Pharmacology II Flashcards
1
Q
What are non rx therapies for headache?
A
Acetaminophen, acetaminophen/cafeine/codeine
ASA
Ibuprofen
Naproxen sodium
2
Q
What are treatments for pregnancy (headache)
A
Ibuprofen, ASA (safe in intermittent doses during 1st and 2nd trimesters)
Acetaminophen safe during all trimesters
3
Q
What are Natural products for migraines
A
Butterbur, coenzyme Q10, melatonin, magnesium, vitamin b2
4
Q
What are causes of fever?
A
Infection, heat exhaustion, inflammatory conditions (rheumatoid arthritis), cancerous and medications
5
Q
Medications for treating fever and how they work
A
Acetaminophen, ASA, ibuprofen and naproxen sodium (reduce patient discomfort)
Naproxen and ASA should not be used in children
Antipyretics (Naproxen sodium, ASA) reduce body temperature by decreasing prostaglandin synthesis in the brain and reducing the thermoregulatory set-point. They do not lower normal body temperature.
6
Q
Treatment for fever in kids
A
Naproxen and ASA (Reye disease) should not be used
Ibuprofen
Acetaminophen
7
Q
What are Antihistamine classes
A
Second generation (bilastine, cetirizine, desloratadine, fexofenadine, loratadine, rupatadine) , : more selective for H1 receptor and less lipophilic
Do not cross the blood-brain barrier
First generation (chlorpheniramine, diphenhydramine) : dry mouth and nasal passages, difficulty voiding urine, constipation, CNS effects (sedation, psychomotor and cognitive impairment)
8
Q
Side effects of topical decongestants
A
oral : (Mild CNS, nervousness, excitability, restlessness, dizziness, weakness, insomnia)
Increased Blood pressure, tachycardia or palpitation
Topical: local burning and stinging, sneezing, dryness of the nasal mucosa
Rhinitis medicamentosa used more than 3-5 days
9
Q
Non pharm therapy for colds
A
Hydration with oral liquids and humidification of room air may be beneficial
Nasal saline irrigation can help nasal congestion
Avoid inhaled irritants such as smoke, dust, pollutant and allergens
10
Q
Types of decongestants
A
Pseudoephedrine (oral)
Phenylephrine (oral)
Oxymetazoline (topical)
Phenylephrine (Topical)
Xylometazoline (topical)
11
Q
What is a antitussive and what are examples?
A
Act centrally to suppress cough
Inhibit motor control of cough
If used by a patient with a productive cough, more mucus is retained
Dextromethorphan and codeine
12
Q
Antitussives for kids
A
Dextromethorphan > 12 (6-11 years old)
Honey 1-18
Codeine not good for children
13
Q
What is an expectorant?
A
The protussive agents act peripherally
Reduce sputum viscosity. Permitting more effective removal of secretions from the respiratory tract
14
Q
What is a common type of expectorant?
A
Guaifenesin
15
Q
What are expectorant used for?
A
Enhance cough effectiveness by promoting the clearance of airway secretions.
16
Q
Natural health products for colds
A
Echinacea
Garlic
Ginseng
Vitamin C
Zinc
17
Q
How to prevent swimmer’s ear
A
Avoid cotton-tipped swabs
Avoid water sports for at least 7-10 days during treatment
Earplugs and bathing caps
Avoid overzealous cleansing and scratching
After swimming or bathing, dry the external canal with a blow dryer set on low
18
Q
Dimenhydrinate vs promethazine
A
Promethazine has a longer duration of action as compared with dimenhydrinate and may be an alternative in patients with refractory nausea or when dimenhydrinate is ineffective
19
Q
Non pharm measures for nausea and vomiting
A
Smaller meals
Adequate hydration
Avoid smells and foods
Dietary interventions
Relaxation therapy
Acupressure wristbands
Aromatherapy
Maintaining fluid intake
20
Q
Non pharm for constipation
A
Increase calories if low caloric intake
Have a regular bowel regimen
Consume a high-fiber diet
Fruit/ juice: natural laxative sorbitol
Restrict dairy: cow milk-free diet may improve constipation in kids
Exercise, weight loss,biofeedback/relaxation
21
Q
Symptoms of dehydration
A
Feeling thirsty and lightheaded
A dry mouth
Tiredness
Having dark coloured, strong-smelling urine
Passing urine less often than usual
22
Q
Types of laxatives
A
Bulk-forming (psyllium, bran): increase stool volume and are considered for long-term use.
