responses to Nonprescription Drug Therapy Communication With Culturally Diverse Groups Collecting and Assessing Patient Information Using Language Assistance and Support Developing a Self-Care Plan Ensuring Cultural Competence in Health Care Organizational Commitment Case 3–1 Case 3–2 Key Points for Multicultural Aspects of Self-Care Chapter 4: Legal and Regulatory Issues in Self-Care Pharmacy Practice History of Self-Care Nonprescription Drugs: Approval and Regulatory Processes Definition of Nonprescription Status The Nonprescription Drug Review Process Pathways to Nonprescription Status Prescription-to-Nonprescription Switch Safe Use of Nonprescription Drugs Adulteration and Misbranding Adverse Drug Reaction Reporting Labeling Packaging Advertising Third Class of Drugs De Facto Third Class of Drugs Abuse of Nonprescription Medications From Cosmetic to Drug: Crossing the Line Compounding Nonprescription Drugs Nonprescription Homeopathic Drugs Dietary Supplements Direct-to-Consumer Diagnostic Devices Nonprescription Product Liability Liability for Advice on Nonprescription Drugs Liability Associated With Nonprescription Drugs The Future: Innovative Approaches for Nonprescription Drug Products Key Points Chapter 5: Headache Pathophysiology of Headache Clinical Presentation of Headache Algorithm: Headache Treatment of Headache Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Acetaminophen Nonsalicylate Nonsteroidal Anti-inflammatory Drugs A Word About NSAIDs and Stomach Bleeding Salicylates Combination Products Pharmacotherapeutic Comparison Aspirin Versus Nonacetylated Salicylates Aspirin Versus Acetaminophen Aspirin Versus Nonsalicylate NSAID NSAID Versus Acetaminophen Naproxen Versus Ibuprofen Product Selection Guidelines Special Population Considerations Patient Factors Patient Preferences Complementary Therapies Assessment of Headache: A Case-Based Approach Patient Counseling for Headache Evaluation of Patient Outcomes for Headache Case 5–1 Case 5–2 Patient Education for Headache Key Points for Headache Chapter 6: Fever Pathophysiology of Fever Clinical Presentation of Fever Detection of Fever Complications of Fever Treatment of Fever Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Pharmacotherapeutic Comparison Product Selection Guidelines Complementary Therapies Algorithm: Fever Assessment of Fever: A Case-Based Approach Case 6–1 Case 6–2 Patient Counseling for Fever Evaluation of Patient Outcomes for Fever Patient Education for Fever Key Points for Fever Chapter 7: Musculoskeletal Injuries and Disorders Pathophysiology of Musculoskeletal Injuries and Disorders Clinical Presentation of Musculoskeletal Injuries and Disorders Treatment of Musculoskeletal Injuries and Disorders Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Systemic Analgesics Topical Products Topical NSAIDs Counterirritants Other Topical Analgesics Trolamine Salicylate Topical Anesthetics Combination Products Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Algorithm: Musculoskeletal Injuries and Disorders Assessment of Musculoskeletal Injuries and Disorders: A Case-Based Approach Case 7–1 Case 7–2 Patient Counseling for Musculoskeletal Injuries and Disorders Patient Education for Musculoskeletal Injuries and Disorders Evaluation of Patient Outcomes for Musculoskeletal Injuries and Disorders Key Points for Musculoskeletal Injuries and Disorders Chapter 8: Vaginal and Vulvovaginal Disorders Differentiation of Common Vaginal Infections Vulvovaginal Candidiasis Pathophysiology of Vulvovaginal Candidiasis Clinical Presentation of Vulvovaginal Candidiasis Algorithm: Vulvovaginal Candidiasis Treatment of Vulvovaginal Candidiasis Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Vaginal Antifungals Pharmacotherapeutic