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812 OTC > Exam 1 info > Flashcards

Exam 1 info Flashcards

1
Q

Nausea- Retching- Vomiting-

A

Nausea- person’s subjective feeling of a need to vomit Retching- involuntary rhythmic diaphragmatic and abdominal contractions Vomiting- rapid, forceful expulsion of GI tract contents

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2
Q

Motion sickness

A

overstimulation of the labyrinth altering the chloringinic pathway. Generally caused by unusual motion, inaccurate interpretation of the visual stimuli. Example: flying, boat, driving, etc. (Women and children 2-15 age have reported increased frequency in motion sickness, children younger than 2 years rarely get motion sickness)

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3
Q

Pregnancy-

A

unclear neurotransmitter, multifactorial. Symptoms and NV generally occur between 6-12 week of prego- hyperemesis gravidarum- severe vomiting during prego.

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4
Q

Food poisoning/Viral Gastroenteritis

A

inflammation of the stomach and small intestines generally presents as acute vomiting and diarrhea, affects all age groups. Generally caused by rotavirus and norovirus.

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5
Q

Signs and symptoms of dehydration in children

A

-Dry mouth and tongue -Sunken and/or dry eyes -Sunken fontanelle -Decreased urine output (dry diapers for several hours) -Dark urine -Fast heart beat -Thirst (drink extremely eagerly) -Absence of tears when crying -Decreased skin turgor -Unusual Lethargy- sleepiness, decreased alertness, or irritability “Floppy” body -Lightheadedness- when sitting or standing -Difficulty waking up -Weight Loss -Noticeable decrease in abdominal size -Clothes or diapers fit loosely <3% body weight loss-minimal dehydration 3-9% weight loss-mild-moderate dehydration >9% weight loss-severe dehydration

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6
Q

Exclusion for Nausea and Vomiting

A
  • Urine Ketone and BG with signs of dehydration in patients with diabetes (indicate (DKA or HHS) -Food poisoning that doesn’t clear up in 24 hrs -Severe abdominal pain that in middle or right lower quad -NV with fever and diarrhea may be infectious disease -Blood in vomit (ulcers, esophageal tears, or severe nose bleed) -Yellow skin or eye discoloration and dark urine (indicate hepatitis) -Stiff neck w/w-out sensitivity to brightness or normal light (indicate meningitis -Head injury w/ NV, blurry vision, or numbness -Person with glaucoma, BPH, chronic bronchitis, asthma -Pregnancy (severe symptoms) or breastfeeding -NV caused by cancer chemotherapy, radiation, metabolic disorders, CNS, GI, or endocrine -Drug-induced NV- adverse effect -Psychogenic-bulimia, anorexia -Chronic disease induced- gastroparesis w/ diabetes, GERD
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7
Q

Antacid and H2RA related to NV

A

Antacid- overindulgence in food or beverage or consumption of disagreeable food, relieve acid indigestion and sour stomach H2RA- overindulgence in food or beverage or consumption of disagreeable food, relieve acid indigestion and sour stomach

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8
Q

Bismuth Salicylate related to NV

A

ausea associated with consumption or nonulcer dyspepsia. Nausea, heartburn, and fullness

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9
Q

Phosphorated Carbohydrate Solution related to NV

A

nausea associated with food or beverage. Solution is a mixture of dextrose, levulose, and phosphoric acid. The hyperosmolar solution relieve NV by direct local action on the GI tract wall and decrease smooth muscle contraction

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10
Q

Antihistamine related to NV

A

generally safe and tolerated for nausea and vomiting related to motion sickness- These meds work due to the anticholinergic effects. Pregnant women should avoid

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11
Q

Meclizine

A

Meclizine is the only FDA approved non prescription. Meclizine is less sedating than DD. 25-50mg 1 hour before travel Onset- 60min duration= 24 hours

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12
Q

Doxylamine (sleepy)

A

In pregnancy, 10-12.5 mg w/or w/-out pyridoxine every 8 hr

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13
Q

Diphenhydramine (sleepy)

