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z S1: Self Care > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Product line extensions

A

marketing strategy based on brand loyality

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2
Q

Product Reformulations

A

change the ingredients but keep the brand name

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3
Q

What is the 5 steps in PPCP

A

Collect
Assess
Plan
Implement
Follow-up

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4
Q

How can PPCP be applied to self care

A

Patients can take OTCs and save money without having to go to the doctor

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5
Q

What are general characteristics of OTC

A

-consumers can use them for self-diagnosed conditions
-health care providers are not needed for safe/effective use of product
-benefits outweigh risks

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6
Q

What are the standard content area of drug facts label

A

Drug Facts: active ingredients
Purpose: type of medicine for each active ingredient
Uses: symptoms medicine is approved to treat
Warnings: side effects, when to stop using the medicine, and pregnancy-related warnings
Arrow: additional information
Directions: how it should be stored, if the product has a tamper-resistant feature
Inactive ingredients: used to make the medicine but have no effect
Questions: telephone number or website

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7
Q

Patient factors to consider when taking a medicine

A

allergies
medical conditions
current medications
pregnancy
breastfeeding
age

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8
Q

Nonprescription Analgesics/Antipyretics are FDA approved to reduce fever and relieve mild to moderate pain caused by what

A

headache, toothache, backache, muscle ache, minor arthritis, menstrual cramps, common cold

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9
Q

Patient factors to consider when choosing an analgesic/antipyretic to recommend

A

age
allergy history
PMH/med history
pregnancy/lactation

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10
Q

Properties of aspirin at OTC doses

A

Antipyretic (reduce fever)
Analgesic (reduce pain)
NOOOO inflammation reduction

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11
Q

GI effects of aspirin in gastritis/esophagitis

A

local effect
caused at low doses
irritation of GI mucosa
micro bleeding
enteric coded tablets cause less injury

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12
Q

GI effects of aspirin in ulceration

A

systemic effect
low doses
COX-1 inhibition
major bleeding
all dosage forms have same risk

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13
Q

Purpose of enteric coded tablets

A

best dosage form for chronic use
cause less local damage
absorption is delayed

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14
Q

Risk factors for GI ulceration and major bleeding from aspirin

A

Age >60
h/o GI bleeding or ulceration
higher doses
concomitant anticoagulant use (Warfarin)

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15
Q

Aspirin allergy/hypersensitivity

A

occur w/in 3 hours of ingestion (hives, bronchospasm, shock, death)

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16
Q

What is aspirin’s cross reactivity

A

90% chance they will be allergic to other NSAIDs so you have to recommend tylenol or acetaminophen

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17
Q

What is reye’s syndrome

A

excessive vomiting and development of a fatty liver and brain swelling occurs <15 yo following aspirin during viral illness

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18
Q

Aspirin should not be used to treat ______ from dental procedures or surgical procedures

A

pain

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19
Q

Low dose aspirin strength, regular dose, extra strength

A

low: 81mg
regular: 325 mg
extra: 500 mg

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20
Q

Should aspirin be used during pregnancy or lactation

A

pregnancy: not during 3rd trimester
lactation: NO

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21
Q

Properties of acetaminophen

A

antipyretic
analgesic
no anti-inflammatory at any dose

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22
Q

Acetaminophen dose for regular strength and extra strength, arthritis strength

A

regular: 325 mg
extra: 500 mg
arthritis: 650 mg

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23
Q

Childrens acetaminophen doses

A

80 mg and 160 mg
160mg/5ml liquid

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24
Q

What is the max adult dose of acetaminophen

A

4000 mg in 24 hrs

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25
Q

Pediatric dosing of acetaminophen for children 2-11

A

10-15 mg/kg per dose
do not exceed 5 doses daily

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26
Q

Situations of increased clinical concern for hepatotoxicity

A

patients with liver disease
patients who drink >3 a day

cachectic
sever liver disease

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27
Q

Acetaminophen in pregnancy and lactation

A

pregnancy: safe drug of choice
lactation: compatible with breast feeding

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28
Q

What are the only two approved OTC NSAIDs on the market

A

ibuprofen
naproxen

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29
Q

What are the properties of OTC NSAIDs at OTC doses

A

Antipyretic (reduce fever)
Analgesic (for pain)