Comparison Product Selection Guidelines Special Populations Patient Factors and Preferences Complementary Therapies Assessment of Vulvovaginal Candidiasis: A Case-Based Approach Patient Counseling for Vulvovaginal Candidiasis Case 8–1 Evaluation of Patient Outcomes for Vulvovaginal Candidiasis Atrophic Vaginitis Pathophysiology of Atrophic Vaginitis Patient Education for Vulvovaginal Candidiasis Clinical Presentation of Atrophic Vaginitis Treatment of Atrophic Vaginitis Treatment Goals General Treatment Approach Nonpharmacologic Therapy Vaginal Lubricants Algorithm: Atrophic Vaginitis Assessment of Atrophic Vaginitis: A Case-Based Approach Patient Counseling for Atrophic Vaginitis Case 8–2 Patient Education for Atrophic Vaginitis Evaluation of Patient Outcomes for Atrophic Vaginitis Vaginal Douching Prevalence of Douching Potential Adverse Effects of Douching Use of Douching Equipment Patient Counseling for Douching Patient Education for Douching Key Points for Vaginal and Vulvovaginal Disorders Chapter 9: Disorders Related to Menstruation Dysmenorrhea Pathophysiology of Primary Dysmenorrhea Clinical Presentation of Primary Dysmenorrhea Treatment of Primary Dysmenorrhea Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Aspirin Acetaminophen Nonsalicylate NSAIDs Dietary Supplements Pharmacotherapeutic Comparison Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Algorithm: Primary Dysmenorrhea Assessment of Primary Dysmenorrhea: A Case-Based Approach Patient Counseling for Primary Dysmenorrhea Evaluation of Patient Outcomes for Primary Dysmenorrhea Case 9–1 Patient Education for Primary Dysmenorrhea Premenstrual Disorders Pathophysiology of Premenstrual Disorders Algorithm: Premenstrual Syndrome Clinical Presentation of Premenstrual Disorders Treatment of Premenstrual Syndrome (PMS) Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Pyridoxine Calcium and Vitamin D Magnesium Vitamin E Nonsteroidal Anti-inflammatory Drugs Diuretics Combination Products Pharmacotherapeutic Comparison Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Assessment of Premenstrual Syndrome: A Case-Based Approach Case 9–2 Patient Counseling for Premenstrual Syndrome Evaluation of Patient Outcomes for Premenstrual Syndrome Patient Education for Premenstrual Syndrome Toxic Shock Syndrome Pathophysiology of Menstrual TSS Clinical Presentation of Menstrual TSS Prevention of Menstrual TSS Assessment of Menstrual TSS: A Case-Based Approach Patient Counseling for Menstrual TSS Patient Education for Toxic Shock Syndrome Key Points for Disorders Related to Menstruation Chapter 10: Prevention of Pregnancy and Sexually Transmitted Infections Overview of Pregnancy and STIs Prevention of STIs and Pregnancy: Methods and Strategies Vaccines for STI Prevention Human Papillomavirus Vaccine Hepatitis B Vaccine Contraception for Pregnancy and STI Prevention Nonprescription Contraceptive Products Male Condoms Female Condoms Vaginal Spermicides Contraceptive Sponge Emergency Contraception Fertility Awareness–Based Methods Calendar Methods Cervical Mucus Methods Symptothermal Method Home Tests for Ovulation Prediction Lactational Amenorrhea Method Effectiveness of Fertility Awareness–Based Methods Coitus Interruptus Algorithm: Unintended Pregnancy and STIs Assessment of Prevention of Pregnancy and STIs: A Case-Based Approach Patient Counseling for Prevention of Pregnancy and STIs Case 10–1 Case 10–2 A Word About Provision of Hormonal Contraception by Pharmacists Evaluation of Patient Outcomes for Prevention of Pregnancy and STIs Key Points for Prevention of Pregnancy and STIs Chapter 11: Colds and Allergy Colds Pathophysiology of Colds Clinical Presentation of Colds Treatment of Colds Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Decongestants