FInal exam main concepts Flashcards
SCHOLAR-MAC
-Symptoms:what are the main associated symptoms?
-Characteristics: What is the situation like? stable of changing?
-History: What have you done so far?
-Onset
-Location
-Aggravating factors
-Remitting Factors
-MAC: medications, allergies, conditions
What are the 4 C’s of cultural sensitivity?
1) What do you CALL the problem?
2)What to you think CAUSED the problem?
3)How do you COPE with the problem?
4)What CONCERNS do you have about the problem/treatmen?
Symptoms of teething discomforts
-mild pain
-gingival irritation, redness
-drooling
-mouth biting, gum rubbing with fingers
-low-grade fever
-irritability/crakiness
Onset and duration of teething discomfort
-as early as 3 months old
-8 days per tooth
Non drug therapy for teething
-gum massage
-cold teething ring
-washcloth: damp, twisted, frozen
-food: dry toast, teething biscuits
What non drig therapies should be avoided with teething?
-teething necklaces, braclets, anklets because of choking risk
-high sugar/carb foods
OTC treatments for teething
-systemic acetaminophen or ibuprophen
pediatric acetaminophen dosing
-10-15 mg/kg
-every 4-6 hours
-max 2400mg/24hours
pediatric ibuprophen dosing
-5-10 mg/kg
-every 6-8 hours
-max 1200mg/24 hours
7 general considerations for OTC use in pregnancy
1) non drug therapy more appropriate(especially true in XXX trimester)
2)Stage of pregnancy
3) lowest dose possible
4)topical/local dose preferable to systemic
5)avoid extra strength/ER formulations
6)Avoid combo products
7)adhearence issues due to N/V
How many older adults experiance GI bleeds with NSAID use?
-81% of older adults with a GI bleed used NSAIDs
—–95% of these people have misuse
How can a pharmacist increase OTC safety in older adults?
-pharmacist consultation
-student consultations
-follow up calls
-“Senior section”: point out medications with higher risk for older adults
Do not self treat conditions for cold
-oral temp higher than 100.4
-chest pain
-shortness of breath
-worsening symptoms
-concurrent health conditions
-AIDS or immunosupressing therapy
-frail older adults
-infants less than 3 months
Psedoephederine MOA
-alpha-adrenergic agonist constrict blood vessels decreasing sinus congestment
Psedoephederine side effects
-CV: elevated BP and HR
-CNS: tremor, insomia, anxiety, irritability, dizziness, HA
-other: rebound nasal congestion, nausea/anorexia, XXX
Psedoephederine drug interactions
-ergot derivatives
-linezolid
-MAOIs
-SNRIs
Topical nasal decongestants side effects
-rebound nasal congetion
-burning stinging
-sneezing
-nasal dryness
Oxymetazoline dosing
0.05% 2-3 sprays every 10-12 hours
-for ages 6+
!st gen antihisamine MOA
-blocks histaminic and muscarinic receptors in the medulla
1st gen antihistamine side effects
sedation, dry mouth/nose/throat, nausea, dizziness, difficult
urination, constipation, blurred vision, cognitive problems, excitation
adult acetaminophen dosing
-325-1000mg evergy 4-6 hours PRN
-max 3250 mg/day
adult ibuprophen dosing
-200-400 mg every 4-6 hours PRN
-max 1200 mg/day
adult naprozen dosing
-220 mg every 8-12 hours PRN
-max 660 mg/day
-may take 440 mg as first dose
local anesthetics MOA
local anesthetic effect to provide pain releif
local anesthetics side effects(throatspray)
-altered taste, nausea
Do not self treat cough
-difficulty breathing
-cyanosis
-hemoptysis
-weight loss
-night sweats
-worsens or persists 2-3 weeks
-younger than 4
-temp > 100.4
-returms
barking cough
-whooping cough
-sudden onset withour fever
immunocomprimised
-TB
-HIV
-chronic conditions
honey for cough
-not for less than 1 yr old
-honey is more effective than placebo, and ewually effective as dextromethorphan
-2.5 to 5 ml in syringe of in a liquid
-can substitute forcorn syrup
How to make saline for nasal irrigation
