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OTC Therapeutics > Final 3- Test Devices, leg cramps, dental, sleep aids, hangover > Flashcards

Final 3- Test Devices, leg cramps, dental, sleep aids, hangover Flashcards

1
Q

false positives and negatives on preg tests due to

A
  • waiting too long to read or reading too soon
  • doing test too soon
  • insufficient contact time on strip
  • fertility drugs taken (Profasi gives HCG-human chorionic gonadotropin which is what test tests for)
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2
Q

pregnancy tests test for

A

HCG- human chorionic gonadotropin

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3
Q

basal temperature method for ovulation

A

take temp orally in morning, do over 3 cycles, increase of .2’ for 3 days means done ovulating

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4
Q

ovulation tests test for

A

LH

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5
Q

when to start testing for ovulation

A

subtract 14 days from last day of cycle (likely day of ovulation), then start 3 days earlier than that

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6
Q

ovulation watch

A

picks up Cl ions on skin, useless

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7
Q

normal fasting blood glucose

A

3.8-6.1; optimal is 4-7

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8
Q

post prandial blood glucose

A

4.4-7, optimal 5-11

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9
Q

post prandial blood glucose

A

4.4-7, optimal 5-11

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10
Q

fecal occult blood test

A
  • detects presence of blood in stool
  • test for colorectal cancer, evaluate cause of abdominal pain, evaluate cause of anemia, as part of routine physical exam if over 50
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11
Q

clues to colorectal cancer

A
  • over 50
  • rectal bleeding
  • change in bowel habits
  • cramps/lower abdominal pain
  • painful defecation
  • polyps (via exam)
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12
Q

taking blood pressure

A
  • correct cuff size (snug, but can put 2 fingers in space)
  • empty bladder
  • rest 5 minutes before
  • no smoking or caffeine in hr leading up to it
  • don’t wear restrictive clothing
  • bottom edge of cuff 2 cm (1 inch) above elbow
  • arm at heart level/rest arm on table
  • sit with back supported and feet flat, legs uncrossed
  • don’t communicate during
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13
Q

how many bp readings?

A

3 at least 5 minutes apart

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14
Q

optimal bp

A

systolic less than 120 and diastolic less than 80

-normal is less than 130 and less than 85

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15
Q

who needs and how often: bp test

A

all adults ever 2 years, more frequently if high reading or over 60

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16
Q

who needs and how often: cholesterol measurements

A

all adults, every 5 years, more for those at high risk

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17
Q

who needs and how often: pap test

A

all women within 3 years of being sexually active, no later than 21; annually until 30 if 3 consecutive have been normal, then once every 2-3 years (unless smoke or have multiple sexual partners)

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18
Q

who needs and how often: breast cancer

A

all women over 50 annually

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19
Q

who needs and how often: colorectal cancer screening

A

everyone over 50 annually

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20
Q

who needs and how often: prostate cancer screening

A

black men, family history of it, starting at age 40. All other age 50 annually

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21
Q

who needs and how often: diabetes screening

A

45 and older every 2 years

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22
Q

who needs and how often: thyroid and bone density

A

over 50/65 respectively, on professional advice

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23
Q

who needs and how often: thyroid and bone density

A

over 50/65 respectively, on professional advice

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24
Q

who needs and how often: chlamydia

A

sexually active 24 and younger annually

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25
Q

possible causes of leg cramps

A
  • growing pains, muscle cramps (charley horse) (kids)
  • muscle cramps (adults)
  • nocturnal leg cramps, drug induced (elderly)
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26
Q

possible causes of leg cramps

A
  • growing pains, muscle cramps (charley horse) (kids)
  • muscle cramps (adults)
  • nocturnal leg cramps, drug induced (elderly)
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27
Q

muscle cramp (charley horse)

A

painful contraction of calf muscle, often while in bed/lying down
-linked to activity level (too much/little)

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28
Q

growing pains in kids

A
  • age 4-8 typically

- possible link to nutritional deficiency, but if deficient will have other issues as well