- Gas formation. Increased osmotic load, water retention and wall stress
Emollient: Stool softeners (docusate sodium or docusate calcium) act as surfactants to often the stool by allowing the mixing of aqueous and fatty substances.
Osmotic: increased pressure on the lumen wall induces gastric motility
(Polyethylene, glycol, lactulose)
Stimulant: Bisacodyl, senna, sodium picosulfate
- increases colonic peristalsis by producing rhythmic muscle contractions in the intestines
23
Q
Special considerations for bulk forming laxatives
A
Given > 250 ml water/juice to prevent fecal impaction and or esophageal obstruction
Do not use in patients dehydrated,fluid restricted, opioids
Require 12-72 hours for onset of effect
Psyllium improves stool frequency and consistency
Bran reduces use of laxatives in the elderly
24
Q
Signs and symptoms of constipation
A
Infrequent defecation
Abdominal distention
Flatulence
Nausea
Vomiting
Anorexia
Early satiety
Stools that are small, hard and or difficult to evacuate
Incomplete rectal emptying
Rectal bleeding due to fissures or hemorrhoids
Weight loss
25
What is ORT
Can treat the majority of patients with diarrhea as well as prevent most diarrhea-related complications
Rehydration and maintaining electrolyte balance
26
Examples of ORT?
Gastrolyte, pedialyte and hydralyte
27
Non rx therapy for gerd and dyspepsia
Alginic acid (Gavision), aluminum (Alugel), aluminum hydroxide (Diovol), calcium carbonate (tums), magnesium salts (Milk of magnesia)
Famotidine (Pepcid) ranitidine (Zantac)
28
Hemorrhoid products and dosage forms
Anesthetics: dibucaine (ointment/cream, suppository), pramoxine (ointment, suppository)
Anti-infectives: framycetin (ointment, suppositories)
Anti-inflammatory agents: hydrocortisone (ointment, suppositories)
Astringents: hamamelis (gel, pads, wipes), zinc sulfate (ointment/cream, suppository)
Phlebotonics: diosmin (tablet), citrus bioflavonoids (Tablets)
Protectants: glycerin (ointment), petrolatum (ointment)
Vasoconstrictors: phenylephrine (gel)
Yeast derivatives: yeast (ointment/cream, suppository)
29
Monitoring blood glucose why it is important?
Helps to determine if you are meeting your glucose targets which helps to reduce the unpleasant symptoms of high and low blood sugar and avoid long-term diabetes complications.
30
Proper use of lancing device and lancet
Apply device to skin, exert gentle pressure and press the trigger
Site rotation is important
Frequent users will rotate between fingers, right-handed users might prefer lacing the left hand and vice versa
31
Urine glucose monitoring
Less expensive however does not reflect current BG levels and will not detect hypoglycemia (low glucose)
Not appropriate for most patients using insulin
32
Iron deficiency and risks
Increased requirements (pregnancy, infancy, adolescence)
Decreased intake (vegetarian)
Diminished absorption (elderly)
Excessive or regular blood loss (menstruation)
Can lead to anemia, decreased energy, impaired immunity
33
Various forms of calcium salts
Calcium carbonate should be taken with or after meals as it needs an acidic medium for best absorption
Calcium citrate is better absorbed in patients with higher gastric pH, and can be take on an empty stomach but less elemental calcium
34
How to increase iron absorption
Vitamin C can also improve non-heme iron absorption by improving its solubility
Glass of orange juice can increased vitamin absorption
35
RICE
Rest, Ice, Compression, Elevation (After 48 hours) then can be replaced by heat
36
Muscle relaxants and sports injuries
Methocarbamol not considered first-line in acute musculoskeletal injuries because they provide limited pain relief
Intended to provide pain relief when muscle spasm is a component of an acute injury
37
External analgesics (sports injury)
Methyl salicylate,menthol, camphor, capsaicin
Treat general aches and pains
Useful during rehabilitation as cooling or heating rubs or massage therapy
Cause skin skin reactions such as a rash or blisters
Applied to acute injuries
Not be used more than 3-4 times a day
Used concurrently with thermotherapy devices as burns
38
Athletes foot
How it’s transmitted
Directly via contact with infected person or indirectly through contaminated surfaces
Spread to other parts of body by autoinoculation
39
How do you treat Athletes foot?