A

25-50mg every 6-8 hr children (6-12years) 12.5-25mg every 6-8 hr onset - 15-30 min and duration is 7-12 hours

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14
Q

Dimenhydrinate

A

50-100mg every 4-6 hr children(6-12years) 25-50mg every 6-8 hr children(2-6years) 12.5-25mg every 6-8 hr Onset- 15-20min and duration is 4-6 hours

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15
Q

doxylamine and diphenhydramine (DD) sideeffects

A

Both doxylamine and diphenhydramine (DD) have been used as off label treatments for nausea. Side effects- benign prostatic hypertrophy, dry mouth, confusion, dizziness, tremors, and constipation. Caution w/ opiates, psychmeds, beta blockers, and antiarrhythmic

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16
Q

Complementary therapy for NV

A

Ginger, Pyridoxine (Vitamine B6), Acupressure and Aromatherapy.

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17
Q

Ginger-

A

Ginger- use for nausea related to pregnancy, motion sickness and surgery, 250mg per day in 3-4 divided dosage. As effective as pyridoxine

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18
Q

Pyridoxine

A

Pyridoxine- water soluble B vitamin that is important in various metabolic functions, 1.3-2mg/day. NVP-10-25mg 3 times a day.

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19
Q

Acupressure

A

pressure on the wrist, pressure can be placed with two fingers or wrist band, vary from as need to 10min 3xday. Can throw off pace maker

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20
Q

Aromatherapy

A

peppermint oil for NV, does not have reliable evidence to support is efficacy.

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21
Q

ORS

A

ORS- Oral Rehydration Salt, used for dehydration associated with vomiting or diarrhea. Consists of carbohydrates, sodium, potassium, chloride, citrate. Glucose based ORS does not consist of potassium so supplementation of bananas and orange juice should be given.

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22
Q

Anorectal Gas

A
  • Anorectal disorders occur in the perianal area, anal canal, and lower portion of the rectum. - Hemorrhoids are abnormally large, bulging, symptomatic conglomerates of hemorrhoidal vessels, supporting tissues, and overlying mucous membranes of skin in the anorectal region
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23
Q

List some Non-Hemorrhoidal anorectal disorders and can they be self treated?

A

Potentially serious non-hemorrhoidal anorectal disorders, including abscesses, fistulas, fissures, neoplasms, polyps, pruritus ani, and inflammatory bowel disease (IBD), may present with hemorrhoid-like symptoms and SHOULD NOT be self-treated. Patients should be referred for medical evaluation if any of the conditions are suspected

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24
Q

self treatable anorectal disorders

A

Itching (pruritus) Discomfort Irritation Burning Inflammation Swelling

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25
Q

Medical referal for Anorectal Disorder

A

-Pain - internal hemorrhoids usually painless; external hemorrhoids often cause mild pain Bleeding - hemorrhoids most common cause -Seepage- involuntary passage of fecal material or mucus caused by an anal sphincter not closed completely -Change in bowel pattern - Unexplained change in bowel frequency or in stool form; may signal serious underlying GI disorder (e.g. IBD, or colorectal cancer -Prolapse (protrusion) - protrusion of hemorrhoidal or rectal tissue of variable size into anal canal -Thrombosis (blood clotting)- associated pain is most acute during the first 48-72 hours, but usually resolves after 7-10 days. Minimal pain with thrombosed internal hemorrhoids

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26
Q

Exclusions for Self-Treatment for Anorectal Disorder

A

Anorectal disorders, including hemorrhoids, in patients <12 years Diagnosed GI diseases associated with colorectal bleeding: ulcerative colitis Crohn’s disease Family history of colon cancer Potentially serious anorectal disorder such as abscess, fistula or fissures, neoplasm or malignancy, polyps, or anorectal disorders previously diagnosed by PCP Anorectal signs or symptoms such as acute onset of severe pain; bleeding; seepage; prolapse; thrombosis; black tarry stools; and moderate-to-severe itching, burning, inflammation, swelling, and discomfort Minor anorectal symptoms that do not respond to 7 days of self-treatment