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29
Q

leg pain/cramps common in pregnancy in ___

A

3rd trimester, at night usually, 30% of women

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30
Q

varicose veins

A

worse on standing, evident visually

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31
Q

drugs that can induce leg cramps

A

diuretics, statins

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32
Q

myositis vs muscle cramping

A
  • muscle cramping and weakness, increased liver enzymes, only 0.1-1% drug users
  • cramping is usually mild and goes away with use, but happens 5-10% of users
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33
Q

myositis vs muscle cramping

A
  • muscle cramping and weakness, increased liver enzymes, only 0.1-1% drug users
  • cramping is usually mild and goes away with use, but happens 5-10% of users
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34
Q

peripheral neuropathy

A

more tingling than pain, diabetics, worse at night

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35
Q

peripheral vascular disease

A

cholesterol build up in legs, coolness in toes, numbness, harder to find pulse, 10% get intermittent claudication( get symptoms (pain/cramping) with exertion)

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36
Q

intermittent claudication

A

in peripheral vascular disease, get symptoms (pain/cramping) with exertion

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37
Q

DVT (deep vein thrombosis)

A

leg swelling, warm to touch, tender in clot area

-brought on by exertion, relieved with rest

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38
Q

nocturnal leg cramps

A

contraction of calf muscle at night, NOT RLS

-cause unknown, linked to posture, feet, drugs, thyroid, etc

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39
Q

non medical treatment for nocturnal leg cramps

A

-stretch out calf, relaxing bath, ice/cool packs

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40
Q

quinine

A
  • last resort for leg cramps, historically for malaria
  • tonic water doesn’t have enough to be effective
  • won’t see high enough dose in OTC because of potential SEs
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41
Q

magnesium and leg cramps

A

unlikely to help

  • 320-420 is safe
  • 800-900 mg starts laxative dose (400 mg/ 5mL contains 160 mg elemental; laxative dose is 30-60 mL HS)
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42
Q

painkillers and leg cramps

A

will be gone by time take unless know one is coming on

-use acet over NSAIDs as age

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43
Q

restless leg syndrome

A

sleep disorder for 5-10% people

  • compelling urge to move legs and irritable sensation
  • worsens during rest/evening
  • inability to stay still while at rest
  • walking/movement helps
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44
Q

sciatica

A

pain from low back to back of thigh/behind knee down bum

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45
Q

drugs that can induce leg cramps

A

diuretics, statins

-antipsychotics, estrogens, CCBs, lithium, oral steroids

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46
Q

peripheral vascular disease

A

cholesterol build up in legs, coolness in toes, numbness, harder to find pulse, 10% get intermittent claudication( get symptoms (pain/cramping) with exertion)
-poor wound healing and painful to walk on

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47
Q

sciatica

A

pain from low back to back of thigh/behind knee down bum

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48
Q

fibromyalgia

A

widespread muscle pain throughout body for minimum of 3 months

  • pain radiating or just sore and achy
  • most tender points on upper body
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49
Q

chronic fatigue syndrome

A

more than 6 months, in women more, exhaustion/joint/muscle pain, headahces, memory/thinking dysfunction, depressed immune, sore throat and lymphnodes

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50
Q

parkinson’s

A

tremor and shaking at rest, sluggish movement initiation, muscle rigidity

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51
Q

multiple sclerosis

A

women more than men, age 20-40 most common, tingling/numbness/weakness in arms/legs/trunk/face
-muscle stiffness and may lose strength or dexterity in leg or hand

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52
Q

huntingtons

A

occasional jerks or spasms eventually leading to abnormal movements of entire body

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53
Q

muscular dystrophy

A

young children, weakness of muscles closest to torso (pelvis–> shoulders)
-can’t fully extend muscles

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54
Q

dystonia

A
  • ex// writers cramp

- involuntary, slow repetitive sustained muscle contractions that cause freezing in the middle of an action

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55
Q

dystonia

A
  • ex// writers cramp

- involuntary, slow repetitive sustained muscle contractions that cause freezing in the middle of an action

56
Q

guillain barre syndrome

A

rapid (2-3 weeks) muscle weakness sometimes leading to paralysis (begins with tingling and loss of sensation)