Antihistamines Local Anesthetics Systemic Analgesics Antitussives and Protussives (Expectorants) Combination Products Pharmacotherapeutic Comparison Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Algorithm: The Common Cold Assessment of Colds: A Case-Based Approach Case 11–1 Patient Counseling for Colds Patient Education for Colds Evaluation of Patient Outcomes for Colds Allergic Rhinitis Pathophysiology of Allergic Rhinitis Algorithm: Mediator-specific symptoms Clinical Presentation of Allergic Rhinitis Algorithm: Allergic Rhinitis Treatment of Allergic Rhinitis Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Intranasal Corticosteroids Antihistamines Combination Antihistamine Products Decongestants Cromolyn Sodium Pharmacotherapeutic Comparison Product Selection Guidelines Special Populations Patient Factors and Preferences Complementary Therapies Assessment of Allergic Rhinitis: A Case-Based Approach Case 11–2 Patient Counseling for Allergic Rhinitis Patient Education for Allergic Rhinitis Evaluation of Patient Outcomes for Allergic Rhinitis Key Points for Disorders Related to Colds and Allergic Rhinitis Chapter 12: Cough Pathophysiology of Cough Clinical Presentation of Cough Algorithm: Cough Treatment of Cough Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Oral Antitussives Codeine Dextromethorphan Diphenhydramine Chlophedianol Protussives (Expectorants) Topical Antitussives Product Selection Guidelines Efficacy Dosage Formulations Special Populations Patient Factors Complementary Therapy Assessment of Cough: A Case-Based Approach Case 12–1 Case 12–2 Patient Counseling for Cough Patient Education for Cough Evaluation of Patient Outcomes for Cough Key Points for Cough Chapter 13: Heartburn and Dyspepsia Pathophysiology of Heartburn and Dyspepsia Clinical Presentation of Heartburn and Dyspepsia Algorithm: Heartburn Treatment of Heartburn and Dyspepsia Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Antacids Histamine Type 2 Receptor Antagonists Proton Pump Inhibitors Bismuth Subsalicylate Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Assessment of Heartburn and Dyspepsia: A Case-Based Approach Case 13–1 Case 13–2 Patient Counseling for Heartburn and Dyspepsia Evaluation of Patient Outcomes for Heartburn and Dyspepsia Patient Education for Heartburn and Dyspepsia Key Points for Heartburn and Dyspepsia Chapter 14: Intestinal Gas Pathophysiology of Intestinal Gas Clinical Presentation of Intestinal Gas Algorithm: Intestinal Gas Symptoms Treatment for Intestinal Gas Treatment Goals Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Simethicone Activated Charcoal α-Galactosidase Lactase Replacement Products Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Assessment of Intestinal Gas Complaints: A Case-Based Approach Case 14–1 Case 14–2 Patient Education for Intestinal Gas Patient Counseling for Intestinal Gas Evaluation of Patient Outcomes for Intestinal Gas Key Points for Intestinal Gas Complaints Chapter 15: Constipation Pathophysiology of Constipation Clinical Presentation of Constipation Algorithm: Constipation Treatment of Constipation Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Bulk-Forming Agents Hyperosmotic Agents Emollients Lubricants Saline Laxatives Stimulant Agents Combination Products Pharmacotherapeutic Comparison Product Selection Guidelines Special Populations Patient Factors Patient Preferences Complementary Therapies Assessment of Constipation: A Case-Based Approach A Word About Opioid-Induced Constipation A Word About Laxative Overuse Case 15–1 Case 15–2 Patient Counseling for Constipation Evaluation of Patient Outcomes for Constipation Patient Education for Constipation Key Points for Constipation Chapter 16: Diarrhea