Final Exam Study Deck Flashcards
(129 cards)
1
Q
What injuries qualify at “minor wounds”?
A
Scratches, blisters, scrapes/abrasions, avulsions (tears), splinters, paper cuts
2
Q
When should medical attention be sought for a wound?
A
- When it covers a large area
- When there are injuries to tendons, nerves or muscles
- Chronic or recurring infections
- Immunosppressed patients
3
Q
What non-pharmacologic therapy can be used to treat minor wounds?
A
Use normal saline to gently clean wound, using tweezers to remove debris.
Apply petrolatum & dressing, keeping wound moist and changing daily (24-48hr)
4
Q
What pharmacologic therapies can be used to treat minor wounds?
A
Benzalkonium chloride
Povidone-iodine
Isopropyl alcohol
Chlorhexidine
Do NOT us Hydrogen Peroxide as it interferes with healing!
5
Q
Name three topical Anti-Infectives that can be used to treat minor wounds.
A
- Bacitracin
- Polymyxin B
- Gramidin
NOTES: Used to reduce crust formation and prevent dressing adherence to the wound. Do not use longer than one week!
6
Q
Name three local anesthetics that can be used to treat minor wounds.
A
- Benzocaine
- Lidocaine
- Pramoxine HCL
NOTE: Watch for allergic reaction
7
Q
What analgesics can be used to treat pain associated with a minor wound?
A
Acetaminophen, codeine
8
Q
Topical antipruritic and antihistamine (Benadryl) is contraindicated1 if the wounds is __________.
A
Open
9
Q
What are the four phases of wound healing?
A
- Hemostasis: vasoconstriction, platelet aggregation and clot formation (dy 1-3)
- Inflammatory: vasodilation and increased blood flow, redness, swelling, pain (dy 3-20)
- Proliferative: collagen forms scar tissue to hold edges together (wk 1-6)
- Maturation: formation of new tissue, wound contraction and new epithelium (wk 6-2yr)
10
Q
Looking at the minor wounds assessment chart, what red flags might lead the pharmacist to recommend patient seek advanced treatment?
A
- Requires Tetanus shot
- Underlying conditions/factors like diabetes, elderly, malnourishment, smoking, obesity, or immunocompromised
- Animal/human bite
- Deep puncture (fat/bone), or fat/bone exposed
- Deep partial or full thickness burn
- Large, gaping wound, stitches required
- Signs of infection or embedded foreign material that cannot be removed with irrigation
- Severe pain
11
Q
If a patient presents to the pharmacy with a chemical or electrical burn, the pharmacist should always ___________________.
A
Refer to a physician
12
Q
What is the “Rule of 9” and how does it apply to burn assessment?
A
An easy way to quickly assess and calculate burn surface area.
- Each arm is 9%, each leg is 18%, head is 9%, front trunk is 18%, back trunk is 18%, palms are 1%
13
Q
What non-pharmacological therapies can be used to treat a burn?
A
- immerse in cool water or use a cool compress for 30min
- NO ICE
- leave small blisters intact
- do not apply petrolatum, butter or margarine
14
Q
What pharmacological therapies can be used to treat a burn?
A
- Topical antibiotics (open blisters)
- Analgesics like acetaminophen and NSAIDs (avoid ASA)
- Anesthetics (limit use)
15
Q
When assessing a burn patient for treatment, what red flags might cause the pharmacist to send the patient to the hospital for treatment?
A
- Deep partial or full-thickness burn
- under the age of 5 or over the age of 60
- Burns on/including the face, ear, eyelid, inside of arm, hands, feet, groin
- Burns covering a large or circumferential area
- Chemical, electrical or inhalation burn
- Underlying medical conditions or immunosuppressed
16
Q
What is Frostbite?
A
- Cold-induced injury where ice crystals form in tissue
- Can look waxy-white, yellowish or mottle blue-white surrounded by red
- Area is numb and hard
- 90% of all cases occur in the hands or feet
- Levels 1-3 of severity
17
Q
What is Frostnip?
A
- Pre-freeze superficial injury (before frostbite)
- Blue-white, numbness and tingling
18
Q
What are the degrees of Frostbite?
A
Frostnip (superficial)
Superficial frostbite (blisters form, no major damage)
Frostbite (all layers of skin, permanent tissue damage/death)
19
Q
What non-pharmacologic therapy would be recommended for a patient with frostnip/frostbite?
