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OTC Therapeutics > Final 2- Alternative Medicine, Weightloss, Dandruff, Poison Ivy, Diaper Rash > Flashcards

Final 2- Alternative Medicine, Weightloss, Dandruff, Poison Ivy, Diaper Rash Flashcards

1
Q

acupuncture

A

stimulate specific points on body through inserting thin needs through skin

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2
Q

homeopathy

A

-use cause to treat; dilute it to make it more potent (10C=100x dilution- diluted 10x), non toxic and no SEs because nothing, BS. Can be harmful if putting off other things

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3
Q

alternative medicine good on own

A

only if not putting off something serious, but can be great adjunct to therapy, pre surgery, with cancer, etc

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4
Q

how to potentially lose 1 lb

A

500 calories/day for 7 days; eventually will plateau and become harder to lose weight

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5
Q

must add if viscous dieting

A

multivitamin

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6
Q

phenylpropanolamine

A
  • used to be standard decongestant, amphetamine like (raise heart rate, stay awake)
  • removed due to heart effects
  • never indicated for appetite suppressent OTC
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7
Q

methylcellulose in weight loss product thought to

A

-bind and absorb water, swell, make feel more full. didn’t work

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8
Q

ephedra/ephedrine for weight loss

A
  • not significant
  • 8mg as decongestant
  • decrease half a kg per month only if in high doses (100-150 mg/day)
  • with caffeine can be 1kg/month, again only in high doses
  • ephedra is not as good as parent compound (ephedrine) and will get even slimmer chance of losing weight
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9
Q

bitter orange

A
  • in caffeine naive people, will get initial water loss from duresis, but coffee drinkers will see no effect
  • little value
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10
Q

caffeine

A
  • CNS stimulant, early diuresis

- cocoa bean, yerba mate, green tea, guarana, kola nut are sources

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11
Q

green tea

A

-has natural phenols in unroasted beans , some link to antioxidants maybe cancer/heart benefit, not good for weight loss

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12
Q

chlorogenic acid

A

a phenolic compound in coffee

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13
Q

chlorogenic acid

A

a phenolic compound in coffee

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14
Q

hoodia

A

no value in weight loss

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15
Q

desperate for weight loss product

A

-give one a day weightsmart vitamin with green tea, at least its a multivitamin with some minerals too

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16
Q

raspberry ketones

A

can be linked to decongestion, but unlikely to increase metabolism

  • flavoring agent that may or may not be from raspberries
  • chemically similar to synephrine, that’s why thought to increase lipid metabolism
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17
Q

slim fast

A

less bad than just taking chemicals, at least still get carbs, etc
-may even lose weight with it;take less calories in (meal replacement)

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18
Q

gluten free products: calories

A

may have increased amounts

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19
Q

PGX

A

-bulking tool; but it is just as important as exercise ie it doesn’t work

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20
Q

acai and weight loss

A

doesn’t work

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21
Q

orlistat (xenical, Alli)

A

inhibits intestinal lipase so fat you had in meal is less digested (1/3 less fat absorption); ALL IT DOES IS MAKE YOU WANT TO CHANGE YOUR DIET

  • TID during or within 1 hr after meals
  • officially used for BMI over 30
  • Alli is USA OTC- has half dose of rx
  • GI SEs are significant and unpleasnt: if don’t lower fat intake on own, will get fatty, gross, smelly stool, flatulance, oily spotting in underwear, frequency and urgency
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22
Q

spirulina

A

seen in weight loss products as kelp and algae

  • contain iodine, link to thyroid activity,
  • rare that obesity results from hypothyroidism and no evidence this will help weight loss
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23
Q

sibutramine (Meridia)

A
  • increases NA and seratonin blockade to emhance satiety
  • SE= dry mouth, constipation, insomnia, CV
  • 10 mg OD
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24
Q

diethylpropion

A

amphetamine like, central appetite suppression

-potential for dependence and CV SEs

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25
Q

malassezia

A

yeast like, fungal organisms that causes dandruff and seborrhea

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26
Q

increased incidence of dandruff and seborrhea

A

-malessezia, puberty (androgens), male, stress, genetics, HIV patients, psoriasis patients