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27
Q

Nonpharmacologic Therapy for Anorectal Disorder

A

-Dietary modification -Improvement of hygiene practices -Surgical intervention -Avoid lifting heavy objects -Discontinue foods that irritate or aggravate symptoms -Increased dietary fiber or adding in fiber supplements can prevent further irritation -Proper bowel habits -Sitting in warm water in the bathtub for 10-20 min for 2-4 times/day

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28
Q

Local Anesthetics for anorectal disroder

A
  • Benzocaine -Benzyl alcohol -Dibucaine -Lidocaine -Pramoxine hcl -Tetracaine Provide relief of itching, burning, discomfort, and pain by reversibly blocking transmission of nerve impulses Avoid using on open sores
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29
Q

Vasoconstrictors for anorectal disorder

A

*Ephedrine sulfate Epinephrine HCL *Phenylephrine HCL reduction of swelling/slight anesthetic effect

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30
Q

Skin Protectants

A

-*Aluminum hydroxide gel, cocoa butter, hard fat, kaotin, lanolin, mineral oil, white petrolatum, calamine, shark liver oil, zinc oxide, cod liver oil -Glycerin Provide a physical protective barrior and soften the anal canal by preventing fecal matter from irritating the perianal mucosa Glycerin is for external use only (all others are approved for internal and external) Apply to clean and dry skin

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31
Q

Astringents

A

*Calamine *Zinc Oxide Witch Hazel Promote coagulation of surface protein in the anorectal skin cells to protect the underlying tissue; decrease cell volume, drying the area; create a thin protective layer

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32
Q

Corticosteroids

A

Hydrocortisone Acts as a vasoconMay take up to 12 hours to feel effectstrictor and antipruritic -Onset of action:up to 12 hours -Duration of action: much longer than other agents

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33
Q

exclusion for Intestinal Gas

A
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34
Q

Nonpharmacologic Therapy for intestinal gas

A

Patient may benefit from changes in eating habits

  • Don’t rush through a meal
  • Do not overeat
  • Avoid smoking
  • Etc.

Patients may benefit from dietary modifications

  • Keeping a dietary diary
  • Avoiding foods that cause gas symptoms
  • Avoid carbonated beverages, such as sodas and beer

Medication use and lifestyle habits

  • Avoid long-term or frequent intermittent use of medications intended for relief of cold symptoms
  • Avoid tight fitting garments, girdies, and belts
  • Do not lie down or sit in the slumped position immediately after eating
  • Develop a regular routine of exercise and rest
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35
Q

Pharmacological Therapy for intestinal gas

A

Simethicone, Activated Charcoal, 𝝰 Galactosidase Replacement Products, Lactase Replacement Products

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36
Q

Simethicone for intestinal gas

A

Simethicone

  • Used as a defoaming agent to relieve gas
  • Used in patients with acute, non specific diarrhea
  • Used to treat intestinal gas AFTER it has occurred
  • No side effects
  • discontinue if adequate relief is not obtained within 24 hours
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37
Q

Activated Charcoal in terms of intestinal gas

A

Promoted BUT NOT approved nor shown to be effective for intestinal gas, DON’T RECOMMEND

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38
Q

𝝰 Galactosidase Replacement Products in terms of intestinal gas

A
  • For use as an antiflatulent
  • Recommended as a preventive treatment of intestinal gas symptoms produced by high-fiber diets of foods that contain oligosaccharides.
  • Must be administered just BEFORE or with the first bite of food that causes flatus and/or bloating
  • Heat can inactivate the enzyme
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39
Q

Lactase Replacement Products in terms of intestinal gas

A
  • Used in patients with lactose intolerance.
  • No adverse effects
  • To be taken with the 1st bite of food containing dairy
  • Lactase enzyme use with ages >12 years old
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40
Q

dosage for intestinal gas

A
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41
Q

probiotic for intestinal gas

A
  • Used for GI complaints including intestinal gas and bloating.
  • Formulated from either one bacterium or multiple bacteria
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42
Q

Complementary Treatments for intestinal gas

A

Fennel can cause photodermatitis, is contraindicated during pregnancy, and enters breast milk in lactating women. If fennel is used, patients should be advised to avoid excessive sunlight and avoid use during pregnancy and lactation. It can also lower ciprofloxacin levels

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43
Q

Differentiate between the clinical presentation of heartburn, gastroesophageal reflux disease (GERD), dyspepsia and peptic ulcer disease (PUD).