Pathophysiology of Diarrhea Clinical Presentation of Diarrhea Algorithm: Acute Diarrhea in Children 6 Months to 5 Years Algorithm: Acute Diarrhea in Children Older than 5 Years Treatment of Diarrhea Treatment Goals General Treatment Approach Nonpharmacologic Therapy Fluid and Electrolyte Management Dietary Management Preventive Measures Pharmacologic Therapy Loperamide Bismuth Subsalicylate Digestive Enzymes Product Selection Guidelines Special Populations Patient Factors and Preferences Complementary Therapies Assessment of Diarrhea: A Case-Based Approach Case 16–1 Case 16–2 Patient Counseling for Diarrhea Evaluation of Patient Outcomes for Diarrhea Patient Education for Diarrhea Key Points for Diarrhea Chapter 17: Anorectal Disorders Pathophysiology of Anorectal Disorders Relevant Anatomy Clinical Presentation of Anorectal Disorders Algorithm: Hemorrhoids Treatment of Anorectal Disorders Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Local Anesthetics Vasoconstrictors Protectants Astringents Keratolytics Analgesics, Anesthetics, and Antipruritics Corticosteroids Combination Products Product Selection Guidelines Special Populations Patient Factors Complementary Therapies Assessment of Anorectal Disorders: A Case-Based Approach Case 17–1 Case 17–2 Patient Counseling for Anorectal Disorders Evaluation of Patient Outcomes for Anorectal Disorders Patient Education for Anorectal Disorders Key Points for Anorectal Disorders Chapter 18: Pinworm Infection Pathophysiology of Pinworm Infection Clinical Presentation of Pinworm Infection Algorithm: Pinworm Infection Treatment of Pinworm Infection Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Pyrantel Pamoate Product Selection Guidelines Complementary Therapies Assessment of Pinworm Infection: A Case-Based Approach Case 18–1 Case 18–2 Patient Counseling for Pinworm Infection Evaluation of Patient Outcomes for Pinworm Infection Patient Education for Pinworm Infection Key Points for Pinworm Infection Chapter 19: Nausea and Vomiting Pathophysiology of Nausea and Vomiting Clinical Presentation of Nausea and Vomiting Treatment of Nausea and Vomiting Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Nausea Associated With Motion Sickness Nausea Associated With Food or Beverages Product Selection Guidelines Special Populations Complementary Therapies Ginger Pyridoxine (Vitamin B6) Acupressure Cannabinoids Algorithm: N/V in Adults Algorithm: N/V in Children Assessment of Nausea and Vomiting: A Case-Based Approach Case 19–1 Case 19–2 Patient Counseling for Nausea and Vomiting Evaluation of Patient Outcomes for Nausea and Vomiting Patient Education for Nausea and Vomiting Key Points for Nausea and Vomiting Chapter 20: Prebiotics and Probiotics The Gut Microbiota Prebiotics Probiotics Sources Health Effects Indications (With Available Data for Prebiotics) Inflammatory Bowel Disease Irritable Bowel Syndrome Hepatic Disorders Clostridioides difficile Infection Antibiotic-Associated Diarrhea Necrotizing Enterocolitis Helicobacter pylori Infection Diabetes Mellitus Cardiovascular Risk Factors Eczema and Dermatitis Atopic Dermatitis Respiratory Syndromes Assessment of Safe Use of Probiotics Case 20–1 Case 20–2 Patient Counseling Key Points for Prebiotic and Probiotic Use Chapter 21: Poisoning Clinical Presentation of Poisoning Algorithm: Poisoning Treatment of Poisoning Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Treatment With Activated Charcoal Pharmacotherapeutic Considerations for Activated Charcoal Assessment of Poisoning: A Case-Based Approach Case 21–1 Case 21–2 Patient Counseling for Poisoning Evaluation of Patient Outcomes for Poisoning Patient Education for Toxic Exposures Key Points for Poisoning Chapter 22: Ostomy Care and Supplies Indications