Treated with topical antifungal agents: ciclopirox, clotrimazole, ketoconazole, miconazole, terbinafine
Can be applied twice daily for up 4 weeks
Terbinafine higher cure rates
Anti-inflammatory (betamethasone and hydrocortisone)
Ointments remain in contact longer (but slowing healing)
Powders may be non medicated or medicated
Solutions, sprays or foams (allowed to air dry)
40
What is Corns and calluses
Overactive keratinization, attempt of body to protect food from excessive friction
Result of poorly fitting footwear, weight gain, abnormal gait or foot structure
Tough layer of compacted dead skin cells
Calluses tend to occur on soles of feet (heel or ball of the foot)
Not contagious
41
Treatment for dandruff and seborrhea
Antifungal agents (first line therapy for both), anti-inflammatory agents (creams used in moist areas) (lotions and solutions are best for the scalp and hairy areas) and keratolytics (Salicylic acid and sulfur)
Medicated shampoos
Associated anti-inflammatory and keratolytic action
Topical therapies are recommended first with oral treatment reserved for severe cases
Moisturizers (support role for softening): mineral oil or surfactant- containing bath oils
Ketoconazole, ciclopirox olamine, selenium sulfide, zinc pyrithione, propylene glycol 15% solution
Ketoconazole (fungistatic): can mediate inflammation through inhibition of leukotriene production
Topical calcineurin inhibitors ( tacrolimus, pimecrolimus) used in seborrheic dermatitis
Topical tacrolimus together with zinc pyrithione treat scalp seborrheic dermatitis.
Keratolytics: increase penetration of other topical medications and increase effectiveness
42
Coal tar side effects
Is mildly effective for seborrheic dermatitis as it reduces local swelling and inflammation, relieves itching is keratolytic and antiseptic and has minimal antifungal activity
Messy, can stain blond or gray hair and clothing, have an unpleasant odor, cause tar acne, contact dermatitis, photosensitivity and possible carcinogenicity
43
Acne What's beneficial in treatment?
Management by evaluting psychological impact of acne, aid in detection of depression or need for psychological care and improve therapeutic outcomes.
- The longer acne countines, the greater the psychological harm and therefore the greater impact on personal/social life.
- The longer acne continues the greater the psycholgical harm and therfore the greater impact on personal/social life
44
Types of exfoliants
Rescorcinol
Salicylic acid
Sulfur
Glycolic acid
Azelaic acid
Topical retinoids
45
Benzoyl peroxide for acne
-Antibacterial most effective for inflammatory acne
- mild to moderate popular-pustular acne
- Derivative of coal tar
- absorbed through the stratum corneum
- useful in both inflammatory and noninflammatory acne
- produces powerful anaerobic antibacterial activity due to slow release of oxygen
- Combined with topical antibiotics or retinoids to improve efficacy, decrease irritation and reduce development of antibiotic resistance
- Irritation more likely in fair complexions (sunburn easily)
- irritation dependent on the concentration
- contact allergic dermatitis can occur
- Soap/wash, gel, lotions
- do not use if very sensitive skin
- apply the product and leave on for 15 miuntes the first evening each evening double the contact time until the product is left on overnight
46
How to self treat minor wounds
Cleanse Wound: Remove dirt and debris as soon as possible to prevent infection and promote healing. Wash with water
Stop the bleeding: Apply clean dressing or gauze for 10 minutes. seek attention if bledding does not stop.
Apply dressing that maintains moist wound bed to protect from possible infection and imporve healing process.
Debridement: Removal of foreign material performed only by trained health-care pracitioner under sterile conditions.
47
Topical antibiotics (wound therapy)
recommended only for prevention of complication in wounds at highter risk of infection or chronic wounds not healing
- Discontiuned as soon as signs and symtoms of infection are no longer present
48
Examples of topical antibiotics for wound care?
