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PEBC- OTC > OTC 1 > Flashcards

OTC 1 Flashcards

1
Q

Max dose acet (adult and child)

A

4g- 10-15mg/kg q4-6h max 75 mg/kg/day

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2
Q

max dose ibu (adult and child)

A

1.2 (OTC), 3.2 Actual, 5-10mg/kg q6-8h max 40mg/kg/day

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3
Q

when to refer back pain

A

trauma from height, fever/chills/unexplained weight loss, worse lying down, numb in bum or radiating pain, bowel/bladder dysfunction,

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4
Q

dealing with burns

A

remove heat source, keep cool to remove heat (run under cold water, etc), keep moist, cover,

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5
Q

disorder helped by sun, and made worse by sun

A

psoriasis better, rosacea and sometimes cold sores can be worse

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6
Q

ceiling of sunscreen protection, apply ___ minutes before sun exposure

A

SPF 50, 30

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7
Q

minoxidil is used topically for ____ and works best for ____. Use for ___ months before results (__________). Side effects include

A

used for androgenic alopecia. Best if loss is from crown vs receding. Fine baby hair most likely to grow. D/c if new hair lost within 3 months, ad try for 8-12 to get results. Low systemic absorption, but used to be used for BP so small possibility of decreased BP

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8
Q

what is finasteride’s role in hair loss

A

type 2 alpha reductase inhibitor only for hair loss in med- dosed 1mg vs 5mg used for BPH. Works in about 3 months, can also slow hair loss

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9
Q

comedone types

A

open (black), closed (white)

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10
Q

what to tell a patient whose baby has milia

A

baby acne- self limiting, normal (about 1 in 2), disappears without treatment in about 2 weeks

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11
Q

salicylic acid for acne

A

keratolytic, mild therapy

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12
Q

BP for acne

A

5% most, antibacterial and exfollient, SE= red/peel/dry and bleach clothes, lotion better for dry or sensitive, gel is stronger acting. Start; slow in 1-2 hour intervals to decrease irritation (goal is 12 hours contact at least), worse before better as pull bacteria and dirt out of pores, lotion good adjunct but not immediately after BP (20-30 min)

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13
Q

retinoids for acne

A

-decrease stickiness of follicular wall and increase penetration of other agents (combined with BP is great- combo product okay to use together, if seperate products use one in AM and one HS as can inactivate retinoid), side effects same as BP so start low and go slow (work up to 12 hours on), best HS becuase photosensitizing,

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14
Q

compare the retinoids (adapalene, tretinoin, tazarotene)

A

adap= least irritating, tret=most photosensitizing, tazar=most potent, Cat X for preg. Other two okay in preg but not recommended

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15
Q

antibiotics in acne

A

must be used in combo to prevent resistance and increases efficacy (with BP or ret- for both oral and topical),

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16
Q

tetracycline administration differences:

A

avoid antacids in all, avoid food/dairy with tetra, less problems with mino but could still avoid, and give with good for doxy

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17
Q

isotretinoin

A

for acne, for severe acne, CI in women of childbearing age unless taking contraceptive measures (one month before and one after), 2 negative preg tests before starting, and they understand potential risks to fetus, monitor for dryness (esp eyes- can use drops, shold go away within 6 weeks in most) and depression

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18
Q

how long before see an improvement in acne?

A

about 8 weeks

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19
Q

when do you repeat lice application and why

A

7-10 days- to get full life cycle of adults and eggs

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20
Q

how long do lice live away from the scalp

A

2-3 days- washing items in hot water for 15 minutes or dryer on hottest setting for items with close contact, or in a sealed plastic bag for 2 weeks freeze.

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21
Q

side effects of nicotine gum

A

throat irritation, burping/hiccups, nausea esp if faster chewing

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22
Q

side effects of nicotine patch

A

local reaction, headache, insomnia, weird dreams/nightmares (can take off patch at night to avoid), nausea

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23
Q

coffee/acidic drinks with nicotine

A

slows absorption if drink it first- reverse order or educate to space

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24
Q

bupropion for smoking cessation

A

increase NA and DA (blocks uptake), SE=dry mouth, insomnia, seizure disorder if dose too high (separate by 12 hours to avoid), interacts with MAOI, “zyban”

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25
Q

varenicline for smoking cessation

A

partial nicotine agonist, SE-N, abnormal dreams, constipation, drowsiness, “champix:”

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26
Q

how much AHA (alpha ydroxy acid) is needed in dry skin lotion for effect

A

5-10% to soften (keratin softening agent)

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27
Q

calamine uses

A

first aid (insect bites, poison ivy, etc) and chicken pox maybe (kids might scratch off when dries crusted though) but NOT dry skin (will suck moisture out) or for blister lesions (draws fluid out)

