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Tài liệu The Drug Supply and Management

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PREFACE The Drug Supply and Management textbook is especially compiled to meet the demand of equipping students of the Pharmacy Department at Lac Hong University with vocabulary and reading comprehension ability. This textbook is designed to help pharmacy – majored students build vocabulary and access pharmaceutical materials. It introduces terms relating to pharmaceutical contexts which are widely used in pharmaceutical prescriptions, reports, journals, and studies. In addition, it also enhances students‟ reading and translation skills through authentic reading texts with carefully planned activities. In spite of the efforts to make it an efficient aid in the study of this ESP course, the compilers are aware of the deficiencies that remain in the textbook. Needless to say, the compilers will greatly appreciate all positive contributions sent to the General English Department via [email protected]. i TABLE OF CONTENTS Page PREFACE ..................................................................................................... i TABLE OF CONTENTS ............................................................................. ii UNIT 1 Drug Information ............................................................................. 1 Cefixime .............................................................................................. 1 Glipizide .............................................................................................. 7 UNIT 2 The pharmacological basis of Therapeutics .................................... 13 Certirizine .......................................................................................... 13 Betamethasone ................................................................................... 19 UNIT 3 The pharmacological basis of disease treatment ............................ 29 Omeprazole ........................................................................................ 29 Chlorpromazine ................................................................................. 38 UNIT 4 Leaflet ............................................................................................. 46 Augmentin ......................................................................................... 46 Amlodipin Stada ................................................................................ 59 UNIT 5 Pharmacovigilance .......................................................................... 65 UNIT 6 Good stockage practices ................................................................. 76 UNIT 7 Pharmaceutical care ......................................................................... 91 UNIT 8 Improving global health by closing gaps in the development, distribution, and responsible use of medicines ................................. 99 UNIT 9 Medical status reports .................................................................... 107 UNIT 10 Purchase Orders .......................................................................... 142 UNIT 11 Pharmaceutical and Clinical Journals ......................................... 149 GLOSSARY ............................................................................................... 182 REFERENCES .......................................................................................... 190 ii UNIT 1 DRUG INFORMATION GUIDED STUDY CEFIXIME SCRUB UP 1. Work in pairs. Write the correct words or phrases given in the table under the corresponding pictures. 1. antibiotic 2. vomit 3. breast-feeding 4. diarrhea 5. rash 6. sore throat 7. dizziness 8. patch 9. diet a. ------------------------ b. ------------------------ c. ------------------------ d. ------------------------ e. ------------------------ f. ------------------------ g. ------------------------ h. ------------------------ i -------------------- 2. Work in pairs. Match each phonetic spelling to one of the words or phrases above. Try to say them to your partner. a. /ˌæntibaɪˈɒːtɪk/ _______ c. /sɔː θrəʊt/ _______ e. /ˈdɪzɪnəs/ _______ b. /ˌdaɪəˈriːə/ _______ d. /ˈvɒmɪt/ _______ 1 READING COMPREHENSION 1. Read the passage below and decide if these sentences are true (T) or false (F). a. Cefixim is always safe. _______ b. An over dose of this medication sometimes causes death. _______ c. This medication may have effects on stomach. _______ d. Pregnant women must be careful with this drug. _______ e. The dosage of children is based on age. _______ f. This medication requires a medical prescription to be dispensed. _______ g. If a patient missed a dose, he or she would take a double dose to catch up the missed dose. _______ 2. Fill in each blank with a suitable word. a. Antibiotics do not fight infections caused by cold and _______ viruses. b. Do not stop taking the antibiotics early even if _______ disappear after a few days. c. You should check with your doctor immediately if any of these side effects, such as stomach upset/pain, diarrhea, nausea, gas, headache, or _______ occurs when taking cefixime. d. Because no information is available on the effect of cefixime on breast milk, you should consult your doctor before _______. e. Do not save any of the antibiotics for another _______ unless told to do so by your doctor. f. Keep cefixime out of the reach of _______ and away from pets. 3. Translate the following sentences into Vietnamese. a. If you are taking the chewable tablets, chew thoroughly and then swallow. b. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection. c. Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection). d. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. e. Although most antibiotics probably do not affect hormonal birth control such as pills, patch, or ring, some antibiotics may decrease their effectiveness. 2 Reading 1 CEFIXIME 1. Uses Cefixime is used to treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria. This antibiotic treats only bacterial infections. It will not work for viral infections (e.g., common cold and flu). Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness. 2. How to use cefixime Take this medication by mouth with or without food as directed by your doctor, usually once a day. For children, this medication may also be taken twice a day (every 12 hours). If you are taking the chewable tablets, chew thoroughly and then swallow. The dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight. Antibiotics work best when the amount of medicine in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection. Tell your doctor if your condition persists or worsens. 