Fusidic acid, mupirocin or combination of bactracin/gramicidine/polymyxin B/neomycin
49
Treating thermal burns
Initial treatment includes removal of the causative agent to minimize further tissue damage. Cooling should be started as soon as possible as it can limit the extent of injury, decrease inflammation and provide some pain relief. Should be cooled for up to 30 minutes with cool-to-touch tap water irrigations, immersion in cool water or application of cool tap water compresses for 20 minutes.
50
Treatment for vaginal dryness
**Vaginal lubricants and moisturizers first-line options **
- Vaginal lubricants are short-acting and reqiure frequent re-application
- Suppository (Mae) and cream (Cleo) for symtomatic relief
- Mae also contains vitamin E and hyaluronic acid
- Moisturizers such as polycarbophil and hyaluronic acid gels attach vaginal epithelium and provide water and electrolytes
- longer duration of action than lubricants
- oil-based products should be avoided due to irritation, difficult to remove
**- Hormonal supplementation with estrogens and progestogens is an option **
-Estrogen replacement reverses vaginal changes seen with menopause and relieves symptoms
**Black cohosh used in managment of menopausal symtoms **
- can cause nausea and headache and contraindicated in pregnancy and breastfeeding
51
Antifungal treatment for candidiasis
Self treatment OTC is recommended
**Fluconazole is an effective option **
**Clotrimazole, miconazole, terconazole,**
Slection determined by length of therapy desired, dosage form preferred and women's previous experience
**Boric acid**- inserted intravaginally
- option for women who do not respond to other therapies
**Probiotics**
- little success in decreasing vaginal candidiasis
52
Basal body temp
What it’s used for
Occurs prior to rising in the morning
Can be orally, rectally or vaginally but must be consistently measured same way same time each day
When ovulation occurs, corpus luteum releases progesterone, causing significant rise in temperature that is detectable and lasts for several days
Increases is about 0.5 or 0.28 and is measurable by a basal thermometer
**- More narrow range of temperature than a fever thermometer **
**Determine when most fertile and likely to conceive **
53
Cane fitting and measuring
**Distance from top of cane or walker handle to ground should equal distance from wrist crease to ground when arm is straight down **
Should be performed with the individual standing erect and wearing everyday shoes
- If cane too short user will lean forward or user will lean backwards if cane too long
54
Support stocking
Elastic compression stockings known as surgical or support stockings
**Intended to relieve tired, aching legs and prevent swelling of feet, ankles and legs **
- May be prescribed for medical conditions such as varicose veins, lymphedema, venous eczema and ulceration
- ranging from 12-20mm Hg at the ankle
- meausrements of nonedematous leg first thing in morning
55
Peak flow metre
how it is measured
**Measure peak expiratory flow rate, or speed of air forced out after the lungs are fullt inflated **
- help predict and prevent exacerbations in chronic pulmonary conditions
- Home monitoring may be suitable for adult patients who are poor perceivers of airway obstruction or with severe asthma
**- After a complete exhalation
- inhale as deeply as possible
- Place the meter in mouth and blow out as hard and fast as possible
- the final postition of indicator on the scale is the PEF measured in liters per minute
- 3 readings are taken the highest of the 3 are recorded
56
Agents for otitis externa
In uncomplicated cases, topical therapy options include acidifying agents, antibiotics alone or antibiotics with corticosteroid combinations
Acidifying Agents: acetic acid 2%, gramicdin/polymyxin B
Miscellaneous: antipyrine/benzocaine, isopropyl alcohol 95%/glycerin 5%
57
Bulk forming laxatives
What they are
**Increase stool volume,considered safest, suitable for long-term use **
Fermentation leags to gas formation, increased osmotic load, water retention and wall stress which stimulate motility
**Examples: Psyllium, Bran, inulin (chicory), fibre **
58
H2 receptor antagonists
**cimetidine, famotidine, nizatidine & ranitidine**
Reduce gastric acid by blocking histamine receptors
inhibits action proton pump and prevents hydrogen ioins into stomach
longer duration of action
59
Atopic dermatitis?