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30
Q

What is the peds dosing for naproxen

A

no dosing

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31
Q

What is the typical tablets for naproxen and how often do you take them

A

220mg
up to 660 mg in 24 hours
take every 8-12 hours

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32
Q

What are the ibuprofen ped dosing

A

50mg/1.25ml -> 100mg/5ml
50 and 100 mg tablets

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33
Q

When does the FDA approve OTC dosing for ibuprofen

A

6 months of age

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34
Q

Adult dosing of ibuprofen

A

> 12: 200-400 q 4-6 hrs
max of 1200mg/24hrs

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35
Q

Ibuprofen weight based dosing range

A

5-10 mg/kg
usually 7.5 mg/kg

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36
Q

Adverse effects of NSAIDs

A

GI (heartburn, dyspepsia, epigastric pain)
Renal (Na and H2O retention, lead to acute kidney injury)

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37
Q

Drug/disease interactions of NSAIDs

A

warfarin
GI problems
Heart failure
Renal dysfunction
Hypertension

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38
Q

NSAIDs with lactation and pregnancy

A

pregnancy - not be used
lactation - can use ibuprofen and naproxen

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39
Q

Diurnal rhythm

A

temps are lower in the morning / higher in late afternoon / evening

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40
Q

Pyrogens cause the production of prostaglandins and they cause the hypothalamus to establish a new ______ thermoregulatory set point

A

higher

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41
Q

Classic signs and symptoms caused by thermoregulation

A

increasing body temp
decreasing body temp
fever
body aches
malaise

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42
Q

The rectal and forehead temp is usually one degree ________ than oral temp

A

higher

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43
Q

The axillary and ear temp is usually one degree __________ than oral temp

A

lower

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44
Q

If patients that are < 3 months and have a rectal temp of >104 what do you do

A

call doctor immediately, its a medical emergency

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45
Q

What is the primary goal of fever treatment

A

relieve discomfort

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46
Q

What do antipyretic drugs do to PGE2 production

A

decrease it which decreases the hypothalamic set point

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47
Q

What is the max temp reduction of antipyretic drugs

A

lower temp by 2 - 2 1/2 degree w/in 2-3 hours

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48
Q

What drug is the least appropriate choice of antipyretic drugs

A

aspirin

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49
Q

Non-drug therapy for fever

A

Increase fluid intake
Cooler enviornment
No sponge baths
Avoid isopropyl alcohol sponging

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50
Q

What is a key importance of infrared temp monitors

A

they make contact with the skin

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51
Q

What does dysmenorrhea mean

A

difficult / painful menstruation

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52
Q

What does menarche mean

A

the very first menstrual period that a female has

53
Q

Etiology of mensural cramps

A

prostaglandins

54
Q

Symptoms of dysmenorrhea

A

cramping
pain in lower abs that can radiate to back or thighs

55
Q

When does mensural pain usually start

A

when period starts
lasts 24 hours and up to 3 days

56
Q

What is the drug of choice for menstrual cramps

A

NSAIDs (take max doses regularly)
then acetaminophen
never aspirin

57
Q

Exclusions of self care of dysmenorrhea

A

sever pain/ heavy blood flow
secondary dysmenorrhea
gynecological problems
IUD usage

58
Q

Cold therapy is used in the first ____ to ____ hours after an acute musculoskeletal injury

A

24-48

59
Q

Benefits of cold therapy for pain

A

vasoconstriction
decrease metabolism
reduce muscle spasms
slow peripheral nerve conduction

60
Q

Risks of cold therapy for pain

A

incorrectly managed can lead to damaged tissue and superficial nerves
(frostbite)

61
Q

When to apply heat therapy for acute musculoskeletal injury

A

48-72 hours

62
Q

Benefits of heat for pain

A

increase blood flow
increase tissue flexibility
relieves muscle spasm
comfort and relaxation

