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Therapeutics > OTC Final Exam > Flashcards

OTC Final Exam Flashcards

1
Q

Colds - Exclusions (Symptoms)

A

chest pain
SoB

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2
Q

Colds - Exlcusions (Age)

A

frail older
infants <3 months

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3
Q

Colds - Exclusions (Conditions)

A

cardiopulmonary disease
immunosuppression

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4
Q

Colds - Exclusions (Persists)

A

worsening while self-treating
persisting 7-14 days

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5
Q

Colds - Decongesants

A

First line
PO vs. Nasal depends on patient variables

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6
Q

Cold/Cough - First generation antihistamines

A

Second line as adjuvant to decongestant for post-nasal drip (cough)

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7
Q

Cough - Exclusions (Symptoms)

A

difficulty breathing
dyspnea
cyanosis
hemoptysis
weight loss
night sweats
signs of croup
sudden onset w/o URI

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8
Q

Cough - Exclusions (Age)

A

Children <4 (no meds)

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9
Q

Cough - Exclusions (Conditions)

A

Immunocompromised
TB exposure
risk of HIV
chronic illness

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10
Q

Cough - Exclusions (Persists)

A

Worsens after 3-5 days

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11
Q

Cough - Antitussives

A

Dextromethorphan
Topicals
Menthol

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12
Q

Cough - Protussives

A

guaifenesin
don’t take at night

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13
Q

Allergies - Exclusions (Symptoms)

A

nonallergic rhinitis (infection, epistaxis, obstruction)
symptoms of asthma/COPD

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14
Q

Allergies - Exclusions (Age)

A

Children <12 years unless diagnosed

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15
Q

Allergies - Exclusions (Conditions)

A

pregnancy or breastfeeding

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16
Q

Allergies - Exclusions (Other)

A

treatment causes unacceptable side effects

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17
Q

Allergies - Special populations

A

Older adults - avoid FGAs
Pregnancy - cromolyn first line, less effective; loratidine safest antihistamine

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18
Q

Allergies - Intranasal corticosteroids

A

First line for mod-sev IAR
First line for all PER

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19
Q

Allergies - Second generation antihistamines

A

First line for mild IAR or episodic AR

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20
Q

Allergies - Other options

A

1st gen antihistamines: inexpensive, but many ADEs
Decongestants: adjuvant if experiencing congestion

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21
Q

Headache - Exclusions (Symptoms)

A

severe pain
high fever
signs of infection
migraine symptoms with no diagnosis
new with sudden onset

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22
Q

Headache - Exclusions (Age)

A

children < 8 years

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23
Q

Headache - Exclusions (Conditions)

A

pregnancy (last trimester)
history of alcoholism or liver disease

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24
Q

Headache - Exclusions (Persists)

A

Persists 10+ days

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25
Q

Acetaminophen

A

First line for headache
Does not help with inflammation

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26
Q

NSAIDs

A
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27
Q

Fever - Exclusions (Symptoms)

A

temp >104 (or 100.1 for infants <3 months)
severe/persistent infection
child with spots/rash, lethargy, or intractable vomiting/diarrhea

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28
Q

Fever - Exclusions (Age/Persists)

A

Children <2 (if fever lasts 24+ hours)

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29
Q

Fever - Exclusions (Conditions)

A

CV or pulmonary disease
Immunocompromised
CNS damage
History of febrile seizures

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30
Q

Fever - Exclusions (Other)

A

risk for hyperthermia

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31
Q

Musculoskeletal Pain - Exclusions (Symptoms)

A

Severe pain (>6)
Pelvic/abdominal pain
Fever, nausea, vomiting
Suspicion of serious injury
*Back pain and bladder/bowel incontinence

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32
Q

Musculoskeletal Pain - Exclusions (Age)

A

Children < 2 years

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33
Q

Musculoskeletal Pain - Exclusions (Conditions)

A

Pregnancy

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34
Q

Musculoskeletal Pain - Exclusions (Persists)

A

Increase in intensity
Marked change in character
Persists 10+ days
Persists 7+ days w/ treatment

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35
Q

Analgesics - Special populations

A

Older adults - avoid naproxen (long-acting)
Children - avoid naproxen and aspirin

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36
Q

Musculoskeletal Pain - Nonpharmacologic

A

Rest (1-2 days)
Ice (10-25 on, cycle off)
Compression
Elevation (above heart)