57
Q

tetra cyclines can’t be used in which trimester

A

2nd and 3rd, or in children whose teeth are still developing (before age 8)

58
Q

if bioflim is not removed, it turns in to

A

plaque, then the bacteria produce acids that harden it

59
Q

plaque turns in to

A

tartar (calculus), which hardens more and is petrified plaque (can’t be brusehd off, needs DDS)

60
Q

if under 3 and at risk for cavities, use

A

F toothpaste, rice grain size

61
Q

if under 3 and not at huge risk for cavities

A

no toothpaste, wipe teeth with wet cloth or finger toothbrush

62
Q

if under 3 and not at huge risk for cavities

A

no toothpaste, wipe teeth with wet cloth or finger toothbrush

63
Q

children 3-6 can brush with assistance from adult, toothpaste wise:

A

F, size of pea

64
Q

what does fluoride do

A

helps remineralize teeth, has a topical and systemic effect, our drinking water has enough

65
Q

fluorosis

A

exposure to too much fluoride during years of enamel develpment

66
Q

sensitive teeth caused by

A

exposing dentin (softer part of tooth under enamel) that has tubes with nerve endings filled with fluid. hot/cold food/drinks causes fluid to move causing pain

67
Q

common ways to expose dentin

A
  • brushing too hard
  • gingivitis
  • receding gums
68
Q

what to use for sensitive teeth

A
  • strontium=most common, blocks tubule openings
  • potassium reduces nerve conduction
  • Ca and PO4 help repair areas
69
Q

causes of toothache

A
  • tooth decay
  • abcess
  • infected gums
  • damaged filling
  • repetitive motions (chew gum, grind teeth=bruxism)
70
Q

red flags of toothache

A

-fever, pus, swelling, headache

71
Q

treatment for toothache

A
  • pain killers (acet or nsaids)
  • heat* or cold packs on outside of cheek
  • topical benzocaine (no relief if pain is from tooth, only if originates from gums)
  • clove oil=likely no effect
72
Q

teething: lower central incisors appear (bottom middle teeth)

A

6-10 months

73
Q

teething; upper central incisors appear

A

8-12 months

74
Q

teething: upper second molars appear

A

25-33 months

-first are around year one

75
Q

age ids have all 20 baby teeth usually

A

3

76
Q

teething symptoms

A
  • extra drooling
  • irritable
  • facial rash
  • mild temperature
  • diarrhea from extra saliva (if beyond mild, likely GI virus)
77
Q

treating teething

A
  • teething ring (toys, cold facecloths)

- rub infant’s gums with fingers

78
Q

topical benzocaine not for children under ___ because

A
  • 2, risk of methomoglobinemia* (blood less efficient at oxygen transport –> death) or disabling gag reflex
  • comes in 7.5-10%
  • apply thin layer QID
79
Q

topical benzocaine not for children under ___ because

A
  • 2, risk of methomoglobinemia* (blood less efficient at oxygen transport –> death) or disabling gag reflex
  • comes in 7.5-10%
  • apply thin layer QID
80
Q

symptom length of cold sores

A

7-10 days (vesicles appear and crust over in 1-3 days)

81
Q

prodromal cold sore period

A

6-24 hours before, tingling and pain

-can start in mouth or lips (generally on lips) around nostrils

82
Q

impetigo vs cold sore

A

impetigo is not on lips usually around and way less painful

83
Q

if lesion lasts more than 2 weeks, might be concern-

A

could be squamous/basal cell (–> cancer)

84
Q

non drug treatment cold sores

A
  • reduce stress (prevention)
  • protect from sun
  • don’t pop/squeeze
  • ice cube
  • lip balm (to keep soft)
85
Q

abreva

A
  • docosonal 10%, 5x/day
  • must be used early on at first sign of tingling, antiviral, can reduce viral entry in to host cell, might resolve about 1 day faster
  • not useful after see vesicle
86
Q

polysporin hydrocolloid

A

seals area of cold sore and just makes look a little better

87
Q

treatment of cold sores

A
  • acyclovir is 5x/day that is too much!
  • BID 2 doses valacyclovir (2500 mg) and famicyclovir 750 mg) are most common prophylactic ones
  • can take 12 hours before as prophylaxis if know when or triggers for it
88
Q