A
- Move to warm location, do not walk on frozen toes/feet and do not thaw if there is a risk of re-freezing
- Remove jewelry and/or constrictive clothing
- Don’t rub area
- Use blankets or can immerse in warm water for 15-30min
- Elevate area and apply sterile dressing
FROSTBITE - send to doctor
FROSTNIP - will respond quickly to re-warming
20
Q
What pharmacologic therapy can be used for frostbite/frostnip?
A
Analgesics: NSAIDS and Acetaminophen
21
Q
What is Impetigo?
A
Highly contagious bacterial infection (S. aureus)
- 2 types: Bullous (30%) and Non-bullous (70%)
22
Q
What are the non-pharmacological treatments for Impetigo?
A
- Use warm, soapy water or saline to remove crusts (10-15 min/2-4 times a day)
23
Q
What pharmacologic measures can be taken for Impetigo?
A
Non-RX: Polymyxin B, bacitracin & gramicidin (Polysporin/Bioderm)
RX: Mupirocin, Fusidic acid, Neomycin
24
Q
What is pediculosis?
A
Lice - a tiny blood sucking parasite common in crowded spaces (shelters, schools, prisons, LTC facilities)
25
What are the three species of lice that affect humans?
1. Head (skin)
2. Body (seams of clothing)
3. Pubic (skin - most common STI)
26
How is lice transmitted?
- Head: hair to hair contact
- Body: sharing clothing or linens - poor hygiene only plays major role in body lice
- Pubic: Sexual or close body contact, bed linens or towels
27
What does the lifecycle of lice look like?
- Eggs are cemented in nits to base of hair or in seams of clothing
- Louse hatches, moults, mates, laying more eggs after mating - total lifecycle is 33-35 days
28
Nits can survive for up to _________ days.
10
29
Adult lice do not have ____________ and cannot ____________.
wings, jump
30
What are pseudonits?
objects in hair that resemble nits (hair spray, dandruff)
31
What symptoms are associated with lice?
Head: itchy scalp, allergic reaction to bites, infection from scratching
Pubic: itchy, reaction to bites, infection from scratching, small, yellow-brown dots
Body: itchy at nighttime (feed at night), red papule around waist and underarms
32
Non-rx therapies for lice include...
- Avoid sharing personal items (hats, brushes), contact of head to seat backs, sharing towels/washcloths
- Nit combs
- Washing items (hot water)
- Vacuum
33
What pharmacologic treatments are available for lice?
1. Dimeticone (Nyda)
2. Cyclomethicone/Isopropyl myristate (Resultz)
3. Permethrin Cream Rinse (Nix-First choice): low toxicity and very ovicidal. Shampoo, apply, and let it sit for 10 minutes. Rinse hair and dry. Use nit comb to remove nits. Second treatment in 7-10 days
4. Pyrethrins (R&C - piperonyl butoxide): low ovicidal, need two treatments, avoid if you have ragweed allergy!
34
What are "Super Lice"?
Lice that have developed resistance to rx treatments - especially pyrethrins and permethrins.
35
Are pharmacological treatments necessary for body lice?
Nope! Only require bathing and laundering for infected articles
36
What is Scabies?
Scabies is a contagious infestation by a small mite (parasite)
37
What is the lifecycle for a scabies infestation?
Females burrow into skin and lay eggs - eggs hatch in 3-4 days and mature in 1-2 weeks - mites can live on humans for 1-2 months and continue living in clothing, bedding, dust for 2-3 days
38
How is scabies transmitted?
Close personal contact (sleeping together)
39
What are the symptoms of a scabies infestation?
- Intense itching that worsens at night or after a hot bath
- wavy lines on skin - hands, feet, finger webs, inner wrists and underarms
- sometimes groin, butt, breasts or fact/head in infants
40
What non-pharmacologic measures can be taken for scabies?
- wash clothes and linens in hot, soapy water
- bag other items in plastic for 5-7 days
- vacuum everything
- avoid contact with others until treatment compleated
41
What pharmacologic measure can be used to treat scabies?
All treatments are to be applied from neck down, including under the nails
- Permethrin: most effective and least toxic, for adults and children over 2 - apply and leave on for 8-14 hours, than wash off
- Crotamiton: Apply for 2 nights in a row and wash off 48hrs later
- Precipitated Sulfer in Petrolatum: Apply for 3 nights in a row and wash off on day 4
42
What prevention measures can be taken to avoid bites, stings?