A
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44
Q

Contributing Factors to Heartburn

A

Dietary

  • Fatty foods
  • Spicy foods
  • Chocolate
  • Salt and salt substitutes
  • Caffeinated or carbonated beverages
  • Citrus fruits or juices
  • Tomatoes/tomato juice

Lifestyle

  • Exercise
  • Smoking
  • Obesity
  • Stress
  • Laying down after eating
  • Tight-fitting clothing

Diseases

  • Motility disorders (e.g. gastroparesis)
  • Scleroderma -rare disease that causes the hardening and tightening of skin
  • PUD (peptic ulcer disease)- painful sores or ulcers in the lining of the stomach
  • Zollinger-Ellison syndrome- disease in which tumors cause the stomach to produce too much acid, resulting in peptic ulcers

Medications

  • Bisphosphonates
  • Aspirin/NSAIDs
  • Iron
  • Potassium
  • Quinidine
  • Tetracycline
  • Zidovudine
  • Anticholinergic agents
  • Calcium channel blockers
  • Alpha/Beta adrenergic agonists
  • Progesterone
  • Chemotherapy
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45
Q

Exclusion to self treatment GERD

A
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46
Q

Alarm Systems for GERD

A

GERD

  • Dysphagia (difficulty swallowing)
  • Odynophagia (painful swallowing)
  • Chest pain
  • Upper GI bleeding
  • Unexplained weight loss
  • Continuous nausea, vomiting, and diarrhea
47
Q

Alarm system PUD

A

PUD

  • Upper GI bleeding
  • Unexplained weight loss
  • Continuous nausea, vomiting, and diarrhea may occur
48
Q

Non Pharmacologic Treatment for GERD

A

Dietary and lifestyle modifications as described previously in the table

Avoid medications that may aggravate symptoms

Avoid eating large meals

Stop/reduce smoking

Lose weight if overweight and not pregnant

Wearl loose fitting clothes

If symptoms at night:

  • Avoid lying down within 3 hours of a meal
  • Elevate the head of the bed
49
Q

Antacids for GERD

A

Neutralizes stomach acid or for mild infrequent heartburn

Okay to use with anyone >2 years old

  • Magnesium can cause diarrhea
  • Aluminum can cause constipation
  • Calcium carbonate & Sodium bicarbonate can cause flatulence

Quick relief. Can take on an empty stomach or after meal

Onset <5min and durationg is 20-30min.

50
Q

H2RAs for GERD

A
  • For mild to moderate infrequent heartburn and for the prevention of heartburn associated with acid indigestion and sour stomach
  • Cimetidine is the shortest-acting (4-8 hours of relief) whereas ranitidine, famotidine, and nizatidine have a somewhat longer duration
  • Not as rapid onset as antacids, but longer duration of relief
  • Tolerance may develop, use as needed
  • Take 30 minutes before eating
  • Okay to use with anyone >12 years old
  • onset 30-45min- 4-10 hours for duration
51
Q
A
52
Q

PPIs (proton pump inhibitor) GERD

A

Omeprazole

Lansoprazole

Esomeprazole

-Brand examples are Prilosec, Prevacid, Nexium

Inhibits the proton pump. <br></br>For the treatment of frequent heartburn in patients who have symptoms 2 or more days a week.