**is a chronic, relapsing, pruitic, inflammatory skin disease caused by mucocutaneous barrier dysfunction. **
- hyper-reactivity of cutaneous/muscous membranes to environmental triggers that are innocuous to nonatopic individuals
- Risk factors: genetics, environmental allergens, climate, sweating, physiologic and psychosocial stress, dietary influences
- affects the flexures and the face
- Distribution of lesions depends on the age of the patient
60
Benzoyl peroxide strengths
Lotion 2.5%, 5% and 10%
2.5% equivalent to the 5% and 10% formulations in reducing the number of inflammatory lesions
61
Insect bites (Spiders and ticks)
**Spiders: Cause initial stinging sensation followed by localized swelling, itching and inflammation **
Bite of black window causes pain without 30-60 minutes followed by sweating, nausea, blurred vision, muscle cramps and swelling and redness at the site
**Ticks attach with specialized mouth parts and feed until they are engorged with blood (groin, armpit and scalp) **
Different ticks can be carried by pets, livestock and wildlife
Tick must be attached to skin for at least 24 hours and can cause Lyme disease
Antibiotics such as doxycycline, amoxicillin and cefurxime can cure Lyme disease in most cases
Can cause Rocky Mountain spotted fever
requires an attachment period between 4-6 hours to transmit bacterium
62
Mosquitoes
Salivary secretions commonly cause local histamine reactions (redness, swelling, intense itchiness)
Red, itchy papules develop within hours and can develop welts for several days
Can carry a number of viral and parasitic diseases (Malaria or Zika virus)
63
Bed bugs?
Feed on blood by picercing skin causing red, itchy lesions at bite site
ites commonly on arms/legs and typically in clusters of 3-5 appearing in line
Allergic reactions (redness, swelling, hives)
Infestations increasing as is interset in whether can transmit infections from person to person
64
Stinging Insects?
Bees, vespids and stinging ants
Venom cantains multiple allergens can lead to severe reaction
Onset of 4-48 hours (pain, redness and swelling)
Systemic reactions (headache, fever, nausea and vomiting within 12-24 hours
Most serious reaction is anaphylaxis can occur within mins or up to several hours after the initial sting
65
Medication used to relieve symtoms of bites and stings?
Oral analgesics such as acetaminophen, ASA, NSAIDs used for pain
Oral antihistamines used in relieving pain, itching and inflamation caused by insect stings
Oral more effective than topical in relieving pain, itching and inflammation caused by insect stings
1st and 2nd generation antihistamines (itching and inflammation)
Topical products contain **local anesthetics **(benzocaine, lidocaine, pramoxine), **astringents **(calamine, zinc oxide), **counterirritants** (camphor, menthol or backing soda)
66
Symptoms of yeast infection
Stinging/burning
Cottage cheese discharge
Itching and irritation in the vagina and vulva
Vaginal pain and soreness
Redness and swelling of the vulva
67
What constitutes a medical device
Includes items such as medical equipment, first aid and wound care products, sports medicine items, incontence aids, palliative care products and diagnostic equipment.
Is any item of quipment, product or system that is ready-made, customized or adapted and used to maintain or improve functional capabilites of people with a permanent disability or physical limitation.
68
What are the most common primary headache disorders? Which one is the most commone type?
Tension-type and migraine. Tension-type is the most common type
69
State the 7 red flags you would refer a patient with a headache to a doctor for?
-Severe/abrupt onset
-onset in middle age or older
-neurologic signs
-Systemic signs (fever, N&V)
-significant change in pattern
-nocturnal occurrence or on awakening in morning
-onset with excercise or intercourse
70
Describe and give reasons for MOH?
Occurs in migraine or tension-type headache sufferers.
Frequent use of analgesics or other acute migraine medication for greater than or equal to 3 months
-Occur in association with simple analgesics (acetaminophen, ASA) or less commonly with NSAIDs
-Associated with combination products containing barbiturates, caffine or opioids
-Overuse of ergotamine or triptans and withdrawal from substances such as caffine, opioids and estrogen
71
How to treat MOH?
Treatment invloves: completely discontiuning the drug, relieving withdrawal symtoms, treating recurrent headaches with migraine-specfic medications, and initiating prophylactic therapy.