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37
Q

Vulvovaginal Candidiasis - Exclusions (Symptoms)

A

Fever
First infection ever
Referred pain (pelvic, etc.)
Severe symptoms

38
Q

Vulvovaginal Candidiasis - Exclusions (Age)

A

Age < 12 years

39
Q

Vulvovaginal Candidiasis - Exclusions (Conditions)

A

Pregnancy
Predisposing condition (diabetes, HIV)
Predisposing medications (ABX, CHCs, corticosteroids, immunosuppressants, chemo)

40
Q

Vulvovaginal Candidiasis - Exclusions (Persists)

A

Last infection <2 months ago
4+ infections in the last year
No improvement in 3 days
Persists at 7 days

41
Q

Vulvovaginal Candidiasis - Antifungals

A

clotrimazole (3 or 7)
miconazole (1, 3, or 7)
tioconazole (1)

42
Q

Vulvovaginal Candidiasis - Antipruritics

A

Cannot be used as monotherapy
Topical only

43
Q

Vulvovaginal Candidiasis - Nonpharmacological

A

yogurt cultures, loose clothing, d/c predisposing meds, sodium bicarbonate sitz bath

44
Q

Atrophic Vaginitis - Exclusions (Symptoms)

A

Severe symptoms
Vaginal bleeding
Symptoms not localized
Not relieved by lubricants

45
Q

Atrophic Vaginitis - Exclusions (Persists)

A

Symptoms worsen
Persists 1+ week with treatment

46
Q

Atrophic Vaginitis - Nonpharmacological

A

Causes:
postpartum/lactating: usually resolves
peri- or post-menopausal: usually long term

47
Q

Primary Dysmenorrhea - Exclusions (Symptoms)

A

Symptoms inconsistent with primary (e.g. pain other than at onset of menses)
Severe symptoms
Menorrhagia

48
Q

Primary Dysmenorrhea - Exclusions (Age)

A

Age < ~20 (inconsistent with primary)

49
Q

Primary Dysmenorrhea - Exclusions (Conditions)

A

History of: PID, infertility, irregular cycles, endo, ovarian cyst
IUD
Active GI disease
Bleeding disorder
Taking warfarin, DOAC, or lithium
Allergy to NSAIDs or aspirin

50
Q

Primary Dysmenorrhea - NSAIDs

A

First line since they target prostaglandins
Can cause fluid retention

51
Q

Primary Dysmenorrhea - Nonpharmacological

A

Sleep
Topical heat
Exercise
Smoking cessatin
Supplements: fish oil, vitamin D3

52
Q

Premenstrual Syndrome - Exclusions (Symptoms)

A

Severe PMS or PMDD
Uncertain pattern of timing
Coincide with start of oral contraceptives or hormone therapy

53
Q

Premenstrual Syndrome - Exclusions (Persists)

A

Symptoms worsen or do not improve

54
Q

Premenstrual Syndrome - Special populations

A

If lactating: no herbs

55
Q

Premenstrual Syndrome - Supplements

A

Better option than diuretics
Calcium
Vitamin D
Pyridoxine (B6)
-concern for neuropathy (tingling, weakness, bone pain)
Vitamin E

56
Q

Premenstrual Syndrome - Nonpharmacological

A

Exercise
Acupuncture
Light therapy
Diet
CBT

57
Q

Heartburn/GERD - Exclusions (Symptoms)

A

Alarm symptoms: dysphagia, odynophagia, upper GI bleed, weight loss
Severe or nocturnal symptoms
Continuous n/v/d
Signs of heart attack

58
Q

Heartburn/GERD - Exclusions (Age)

A

Children <2 (no meds)
<12 years (antacids only)
<18 years (no PPIs)

59
Q

Heartburn/GERD - Exclusions (Persists)

A

Persists after 2+ weeks
Frequent for >3 months

60
Q

Heartburn/GERD - Special populations

A

Older adults: avoid aspirin and H2RAs
Pregnancy: if mild nonpharm, can use antacids or H2RAs (famotidine preferred)
Children: can treat 2-11 if mild (antacid, then refer)

61
Q

Heartburn/GERD - Antacids

A

First line for mild
Alginic acid: only used together with MgCO3 or AlOH

62
Q

Heartburn/GERD - H2 Blockers

A

First line for mild-mod (low or high dose)
Cimetidine strong inhibitor; many interactions (e.g. blood thinners, clopidogrel, phenytoin, nifedipine, metronidazole, propranolol, chlordiazepoxide, lidocaine, diazepam, theophylline, depression or anxiety medications)