Complete relief may take 1-4 days

Most effective when taken 30-60 min before a meal

Okay to use with anyone >18 years old

Onset- 2-3 hours duration 12-24hours

53
Q

Bismuth Subsalicylate for GERD

A
  • Brand example are Pepto-Bismol
  • For heartburn, upset stomach, indigestion, nausea, and diarrhea
  • Side effects may cause the tongue and stool to turn black
  • You wouldn’t use if the patient only has symptoms of heartburn
54
Q

GERD onset and duration

A
55
Q

Constipation

A

Bowel movement less than 3 times a week

refer if it lasts more than 7 days

56
Q

Constipation and pregnant

A

non-pharm and then bulk-forming agent then stool softener, not a suppository

57
Q

various physiological conditions, disturbances, and lifestyle that cause constipation

A

Primary- slower than normal GI transit time or defecatory disorder.

Secondary- cause include systemic, neurological, and psychological disorder and/or structural abnormalities

Others- inadequate dietary fiber and fluid intake (dietary fiber dissolves or swells in the intestinal fluid, which increases fecal bulk to aid peristalsis and eliminating stool). Diet low in calories, carbs, or fiber can decrease fecal bulk. Inadequate intake of fluids may promote constipation in dehydrated patients.

58
Q

Some medications that cause constipation

A

Analgesic

Antacids,

Anticholinergics

Anticonvulsants

Antidepressants

Antihistamines

Antimuscarinic

Opiates

Serotonin agonist

Diuretics etc.

59
Q

Conditions associated with constipation

A

structural

Colorectal or anorectal injury, inflammation or damage

Pelvic floor disorder

structural abnormalities, ex: tumors, hernias, bowel obstruction

Systemic

Thyroid disorder, diabetes mellitus, irritable bowel syndrome, a neurological disorder, autominka, etc.

Psychological

Depression, eating disorder, situational stress

60
Q

Constipation exclusion

A
  • Marked abdominal pain or significant distention or cramping
  • Marked or unexplained flatulence
  • Fever or NV
  • Chronic medical conditions
  • Unexplained changes in bowel habits, especially w/ weight loss
  • Blood in stool or dark, tarry stool
  • Symptoms persists >2 weeks or recur over a period of at least 3 months
  • Anorexia

Age <2 years

61
Q

Diarrhea exclusion

A
  • Young age <6 months
  • Persistent fever
  • Visible blood, pus, or mucus in stool
  • High output, including frequent and substantial -volumes of diarrhea
  • Persistent vomiting
  • Severe dehydration
  • Severe abdominal pain/distress
  • Risk for significant complications, including chronic -medical conditions
  • Pregnancy
  • Chronic or persistent diarrhea
62
Q

Bulk-forming laxatives- constipation

A

contains methylcellulose, polycarbophil, and psyllium. Dosage form includes tablets, capsules, powders to be mixed with water or other liquid, and fiber few, wafters, or gummies.

Usually, the onset of action is <strong>12-24 hours</strong>, onset may be delayed up to <strong>72 hours</strong>

Treatment generally for 1) patients on low-fiber diet 2) postpartum women 3) older adults 4) patients with colostomies, irritable bowel syndrome, or diverticular disease

Few systemic adverse effects, most common abdominal cramping and flatulence. If dose not taken with adequate fluid, maybe swell in throat or esophagus, potentially causing choking.

Patients with intestinal obstruction, intestinal ulcerations, stenosis, or disabling adhesions should not take bulk-forming products.

Calcium polycarbophil contains 150mg of calcium, big risk in hypercalcemia

63
Q

Hyperosmotic agent- constipation

A

includes polyethylene<strong> glycol 3350 and glycerin</strong>. Product contain large, poorly absorbed ions, or molecules that draw water into the colon and rectum through osmosis to stimulate a bowel movement.

<strong>Glycol 3350 is only for patients 17 years of age and older</strong>. Dosage is generally 17g (1 capsule or 1 packet) mixed in with water once daily as needed. <strong>Produce bowel movement in 12-72 hours, onset may take up to 96 hours. </strong>

Effective for short term treatment. Adverse effects are bloating, abdominal discomfort, cramping, and flatulence. Consult doctor if renal or irritable bowel syndrome. Glycerine is available as a suppository for lower bowel evacuation. Effective in 15-30min.

64
Q

Emollient agent- constipation

A

stool softeners. Docusate. Time onset of 12-72 hours, and may take up to 3-5 days to effect laxation. Generally combined with a stimulant laxative for opioid-induced constipation.