63
Q

Low level heat source (thermacare) MOA

A

discs contain iron compound that oxidizes when exposed to air

64
Q

What are the two drug safety issues with heat sources

A

never use w/ transdermal patches
don’t use w/ external drugs

65
Q

What is counterirritation

A

producing mild pain to decrease the perception of a more intense pain

66
Q

Counterirritation MOA

A

stimulate cutaneous nerve fibers, altering perception of pain caused by stimulation
distracts attention from deeper pain in muscles or joints

67
Q

Does methyl salicylate cause hot or cold sensation

A

hot

68
Q

Does menthol cause hot or cold sensation

A

cooling

69
Q

Proper application techniques for counterirritants

A

not for children under 12
not more than tid or qid, for up to 7 days
not for damaged skin or wounds

70
Q

What is capsaicin

A

topical cream that comes from red pepper that causes heat

71
Q

capsaicin MOA

A

depletes substance P in area of application causing a desensitization of nerves (have to use regularly over long-term to work)

72
Q

Most appropriate uses for capsaicin

A

osteoarthritis
post-herpetic neuralgia (pain after shingles)

73
Q

What is myalgia

A

nonspecific complaint in muscle pain or ache
caused by viral illness, physical exertion, etc

74
Q

What is delayed onset muscle soreness (DOMS)

A

overexertion or unaccustomed muscle contraction

75
Q

What is myofascial pain

A

pain from the muscles and fascia
pain from trigger points (local tender areas)
dull, aching, deep

76
Q

What are strains

A

a partials tear of a MUSCLE
caused by force exceeding physical strength

77
Q

Definition of bursitis

A

inflammation of bursa (fluid filled sac that decrease friction btw surfaces)

78
Q

What are sprains

A

a partial tear of LIGAMENT
caused when joint forced beyond normal range of muscle

79
Q

Is this a sprain or strain: when a patient hears a pop followed by pain usually unable to bear weight, bleeding under skin

A

sprain

80
Q

What are the treatment methods of musculoskeletal pain

A

nonprescription analgesics
RICE
heat

81
Q

Osteoarthritis

A

joint pain
loss of cartilage
affects weight bearing joints due to mechanical stress

82
Q

Therapy for osteroarthritis

A

acetaminophen (first line)
NO NSAIDs

Counterirritants
Capsaicin

83
Q

What is severe pain considered as

A

pain that persists or worsens after 10 days of treatment (adults)

84
Q

Where is the highest amounts of histamine located

A

Skin
Lungs
GI mucosa

85
Q

What are mast cells

A

primary site of histamine storage
mainly in nose and eye

86
Q

Where are basophils located

A

In the blood and deeper in tissues

87
Q

What are these physciaological responses caused by:
Vasodilation
Cholinergic activity at certain nerve endings
Stimulates sensory nerves
Edema
Contraction of bronchial smooth muscle

A

Response to histamine at H1 receptor

88
Q

Sensitization of histamine

A

occurs w/ initial exposure
(IgE bodies are produced)

89
Q

Early phase of histamine

A

w/in minutes
mast cell degranulation
produce mediators

90
Q

Recruitment phase of histamine

A

infiltration of mucosa with basophils, macrophages, eosinophils, neutrophils

91
Q

Late phase of histamine

A

2-4 hours after exposure
nasal congestion, obstruction, and mucous hypersecretion

92
Q

What generation histamines are doxylamine and diphenhydramine

A

Gen 1, sedation, anticholinergic
doxylamine (common cold, insomnia)
diphenhydramine (allergy, insomnia)