72
State the three nonpresciption therapy for treatment of tension-type headaches?
Acetaminophen, ASA, NSAIDS (ibuprofen, naproxen)
73
During pregnacy, which drug is considered to be the analgesic of choice?
Acetaminophen
74
What's considered to be a "high" fever?
greater than 40.5C
75
List two other possible causes of fever?
rheumatologic, malignancy
76
What medications are indicated for the treatment of fever? How do they work?
Acetaminophen, ASA, Ibuprofen, Naproxen sodium
Decrease PG synthesis in the brain-reduce the thermoregulatory set-point
77
List other possible adverse effects with the first generation medications?
dry mouth and nasal passages
difficulty voiding urine
Constipation and tachycardia
78
Rhinitis medicamentosa. How to treat it?
"rebound congestion" is inflammation of the nasal mucosa caused by the overuse of topical nasal decongestants.
To treat problem: slow tapering;add or switch to intranasal corticosteroids; abrupt discontiunation of decongestant
79
Oral decongestants?
pseudoephedrine and phenylephrine
80
Topical decongestants?
Oxymetazoline, Phenylephrine and Xylometazoline
81
List 4 pssible side effects of orally administered decongestants?
CNS stimulation, peripheral vasoconstriction, tachycardia/palpitation, increased blood pressure
82
What is the recommended adult antitussive dose of codeine?
10-20mg every 4-6 hours orally (max 120mg/day)
83
What is the antitussive of choice in children between 6 & 12 years old?
Dextromethorphan can be used to treat nonproductive cough.
84
Name the most common expectorant used in cough formulations?
Guaifenesin
85
4 natural products that may be purchased for treatment of colds/respiratory infections?
Echinacea, Ginseng, vitamin C and Zinc
86
What are the topical pharmacological agents that may be used in treatment of OE?
Acidifying agents, antibiotics alone or antibiotic/corticosteroid combinations.
87
What is the most common side effect of dimenhydrinate?
Sedation or drowsiness
88
What is the drug of choice for the treatment of pregnacy assoiated nausea and vomiting?
Diclectin
89
List any four symtoms of dehydration in children?
Dry mouth
no tears
Decreased urination
sunken eyes
grayisk skin
sunken soft spot
decreased skin turgor
90
What are six preventative strategies that may be recommended to patients who suffer from constipation?
High fibre diet
min.fluid consumption of 1500ml daily
regular toilet routine
Heed the urge to defecate
use a prophylactic laxative is using constipating medication
Moderate regular physical activity
91
What are the four basic groups of laxatives? what are they?
Bulk-forming
emollient
osmotic
stimulant
92
7 signs and symptoms of constipation
Infrequent defecation
abdominal distention
nausea
vomiting
anorexia
early satiety
stools that are small, hard
incomplete rectal emptying
weight loss
rectal bleeding
93
What is the most common cause of acute diarrhea?
Viral infection
94
When is ORT contraindicated?
Protracted vomiting despite small frequent feedings
worsening diarrhea
Stupor or coma
intestinal ileus
95
What are the four nonprescription drug therapies available for diarrhea?
Attapulgite, Loperamide, Bismuth Subsalicylate, psyllium
96
What the 5 prescription drug therapies available for diarrhea?
Cholestyramine, antibiotics, clonidine, opioids and somatostatin analogues
97
When shoudl patients be referred to a physician if symptoms persist beyond what time frame?
48 hours
98
eight preventative measures for Dyspepsia
Aoid foods that precipitate events
avoid lying down right after meals
reduce body weight
quit smoking
avoid alcohol intake
avoid caffeine intake
smaller more frequent meals
stress reduction
99
5 non-prescription agents in the antacids class used in the management of GERD and Dyspepsia?
Alginic acid/antacid combinations
Aluminum Hydroxide
Aluminum/ magnesium combinations
Calcium carbonate
Magnesium salts
100
What other agent is magnesium hydroxide commonly combined with? why?
Aluminum Hydroxide
offset the tendency of the respective agents to cause constipation and diarrhea (offset the tendency of Mg to cause diarrhea)
101
Is sodium bicarbonate considered a first line choice for the treatment of Dyspepsia? Why? or why not?