65
Q

Lubricant agent-constipation

A

Mineral oil is the only non prescription lubricant. Onset of action 6-8hours after oral administration and 5-15 after rectal administration. Major concern is lipid pneumonia resulting from aspiration into the lungs after an oral dose. Should not be taken lying down or in patient with aspiration. Not for younger than 6 years, pregnant women, and bedridden or older adults, or people with difficulty swallowing. Don’t recommend it.

66
Q

Saline laxative-constipation

A

Magnesium citrate, Magnesium hydroxide, dibasic sodium phosphate, monobasic sodium phosphate, and magnesium sulfate. available in liquid or solid for oral and liquid for rectal. For occasional constipation in healthy people. Takes about 30min to 6 hour for effect. Adverse effects, abdominal cramping, nausea, vomiting, and dehydration.

67
Q

Stimulant agent-constipation

A

Stimulant agent- anthraquinones or diphenylmethanes. Primarily in the colon to increase intestinal motility either by local irritation of the mucosa or by a more selective action on the intramural nerve plexus of intestinal smooth muscle. The onset of action for bisacodyl is 6-10 hours after oral administration. Bisacodyl suppositories usually take effect 15-60 minutes after administration.

68
Q

Diarrhea

A
  • more than 3 bowel movements in the day

Causes- pathogenic, antibiotics, noravirus…..

Non-Pharm= ORS- Oral Rehydration Solution, mild to moderate dehydration

Referee within 72 hours if nothing gets fixed

69
Q

signs and symptoms of dehydration in children

A
70
Q

Loperamide-diarrhea

A

Loperamide- produces antidiarrheal effects by stimulating peripheral micro-opioids receptors on the intestinal circular muscles to slow intestinal motility. 6 years < older. Used generally for traveler’s diarrhea. Duration of use 48 hours

71
Q

bismuth subsalicylate and lactase (diarrhea)

A

bismuth subsalicylate- Duration of use 48 hours. Black tarry stool Reacts with hydrochloric acid in the stomach to form bismuth oxychloride and salicylic acid, which is insoluble and poorly absorbed from the GI Tract. 12years <.

Lactase- may be taken with milk or other dairy product to prevent osmotic diarrhea

72
Q

Insomnia

A

-Insomnia is a symptom with diverse etiologies, and it can progress to a disorder. Insomnia occurs when a person has trouble falling or staying asleep, wakes up too early and cannot return to sleep, or does not feel refreshed after sleeping.

-REM cycle is the 4 stage, at the end, most important, something with memory.

-H1 receptor, post synaptic receptor, results in wakefulness. But blocking it with an anti-histamine, promote sleepiness, sedation.

73
Q

exclusion for self-treatment insomia

A

referee patient if does not improve in 10 days

74
Q

Diphenhydramine and doxylamine

exclusion related insomnia

A

Diphenhydramine and doxylamine are not indicated to treat insomnia in children younger than 12 years because diphenhydramine may cause paradoxical excitation in younger children and is not recommended to induce sleep in infants.

75
Q

-Pregnancy-related to insomnia

A

-Pregnancy: Should not take it because the safety of antihistamines during pregnancy has not been established. For example pregnant women in the past has experienced nausea and vomiting. And also one trial reported increased risk of teratogeninicty with the use of diphenhydramine during the first trimester and one trial trpoerted cleft palate alone and other fetal abnormailities. Also increased risk of CNS adverse effects can occur in breastfed neonates after maternal intake of a sedating antihistamine.

76
Q

Medical disorders associated with insomia

A
77
Q

drugs that can exacerbate insomia

A
78
Q

sleep hygiene

A
79
Q

-Antihistamines: related to insomnia

A

(Diphenhydramine and doxylamine)

-Diphenhydramine (FDA approved)

H1 antagonist, efficacy poor in chronic insomnia, max sedation 3-6 hours after doses. Tolerance develops within days. Do not use more than 7-10 consecutive nights. 25-50mg nightly. (use 2-3 nights and take a night off b/c of tolerance)

Sideffects: antinocholorgic: can cause dry muscus, dry mouth, constipation, increase in temperature, confusion.

