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z S1: Self Care > Exam 1 > Flashcards

Exam 1 Flashcards

(129 cards)

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1
Q

Product line extensions

A

marketing strategy based on brand loyality

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2
Q

Product Reformulations

A

change the ingredients but keep the brand name

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3
Q

What is the 5 steps in PPCP

A

Collect
Assess
Plan
Implement
Follow-up

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4
Q

How can PPCP be applied to self care

A

Patients can take OTCs and save money without having to go to the doctor

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5
Q

What are general characteristics of OTC

A

-consumers can use them for self-diagnosed conditions
-health care providers are not needed for safe/effective use of product
-benefits outweigh risks

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6
Q

What are the standard content area of drug facts label

A

Drug Facts: active ingredients
Purpose: type of medicine for each active ingredient
Uses: symptoms medicine is approved to treat
Warnings: side effects, when to stop using the medicine, and pregnancy-related warnings
Arrow: additional information
Directions: how it should be stored, if the product has a tamper-resistant feature
Inactive ingredients: used to make the medicine but have no effect
Questions: telephone number or website

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7
Q

Patient factors to consider when taking a medicine

A

allergies
medical conditions
current medications
pregnancy
breastfeeding
age

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8
Q

Nonprescription Analgesics/Antipyretics are FDA approved to reduce fever and relieve mild to moderate pain caused by what

A

headache, toothache, backache, muscle ache, minor arthritis, menstrual cramps, common cold

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9
Q

Patient factors to consider when choosing an analgesic/antipyretic to recommend

A

age
allergy history
PMH/med history
pregnancy/lactation

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10
Q

Properties of aspirin at OTC doses

A

Antipyretic (reduce fever)
Analgesic (reduce pain)
NOOOO inflammation reduction

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11
Q

GI effects of aspirin in gastritis/esophagitis

A

local effect
caused at low doses
irritation of GI mucosa
micro bleeding
enteric coded tablets cause less injury

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12
Q

GI effects of aspirin in ulceration

A

systemic effect
low doses
COX-1 inhibition
major bleeding
all dosage forms have same risk

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13
Q

Purpose of enteric coded tablets

A

best dosage form for chronic use
cause less local damage
absorption is delayed

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14
Q

Risk factors for GI ulceration and major bleeding from aspirin

A

Age >60
h/o GI bleeding or ulceration
higher doses
concomitant anticoagulant use (Warfarin)

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15
Q

Aspirin allergy/hypersensitivity

A

occur w/in 3 hours of ingestion (hives, bronchospasm, shock, death)

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16
Q

What is aspirin’s cross reactivity

A

90% chance they will be allergic to other NSAIDs so you have to recommend tylenol or acetaminophen

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17
Q

What is reye’s syndrome

A

excessive vomiting and development of a fatty liver and brain swelling occurs <15 yo following aspirin during viral illness

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18
Q

Aspirin should not be used to treat ______ from dental procedures or surgical procedures