63
Q

Heartburn/GERD - Proton Pump Inhibitors

A

First line for frequent (2+ episodes/week)

64
Q

Heartburn/GERD - Nonpharmacological

A

Food diary, avoid trigger foods, smaller meals, avoid bedtime eating, weight loss, smoking cessation

65
Q

Constipation - Exclusions (Symptoms)

A

Abdominal pain or cramping
Marked/unexplained flatulence
Fever, nausea, vomiting
Unexplained changes or weight loss
Blood in stool
Marked change in character of stool

66
Q

Constipation - Exclusions (Age)

A

Children <2 years old

67
Q

Constipation - Exclusions (Conditions)

A

Paralysis, IBD, colostomy
Daily laxative use (except fiber)
Anorexia

68
Q

Constipation - Exclusions (Persists)

A

Persists >2 weeks
Recur over 3+ months
Recur after treatment

69
Q

Constipation - Special populations

A

First line: check med list and nonpharmacological
Older adults: bulk-forming (or PEG)
Pregnancy: bulk-forming (or PEG), short-term stimulants are ok
Children: MgOH, senna, PEG

70
Q

Constipation - Bulk-forming

A

First line
May be more effective in low fiber intake, postpartum, or GI disease
Onset:

71
Q

Constipation - Hyperosmotics

A

First line

72
Q

Constipation - Stimulants

A

First line for opioid-induced (+emollient)
Otherwise second line

73
Q

Constipation - Emollients

A

Second line
does not treat
docusate

74
Q

Constipation - Lubricants

A

Not preferred

75
Q

Constipation - Saline

A

Not preferred

76
Q

Constipation - Duration of treatment

A

7 days
Avoid laxatives within 2 hours of other meds

77
Q

Constipation - Nonpharmacological

A

Insoluble fiber, hydration, exercise, bowel habits

78
Q

Diarrhea- Exclusions (Symptoms)

A

Fever (102.2, or 100.4 if <3 months)
Visible blood/pus/mucus in stool
Extremely high output
Persistent vomiting
Severe dehydration (e.g. AMS, anuric, no tears)
Severe abdominal pain

79
Q

Diarrhea- Exclusions (Age)

A

Infants <6 months or <8 kg
Frail patients 65+

80
Q

Diarrhea- Exclusions (Conditions)

A

Pregnancy
Diabetes
Severe CVD
Renal disease
Immunosuppression

81
Q

Diarrhea- Exclusions (Persists)

A

Chronic (>4 weeks)
Poor response to ORS
Persists 72+ hours with treatment

82
Q

Diarrhea- Oral Rehydration Solution

A

First line for mild-mod
Adults: 2-4 L over 3h

83
Q

Diarrhea- Loperamide

A

Can be used if afebrile, no signs of bacterial/protozoal infection

84
Q

Diarrhea- Bismuth subsalicylate

A

Preferred if vomiting

85
Q

Diarrhea- Severity

A

Mild dehydration: <3% loss, virtually no symptoms, <3 stools/day
Moderate: 3-9%, some symptoms, e.g. thirst, 3-5 stools/day
Severe: >9%, serious symptoms, 6-9 stools/day

86
Q

Intestinal Gas - Simethicone

A

safe in pregnancy
safe in children, questionable efficacy in colic

87
Q

Nausua/Vomiting - Exclusions

A

Infants <6 months or <8 kg (Same as diarrhea), signs of serious condition

88
Q

Nausua/Vomiting - Pregnancy

A

Pyridoxine (B6) +/- doxylamine
BF: no antihistamines or bismuth

89
Q

Nausua/Vomiting - Children

A

dimenhydrinate 2+
diphenhydramine 6+
cyclizine 6+
meclizine 12+

90
Q

Anorectal Disorders - Exclusions

A

Children <12 years
GI disease or abnormality

91
Q

Anorectal Disorders - Special populations

A

If >40, refer for cancer eval
If pregnant, avoid internal products

92
Q

Anorectal Disorders - Internal products

A

Corticosteroids
Vasoconstrictors
Protectants (except glycerin)
Astringents (calamine and ZnO)

Therapeutics (9 decks)

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