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OTC Exam 3 > Analrectal > Flashcards

Analrectal Flashcards

1
Q

Definition

A

• Engorged blood vessels in the anal area can be itchy and/or painful

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2
Q

Contributing Factors

A
  • Erect posture
  • Pregnancy
  • Prolonged standing or sitting
  • Lack of dietary fiber
  • Constipation
  • Diarrhea
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3
Q

Contributing Factors Cont

A
  • Heavy lifting with straining
  • Toilet habits
  • Hereditary
  • Socioeconomic factors
  • Cultural factors
  • Geographic location
  • Age
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4
Q

Internal

A

Above the dentate line

Nerve fibers endless feeling of pain

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5
Q

External

A

Below the dentate line

Bluish bumps

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6
Q

Minor Disorder S&S

A
  • Itching
  • Discomfort
  • Irritation
  • Burning
  • Inflammation
  • Swelling
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7
Q

Referral required

A 
•	Pain
•	Bleeding 
Crohn’s
Colitis
Anal fissure
CA
•	Seepage
•	Change in bowel patterns
•	Prolapse
•	Thrombosis
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8
Q

Exclusions to Self-Treatment

A
  • <12 y.o.
  • Known GI diseases
  • Family hx of colon cancer
  • Potentially serious anorectal disorder
  • Patients with serious signs/symptoms
  • Minor anorectal sx unresponsive after 7 days of treatment
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9
Q

Treatment Goals

A
  • Alleviate symptoms
  • Prevents reoccurrence of symptoms
  • Prevent complications that could lead to adverse consequences
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10
Q

General Treatment Approaches

A
  • Nonpharmacologic measures
  • Nonprescription meds
  • Prescription meds/intervention
  • Surgery
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11
Q

Non-pharm Treatments

A

• Well-balanced diet
o High fiber/bulk
o If unable, then bulk laxative
• Good perianal hygiene
o Clean with soap and water or hygiene wipes or pads
o Don’t scrub when bathing/showering
o Sitz bath – warm water BID-TID for 15 minutes

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12
Q

Non-pharm cont.

A 
•	Avoid prolonged sitting on toilet
o	No more than 10 minutes
•	Avoid lifting heavy objects
•	Avoid food that may irritate or aggravate sx 
•	Exercise
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13
Q

Local Anesthetic location

A
  • External Only

* Topical anesthetics

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14
Q

LA - function

A
  • Itching
  • Irritation
  • Burning
  • Discomfort
  • Pain
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15
Q

LA- MOA

A
  • Rapid absorption through rectal mucosa and abraded perianal skin
  • Numb the area
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16
Q

LA- cautions

A
  • Caution with allergic reactions
  • Not for internal use
  • Contact dermatitis common with benzocaine – may be used in the mouth
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17
Q

LA - types

A
  • Benzocaine
  • Benzyl alcohol
  • Dibucaine HCl
  • Dyclonine HCl
  • Lidocaine
  • Pramoxine HCl
  • Tetracaine HCL
  • Tertracaine
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18
Q

Vasoconstrictors - location

A

Internal:
• Ephedrine sulfate
• Phenlphrine

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19
Q

VC - function

A
  • Itching
  • Discomfort
  • Irritation
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20
Q

VC- MOA

A

• Reduction of swelling and slight anesthetic effect

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21
Q

VC - avoid

A
  • Diabetic
  • Thyroid disease
  • Hypertension
  • Angina Pectoris
  • Enlarged prostate
  • Antidepressants
  • Antihypertensives
  • Cardiac Meds
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22
Q

VC - types

A
  • Ephedrine sulfate
  • Epinephrine HCl
  • Epinephrine
  • Phenylephrine HCl – min effects on cardiac rhythm, and for bags under eyes
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23
Q

Protectants location

A

• Glycerin: external only

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24
Q

Pro - function

A
  • Irritation
  • Itching (kaolin and AlOH gel)
  • Burning
  • Discomfort
25
Q

Pro -MOA

A
  • Form a physical barrier on the skin

* Protective coat, soften area (moisture)

26
Q

Pro - cautions

A

• Must be a 50% conc. if a single protectant is used in a combination product

27
Q

Pro - types

A
  • AlOH gel
  • Cocoa butter
  • Glycerin
  • Hard fat
  • Kaolin
  • Lanolin (sheep)
  • Astringents
  • Others, multiple active ingredients
28
Q

Astringents location

A
  • Witch hazel – external only

* Calamine and ZnO – external and internal

29
Q

Ast function

A
  • Itching
  • Burning
  • Irritation
30
Q

Ast MOA

A
  • Promote coagulation of the skin cells  protects underlying tissue and cell vol
  • Thin layer of protection
  • Contracting, wrinkling, blanching, and  secretion = dryness
31
Q

Ast types

A
  • Witch hazel
  • Calamine
  • ZnO
32
Q

Keratolytocs location

A

External Only

33
Q

Ker Function

A
  • Itching

* Discomfort

34
Q

Ker MOA

A

• Desquamation and debridement (sloughing)

35
Q

Ker cautions

A
  • Should not be used internally

* Resorcinol – allergic reactions, do not apply to open wounds

36
Q

Ker Types

A
  • Al chlorhydroxy allantoinate

* Resorcinol

37
Q

Analgesics/Anesthetics/Antipruitis location

A

External Only

38
Q

A/A/A function

A
  • Pain
  • Itching
  • Burning
  • Discomfort
39
Q

A/A/A MOA

A

• Produce a local sensation (cool, warm, tingling) that distracts

40
Q

A/A/A cautions

A
  • Menthol – allergic reaction

* Do not use internally

41
Q

A/A/A Types

A
  • Menthol
  • Juniper Tar
  • Camphor
42
Q

Corticosteroids location

A

External Only

43
Q

CS - function

A
  • Itching

* Pain

44
Q

CS - MOA

A
  • Vasoconstrictor
  • Antipruitic
  • Onset – 12 hours but longer effect than others
45
Q

CS - cautions

A
  • Do not use internally

* Can mask symptoms of fungal and bacterial infections

46
Q

CS - types

A

• Hydrocortisone 1%

47
Q

internal dosage forms

A
  • Ointments
  • Creams
  • Suppositories
  • Gels
  • Foams
48
Q

external dosage forms

A
  • Creams
  • Ointments
  • Gels
  • Pastes
  • Liquids
  • Foams
49
Q

Diet and LS

A
  • Consume sufficient dietary fiber and fluids, exercise, and proper perianal hygiene
  • Avoid lifting heavy objects
  • Avoid foods that irritate/aggravate symptoms
50
Q

Product Selection

A
  • Fewest active ingredients possible to minimize side effects
  • Special Population
  • Proper Use
51
Q

Pregnant/breastfeeding use

A

External use products except protectants (internal)

52
Q

<12 use

A

Refer

53
Q

Peru Balsam

A

• Suppository to treat hemorrhoids

54
Q

Plantain

A
  • Pulverized seeds mixed with oil applies topically or taken orally as bulk laxative
  • Reduces bleeding and pain during defecation
55
Q

Witch Hazel

A

• FDA approved

56
Q

Butcher’s Broom

A

• Supportive therapy for itching and burning

57
Q

Sweet Clover

A

• Supportive therapy for itching and burning

58
Q

Polar bud

A

• Semisolid preps approved to aid in wound healing

59
Q

Manna. black/blonde psyllium seed husks

A

• Prevents further irritation/development of hemorrhoids because of their laxative effects

OTC Exam 3 (6 decks)

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