No onyl for occasional use due to its high sodium content
102
Explain Diabetic Ketoacidosis. Sate any five symtoms associated with it?
impaired insulin activity causes body to shift from carbohydrate to fat metabolism. Ketones are a byproduct of this process. Elimination of ketone level in urine is not fast enough and ketones accumlate in bloodstream causing the blood to become acidic.
Thirst, dry mouth, frequent urination, nausea and vomiting, blurred vision
103
What are lancets? why it is important that patients wash their hands well prior to using a lancing device?
A small needle of varying gauge r size used to puncture the skin
Diabetic patients are more susceptible to infections
104
What is glucagon? Who mainly uses glucagon kits?
Glucagon is a hormone that counteracts the action of insulin easing the symptoms of low blood glucose
Mainly for use by family or friends in treating a severe insulin reaction in patients unable to take suagr by mouth
105
4 factors that can contribute to iron deficiency
increased reqiurements (pregnancy, infancy or adolescence
decreased intake (vegetarian diet)
diminished absorption (elderly)
excessive or regular blood loss
106
Slow-Fe is a sustained release enteric-coated iron product. Does it have any advantage over regular nonenteric-coated products? Explain?
No
Non-enteric coated products are recommended due to concerns with the effectiveness of enteric coated and time-release preparations in releasing iron in the gastric environment.
107
What are the three forms of calcium that are not recommended? why?
Calcium dolomite, bone meal and osyter-shell products
Not recommended as they be contaminated with lead
108
For indiciduals with decreased gastric acid secretion which calcium salt should be recommended?
Calcium citrate
109
What other OTC supplement has been shown to improve calcium balance? what is the necessary dosage?
Vitamin D
400 IU/DAY
110
What are the two most common Probiotics on the market?
Lactobavillus acidophilus: reduce diarrhea, bloating and cramps and L.bifidus: regulates the digestive system
111
How are cold sources applied to an injury?
10-30 minutes
apply at regular intervals throughout the waking hours of the day allowing a few hours between treatments
112
How are heat sources applied to an injury?
20-30 miuntes every 2-4 hours as needed
113
Describe the precautions related to using external analgesics?
Do not apply to acute injuries where there is bleeding if wounds are open or under dressings
Do not use more than 3-4x/day
do not use concurrently with thermotherapy devices since burns may result
114
What is the mainstay therapy for athlete's foot? Name three agents that can be used?
Treatment of the skin with a topical antifungal agent
ciclopriox 1%, clotrimazole 1%, ketoconazole 2%
115
What is the most common intervention and often the only treatment needed, in dealing with corns and calluses?
A change in footwear
116
Salicylic acid is the pharmacologic treatment of choice to treat plantar warts. In what concetration is it usually available? Discuess its advantage and disadvantage?
5-40%
Advantage: control over the amount of disability and discomfort/low risk of scarring
Disaadvatage: length of treatment
117
What are two types of wet dressings? What is the major difference between the two? Describe the process for each?
Compresses: drying
Soaks: hydrating
Compresses: non-irritating gauze or thin cloth soaked with solution and wrung so remains we but not dripping-applied to skin, removed and remoistened and reapplied every few miuntes for 20-30 miuntes, four to six times daily
Soaks: saturate cloth, apply to area for 15-20 minute without removal
118
What are emollients?
Semi-solid bases designed to control dryness
119
Do emollients hydrate the skin?
No, reqiure concentration of water in the skin and function only to trap existing moisture and therfore should be applied while the skin is still damp from bathing
120
What are hydrating agents? Examples?
are emollients to which humectants have been added
Examples: glycerin, propylene glycol, phospholipids, urea
121
What are the concentrations and how is each one used?
10% hydrate dry skin
15% accelerate fibrin digestion
20-30% are antiprunritic, break down keratin, decrease thinkness of stratum corneum and used in scaling conditions
40% are proteolytic and may be used to dissolve and peel dystrophic nails
122
When are topical corticosteroids indicated? State the factors considered when choosing a particular product?
In atopic dermaitis and allergic contact dermaitis
Patient age, areas of the body to which the medication will be applied and other patient factors such as degree of xerosis, patient preference and cost.
123
5 possible side effects of using coal tar?
