Midterm review questions Flashcards
Name 3 types of headaches and describe how they differ
Tension type headache: is bilateral and is often chracterized by pressing or tightening. Not caused by exercise
Migraine: unilateral and is often chracterized by throbbing and can cause you to have nausea and vomiting. Caused by exercise
MOH: medication overuse headache is caused by the overuse of migraine medication. Caused by acetaminophen and NSAID. Can occur in both tension type headache and migraine.
What severe reaction can occur with acetaminophen and when it is likely to occur?
Hepatotoxicity with overdose or alcohol use
Name two contraindications for the use of NSAIDs
Pregnancy (third trimester), renal failure, peptic ulcer, bleeds
Name 4 red flags where a patient with fever should be referred to a physician?
Less than 6 months old, new medication, had surgery, new rash, child is irritation or in distress
What is the MOA of an antipyretic> will it work in absence of fever?
Decrease prostaglandin which causes decrease thermogularly set point
No it will not because antipyretic’s do not lower body temperature
Two types of allergic rhinitis
Intermittent and persistent
Two goals of therapy for allergic rhinitis
Prevent symtoms by avoiding exposure to allergens
Alleviate signs and symptoms produced by the allergic reponse
Minimize adverse reactions of treatment
Improve quaility of life
Which medications are recommended for allergic rhinitis in pregnacy?
-second generation antihistamines
-first-generation antihistamines
-Topical decongestants
-Cortiosteroids
How does influenza and the common cold differ?
Common cold
Caused by many viruses
Sore throat usually resolving in a few days, Nasal congestion, rhinorrhea, Sneezing and cough, Fever in children but less common in adults
Symptoms peak at 2-4 days and begin to resolve by day 7 with cough sometimes lingering for 3 weeks
Usually self-limiting
Influenza
caused by influenza A and/or B virus
Fever, myalgia, headache, malaise and chills, sore throat, nonproductive cough and rhinitis
Viral shedding before symptoms show, usually lasts 5-7 days but shedding may continue for 7 days or longer after onset of symptoms
Complications include pneumonia and even death
What could be recommended for fever, aches & pain due to influenza?
Acetminophen or ibuprofen
What could be an optimal therapy for an adult patient with aches & pain, congestion and a runny nose and no allergies or comorbidlities?
What adverse effects could be expected?
Acetaminophen for the pain and aches and a decongestants for the congestion and runny nose
Decongestants can increased blood pressure and may cause rhinitis medicaments if used more than 3-5 days.
Acetaminophen can cause nausea and vomiting and can cause hepatotoxicityin high doses.
Name 3 non-pharmacologic therapies for cough?
Hydration, humidifiers, avoiding irritants
Name two antitussive agents and their side effects and interactions?
Codeine can cause drowsiness/sedation
Interaction: CNS depressants
Dextromethorphan can cause occasional dizziness
Interaction: SSRIs/ MAOI
What are expectorant?
Expectorants are protussives (make cough more effective)
guaifenesin enhances cough by promoting clearance of airway secretions.
how can impacted ear wax be prevented?
-external opening canbe cleaned with washcloth
- Discourage cotton-tipped applicators to clean ears
- instillation of olive oil, light mineral oil, hydrogen peroxide
What are 3 monitoring points for otitis externa?
-Symtoms relief should occur as soo wax expelled
-Initially, hearing loss or fullness may exacerbate due to swelling of wax
-if irritation of the canal occurs, use of the product should be discontiuned.
Name 3 potential complication of N&V?
esophageal rupture, dehydration, malnutrition, dental cariers, hypokalemia
Name an anticholinergic and an antihistamines used for N&V and describe their main side effect?
Anticholinergic: Promethazine (restnessless)
Antihistamines: Benadryl (Sedation)
Example of each laxative?
Bulking agents: Bran
Emollient: Docusate
Osmotic: Polyethylene gel
Stimulant: Bisacodyl
What 3 types of enemas are available for bowel cleansing?
Phospahte, bisacodyl, mineral oil
What is opioid induced constipation and which laxatives could you use for this condition?
Decreased GI motility, increased intestinal fluid absorption, increased anal sphincter tone and decreased anorectal sensitivity to distention due to opioid use
Stimulant laxatives mainstay with rescue enemas or bisacodyl suppositories used PRN not exceeding 3 days. Commonly require combination of both osmotic and stimulant. Either lactulose and PEG also may be used but may cause nausea. Avoid bulk-forming agents since they may cause impaction
6 red flags for diarrhea?
watery stool, blood in stool, pregnacy, fever, constant cramping, vomiting and nausea
Name a bulk forming agent and an antimotility agent used for diarrhea
Bulk forming agent: Psyllium
Antimotility: Attapulgite
What products could be appropriate for diarrhea in pregnancy?
Metamucil/psyllium
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