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28
Q

how long is breastfeeding recommended

A

first year

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29
Q

only vitamins where synthetic is better than natural

A

B12 and folate

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30
Q

vitamin D supplementation in infants

A

breast fed- 400 IU, formula fed none OR in winter months increase both of those by 400IU

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31
Q

iron in infants, vitamins in kids

A

before 6 months stores are sufficient in iron, after choose multivitamin in kids that has minerals and vitamins as mix

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32
Q

prenatal vitamin requirements

A

Fe= 27mg (child bearing age- 18), 600ug folate (400 child b) (1mg in most products ie 1000ug), 1000mg Ca (no change), vitamin D important too

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33
Q

amounts of calcium in: carbonate,lactate, gluconate

A

carb (40%), lact (13), gluc (9)

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34
Q

iron products and amounts in each

A

fumarate (blue-33), sulfate (red-20), gluconate (green-12)

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35
Q

AREDs may do what for AMD, and what type is it maybe effective for?

A

slow progression in dry type (ie 90% of cases)

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36
Q

interactions with Fe

A

coffee/tea/wine/antacids decrease absorption, tetracyclines, any drug with potential for constipation or GI issues

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37
Q

interactions with Ca

A

tetracyclines, CSs, chronic PPI use, potential for constipation

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38
Q

simethicone for colic

A

defoaming agent (ovol), gets rid of trapped gas and may help, really no side effects and very safe

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39
Q

gripe water for colic

A

sodium bicarbonate, almost no SE, more for gerd vs colic

40
Q

cocyntal for colic

A

homeopathic, no benefit

41
Q

difference between dandruff and seborrhea

A

dand= dry powdery scales with minimal inflammation, seb= yellow, oily greasy scales with inflammation. Dand=OTC, seb= rx

42
Q

for derm conditions, when to see a doc if not getting better generally

A

7 days

43
Q

OTC dandruff options

A

tar, tar solution, selenium, zinc, ketoconazole (*AF most common)

44
Q

products for seborrheic dermatitis

A

apply to body; tar, antifungal (*most common), topical steroids, picrolimus if very bad and more chronic

45
Q

how to treat cradle cap

A

common, disappears about 8 months, unknown why, treat with baby oil and vaseline to soften scales

46
Q

different between irritant and allergic contact dermatitis

A

amount of exposure: is not important for allergic (poison ivy, nickel, cosmetic, metals, latex, glue, topical meds) (concentration not important), is for irritant (ie more is worse- usually chemicals-dish soap, detergents, diaper rash, etc)

47
Q

how to treat contact dermatitis

A

acute- cool/wet dressing QID x20 minutes when gross blisters, sub acute means blisters are gone so d/c wet dressings and use steroid lotion/cream, for chronic use warm water soaks to soften and dry skin or steroid creams prn)

48
Q

describe the properties of coal tar, sulfur/salicyclic acid, and selenium/zinc/ketoconazole

A

coal tar= anti proliferative and anti pruritic (not for broken or hairy areas as can clog pores), sulfur/sal acid have mild keratolytic properties, selenium/zinc/keto slow cell turnover and have antifungal effects (keto most)

49
Q

length of diaper rash time and likelihood of infection

A

if allowing air time, keeping clean and using barrier products and has been over 3 days fungal more likely

50
Q

rash in skin folds for diaper likely means

A

fungal- if just irritant, fold will protect area

51
Q

how to treat fungal diaper rash

A

2 weeks max plus one week after clearing applied BID - if not better in 3 weeks, may be bacterial. Try mupirocin

52
Q

if using canestan vag cream to treat diaper rash, which kit/what duration/strength?

A

6 day (1%)

53
Q

treating uninfected diaper rash

A

HC 1%, wait five minutes, apply barrier product. Can do this with antifungal too- always apply med before barrier product

54
Q

when to refer diaper rash

A

pimples/ulcers form, fever,rash spreads to other areas, doesn’t get better in 7 days with treatment

55
Q

red flags of dental pain

A

fever, pus, swelling, headaches

56
Q

topical benzocaine is not recommended in

A

kids under 2 due to risk of methemoglobinemia (can lead to death as blood less efficient at O2 transport) (can also disable infant’s gag reflex if swallowed)- for teething, best is cold washcloth, rubbing gums, acet, teething rings, etc

57
Q

effectiveness of abreva for cold sores

A

docosonal- heals 1-2 days faster maybe if used at onset of tingling 5x/day. If too late (past prodromal), keep moist to promote healing but abreva no longer has benefit and is more expensive

58
Q

how to differentiate oral candidiasis

A

white creamy lesions on tongue or cheek that don’t easily wipe off and may bleed a little if scraped, painful or burning possible

59
Q

comment on nystatin in infant and children

A

infant swirl in mouth on q tip, child/adult swish and hold in mouth as long as possible then swallow, well tolerated with minimal systemic absorption so no DI, short contact time limits efficacy