for Ostomies Types of Ostomies Ileostomy Colostomy Urinary Diversions Algorithm: Selection of Ostomy Pouching System Management of Ostomies Management Goals General Management Approach Types of Ostomy Pouching Systems Fit and Application Wear Time Product Selection Guidelines Ostomy Accessories Belts Skin Barrier Rings, Powder, Paste, Barrier Strips Absorbent Gel Packets and Flakes Cleansing and Special Skin Care Products Adhesive Removers and Releasers Irrigation Kits Deodorizers Changes in Diet Complications of Ostomies Psychological Complications Physiologic Complications Systemic Complications Peristomal Skin Complications Stoma Complications Medication Considerations With Ostomies Medication Absorption With Ostomies Formulation Characteristics and Absorption With Ostomies Specific Drug Classes Associated With Adverse Effects Including Malabsorption in Patients With Ostomies Antibiotics Sulfa Drugs Diuretics Laxatives Antacids Opioid-Containing Products Additional Medication-Related Issues With Ostomies Urine and Stool Discoloration Dietary Supplements Assessment of Patients With Ostomies: A Case-Based Approach Case 22–1 Case 22–2 Patient Counseling for Ostomy Care Patient Education for Ostomy Care Key Points for Ostomy Care Chapter 23: Essential and Conditionally Essential Nutrients Epidemiology and Etiology of Nutritional Deficiencies Pathophysiology of Nutritional Deficiencies Clinical Presentation of Nutritional Deficiencies Nutrient Supplementation: Principles and Terminology Vitamins Fat-Soluble Vitamins Vitamin A Vitamin D (Calciferol) Vitamin E (Tocopherol) Vitamin K Water-Soluble Vitamins Vitamin C (Ascorbic Acid) Vitamin B12 (Cyanocobalamin) Folic Acid (Pteroylglutamic Acid, Folate) Niacin (Nicotinic Acid) Vitamin B6 (Pyridoxine) Thiamine (Vitamin B1) Pantothenic Acid, Riboflavin (Vitamin B2), and Biotin (Vitamin H) Vitamin-like Compounds: Pseudovitamins Choline Minerals Principal Minerals in Health and Nutrition Calcium Iron Magnesium Phosphorus Trace Elements Copper Fluoride Iodine Zinc Nutritional Considerations in Special Patient Populations Multivitamin and Multimineral Supplements Assessment of Nutritional Adequacy: A Case-Based Approach Case 23–1 Case 23–2 Patient Education for Nutritional Deficiencies Patient Counseling for Nutrient Supplementation Evaluation of Patient Outcomes for Nutritional Adequacy Key Points for Nutritional Adequacy Chapter 24: Functional and Meal Replacement Foods Functional Foods Categories of Foods Classified as Functional Foods Foods With Health Claims Foods With Structure–Function Claims Foods for Special Dietary Use Medical Foods Conventional Foods Protective Effects of Functional Foods Functional Foods and Biomarkers: Epigenomics and Chemoprevention Fiber Recommended and Actual Intake Soluble and Insoluble Fibers Benefits of Fiber Laxation Normalization of Blood Lipid Concentrations Attenuation of Blood Glucose Response Weight Loss and Maintenance Assessment of Functional Food Use: A Case-Based Approach Case 24–1 Medical Foods and Meal Replacement Foods Enteral Formula Uses Tube Feeding Supplementation of Nutrient Intake Classification of Enteral Nutrition Products Polymeric Formulas Oligomeric Formulas Modular Products Specialty Formulas Product Use for Self-Care Administration and Monitoring Guidelines for Enteral Nutrition Food–Medication Interactions Other Medical Foods and Meal Replacement Foods Assessment of Enteral Nutrition and Meal Replacements: A Case-Based Approach Case 24–2 Patient Counseling for Enteral Nutrition and Meal Replacements Patient Education for Enteral and Meal Replacement Products Key Points for Functional and Meal Replacement Foods Chapter 25: Sports Nutrition and Performance-Enhancing Nutrients and Supplements