- Avoid scented products
- Don't carry ripe, fresh fruit
- Good hygiene
- Citronella candles
OTC Products:
- DEET 10-30%
- Citronella
- Lemon Eucalyptus
- Icaridin 10-20%
43
What non-rx therapies can help with bites and stings?
- Clean area with warm soap and water
- cool compresses
- baking soda paste
- remove stinger by gently scraping with fingernail or credit card edge
44
What pharmacologic therapies can help with bites and stings?
- Calamine lotion
- Acetaminophen or NSAIDs
- Diphenhydramine (itching/swelling)
- Loratadine
- AVOID: benzocaine, lidocaine
45
What diseases can ticks carry?
RMSF or Lyme disease
46
Tick disease transmission if higher if the tick remains attached for more than __________.
24 hours
47
What is the safest way to remove ticks?
- NOT with kerosene or match
- Use tweezers, as close to head as possible, pull with steady pressure until it releases grip
- Avoid injuring/killing as the tick might expel infected fluid into patient
48
What is Acne Vulgaris?
Common skin disorder consisting of breakouts of multiple pimples
- adolescents and some adults
- no cure (controlled with treatment)
- obstructed sebaceous follicle
49
Blackheads are _______ comedones and Whiteheads are ___________ comedones.
Open, closed
50
What are the different causes of Acne?
1. Acneiform - caused by certain medications (OCs, lithium, steroids)
2. Environmental (heat, pressure, scrubbing, hair styles)
3. Emotions: Intense anger, stress
4. Neonatal: baby cheeks from placental transfer of androgens
5. Cosmetic: oil-based cosmetics and hairspray
6. Occupational: exposure to oils in the workplace
51
What are the goals of Acne treatment?
- Alleviate symptoms
- Reduce number and severity of lesions
- Limit recurrence
- Prevent scarring
- Avoid psychological suffering
52
What are some non-pharmacological treatments for Acne?
- Washing twice daily with a mild soap or soapless cleanser
- Extractions (not recommended - possibility of scarring and infection)
- UV light (not advised due to carcinogenic nature of UV)
53
What pharmacological treatments are recommended for Acne?
- Medicated soap/wash/gel/lotion/pasted: leave in contact with area for 15 seconds - 5 minutes
- Exfoliants (peeling): Salicylic acid in combination with hydrogen peroxide, sulfer, resorcinol (can be in combination with surfer)
- Abrasives: pumice
- Antibacterial/Antifungal: triclosan
- Antibacterial: Benzoyl peroxide (first line treatment), decrease number of lesions in 5 days, can cause bleaching, can be in a water, alcohol, acetone, or hydro phase gel, avoid sun exposure
54
What role does UVB play in skin damage?
- Damages stratum corneum and epidermal layers
- Skin cancer, photo-aging, immunosuppression
- DAILY UV REPORTS ARE UVB ONLY
- Produces sunburn
- Plays role in tanning
55
What role does UVA play in skin damage?
- Penetrates dermis and SC Fat
- 10-15% role in sunburn
- With UVB - major factor in skin aging
- Least potent, but still significant contributor to skin cancer
- More UVA than UVB/UVC
- DNA damage
- UVA absorbed by photosensitizing drugs (cause bad sunburn)
56
What about UVC?
- Most carcinogenic
- Does not reach earth
57
Photo____________ : resembles sunburn, Photo_________: blisters and oozing lesions.
Toxicity, allergy
58
What is "photo-aging"?
- Premature skin aging
- Most damage done before age of 20
- Rough, coarse, dull skin with fine/deep wrinkles
59
Actinic Keratosis is considered to be ______________.
Pre-cancer
60
Risk for skin cancer is related to....
Squamous cell carcinoma: cumulative lifetime exposure
Basal cell carcinoma and melanoma: exposure during childhood and adolescence
61
What is the difference between HYPER and HYPOpigmentary changes related to UV exposure?
Hyper: hypermelanosis - irregular spots of mottled hyperpigmention that is treated with hydroquinone
Hypo: back of head and forearms on those over 60
62
UV exposure can cause age related ___________________ and ___________________.
Macular degeneration, cataracts
63
What is the best way to reduce/prevent skin damage from UV exposure?
- Avoid direct sun from 11-3
- Avoid sun exposure in infants less than 6 months in age
- Wear protective clothing
- Avoid tanning
- Wear sun-screen
64
How does sunscreen help protect us from UV exposure?