-water at body temp, sterile, 1-2 cups
-1/4 to 1/2 tsp of non-iodized salt
-pinch of baking soda
Codeine drug interactions
-CNS depressants
-alcohol
detromethorphan drug interations
-strong CYP2D6 inhibitors
-SSRIs
-MAOIs
diphenhydramine drug interactions
-CNS depressant
-narcotics
-alcohol
-XXX
-XXX
general treatments for muscle pains
-RICE
-systemic analgesics: over 1-3 days decrease dose and increase intervol, max 10 days
-topical counterirritants: 3-4x/day, max 7 days
exclusions for self treatment of fever
- fever 104 or higher
-infants less than 6 m: ficer higher 101
-infection
-hyperthermia
-Concurrent respritory diseases
-immunosuppressed
CNS damage
-febrile seziurs
-last more 3 days
-in children: rash, won’t drink, lethargic, vommiting
non pharma for fever
-increase fluid intake
–don’t do cold bath or isopropyl sponging
-lightweight clothing, remove blankets, comfortable room T
OTC treatment for fever
-acetaminiphen
-ibuprophen
-naproxen
-max 3 days of systemic treatment
exclusions for tretments of insomnia
-<12
->65
-pregnant/breastfeeding
-frequent noctural/early morning awakenings
-chronic insomnia(more than 3 months)
-sleep disruption be other other conditions
-significant sleep disorder
treatments for sleepiness
-nondrug: sleep hygiene, etc
-OTC: caffeine(100-200 mg every 3-4 hours), Guarana(caffeine producing plant)
antbiotic ointment
-prevent infection
-use until would closes
-Apply within XXX of injury
-apply 1-XXX times day
Types of tape
-plastic: rips easy, strong adhearence, slight residue, movable part of body but not joints
-paper: least adhearent, less likely to cause rxn/leave residue, flat skin
-cloth: medium adhearence, rxns, residue
-waterproof: hard to rip, thickest, strongest adhearence, leave most residue, can be used over joints
How to use mouthrinse?
-1-2 tabelspoons
-swish 30 seconds
-spit
-1-2x/day
-supervise <12
-avoid eating drinking 30 min after
-no fluoride: before brushing otherwise use after
Treatments for cold sores
-keep clean
-topical skin protectants
external analgesics
-docosanol: need to start in prodrome
-follow up in 14 days
non drug self care for xerostomia
-avoid tobacco, caffeine, hot spicy foods
-adjust meds
-limit sugar
-limit acidic food
-chew gum with sugar alcohol
-increase XXX
cool mist humidifier
-very soft bristled toothbrush
OTC treatments xerostomia
-artificial salivia: 1/2 inch gel on tongue after meals and at bedtime
teeth bleaching ingrediants
-hydrogen peroxide(up to 10%)
-carbamide peroxide
teeth whitening ingrediants
-baking soda
-hydrated silica
-may be combined with peroxide
teeth bleaching
-many forms
-used 30 min to 2 hours for 5-14 days
teeth whitening
-abrasives
remove surface stains and prevent formation of new stains
how to manage sensitivity caused by whitening/bleaching agents?
-decrease frequency
-lower concentration
-don’t brush teeth before using product
-systemic analgesics
symtoms of dyspepsia
-lower stomach
-get full fast
–belching, nausea, vommiting, bloating, heartburn, regurgitation
Non harma for heartburn
–sleep on left side
-elevate head 6-8 inches:gerd pillows
-mediterrian diet
treatment for mild heartburn/dyspepsia
antacid for rapid releif
treatment for moderate heartburn/dyspesia but need longer lasting relief
H2RA
treatment for heartburn more than 2 days per week
-PPi or H2RA
Antacids for pregnancy
-calcium
-magnesium
Antacids for lactation
aluminum, calcium, magnesium
dyspesia OTC treatment
H2RA, antacids not very effective
pediatric heartburn considerations
-child formulation of calcium carbonate antacid and lifestyle changes
water maintence equation
-first 10kg: 100mL/kg
-second 10 kg: 50ml/kg
-additional kg: 20ml/kg
how to make a fortifier for premature infants
-mix 60-100 mL milk with fortifier
Which formulas can be used with premature infants?