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27
Q

dandruff

A

dry, large, thin, white powdery scales, minimal inflammation

-even distribution over scalp

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28
Q

seborrhea

A

yellow, oily, greasy scales, with inflammation

  • can be in other areas of body too
  • tends to be more patchy
  • can be on eyelids (blepharitis), ear cannal, cradle cap (seen at 3-4 weeks old)
  • can be on face/chest
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29
Q

dandruff treatment products

A
  • triclosan= not strong enough
  • salicylic acid (2-4%)- keratolytic and helps get top layers off (rarely given on own, good to combine with coal tar)
  • coal tar- cytostatic (either as percent 0.5% or solution 10% )
  • cytostatic antifungals like selenium sulfide, zinc pyrithione, or even stronger ketoconazole, ciclopirox
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30
Q

dandruff treatment factors

A
  • treat scalp not hair
  • use 2x per week
  • if see tachyphylaxis to standard agent, switch
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31
Q

coal tar 0.5% equivalent solution

A

10%

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32
Q

treating sebhorreic dermatitis

A
  • by Rx, apply to body region
  • tar shampoos
  • anti fungal products (ketoconazole cream 2% OD-BID for 4 weeks) (ciclopirox shampoo)
  • topical steroids
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33
Q

chronic case of seb derm

A

nimecrolimus cream

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34
Q

treating sebhorreic dermatitis

A
  • by Rx, apply to body region
  • if ask, can use non rx agents as well
  • tar shampoos
  • *anti fungal products (ketoconazole cream 2% OD-BID for 4 weeks) (ciclopirox shampoo)
  • *topical steroids
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35
Q

chronic case of seb derm

A

nimecrolimus cream

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36
Q

relapses with seb derm?

A

expect them

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37
Q

cradle cap occurance

A

3-4 weeks of birth

  • scales on scalp with no oozing or weeping
  • disappears after 8 months
  • unknown etiology
38
Q

cradle cap treatment

A

-baby oil, vaseline to soften scales prn over night for 5-6 days

39
Q

contact dermatitis: allergic vs irritant exposure time

A

-allergic: amount of exposure not important
-irritant: amount of exposure is important
BUT get almost exact same result on skin for both

40
Q

what to do for acute contact dermatitis

A

cool, wet compress/dressing QID for 20 minutes

41
Q

what to do for subacute contact dermatitis

A
  • discontinue the wet dressings from acute

- use steroid lotion or cream

42
Q

what to do for chronic contact dermatitis

A

warm water soaks (to soften)

  • dry skin creams
  • steroid or fungal creams
  • maybe spectro eczema cream
43
Q

for infected ears use/ don’t use

A
  • USE: soap and water, maybe polysporin

- DON’T: burrows solution, calamine

44
Q

don’t use burrows solution for

A

dermatitis

45
Q

resin from poison ivy

A

urushiol

46
Q

resin from poison ivy

A

urushiol

47
Q

wash off contacted areas with poison ivy within

A

15 minutes

48
Q

symptoms of poison ivy contact

A

-burning, red rash in 12-48 hours in streaks from contact

49
Q

how to spread poison ivy

A
  • NOT from you blister fluid

- oil/resin left on clothes, hands, etc

50
Q

treat poison ivy rash

A
  • burrow’s
  • cool compress*
  • calamine: a few times a day only for a day or 2 because it pulls out fluids (don’t want for too long) *do not put on dry lesions it will make itchier and drier
  • DO NOT SCRATCH
  • short, lukewarm baths with colloidal ointmeal or baking soda to soothe itch (also short, cool showers, lotion, etc)
  • can use antihistamine pills
51
Q