93
Q

What generation histamines are cetirizine and levocertirizine

A

gen 2, used for allergies, low sedation

94
Q

What generation histamines are fexofenadine and loratadine

A

gen 2, used for allergies

95
Q

What generation histamines are brompheniramine and chlorpheniramine

A

gen 1
little sedation
common cold and allergy prevention

96
Q

What do 1st generation histamines cause

A

sedation (cross BBB)
non-selective for H1 receptor

97
Q

What do 2nd generation histamines cause

A

lipophobic
does not cross BBB
selective peripheral H1 receptors

98
Q

MOA of inverse receptor agonists at H1 receptors

A

exists in active (histamines) and inactive conformation (antihistamines)
if antihistamine present in high concentrations before histamine release then H1 receptor is primarily in inactive state and allergy symptoms are prevented

99
Q

What allergy symptoms are relieved by oral antihistamine

A

eye
nasal
(NOT nasal congestion)

100
Q

Adverse effect of gen 1 antihistamines

A

sedation
anticholinergic (dry mouth, dry nose, dry eyes, constipation, blurred vision, urinary retention)

101
Q

If men have BPH what antihistamines do you not use

A

Generation 1 because they promote urinary rentention

102
Q

What are first gen antihistamine age restriction

A

6 or older

103
Q

What two low sedation second generation antihistamines do you NOT use for patients with kidney disease and over 65 years old

A

Cetirizine
Levoceritizine
(give in evening)

104
Q

What is the age restriction for second generation antihistamine drugs

A

2 years

105
Q

What route is the most effective for treatment if allergic rhinitis

A

intranasal corticosteriods

106
Q

What is the administration technique for intranasal corticosteriods

A

opposite hand technique to not hit septom

107
Q

Adverse effects of intranasal corticosteriods

A

sneezing
sore throat
cough
nasal irritation/ bleeding

108
Q

MOA of oral nasal decongestants

A

alpha-adrenergic activity (constriction of blood vessels to reduce swelling)
helps nasal congestion

109
Q

Adverse effects of oral nasal decongestants (pseudoephedrine and phenylephrine)

A

cardiovascular

110
Q

Age restrictions on oral nasal decongestants (pseudoephedrine and phenylephrine)

A

4

111
Q

Azelastine is an intranasal antihistamine and is approves at which age

A

6 years

112
Q

What allergic nasal symptoms are relieved by intranasal antihistamines

A

itchy nose
runny nose
sneezing
nasal congestion

113
Q

What is the adverse effect of (azelastine) intranasal antihistamine

A

drowsiness

114
Q

What is intermittent allergic rhinitis

A

seasonal allergic rhinitis
symptoms last <4 days/wk or <4 wks

115
Q

What are persistent allergic rhinitis

A

perennial allergies
>4 d/wk or >4wk
chronic

116
Q

What are episodic allergic rhinitis

A

occurs when exposed to allergen that is not normally in person’s envirospectivenment
“trigger” (ex: cat hair)

117
Q

Nasal allergy symptoms

A

itchy nose
runny nose
sneezing (repetitively)
nasal congestion

118
Q

Eye allergy symptoms

A

itchy eyes
watery eyes
ref eyes

119
Q

Systemic allergy symptoms

A

fatigue, HA, cognitive impairment

120
Q

What are mild allergy symptoms

A

do not impair sleep or daily activities
(non troublesome)

121
Q

What are moderate-severe allergy symptoms

A

impaired sleep
impair daily activities
(troublesome)

122
Q

Non drug ways to relieve allergies

A

avoidance of allergy
nasal wetting agents
nasal irrigation

123
Q

What treatment to use for episodic allergies

A

oral antihistamines

124
Q

What treatment to use for mild intermittent allergies

A

oral antihistamines

125
Q

What treatment to use for moderate to severe intermittent allergies

A

oral antihistamines
intranasal corticosteroids

126
Q

What treatment to use for mild persistent allergies

A

oral antihistamines
intranasal corticosteroids

127
Q

What treatment to use for severe persistent allergies

A

intranasal corticosteroids
(oral antihistamines)

128
Q

When should internasal corticosteroids (INCS) be started

A

one week before anticipated allergy season
administered once daily as long as allergies exist
NOT PRN
NOT for episodic

129
Q

Exclusions of self-care of allergic rhinitis

A

asthma symptoms
one-sided symptoms
pregnancy

z S1: Self Care (2 decks)

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