3. Side effects Stomach upset/pain, diarrhea, nausea, gas, headache, or dizziness may occur. If any of these effects persists or worsens, notify your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these rare but very serious side effects occur: severe stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin, dark urine, unusual tiredness, new signs of infection (e.g., persistent sore throat, fever), 3 easy bruising/bleeding, change in the amount of urine, mental/mood changes (such as confusion). This medication may rarely cause a severe intestinal condition (Clostridium difficileassociated diarrhea) due to a resistant bacteria. This condition may occur weeks to months after treatment has stopped. Do not use anti-diarrhea products or narcotic pain medications if you have the following symptoms because these products may make them worse. Tell your doctor immediately if you develop: persistent diarrhea, abdominal or stomach pain/cramping, or blood/mucus in your stool. Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. 4. Precautions Before taking cefixime, tell your doctor or pharmacist if you are allergic to it; or to penicillins or other cephalosporin antibiotics (e.g., cephalexin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, a certain intestinal disease (colitis). Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). The chewable form of this medication may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid 4 aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding. 5. Interactions Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: "blood thinners" (e.g., warfarin), live bacterial vaccines. Although most antibiotics probably do not affect hormonal birth control such as pills, patch, or ring, some antibiotics may decrease their effectiveness. This could cause pregnancy. Examples include rifamycins such as rifampin or rifabutin. Be sure to ask your doctor or pharmacist if you should use additional reliable birth control methods while using this antibiotic. This medication may cause false positive results with certain diabetic urine testing products (cupric sulfate-type). This drug may also affect the results of certain lab tests. Make sure laboratory personnel and all your doctors know you use this drug. 6. Overdose If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: severe vomiting, seizures. Notes Do not share this medication with others. This medication has been prescribed for your current condition only. Do not use it later for another infection unless told to do so by your doctor. A different medication may be necessary in those cases. 5 7. Missed dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. 8. Storage Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. 6 SELF-STUDY GLIPIZIDE READING COMPREHENSION 1. Answer the questions about the text. a. How should glipizide be used? b. Can glipizide cause upset stomach? c. Will taking glipizide for diabetes make people gain weight? d. Are people with type 1 diabetes allowed to use glipizide? e. What should people do if they forget a dose? f. What side effects can this medication cause? g. What should people know about storage and disposal of this medication? 2. Translate the following paragraphs into Vietnamese. a. Glipizide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Glipizide belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body's natural insulin. b. Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, thyroid disease, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate secretion of antidiuretic hormone-SIADH), electrolyte imbalance (hyponatremia). c. Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. d. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local company waste disposal 7 Reading 2 GLIPIZIDE 1. Uses Glipizide is used with a proper diet and exercise program to control high blood sugarin people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Glipizide belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body's natural insulin. 2. How to use glipizide Take this medication by mouth 30 minutes before breakfast or the first meal of the day as directed by your doctor, usually once daily. Some patients, especially those taking higher doses, may be directed to take this drug twice a day. The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. If you are already taking another anti-diabetic drug (such as chlorpropamide), follow your doctor's directions carefully for stopping the old drug and starting glipizide. Colesevelam can decrease the absorption of glipizide. If you are taking colesevelam, take glipizide at least 4 hours before taking colesevelam. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. Tell your doctor if your condition does not improve or if it worsens (your blood sugar levels are too high or too low). 3. Side effects Nausea, vomiting, loss of appetite, diarrhea, constipation, upset stomach, headache, and weight gain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. 8 Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: signs of infection (such as persistent sore throat, fever), easy bleeding/bruising, stomach pain, yellowing eyes/skin, dark urine, unusual tiredness/weakness, unusual/sudden weight gain, mental/mood changes, swelling hands/feet, seizures. This medication can cause low blood sugar (hypoglycemia). This may occur if you do not consume enough calories from food or if you do unusually heavy exercise. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor immediately about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor immediately. Your dosage may need to be increased. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. 4. Precautions Before taking glipizide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. 9 Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, thyroid disease, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate secretion of antidiuretic hormone-SIADH), electrolyte imbalance (hyponatremia). You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar levels. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcohol while taking this medication because it can increase your risk of developing low blood sugar. Alcohol can rarely interact with glipizide and cause a serious reaction disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol. It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Older adults may be more sensitive to the side effects of this drug, especially low blood sugar. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may change your diabetes treatment during your pregnancy (such as diet and medications including insulin). It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding. 10 5. Interactions Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Many drugs can affect your blood sugar levels, making it more difficult to control your blood sugar. Before you start, stop, or change any medication, talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor about the results and of any symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your anti-diabetic medication, exercise program, or diet. Beta-blocker medications (including metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs. Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could affect your blood sugar. Ask your pharmacist about using those products safely. 6. Overdose If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: shakiness, fast heartbeat, sweating, loss of consciousness. Notes Do not share this medication with others. Attend a diabetes education program to learn more about diabetes and the important aspects of its treatment, including medications, diet, exercise, and getting regular eye/foot/medical exams. Learn the symptoms of high and low blood sugar and how to treat low blood sugar. Check your blood sugar levels regularly as directed. 