mild reactions to poison ivy subside in

A

7-10 days

52
Q

dandruff treatment products

A
  • try non medicated shampoo first
  • triclosan= not strong enough
  • salicylic acid (2-4%)- keratolytic and helps get top layers off (rarely given on own, good to combine with coal tar)
  • coal tar- cytostatic (either as percent 0.5% or solution 10% ), antipruritic, unpleasant odor, stains
  • cytostatic antifungals like selenium sulfide, zinc pyrithione, or even stronger ketoconazole (cream 2% or shampoo), ciclopirox
53
Q

contact dermatitis: allergic vs irritant exposure time

A

-allergic: amount of exposure and concentration not important (cosmetic, metal, plant, latex, topical meds)
-allergic is usually delayed reaction, 12 to 48 hours
-irritant: amount of exposure and concentration are important (soap, detergent, solvent, fiberglass)
BUT get almost exact same result on skin for both (reddened, itchy skin with some weeping and inflam, can progress to thickened, scaling, patchy lesions)

54
Q

resin from poison ivy, oak or sumac

A

urushiol

55
Q

wash off contacted areas with poison ivy within

A

15 minutes, use normal saline or water (best), or waterless cleanser if really have to to get rid of some oils and don’t have anything else
-skin can react within 2-3 days (minimum 12 hours)

56
Q

mild reactions to poison ivy subside in

A

7-10 days

57
Q

prevention of poison ivy

A
  • covering clothes=good

- prevention/blockers=make no sense

58
Q

coal tar on hairy or broken skin areas

A

can cause folliculitis

59
Q

clinical presentation of acute dermatitis

A

PEEV

  • pruritis
  • erythema
  • edema
  • vesicles
60
Q

clinical presentation of sub acute dermatitis

A

PELM

  • pruritis
  • erythema
  • lesions drying
  • minimal scaling
61
Q

clinical presentation of chronic dermatitis

A

PLTS

  • pruritis
  • lichenification
  • thickened skin
  • scaling
62
Q

what to do for subacute contact dermatitis

A
  • discontinue the wet dressings from acute

- use steroid lotion or cream (rehydrate skin)

63
Q

what to do for chronic contact dermatitis

A

warm water soaks (to soften)

  • dry skin creams/ointments prn
  • steroid (sparingly tid-qid) or fungal creams
  • maybe spectro eczema cream
64
Q

treat poison ivy rash

A
  • burrow’s dressing 3-4x dat
  • cool compress*
  • calamine: a few times a day only for a day or 2 because it pulls out fluids (don’t want for too long) *do not put on dry lesions it will make itchier and drier
  • DO NOT SCRATCH
  • short, lukewarm baths with colloidal ointmeal (Aveeno) or baking soda to soothe itch (also short, cool showers, lotion, etc)
  • can use antihistamine pills
65
Q

clinical presentation of chronic dermatitis

A

PLTS

  • pruritis
  • lichenification
  • thickened skin
  • scaling
66
Q

clinical presentation of chronic dermatitis

A

PLTS

  • pruritis
  • lichenification
  • thickened skin
  • scaling
67
Q

diaper rash is a type of ____ contact dermatitis

A

irritant, where skin fold are typically spared, last 2-3 days

68
Q

cause of diaper rash

A
  • fecal (esp viral gastroenteritis ie stomach flu with GI enzymes coming out in diarrhea which is hard on baby’s bum- enzymes degrade skin)/urine contact
  • chemical residue- very, very small risk (esp from wipes- prop glycol has been removed therefore very safe unless extremely sensitive skin/eczema)
  • chafing
  • antibiotic use- post use can increase diarrhea
  • formula more risky than breast milk
69
Q

treatment of diaper rash

A

same approach as prevention:

  • keep clean
  • use barrier products- can be after every change or not, no difference baby can handle both (but if use barrier, can help decrease chance of diaper rash)
  • allow air time
  • bigger diaper
70
Q

time to treat diaper rash

A

less than 3 days: if more, and not getting any better, likely fungal

71
Q

diaper rash is a type of ____ contact dermatitis

A

irritant, where skin fold are typically spared, lasts 2-3 days, is not an infection, contained in diaper area and to wherever contact was

72
Q

time to treat diaper rash

A

less than 3 days: if more, and not getting any better, likely fungal

73
Q

if child has diaper rash as well as oral thrush

A

assume diaper area is infected with yeast

74
Q

yeast infection of diaper area

A

in skin folds, lesions beyond diaper often, fiery red and spotty, vesicles/satellites, need antifungals

75
Q

eczema or diaper rash/yeast?