-Liquid formulas only(sterile)
syptoms of infant dehydration
-rapid
-increased heartrate
-irritability/lethargic
-poor skin turgor
-sunken fontanell, eyes
-no tears
-decreased urine output
refferal for infant dehydration
-severe
-72 hours
-bloody stool
-pprojectile vommiting of grreen bilios stuff
Drugs for internal hemmeroids
-vasoconstrictor:ephedrine
-protectants:all except glycerin
-calamine, zinc oxide
Drugs for external hemmeroids
-local anestetics
-vasoconstrictor
-glycerin and other prrotectants
-astringents
-keratolytics:resorcinol
-menthol, camphor, juniper tar
-corticosteriod
dimenhydranate use
-motion sickness for ages 2+
-2-6: 12.5-25mg every 6-8hrs
-6-12: 25-50mg every 6-8 hrs
-12+: 50-100 mg every 4-6 hours
do not self treat gastroenteritis
-less than 6m or 17.5 Ibs
-persistant fever
-visible blood, pus, mucos
-vommiting
-severe dehydration
-severe pain
-other concurrent illnesses
-pregnant
-persistant diarrhea
-poor response to ORS
-no improvment in 28 hours
Loperiamide
-acute, nonspecific diarrhea
-adults: 4mg them 2 mg after each loose stool, max
-6-11: 2mg then 1 mg after each loose stool, max 4 or 6 mg depending on age
components of authorized health claim
-publication of FDA regulation and literature review
-reduce disease risk: wording may or might
-label must say that condition depends on many factors not just food
-no claim allowed if high in salt, fat, cholesterol
-not allowed less than 2
Fiber reccomendations
-Reccomended: 14g fiber per 1000 calories consumed
-caution for thos with poor GI motility
How to increase fiber intake
-slowly
-1-2 serving of fiber every 1-2 weeks until goal fiber
symptoms of deficiency for vitamin A
blindness, decreased immune function, skin effects, impaired appetite
symptoms of deficiency for vitamin D
(calciferol)
“rickets”, osteopenia, fractures, falls
symptoms of deficiency for vitamin E(tocopherol)
-peripheral neuropathy, muscle weakness, hemolytic anemia
symptoms of deficiency for vitamin K
impaired coagulation
daily calcium requirments
-Male: less than 70=1000mg, over 70=1200mg
-femal less than 50=1000mg
-female over 50=1200mg
calcium carbonate salf form
-40% elemental calcium
-for acidic enviorment
calcium citrate salt form
-21% elemental calcium
-less dependent on pH
Supplements with drug interactions with warfarin
-Danshen, ginko, feverfew, coumarin containing, St johns wort, garlic, dong quai, papaya, red clover
Deet
-prevents bites from mosquitoes, blackflies, midges, mites, ticks, chiggers
picardin
-biting flies, mosquitoes, ticks
permethrin
-ticks, fleas, blackflies
–more effective for ticks than deet
How to use pediculocides
-wash hair with shampoo and towel dry
-apply product(2 bottles if hair longer than sholders), leave on for 10 min, rinse with water, avoid shampooing for 1-2 days
-dress in clean clothing
-chech hair in 8-12 hours
-comb hair every 2-3 days for 2-3 weeks
how to treat tinea coporis
antifungal 2x/day for 4 weeks
tinea coporis description
-anywhere on body, red scaly, ring shaped
-very itchy
salicylic acid for warts
-apply gel 2-3x/day
-or apply plaster pad every 48 hours
side effects of cryotherapy
-blistering
-pain/tenderness
-scarring/burns
-hypo/hyper pigmentation
-tendon/nerve damage
hard corns
-tops of toes near joints
-salicylic acid 1-2x/day
-or plaster pad every 48 hours for 14 days
soft corns
found between toes
-treat with salicylic acid 1-2x/day for 3-6 days
exclusions for hair loss
-less than 18
-pregnant/lactating
-postparrtum
no family history
-endocrine dysfunction
-medications like chemo
-dietary deficiecies
-sudden or pathchy losss
-fever
-skin lesions
-scaling
-broken hairs
loss of eyebrows
-pitting of nails
treatments for water clogged ears
-ear positioning
-warm air near ear
-water absorbing ear plugs: remove after 10 min
-95% isopropyly alcohol:4-5 drops
-5%acetic acid:4-5 drops
prevention of contact allegic dermatitis
-avoid plant
-ivy block
-protective clothing
post exposure contact allergic dermatitis treatment
-zanfel
-hydrocortisone(1st line)
-topical anestetics
-astringents
sideeffects of dextran 70
temporary stinging
side effects of cellolose ethers
crust on eyelids
allergic conjuctivitis treatments
-artificial tears: 1st line to flush eye
-decongestants
-antihistammines
-decongestant/antihistamine
-antihistamine-mast cell stabilizer
-oral antihistamines
causes minor eye irritation
-lose forieng body in eye
-contact lense
-enviorment
treatments for minor eye irritation
-artificial tears
-zinc ssulfate solution
symptoms of psoriasis
-symmetrical lesions
-plaques well defined and vary in color
-localized or diffuse
treatment for psoriasis
-emollients 4x/day
-scalp: coal tar or salicylic acid shampoos
-limbs,body: coal tar, hydrocortisone
-acute localized: hydrocortisone 1% ointment, emollients
-thick scaled plaques: salicylic acid
dandruff treatments
pyrithione zinc, selenium sulfide, ketoconazole