A

pain

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19
Q

Low dose aspirin strength, regular dose, extra strength

A

low: 81mg
regular: 325 mg
extra: 500 mg

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20
Q

Should aspirin be used during pregnancy or lactation

A

pregnancy: not during 3rd trimester
lactation: NO

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21
Q

Properties of acetaminophen

A

antipyretic
analgesic
no anti-inflammatory at any dose

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22
Q

Acetaminophen dose for regular strength and extra strength, arthritis strength

A

regular: 325 mg
extra: 500 mg
arthritis: 650 mg

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23
Q

Childrens acetaminophen doses

A

80 mg and 160 mg
160mg/5ml liquid

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24
Q

What is the max adult dose of acetaminophen

A

4000 mg in 24 hrs

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25
Pediatric dosing of acetaminophen for children 2-11
10-15 mg/kg per dose do not exceed 5 doses daily
26
Situations of increased clinical concern for hepatotoxicity
patients with liver disease patients who drink >3 a day cachectic sever liver disease
27
Acetaminophen in pregnancy and lactation
pregnancy: safe drug of choice lactation: compatible with breast feeding
28
What are the only two approved OTC NSAIDs on the market
ibuprofen naproxen
29
What are the properties of OTC NSAIDs at OTC doses
Antipyretic (reduce fever) Analgesic (for pain)
30
What is the peds dosing for naproxen
no dosing
31
What is the typical tablets for naproxen and how often do you take them
220mg up to 660 mg in 24 hours take every 8-12 hours
32
What are the ibuprofen ped dosing
50mg/1.25ml -> 100mg/5ml 50 and 100 mg tablets
33
When does the FDA approve OTC dosing for ibuprofen
6 months of age
34
Adult dosing of ibuprofen
>12: 200-400 q 4-6 hrs max of 1200mg/24hrs
35
Ibuprofen weight based dosing range
5-10 mg/kg usually 7.5 mg/kg
36
Adverse effects of NSAIDs
GI (heartburn, dyspepsia, epigastric pain) Renal (Na and H2O retention, lead to acute kidney injury)
37
Drug/disease interactions of NSAIDs
warfarin GI problems Heart failure Renal dysfunction Hypertension
38
NSAIDs with lactation and pregnancy
pregnancy - not be used lactation - can use ibuprofen and naproxen
39
Diurnal rhythm
temps are lower in the morning / higher in late afternoon / evening
40
Pyrogens cause the production of prostaglandins and they cause the hypothalamus to establish a new ______ thermoregulatory set point
higher
41
Classic signs and symptoms caused by thermoregulation
increasing body temp decreasing body temp fever body aches malaise
42
The rectal and forehead temp is usually one degree ________ than oral temp
higher
43
The axillary and ear temp is usually one degree __________ than oral temp
lower
44
If patients that are < 3 months and have a rectal temp of >104 what do you do
call doctor immediately, its a medical emergency
45
What is the primary goal of fever treatment
relieve discomfort
46
What do antipyretic drugs do to PGE2 production
decrease it which decreases the hypothalamic set point
47
What is the max temp reduction of antipyretic drugs
lower temp by 2 - 2 1/2 degree w/in 2-3 hours
48
What drug is the least appropriate choice of antipyretic drugs
aspirin
49
Non-drug therapy for fever
Increase fluid intake Cooler enviornment No sponge baths Avoid isopropyl alcohol sponging
50
What is a key importance of infrared temp monitors
they make contact with the skin
51
What does dysmenorrhea mean
difficult / painful menstruation
52
What does menarche mean
the very first menstrual period that a female has
53
Etiology of mensural cramps
prostaglandins
54
Symptoms of dysmenorrhea
cramping pain in lower abs that can radiate to back or thighs
55
When does mensural pain usually start
when period starts lasts 24 hours and up to 3 days
56
What is the drug of choice for menstrual cramps
NSAIDs (take max doses regularly) then acetaminophen never aspirin
57
Exclusions of self care of dysmenorrhea
sever pain/ heavy blood flow secondary dysmenorrhea gynecological problems IUD usage
58
Cold therapy is used in the first ____ to ____ hours after an acute musculoskeletal injury
24-48
59
Benefits of cold therapy for pain
vasoconstriction decrease metabolism reduce muscle spasms slow peripheral nerve conduction
60
Risks of cold therapy for pain
incorrectly managed can lead to damaged tissue and superficial nerves (frostbite)
61
When to apply heat therapy for acute musculoskeletal injury
48-72 hours
62
Benefits of heat for pain
increase blood flow increase tissue flexibility relieves muscle spasm comfort and relaxation
63
Low level heat source (thermacare) MOA
discs contain iron compound that oxidizes when exposed to air
64
What are the two drug safety issues with heat sources
never use w/ transdermal patches don't use w/ external drugs
65
What is counterirritation
producing mild pain to decrease the perception of a more intense pain
66
Counterirritation MOA
stimulate cutaneous nerve fibers, altering perception of pain caused by stimulation distracts attention from deeper pain in muscles or joints
67
Does methyl salicylate cause hot or cold sensation
hot
68
Does menthol cause hot or cold sensation
cooling
69
Proper application techniques for counterirritants
not for children under 12 not more than tid or qid, for up to 7 days not for damaged skin or wounds
70
What is capsaicin
topical cream that comes from red pepper that causes heat
71
capsaicin MOA
depletes substance P in area of application causing a desensitization of nerves (have to use regularly over long-term to work)
72
Most appropriate uses for capsaicin
osteoarthritis post-herpetic neuralgia (pain after shingles)
73
What is myalgia
nonspecific complaint in muscle pain or ache caused by viral illness, physical exertion, etc
74
What is delayed onset muscle soreness (DOMS)
overexertion or unaccustomed muscle contraction
75
What is myofascial pain