A

eczema spares under diaper because moist

76
Q

seb derm or diaper rash/yeast?

A

seb derm usually seen in other areas (cradle cap) and is yellowy scales usually only in skin folds

77
Q

impetigo or diaper rash/yeast?

A

impetigo is honeycolored, crusted erosions, common cause of rash on infant bottom, 1-2 mm fragile pustules

78
Q

scabies or diaper rash/yeast?

A

widespread, pruritic rash

79
Q

psoriasis or diaper rash/yeast?

A

sharply demarcated scaly papules and plaques

80
Q

treating yeast diaper infection

A

antifungals BID for 2 weeks (or until baby is “clear”) then 1 week after clearing. IF not better in 3 weeks, could be bacterial. Should visibly improve in a few days.

  • miconazole or clotrimazole 1%
  • ketoconazole is most common rx, we can prescribe
  • steroid can be used to control faster, but do not use in a combo product (1% BID for 3-7 days) use one one day, one next if really want both- but steroids can get rid of very important clinical monitor
81
Q

canesten vaginal cream for diaper yeast infections

A
  • the 1% (ie 6 day) is best
  • do not use 1 day (10%)
  • if really stuck, 2% 3 day would be okay
82
Q

treatment of diaper rash

A

same approach as prevention:

  • keep clean
  • use barrier products- can be after every change or not, no difference baby can handle both (but if use barrier, can help decrease chance of diaper rash)
  • allow air time
  • bigger diaper
  • can use HC 1% (3-7 days), then wait 5 minutes and apply barrier
83
Q

treating yeast diaper infection

A

antifungals BID for 2 weeks (or until baby is “clear”) then 1 week after clearing. IF not better in 3 weeks, could be bacterial. Should visibly improve in a few days.

  • miconazole or clotrimazole 1%
  • ketoconazole 2% cream BID for up to 2 weeks is most common rx, we can prescribe
  • steroid can be used to control faster, but do not use in a combo product (1% BID for 3-7 days) use one one day, one next if really want both (or steroid first then a few minutes later antifungal)- but steroids can get rid of very important clinical monitor
84
Q

canesten vaginal cream for diaper yeast infections

A
  • the 1% (ie 6 day) is best
  • do not use 1 day (10%)
  • if really stuck, 2% 3 day would be okay
85
Q

talc powder on babies

A

not loved by pediatricians because can get in to lungs, but as long as child doesn’t inhale it’s okay

86
Q

diaper rash; ointment vs cream

A

ointment

87
Q

when to refer diaper rash/ yeast

A

if no improvement/ resolvement in 7 days

88
Q

zinc vs vaseline

A

more protective (zn)

89
Q

diaper rash is a type of ____ contact dermatitis

A

irritant, where skin fold are typically spared, lasts 2-3 days, is not an infection, contained in diaper area and to wherever contact was, mild redness and swelling that can have pimples, blisters and sores

90
Q

cause of diaper rash

A
  • fecal (esp viral gastroenteritis ie stomach flu with GI enzymes coming out in diarrhea which is hard on baby’s bum- enzymes degrade skin)/urine contact
  • chemical residue- very, very small risk (esp from wipes- prop glycol has been removed therefore very safe unless extremely sensitive skin/eczema)
  • chafing
  • antibiotic use- post use can increase diarrhea
  • formula more risky than breast milk
  • intro of new foods
91
Q

yeast infection of diaper area

A

in skin folds, lesions beyond diaper often, fiery red and spotty, probably swollen, vesicles/satellites, need antifungals

OTC Therapeutics (5 decks)

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