Popularity of Sports Nutrition Products Use and Regulation of Performance-Enhancing Supplements: Labeling and Antidoping Considerations Macronutrient Use for Athletic Performance—Basic Concepts Sports Nutrition Market Basics Carbohydrate-Based Products Fats: Triglyceride-Containing Products Protein Products for Muscle Mass Gain Clinical Evidence of Protein Needs for Muscle Building Adverse Effects of Protein Supplement Use and High Protein Intake Water and Electrolytes Health Conditions Related to Hydration and Electrolytes Prevention of Dehydration Hyponatremia Risk From Drinking Excessive Free Water Carbonated and Oxygen-Enhanced Water Electrolytes and Water Without Added Carbohydrates Electrolytes, Carbohydrates, and Water Electrolytes, Carbohydrates, Protein, and Water Pre-exercise Nutrition and Hydration Nutrition and Hydration During Exercise Post-exercise Nutrition and Recovery Drinks Safety and Efficacy of Specific Ergogenic Supplements Caffeine and Caffeine-Supplemented Energy Drinks Creatine Dimethylamylamine Ephedra and Pseudoephedrine Steroidal Precursors, Dehydroepiandrosterone, and Aromatization Inhibitors Stacking Products and Use of Proprietary Blends Assessment of Performance-Enhancing Nutrients: A Case-Based Approach Case 25–1 Case 25–2 Patient Counseling for Performance-Enhancing Nutrients Patient Education for Performance-Enhancing Nutrients Key Points for Sports Nutrition and Performance-Enhancing Nutrients Chapter 26: Infant Nutrition and Special Nutritional Needs of Children Organ Maturation and Infant Growth Energy Requirements and Growth Infant Nutritional Standards Components of a Healthy Diet Fluid Carbohydrates Protein and Amino Acid Fat and Essential Fatty Acids Micronutrients Infant Food Sources Human Milk Cow Milk Whole Cow Milk Reduced-Fat Cow Milk Evaporated Milk Goat Milk Commercial Infant Formulas Formula Properties Microbiologic Safety Physical Characteristics Caloric Density Osmolality and Osmolarity Potential Renal Solute Load Types, Uses, and Selection of Commercial Infant Formulas Milk-Based Formulas Therapeutic Formulas Nutritional Problems in Infancy Diarrhea Other Gastrointestinal Issues Tooth Decay Nutritional Deficiencies or Toxicities Infant Formula Preparation Preparation Techniques Adverse Effects of Improperly Prepared and/or Administered Formulas Product Selection Guidelines Vitamin and Mineral Supplementation Human Milk–Fed, Full-Term Infants Formula-Fed, Full-Term Infants Preterm Infants Fluoride Supplementation Assessment of Infant Nutrition: A Case-Based Approach Case 26–1 Case 26–2 Patient Counseling for Infant Nutrition Patient Education for Infant Nutrition Key Points for Infant Nutrition and Special Nutritional Needs of Children Chapter 27: Overweight and Obesity Clinical Indicators of Overweight and Obesity Pathophysiology of Overweight and Obesity Obesity and Chronic Health Problems Algorithm: Overweight and Obesity Management of Overweight and Obesity Management Goals and General Management Approach Nonpharmacologic Therapy: Lifestyle Intervention Dietary Change Caloric Restriction Altered Proportions of Food Groups Use of Food Additives Meal Replacement Therapy Commercial Weight Loss Programs Physical Activity Behavioral Therapy Public Health Initiatives Pharmacologic Therapy Status of Nonprescription Weight Loss Products Use of Inappropriate Medications for Weight Loss Complementary Therapies Botanicals and Other Preparations Economically Motivated Adulteration Assessment of Overweight and Obesity: A Case-Based Approach Case 27–1 Case 27–2 Patient Counseling for Overweight and Obesity Evaluation of Patient Outcomes for Overweight and Obesity Patient Education for Overweight and Obesity Key Points for Overweight and Obesity Chapter 