Week 6: Insomnia, Anorectal Disorders, Pinworms

Question 1

when to refer for insomnia?

Answer 1

patient under 12 or over 65
pregnancy
occurring longer than 3 weeks

Question 2

what’s the dose range for melatonin? how effective is it for insomnia?

Answer 2

0.3-5mg, not significantly effective for insomnia

Question 3

what’s a helpful drug for acute insomnia but not chronic insomnia?

Answer 3

diphenhydramine

Question 4

do not use diphenhydramine more than ____ consecutive nights for insomnia

Answer 4

7-10

Question 5

if self-treating insomnia, when should pt see Dr if there’s no improvement?

Answer 5

after 10 days

Question 6

should a patient with an anorectal disorder take NSAIDs/aspirin to help treat the pain?

Answer 6

No, they may promote bleeding

Question 7

diosmin and hespiridin may help in what way for an anorectal disorder?

Answer 7

reduce or stop bleeding

Question 8

what symptoms would topical anesthetics help with for anorectal disorder?

Answer 8

relieve itching, irritation, burning, and pain

Question 9

how often can dibucaine be applied to the anorectal area?

Answer 9

up to 4 times daily

Question 10

how often can pramoxine be applied to the anorectal area?

Answer 10

up to 5 times daily

Question 11

how often can benzo/lido/tetracaine, benzyl alcohol, and dyclonine be applied to the anorectal area?

Answer 11

up to 6 times daily

Question 12

list the vasoconstrictors:

Answer 12

ephedrine sulfate, phenylephrine hydrochloride, and epinephrine hydrochloride

Question 13

which vasoconstrictor is for external use only?

Answer 13

epinephrine hydrochloride

Question 14

how often can vasoconstrictors be used?

Answer 14

qid

Question 15

how to apply protectants to anorectal area?

Answer 15

6 times daily or after bowel movements

Question 16

how often can petrolatum/white petrolatum be applied to anorectal area?

Answer 16

applied as needed

Question 17

how to apply astringents to anorectal area?

Answer 17

6 times daily or after bowel movements

Question 18

list the astringents:

Answer 18

calamine, zinc oxide, and witch hazel

Question 19

which astringent is for external use only?

Answer 19

witch hazel

Question 20

how often can Analgesics, Anesthetics, Antipruritics be applied to anorectal area?

Answer 20

up to 6 times daily

Question 21

how do corticosteroids help with an anorectal disorder?

Answer 21

cause vasoconstriction and relieve itching

Question 22

how often can corticosteroids be applied to anorectal area?

Answer 22

externally up to 6 times daily

Question 23

list the keratolytics used for anorectal disorders:

Answer 23

resorcinol and alcloxa

Question 24

how often can keratolytics be applied to anorectal area?

Answer 24

externally up to 6 times daily

Question 25

if symptoms are not relieved after __ days for anorectal disorders patient should see Dr

Answer 25

7 days

Question 26

when to refer for pinworms?

Answer 26

Liver disease, severe malnutrition pregnancy/lactation under 2 y/o under 25 lb

Question 27

what prescription antiparasitics are available?

Answer 27

mebendazole, albendazole, and thiabendazole

Question 28

what does pyrantel do as a treatment for pinworms?

Answer 28

paralyzes worms