60
Q

symptoms of hemmorhoids

A

bleeding (streaks, bright red), itching, swelling, seepage, pain

61
Q

red flags of hemmorhoids

A

over 50 should be screened, change in bowel habits all of the sudden (C/D), blood in stool (bright red not as worrisome-always ask about amount, and tell if blood should get assessed by dr if over 50 especially), stool narrower than usual, unexplained weight loss, increased pain and cramps, mucous/discharge

62
Q

treatment of hemmorhoids (non pharm too)

A

post BM cleanliness, lotion prn, astringents ingredients (haemmophilis or zinc), base ointment in suppository or cream does most of work (ensure replacement post BM), nothing will “heal” just buys enough time for body to heal itself (self limiting condition) and treat sx; anusol or prep H

63
Q

MSM

A

gives no added value to products such as glucosamine and chondroitin

64
Q

corns

A

hyper keratonic growth from increased friction or trauma. Treat with SA- for ahrd corns, soak first, if soft don’t need to. apply OD-BID for about 6 days. Remove cause and protect

65
Q

best treatment for ingrown toenail

A

get cotton underneath, file edge down. Don’t want to soften because will make clipping more difficult

66
Q

treating warts with salicylic acid

A

soak first x5min, rub off dead skin, vaseline around surrounding skin optional for protection, apply drops, cover, do for 8-12 weeks. With lactic acid added gives no additional benefit and is increased cost

67
Q

when to not use freezing products for warts? patches?

A

diabetes- may not feel. Patches macerate skin around

68
Q

treating warts with freezing products

A

still soak first and pare, contact time about 20s-40s (ie may need more than one application if don’t feel freezing anymore after about 20)

69
Q

T/F- plantar warts may clear up on their own

A

T

70
Q

when to start COC

A

most effective if started on day 1, but can start any day up to day 6. Starting on first sunday after period starts avoids weekend period. If don’t start day 1, back up 7 days

71
Q

benefits of COC

A

improve menstrual symptoms and regularity, decrease PMS, improve acne, decrease endometriosis + endometrial/ovarian cancer + ovarian cyst + OP + hirsutism

72
Q

what amount of estrogen is more likely to have contraceptive failure if pills are missed

A

<20ug estrogen

73
Q

risks with COC

A

VTE (increased with age over 35, smoke, increased estrogen), MI and stroke, breast cancer, cervical cancer

74
Q

early warning signs of COC risks/danger acronym

A

ACHES- severe: abdominal pain, chest pain, headaches, eye problems, leg pain in calf or thigh

75
Q

drugs that induce metabolism of COC

A

anticonvulsants (carba and pheny esp), rifampin, ritonavir, some herbals

76
Q

drugs that have levels reduced by COC

A

lamotrigine, anticoagulants (may increase clotting factors therefore decrease efficacy), potential to increase sugars with antidiabetic drugs (monitor- maybe insig)

77
Q

how long wait post partum to restart COC

A

at least 3 weeks due to increased risk VTE

78
Q

how big is the window for POP admin

A

3 hours- if later, backup x48 hours

79
Q

can the POP be used in breastfeeding

A

yes

80
Q

AE of POP

A

irregular bleeding, HA, bloating, ance, breast tenderness

81
Q

depo-provera- when to use back up with admin?

A

day 1-5 no backup, after day 5 backup for 7 days

82
Q

which contraceptive delays return to fertility and by how long?

A

depo provera- 9 months

83
Q

which contraceptive decreases BMD and increases OP risk

A

depo provera- esp in first 2 years

84
Q

how long an nuvaring be out before concern

A

less than three hours

85
Q

how long is nuvaring stable at room temp

A

4 months

86
Q

the patch contraceptive is applied for ___ week and then removed

A

3 weeks

87
Q

fever is anything greater than ___‘c at any time of day. Neurologic damage happens greater than ___‘c

A

37.5, 41.7

88
Q

temperature cycles (highs and lows)

A

highest in late afternoon, lowest 12 hours later

89
Q

after what length of time is fever worrisome?

A

more than three days

90
Q

when is the oral route preferred for measuring temperature

A

ages 5 and up (watch out for drinking hot/cold or smoking beforehand)

91
Q

what is the preferred route for temperature measurement under five

A

rectum. Can’t? less than two use armpit, over two use ear then armpit

92
Q

red flags with fever

A

under 2 months, temp over 40.5, stiff neck or seizures, chemotherapy, confusion/delerium, child appears very ill or inconsolable crying

93
Q

what is the maximum number of times fever needs to be taken in a day

A

2-3 (unless recent chemo)

94
Q

MOA ASA

A

inhibit PG synthesis through irreversible acetylation and inhibition of COX

95
Q

MOA acet

A

central inhibition of PG synthesis

96
Q

MOA ibuprofen

A

reversible acetylation of COX

97
Q

max dose naproxen and dosing

A

440 mg per day OTC (220 q8-12h)

PEBC- OTC (21 decks)

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