Lectures 72/73 Flashcards
OTC Primers, Garver (48 cards)
cough presentation
irritates throat and chest
interferes with work and sleep
can be productive or non-productive
productive cough
wet or chesty
expelling secretions
facilitates ventilation and ability of lungs to resist infection
nonproductive cough
dry or hacking
no secretions
commonly caused by respiratory infections, atypical bacteria, medications, and GERD
cold presentation
gradual onset of symptoms
common –> sneezing, rhinorrhea/congestion, and sore throat
flu presentation
abrupt onset of symptoms
usual –> fever, aches, fatigue, weakness
common –> headache, chills, chest discomfort, cough
referral for cough, cold, and flu
fever over 101.5F
new chest pain
shortness of breath (worse than baseline)
worsening or new symptoms during self-treatment
comorbidities (AIDs, chronic immunosuppressant therapy)
infants under 3 months old
hypersensitivity to recommended OTC medication
when to refer for skin conditions
dry skin
ringworm/pinworm
diaper rash
poison ivy
when to refer for athlete’s foot
recurrent
failed prior treatment
expansive infection
including genitalia
when to refer for lice
recurrent
refractory
under 2 months old
involvement of hair outside the scalp region
when to refer for hemorrhoids
no relief after one week of OTC treatment
severe pain
bleeding
sensitivity to OTC medications
change in bowel patterns
family history of IBD
fish oil
uses – hypertriglyceridemia
SE – GI upset, heartburn, indigestion, fishy taste or burp
Drug/Drug – anticoagulants, antiplatelets
CI – active bleeding, PUD
Niacin
use – dyslipidemia (not commonly used)
SE – flushing (80% of pts)
ginger
USE – NV (specifically pregnancy)
SE – only with doses over 3g per day, can increase bleeding risks
St. John’s wort
USE – treatment of mild to moderate depression (not major), extensive use with some efficacy
SE – vivid dreams, headache, dizziness, GI upset, dry mouth, photodermatitis
Drug/Drug – CYP Inducer, PGP Inducer, Digoxin, HIV Meds, Warfarin
cranberry
USE – prevention of UTI (not tx)
SE – kidney stones
CI – aspirin allergy (contains salicylic acid)
Saw Palmetto
USE – BPH
SE – GI upset
Echinacea
USE – decrease URTI by 1 day
SE – GI upset, rash, allergic reaction with ragweed, marigold, and daises)
Melatonin
USE – insomnia, shift disorder, jet leg
rhinorrhea treatment
first gen AH
second gen AH
intranasal corticosteroids
non pharm –> environmental, saline washes, and nasal strips
first gen AH
benadryl (diphenhydramine)
unisom (doxylamine)
PROS – relief of rhinorrhea and sneezing
CONS – sedating, short-acting, and anticholinergic (avoid in ederly)
second gen AH
zyrtec (cetirizine)
allegra (fexofenadine)
xyzal (levocetirizine)
claritin (loratadine)
PROS – daily usage ok, non-sedating, relief of rhinorrhea
intranasal corticosteroids
rhinocort (budesonide)
nasacort (triamcinolone)
flonase (fluticasone)
PROS – relief of allergic rhinorrhea
CONS – nasal spray, not good for cold/flu rhinorrhea
congestion treatment
oral decongestants
nasal decongestants
intranasal saline
non-pharm –> neti pot, fridababy nasal aspirator, bulb syringe
oral decongestants
Sudafed PE (phenylephrine)
Sudafed (pseudoephedrine)
PROS – pseudoephedrine effective for decongestant
CONS – phenylephrine ineffective as placebo medication, pseudoephedrine should be avoided in uncontrolled HTN, pseudoephedrine may cause insomnia