treatment of cold sores

A
  • acyclovir is 5x/day that is too much!
  • BID 2 doses valacyclovir (2500 mg) and famicyclovir 750 mg) are most common prophylactic ones
  • can take 12 hours before as prophylaxis if know when or triggers for it
89
Q

topical acyclovir for cold sores

A
  • cream has 8x the drug levels, ointment is useless

- Xerese: improve healing by 1.4 days and was 50% smaller

90
Q

if waited too long to treat cold sore, now what

A
  • keep moist
  • not abreva because so expensive and won’t get full benefits
  • alcohols and sulfates may be drying
  • propolis= honey base
91
Q

treatment of cold sores

A
  • acyclovir is 5x/day that is too much!
  • BID 2 doses valacyclovir (2000 mg) and famcyclovir 750 mg) are most common acute treatment ones, must start before lesion appears
  • can take acyclovir 12 hours before as prophylaxis if know when or triggers for it, 400 mg BID beginning 12 hours before exposure of trigger and for duration of exposure
92
Q

if waited too long to treat cold sore, now what

A
  • keep soft and dry
  • not abreva because so expensive and won’t get full benefits
  • alcohols and sulfates may be drying
  • propolis= honey base
93
Q

aphthous ulcers

A

canker sores

  • cream/white colored lesion with red/inflamed border
  • painful, unknown etiology
94
Q

hand foot and mouth disease

A
  • coxsackie virus
  • begins with fever, malaise, sore throat
  • canker sores are far more painful, but will get other sores in mouth from this
  • skin rash develops over 1-2 days
  • usually only happens once to person
95
Q

drug induced ulcers (mouth)

A
  • NSAIDs (low suspicion)
  • beta blockers
  • cytotoxic agens (methotrexate)
96
Q

stomatitis

A

caused by radiation or chemo

97
Q

non pharm treatment for canker sores

A
  • try to prevent local trauma
  • reduce stress
  • nutritional deficiences
  • sinse with salt water several times a day, esp after meals (hydrogen peroxide not as effective, avoid alcohol based ones)
98
Q

pharm treatment for canker sores

A
  • benzocaine: apply directly to lesion, short term pain relief (under an hour), can be used in combo with analgesics, risk methomoglobemia
  • mucosal adherant protectant (zilactin, orabase-contains benz 20% therefore only 4x/day)
  • magic mouthwash (milk of magnesia and diphenhydramine)= protects as well, lets lesions)
  • RX:
  • oracort (triamcinolone) paste=topical steroid HS, small dab, don’t rub in
  • tantum oral rinse (benzydamine) for lesions quite widespread in mouth from chemo and radiation
99
Q

thrush symptoms

A
  • creamy white lesions along tongue or cheek, can be painful or burning, may bleed when scraped
  • infants increased fussiness
100
Q

thrush symptoms

A
  • creamy white lesions along tongue or cheek, can be painful or burning, may bleed when scraped
  • infants increased fussiness
101
Q

risk factors for thrush

A

disease states (DM

102
Q

risk factors for thrush

A

disease states (DM

103
Q

non pharm treatment thrush

A
  • improve inhaler use (spacer, MDI, gargle with water post use)
  • clean dentures overnight (allows gums to heal)
  • clean baby pacifiers and bottles
104
Q

pharm treatment thrush

A
  • gentian violet 1% (messy, effective, mucosal irritation, treat mom too, some queston safetey)
  • nystatins and iconazoles=most effective
  • nystatin
105
Q

nystatin dose for thrush

A
  • infants up to one year 200000 U suspension QID (sweep in mouth with q tip)
  • children and adults 500000 U susp QID (retain in mouth as long as possible swallow, symptomatic relief in 24-48 hours, continue use for 48 hours after cure, typically 7 days)
  • well tolerated, doesn’t interact with other medicines, short contact limits efficacy
106
Q

xerostomia

A

common in elderly, dry mouth

107
Q

function of saliva

A
  • remineralize teeth
  • lubricates oral mucosa
  • local antimicrobial activity
  • part of taste sensation
108
Q

causes of dry mouth

A
  • radiation/chemo
  • mouth breathing
  • chronic disease
  • medications (many)
109
Q

non pharm treatment xerostomia

A

-sip water, gum/candies (sugar free), humidifier during sleep

110
Q

pharm treatment xerostomia

A

-saliva substitutes (short duration due to swallowing)