11 Keep all regular medical and laboratory appointments. Laboratory and/or medical tests (such as liver and kidney function tests, fasting blood glucose, hemoglobin A1c, complete blood counts) should be performed periodically to monitor your progress or check for side effects. 7. Missed dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. 8. Storage Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. 12 UNIT 2 THE PHARMACOLOGICAL BASIS OF THERAPEUTICS GUIDED STUDY CERTIZINE SCRUB UP 1. Work with a partner. Match each phonetic spelling in column A to one of the words in column B. How do you pronounce those eight words? A B 1. /ˈælədʒɪ/ itching _______ sneezing _______ tablet _______ 2. /haɪv/ bruise _______ 3. /ˈsʌbstəns/ dose _______ rash _______ stomach pain _______ 4. /ˈɪtʃɪŋ/ prescription drug _______ drowsiness _______ restlessness _______ 5. /ˈdraʊzɪnəs/ dizziness _______ swelling _______ substance _______ 6. /ræʃ/ side effect _______ allergy _______ antihistamine _______ 7. /ˈdɪzinəs/ kidney _______ liver _______ hive _______ 8. /bruːz/ irritability _______ symptom _______ 2. Work in pairs. Decide if each of the words in column B is used in the sections (Uses, Side effects, Interactions, etc.). Then, underline the parts of the words that are stressed (the first two words are done). 13 READING COMPREHENSION 1. Choose the word or phrase marked a, b, c, or d that best complete each sentence. 1. Certirizine is used to treat _______. a. allergy symptoms b. cramp c. fever d. diarrhea 2. Certirizine is available in the forms of _______. a. tablet b. syrup c. chewable tablet d. all of the above 3. Serious side effects of certirizine contain _______. a. difficulty urinating c. tiredness b. drowsiness d. dry mouth 4. Chewable tablets may be taken with _______. a. milk b. water c. orange juice d. tea 5. The common side effect of certirizine is _______. a. weakness b. swelling c. drowsiness d. rash 6. Do not use any other antihistamines applied to the skin, such as _______. a. cream b. ointment c. spray d. all of the above 2. Answer the questions about the text. a. Should antihistamines be used by women who are breast feeding? b. Does certirizine interact with other medications? c. What is cetirizine indicated for? d. Are patients allowed to crush or chew enteric-coated preparations of certirizine? e. What should we know about storage and disposal of this medication? 3. Read the passage below and decide if these sentences are true (T) or false (F). a. Certirizine is available without a prescription. _______ b. Certirizine causes anxiety. _______ c. d. e. f. 14 People using this medication may become drowsy. _______ It is okay to take certirizine during pregnancy. _______ It is possible to take certirizine tablet twice a day. _______ People who have missed a dose of certirizine can doube it to catch up. _______ Reading 1 CETIRIZINE 1. Uses Cetirizine is an antihistamine used to relieve allergy symptoms such as watery eyes, runny nose, itching eyes/nose, sneezing, hives, and itching. It works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Cetirizine does not prevent hives or prevent/treat a serious allergic reaction (such as anaphylaxis). Therefore, if your doctor has prescribed epinephrine to treat allergic reactions, always carry your epinephrine injector with you. Do not use cetirizine in place of your epinephrine. 2. How to use cetirizine If you are taking the over-the-counter product to self-treat, read all directions on the product package before taking this medication. If you have any questions, consult your pharmacist. If your doctor has prescribed this medication, take it as directed, usually once daily. If you are using the chewable tablets, chew each tablet well and swallow. If you are using the rapidly-dissolving tablet, allow the tablet to dissolve on the tongue and then swallow, with or without water. If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. The dosage is based on your age, medical condition, and response to treatment. Do not increase your dose or take this medication more often than directed. Tell your doctor if your allergy symptoms do not improve, if your hives do not improve after 3 days of treatment, or if your hives last more than 6 weeks. Get medical help right away if your condition worsens or if you think you have a serious medical problem (such as a very serious allergic reaction/anaphylaxis). 3. Side effects Drowsiness, tiredness, and dry mouth may occur. Stomach pain may also occur, especially in children. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. 15 If your doctor has prescribed this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: difficulty urinating, weakness. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. List cetirizine side effects by likelihood and severity. 4. Precautions Before taking cetirizine, tell your doctor or pharmacist if you are allergic to it; or to hydroxyzine; or to levocetirizine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: difficulty urinating (such as due to an enlarged prostate), kidney disease, liver disease. If you are using this medication to treat hives, tell your doctor right away if you have any of these other symptoms because they may be signs of a more serious condition: hives that are an unusual color, hives that look bruised or blistered, hives that do not itch. This drug may make you drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages. Liquid products may contain sugar. Caution is advised if you have diabetes. Ask your doctor or pharmacist about using this product safely. 16 Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. This medication passes into breast milk. Consult your doctor before breast-feeding. 5. Interactions Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, other antihistamines (such as diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine). Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. Do not use with any other antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray) because increased side effects may occur. Cetirizine is very similar to hydroxyzine and levocetirizine. Do not use these medications while using cetirizine. This medication may interfere with certain laboratory tests (including allergy skin testing), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. 6. Overdose If overdose is suspected, contact a poison control center or emergency room right away. Symptoms of overdose may include: severe drowsiness. In children, mental/mood changes (such as restlessness, irritability) may occur before drowsiness. 17 Notes Keep all regular medical and laboratory appointments. 7. Missed dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. 8. Storage Store at room temperature away from light and moisture. Do not store in the bathroom. Different brands of this medication may have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. 18
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