28: Ophthalmic Disorders Role of Eye Anatomy in Ocular Drug Pharmacokinetics Considerations With Use of Topical Ophthalmic Products Dry Eye Disease Pathophysiology and Clinical Presentation of Dry Eye Disease Treatment of Dry Eye Disease Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Artificial Tear Solutions Nonmedicated Ophthalmic Ointments Formulation Considerations for Ocular Lubricants and Other Ophthalmic Products Ophthalmic Preservatives Ophthalmic Excipients Product Selection Guidelines Preservative-Free Formulations Associated Lesions Allergic Conjunctivitis Pathophysiology and Clinical Presentation of Allergic Conjunctivitis Treatment of Allergic Conjunctivitis Treatment Goals General Treatment Approach Nonpharmacologic Therapy Pharmacologic Therapy Ophthalmic Decongestants/Alpha-Adrenergic Agonists Ophthalmic Antihistamines and Ophthalmologic Antihistamine/Mast Cell Stabilizer Combinations Product Selection Guidelines Complementary Therapies Corneal Edema Pathophysiology and Clinical Presentation of Corneal Edema Treatment of Corneal Edema Treatment Goals General Treatment Approach Pharmacologic Therapy Hyperosmotics Loose Foreign Substances in the Eye Pathophysiology and Clinical Presentation of Loose Foreign Substances in the Eye Treatment for Loose Foreign Substances in the Eye Treatment Goals General Treatment Approach Pharmacologic Therapy Ocular Irrigants Minor Eye Irritation Pathophysiology and Clinical Presentation of Minor Eye Irritation Treatment of Minor Eye Irritation Chemical Burn Pathophysiology and Clinical Presentation of Chemical Burn Emergency Treatment of Chemical Burn Artificial Eyes Contact Dermatitis of the Eyelid Pathophysiology and Clinical Presentation of Contact Dermatitis of the Eyelid Treatment of Contact Dermatitis of the Eyelid Age-Related Macular Degeneration Assessment of Ophthalmic Disorders: A Case-Based Approach Case 28–1 Case 28–2 Algorithm: Eye Surface Disorders Algorithm: Soft Lenses Patient Counseling for Ophthalmic Disorders Evaluation of Patient Outcomes for Ophthalmic Disorders Patient Education for Ophthalmic Disorders Key Points for Ophthalmic Disorders Chapter 29: Prevention of Contact Lens-Related Disorders Use of Contact Lenses Indications for Contact Lenses Contraindications and Warnings for Contact Lens Wear Soft Versus Rigid Contact Lenses Hydrophilic (Soft) Contact Lenses Hydrophilic Lens Fitting Hydrophilic Contact Lenses as Therapeutic Devices Gas-Permeable Contact Lenses Gas-Permeable Lens Fitting Specialty Contact Lenses Algorithm: Soft Lenses Considerations for Lens Care Soft Contact Lens Care Product Selection Guidelines Soft Lens Disinfection Preservatives. Disinfecting Methods. Multipurpose Products Cleaning Products Saline Solutions Rewetting Solutions Generic Solutions Product Incompatibility Insertion and Removal Gas-Permeable Contact Lens Care Product Selection Guidelines Cleaning Solutions Storage Solutions Rewetting Solutions Enzymatic Solutions Insertion and Removal Lens Storage Case Follow-up Care Contact Lens–Related Problems Precautions for Contact Lens Wear Adverse Effects of Drugs Topical Medications Airborne Drugs and Particulate Matter Systemic Medications Use of Cosmetics Exclusions for Self-Care Case 29–1 Case 29–2 Patient Counseling for Prevention of Contact Lens–Related Disorders Patient Education for Prevention of Contact Lens–Related Disorders Key Points for Prevention of Contact Lens–Related Disorders Chapter 30: Otic Disorders Pathophysiology of Otic Disorders Excessive or Impacted Cerumen Pathophysiology of Excessive or Impacted Cerumen Clinical Presentation of Excessive or Impacted Cerumen Algorithm: Excessive/Impacted Cerumen Treatment for Excessive or Impacted Cerumen Treatment Goals General Trea