Messy/stain blond or grey hair and clothing/ unpleasant odor/ cause tar acne, contact dermatitis and photosensitivity
124
why salicylic acid might be added to a compound? explain how it works?
Keratolytic and antiseptic activities
It provides the effect by loosening the bonds between the keratinocytes in the skin, which helps detach flakes and increases the penetration of other drugs
125
why long-term use of potent corticosteroids are discouraged for controlling seborrheic dermaitis?
Replapse rates are often high and may lead to undesirable side effects
126
When comparing efficacy of compounds used in treatment of seborrheic dermaitis rank the compounds from highest to lowest?
Antifungals= moderate-potency corticosteroids > hydrocortisone= calcineurin inhibitors > selenium sulfide > zinc pyrithione> keratolytics > coal tar
127
What are two consequences of acne? Why is early therapy essential?
Hyperpigmentation and scarring
to prevent above complications
128
Two products that are used as exfoliants
Resorcinol, Salicylic Acid, Sulfur, Glycolic Acid
129
What is teh agent that is part of the standard of care for mild-moderate acne?
Benzoyl Peroxide
130
Benzoyl peroxide has three principal actions that make it useful for acne? What are they?
Anaerobic antibacterial activity
Rapid bactericidal effect
Depression of sebum production
131
Describe two routines for inititating therapy with benzoyl peroxide ?
First: gently cleanse the skin
apply gel and leave on for 15 minutes the first evening
Each evening double the contact time until the gel is left on overnight
Second: apply for 2 hours x 4 night
Apply for 4 hours x 4 night
then leave on all night
132
What is hydroquinone used for?
Hypopigmenting agent (as a skin depigmenting agent)
133
List the adverse reactions to DEET ?
Irritating to mucous membranes and open wounds
contact dermaitis
absorbed through intact skin and systemic effects are related to the amount absorbed
If ingested may lead to seizures, hypotension, angioedema or death
134
Why would you not recommend topical Diphenhydramine for relief of itching?
It can cause allergic contact dermaitis and sensitization
135
Why should ice not be used for thermal burns ?
Can cause vasoconstriction that may worsen the injury and lead to frostbite of the area
136
What do home pregnancy test kits test for the presence of?
Human chorionic gonadotropin (HCG)
137
List six products that may improve bathroom safety for indiciduals who are mobile?
Bath mats
Batrub and shower grab bars and poles
hand-held or portable shower nozzles
bath boards/bathtub transfer benches
bath/shower seats
raised toilet seats
138
How shoudl a cane be measured for fit?
Distance from the top of a can's handle to its tip should equal th distance from the wrist crease to the ground when the arm is stright down at the side.
139
What do peak flow meters measure? who should use one? What benfit do they provide?
The peak expiratory flow rate (PEF) or the speed (amount) of air that can be forced out after the lungs are fully inflated
Patients who are poor perceivers of airway obstruction and by patients with severe asthma
Allow home monitoring of a patient's lung function and tituration of their medication in response to their lung function.
140
How do vaporizers and humidiers differ?
Vaporizers use heat to dispense moisture in the air
Humidifers increase humidity by physically dispersing water droplets in the air .
141
What are two types of acne and what are they characterized by?
Noninflammatory=open and closed comedones
Inflammtory=papulopustular and or nodular lesions
142
What is another name for a closed comedone and how long does it take to develop?
White head can take up to 5 months for them to develop
143
What mechanical/physical factors worsen acne?
Physical pressure from headbands, chin straps, sports helmets
Medchanical friction
wool or other rough-textured fabrics
patients may manipulate comedones and pustules
excessive scrubbing/washing can exacerbate by causing rupture
144
Red flags of nausea and vomit
dehydration, abdominal pain, persistent vomiting, blood in vomit, blood in feces and difficulty swallowing
145
Name some types of nausea and vomiting?
Nausea and vomiting of pregnacy, postoperative nausesa and vomiting, drug-induced, chemotherapy-induced, opioid-induced, motion sickness
146
What factors can deplay wound healing and increase the risk of infection?
Age, Smoking, diabetes, low or high body weights
147
What are 3 kinds of macronutrients?
Carbohydrates, fiber, protein, lipids