-Doxylamine: not FDA approved, not suggested.

80
Q

exclusion for insomnia

A
81
Q

-Pregnancy: related to caffeine

A

Caffeine freely crosses the placenta (gynecologists has concluded that moderate caffeine consumption <200mg/day does not contribute to miscarriages or preterm births.

-Children are more susceptible to the cardiovascular and CNS adverse effects of caffeine because of their lower body weight. In one study of adolsecents, 50mg of dosage, increased their diastolic blood pressure significantly.

82
Q

treat fatigue and drowsiness

A
  • Caffeine is the only FDA over the counter use as a stimulant.
  • Blocks adenosine, that promotes sleep.
  • Higher dosages causes jitters, and even less sleep.
83
Q

Understand and be able to explain to a patient which STI’s are preventable with vaccination, curable and incurable

A
84
Q

STI’s preventions

A
85
Q

-Male condoms

A

are important barrier contraceptive devices that help protect against STIs.

86
Q

Polyurethan condoms:

A

Not subjected to degradation by oil-based products. But are not as elastic as latex condoms.

87
Q

-Lamb cecum condoms:

A

labeled for pregnancy prevention only because the presence of pores in the membrane may allow passage of viral organisms, including HIV and HepB viruses.

88
Q

-Female Condoms:

A

Breakage rate of the female condom has been lower than that of latex male condoms. But it can cause irritation and discomfort. (Does protect from STI). The female condom consists of an outer ring, a sheath or pouch that fits over the vaginal musoca, and an inner ring that secures the sheath by fitting like a diaphragm over the cervix.

89
Q

-Vaginal Spermicides:

A

Use surface-active agents to immobilize and kill sperm. It also acts as a physical barrier against sperm. (Does not protect from STI).

90
Q

-Contraceptive Sponge:

A

Doesn’t protect against STI’s. Acts as a contraceptive by serving as a mechanical barrier, providing a spermicide, and absorbing semen. Is a small, circular, disposable sponge made of polyurethane permeated with the spermicide.

91
Q

selected lubricant/products that are safe or unsafe with latex condoms

A
92
Q

emergency contraception

A
93
Q

Pregtests

A
  • Ovulation tests test LH, and predicts ovulation
  • Pregancy test test hCG and tells you if your pregnant.
94
Q

-Disadvantage of FAB methods

A

-Disadvantage of FAB methods is that it lacks STI protection, and it has a lower efficacy than some other contraceptive methods, and the need for periods of abstinence or the use of another method of contraception

95
Q

-Calendar Methods:

A

Uses a woman’s monthly menstrual cycle length to calculate the fertile period. Should avoid intercourse on days 8-19 of her menstrual cycle.

96
Q

Cervical Mucus Methods:

A

Relies on changes in cervical mucus that takes place during a normal menstrual cycle. Basically monitoring cervical secretions, where if she notices any secretions (muscus) that day she is likely to be fertile. If she does not note any secretions, she is unlikely to be fertile.

97
Q

-Symptothermal Method:

A

Combines cervical muscus method along with tracking basal body temperature monitoring. Basal body temperature monitoring is to identify the end of the fertile period, and also used to predict ovulation for conception. Best results seen when taken after 3 hours of uninterrupted sleep and before getting out of bed at the same time every day.

98
Q

-Home Tests for Ovulation Prediction:

A

Designed to aid couples in conceiving by detecting the surge in luteinizing hormone that occurs shortly before ovulation. It detects an increase in urinary excretion of the hormone, which usually occurs 8-40 hours before actual ovulation.