pain from the muscles and fascia pain from trigger points (local tender areas) dull, aching, deep
76
What are strains
a partials tear of a MUSCLE caused by force exceeding physical strength
77
Definition of bursitis
inflammation of bursa (fluid filled sac that decrease friction btw surfaces)
78
What are sprains
a partial tear of LIGAMENT caused when joint forced beyond normal range of muscle
79
Is this a sprain or strain: when a patient hears a pop followed by pain usually unable to bear weight, bleeding under skin
sprain
80
What are the treatment methods of musculoskeletal pain
nonprescription analgesics RICE heat
81
Osteoarthritis
joint pain loss of cartilage affects weight bearing joints due to mechanical stress
82
Therapy for osteroarthritis
acetaminophen (first line) NO NSAIDs Counterirritants Capsaicin
83
What is severe pain considered as
pain that persists or worsens after 10 days of treatment (adults)
84
Where is the highest amounts of histamine located
Skin Lungs GI mucosa
85
What are mast cells
primary site of histamine storage mainly in nose and eye
86
Where are basophils located
In the blood and deeper in tissues
87
What are these physciaological responses caused by: Vasodilation Cholinergic activity at certain nerve endings Stimulates sensory nerves Edema Contraction of bronchial smooth muscle
Response to histamine at H1 receptor
88
Sensitization of histamine
occurs w/ initial exposure (IgE bodies are produced)
89
Early phase of histamine
w/in minutes mast cell degranulation produce mediators
90
Recruitment phase of histamine
infiltration of mucosa with basophils, macrophages, eosinophils, neutrophils
91
Late phase of histamine
2-4 hours after exposure nasal congestion, obstruction, and mucous hypersecretion
92
What generation histamines are doxylamine and diphenhydramine
Gen 1, sedation, anticholinergic doxylamine (common cold, insomnia) diphenhydramine (allergy, insomnia)
93
What generation histamines are cetirizine and levocertirizine
gen 2, used for allergies, low sedation
94
What generation histamines are fexofenadine and loratadine
gen 2, used for allergies
95
What generation histamines are brompheniramine and chlorpheniramine
gen 1 little sedation common cold and allergy prevention
96
What do 1st generation histamines cause
sedation (cross BBB) non-selective for H1 receptor
97
What do 2nd generation histamines cause
lipophobic does not cross BBB selective peripheral H1 receptors
98
MOA of inverse receptor agonists at H1 receptors
exists in active (histamines) and inactive conformation (antihistamines) if antihistamine present in high concentrations before histamine release then H1 receptor is primarily in inactive state and allergy symptoms are prevented
99
What allergy symptoms are relieved by oral antihistamine
eye nasal (NOT nasal congestion)
100
Adverse effect of gen 1 antihistamines
sedation anticholinergic (dry mouth, dry nose, dry eyes, constipation, blurred vision, urinary retention)
101
If men have BPH what antihistamines do you not use
Generation 1 because they promote urinary rentention
102
What are first gen antihistamine age restriction
6 or older
103
What two low sedation second generation antihistamines do you NOT use for patients with kidney disease and over 65 years old
Cetirizine Levoceritizine (give in evening)
104
What is the age restriction for second generation antihistamine drugs
2 years
105
What route is the most effective for treatment if allergic rhinitis
intranasal corticosteriods
106
What is the administration technique for intranasal corticosteriods
opposite hand technique to not hit septom
107
Adverse effects of intranasal corticosteriods
sneezing sore throat cough nasal irritation/ bleeding
108
MOA of oral nasal decongestants
alpha-adrenergic activity (constriction of blood vessels to reduce swelling) helps nasal congestion
109
Adverse effects of oral nasal decongestants (pseudoephedrine and phenylephrine)
cardiovascular
110
Age restrictions on oral nasal decongestants (pseudoephedrine and phenylephrine)
4
111
Azelastine is an intranasal antihistamine and is approves at which age
6 years
112
What allergic nasal symptoms are relieved by intranasal antihistamines
itchy nose runny nose sneezing nasal congestion
113
What is the adverse effect of (azelastine) intranasal antihistamine
drowsiness
114
What is intermittent allergic rhinitis
seasonal allergic rhinitis symptoms last <4 days/wk or <4 wks
115
What are persistent allergic rhinitis
perennial allergies >4 d/wk or >4wk chronic
116
What are episodic allergic rhinitis
occurs when exposed to allergen that is not normally in person's envirospectivenment "trigger" (ex: cat hair)
117
Nasal allergy symptoms
itchy nose runny nose sneezing (repetitively) nasal congestion
118
Eye allergy symptoms
itchy eyes watery eyes ref eyes
119
Systemic allergy symptoms
fatigue, HA, cognitive impairment
120
What are mild allergy symptoms
do not impair sleep or daily activities (non troublesome)
121
What are moderate-severe allergy symptoms
impaired sleep impair daily activities (troublesome)
122
Non drug ways to relieve allergies
avoidance of allergy nasal wetting agents nasal irrigation
123
What treatment to use for episodic allergies
oral antihistamines
124
What treatment to use for mild intermittent allergies
oral antihistamines
125
What treatment to use for moderate to severe intermittent allergies
oral antihistamines intranasal corticosteroids
126
What treatment to use for mild persistent allergies
oral antihistamines intranasal corticosteroids
127
What treatment to use for severe persistent allergies
intranasal corticosteroids (oral antihistamines)
128
When should internasal corticosteroids (INCS) be started
one week before anticipated allergy season administered once daily as long as allergies exist NOT PRN NOT for episodic
129
Exclusions of self-care of allergic rhinitis
asthma symptoms one-sided symptoms pregnancy

z S1: Self Care (2 decks)

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