111
Q

halitosis

A

bad breath

-from poor dental hygeine, aromatic foods, tobacco, caffeine, xerostomia, sinus infection, GERD

112
Q

halitosis treatment

A

-good oral hygeine, clean tongue (white=bacterial build up likely), fluids, sugar free gum, raw veggies, mouth washes, chlorophyll, chlorhexidine (peridex, DDS only, most effective in preventing biofilm, DDS only)

113
Q

gingivitis

A

gums red, swollen, bleed easily

-if untreated results in periodontitis

114
Q

gingivitis causes

A
  • inadequate brushing/flossing–> plaque/tarter
  • medical disorders/meds
  • tobacco
115
Q

temporo mandibular joint

A

-most common between 20 and 40, jaw gets stuck or locked in position, clicking/popping, can’t open mouth wide, pain

116
Q

temporo mandibular joint

A

-most common between 20 and 40, jaw gets stuck or locked in position, clicking/popping, can’t open mouth wide, pain

117
Q

chamomile, Valerian (sleepy time tea), warm milk

A

more TLC factor than help

118
Q

nytol

A

uses diphenhydramine SE of sedation (gravol, dyminhydrinate, is a salt of it, but lower MW so less sedation)

  • can get tolerance and rebound insomnia
  • with long term use only; constipation and urinary retention
119
Q

melatonin (dosing)

A
  • best agent for sleep (better than diphenhydramine)
  • make more naturally at night, but less as age
  • 5-10 mg (try 5 first, but 10 still very safe)
  • no sign of tolerance or negative effects on sleep so far
  • pick one; quick release or XR, both in one product won’t work
  • worth a try for sure
120
Q

breathe right strips and snoring

A

more for congestion, opens up nose

121
Q

sleep apnea

A
  • stop breathing
  • connection with snoring
  • CPAP= positive air pressure in to throat, pushes tissue back and away to help breathe normally)
122
Q

amount needed for caffeine to increase analgesic effectiveness

A

70-*100 mg

123
Q

caffeine and weight loss

A
  • appetite suppression more likely
  • has some effect on fatty tissue but it is minor at best
  • can increase mental alertness
124
Q

caffeine dosing limit

A

400-450 mg /day

125
Q

onset of tolerance/dependancy to caffeine

A

100 mg/day

126
Q

caffeine in pregnancy

A

avoid if possible, but less than 300 mg /day (3 cups) appears safe

127
Q

cause of snoring

A

muscles in roof of mouth, tongue and throat relax as fall asleep; if relax enough, may vibrate and partially obstruct airways (more forceful airflow=increased vibration)
-being overweight contributes, or enlarged tonsils, or alcohol (sedation), or sleep apnea

128
Q

hangovers caused by

A
  • dehydration (inhibition of anti diuretic hormone)
  • cytokines
  • increased acetaldehyde
129
Q

alcohol breakdown pathway

A

alcohol by ADH to acetaldehyde to ALDH to acetic acid

130
Q

destined genetically for hangovers if less

A

ALDH

131
Q

fatty meals do what to alcohol

A

slow dumping into system and allow liver more time to break it down

132
Q

alcohols that give less hangover

A

white rum, vodka, gin

133
Q

alcohols that cause worse hangover

A

wines, tequila, dark liquors

134
Q

resveratrol (wine) and ethanol good for health?

A

falling to wayside, probably not

135
Q

don’t take acetaminophen with alcohol if

A
  • chronic alcoholic

- liver disease

136
Q

ibuprofen/naproxen and GI irritation and dehydration

A
  • alcohol long term may cause GI probs, but acutely NBD
  • dehydration means kidneys are less profused and PGs are what control this; if block with NSAID can cause prob, but probably not significant

OTC Therapeutics (5 decks)

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