99
Q

urine test for pregnancy and fertility

A
100
Q

Vaginal/Vulvovaginal/Menstruation

A
  • Out of the three below, bacterial vaginosis (BV), Trichomoniasis (TV), and Vulvovaginal Candidiasis (VC),
  • Vulvovaginal Candidiasis (VC) is the only one that can be treated with over the counter drugs.
  • (A easy way to differentiate the three, (VC) is usually absent of odor and has white discharge. Also there is no change in pH in the vaginia .
101
Q

-Atrophic vaginitis:

A

Is inflammation of the vagina related to atrophy of the vaginal mucosa secondary to decreased estrogen levels. It is also associated with a decrease in vaginal lubrication. Other symptoms include vaginal irritations, dryness, burning, itching, leucorrhea, and dyspareunia. A thin, watery (occasionally bloody), or yellow malodorous vaginal discharge or “spotting” may also be present.

102
Q

vulvovaginal candidiasis exclusions

A
103
Q

Atrophic vaginitis exclusions

A
104
Q

vulvovaginal candidiasis

A
  • Non-Pharm: For vulvovaginal candidiasis: Yogurt.
  • Pharmacologic Therapy for vulvovaginal candidiasis
  • Vaginal Antifungals (imidazole)
105
Q

pregnanta with VC

A

Pharmacologic Therapy:

-Can be treated with a variety of lubricants

106
Q

using lactobacillus preparations (yogurt) for

vaginal problems

A

-using lactobacillus preparations (yogurt), to reestablish normal vaginal flora and inhibit growth of candida organisms. (data effectiveness are limited and inconsistent)

107
Q

A sodium bicarbonate sitz bath for vaginal problems

A

may provide prompt, temporary relief of vulvar irritation associated with a candida vaginal infection before antifungal agents can provide noticeable benefit. (symptom relief)

108
Q

Tea tree oil:

  • Gentian Violet:
  • Boric Acid.
A

Tea tree oil: has antibacterial and antifungal properties. (no evidence)

  • Gentian Violet: A dye as an old treatment for VVC. (Use up to 5 days, symptom relief)
  • Boric Acid. 70% cure rates when used in women whose infection did not respond to vaginal antifungals. (14 days and should consult with doctor first)
109
Q

Primary dysmemorrhea and seconday dysmemorrhea

A
110
Q

exclusions for secondary dysmenorrhea

A
111
Q

exclusion for primary dysmenorrhea

A
112
Q

Special Populations for dysmenorrhea pharmacology

A
  • Special Populations for dysmenorrhea pharmacology:
  • Children – adolcenscents who have or are recovering from chickenpox or influenza like should avoid
  • Pregnant or menopausal women will not experience dysmenorrhea.
  • Women attempting to become pregnant should avoid use of NSAIDS
  • Acetaminophen and ibuprofen can safely be taken by breastfeeding women.
  • Aspirin should be avoided if women is breastfeeding.
  • Naproxen sodium should be avoided if woman is breastfeeding.
113
Q

-SPECIAL POPULATIONS realted to PMS

A

-SPECIAL POPULATIONS:

PMS DOES NOT OCCUR DURING PREGNANCY OR AFTER MENOPUASE. ADOLESCENTS AND ADULT WOMEN SHOULD INITIALLY ATTEMPT TO MANAGE SYMPTOMS WITH LIFESTYLE CHANGES AND THERAPIES SUCH AS CALCIUM SUPPLEMENTATION.

-Adolescents should avoid combinations products containing aspiring

-Women who are breastfeeding should avoid all herbal products

-Diuretics should be avoided during breastfeeding

114
Q

-Pharmacologic Therapy PMS

A
  • Pharmacologic Therapy
  • Pyridoxine 80-100mg
  • Calcium and Vitamin D (1000-1300mg daily for calcium)
  • Magnesium 360mg a day
  • Nonsteroidal anti-inflammatory Drugs (several days prior to onset of and during the first several days of menses.) For the physical symptoms such as headache and muscle/joint pains and mood symptoms.
  • Diuretics (ammonium chloride, caffeine, and pamabrom) helps with abdominal bloating and water retention.
  • Ammonium chloride 3g/day, 3 doses, no more than 6 consecutive days
  • Caffeine: 100-200mg every 3-4 hours
  • Pamabrom: 50mg 4 times daily.

812 OTC (7 decks)

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