- Physical sunscreen: forms barrier that reflects/scatters light (Zinc oxide, titanium dioxide)
- Chemical Sunscreens Absorbs, reflects or scatters a portion of UV lights
- helps reduce sunburn/photoaging and pre-cancer spots, squamous cell carcinoma
- no risk reduction for basal cell carcinoma or melanoma
65
Octocrylene, Ensulizole, Cinnamate (Octinoxate) and Oxybenzone protects agains mainly _________ and minimal __________.
UVB, UVA
66
Avobenzone protects against _________ and ___________.
UVA, UVB
67
Homosalate, Octisalate protects against __________ only.
UVB
68
SPF (Sun protection factor) of 20 would mean that a person wearing that sunscreen would take 20 times longer to burn. True or False?
True
69
What are the guidelines for sunscreen application?
- Chemical sunscreen ages 6 month and up
- Apply 30 min before exposure and reapply every 2 hours
- 2.5-5ml to face/neck
- 5-7.5ml to each of the following areas: arms/shoulder, chest/back
- 2-2.5 mL to legs/tops of feet
70
What is the difference between a Standard of Practice and Scope of Practice?
71
What is a PRA?
72
What are the three layers of skin?
Epidermis: outermost layer
Dermis: below the epidermis
Subcutaneous: below the dermis, contains fat deposits
73
What is the function of human skin?
Protects lower tissues from contaminants, prevents loss of fluid and electrolytes
74
What are the layers of the epidermis?
Stratum corneum (cells lose their nuclei and form this layer, layer sheds continuously)
Stratum lucidum: stretchy (pads of feet/hands)
Stratum granulosum: granular (cells die and keratohyalin converts to keratin)
Stratum spinosum: spiny (keratohyalin granules)
Stratum basale: basal (cells divide and move up to spiny layer)
Process takes 25-30 days
75
What conditions fall under the umbrella of hyperproliferation skin disorders?
- Cradle Cap
- Psoriasis
- Dandruff & Seborrheic Dermatitis
Abnormality in skin cell reproduction causing noticeable shedding
76
What is Cradle Cap?
- Infantile seborrhoea dermatitis that is caused by a fungal infection and overactive sebaceous glands
- Scales are greasy, yellow/brown and can have redness/inflammation
- Usually treated with petrolatum or mineral oil, but severe cases will need medical intervention
- Follow up with mild, non-medicated baby shampoo
77
What is dandruff and seborrhoea?
Non-inflammatory increased shedding of skin cells with some itching
- Caused by malasezzia fungus
- Common after puberty and peaks in early 20's
- Dandruff (scalp), seborrhoea (body)
NON-Pharm
- Humidifier, daily shampoo and scrub
78
What pharmacologic treatments are suggested for dandruff?
ANTIFUNGALS: Ketoconazole (over 12), Selenium Sulfide (can stain hair), Zinc Pyrithione
KERATOLYTICS: Salicylic acid, Sulfer (in combo), Coal-tar (stain/bleach, acne, contact dermatitis)
79
What is seborrheic dermatitis?
Persistent, lifelong condition that is worse in winter months
- Caused by excessive sebum production that allows yeasts/bacteria to produce fatty acids that irritate the skin
- symptoms are itching, burning, flaking, redness, with yellow, greasy scales
- can appear at the hairline, forehead, face, eyebrows, eyelashes, eyelids, beards, moustache, external ear
80
What pharmacologic therapies are used to treat seborrheic dermatitis
Coal tar, zinc pyrithione, selenium sulphide, salicylic acid, urea
Anti-inflammatory
- Topical corticosteroids (clobetasone, hydrocortisone)
- decrease itching/inflammation
- 1-2 times daily for 1-3 weeks
81
Dermatitis/Eczema has two forms ________________. ___________________.
Endogenous (internal) and Exogenous (External)
82
What disorders fall under the umbrella of ENDOgenous dermatitis?
Atopic Dermatitis
- Starts in childhood with asthma/allergic rhinitis
Nummular eczema (coin patches)
Stasis dermatitis (DVT)
Neurodermatitis (thick skin due to scratching)
Dyshidrotic (palm/sole of foot)
83
What factors play into having Atopic Dermatitis?
Genetics (90% have onset before 5yrs old)
- Early sign (red, chapped baby's cheeks)
- Higher incidence of viral infections
- itchy but no rash
- increased sensitivity to dust, molds, pets, stress, pollen and weather, food and drug allergens
84
Exogenous Dermatitis is also known as _______________ dermatitis.
Contact
- Can be caused by an irritant or an allergy
- triggered by contact with a specific substance
85
What are some important things to note about IRRITANT contact dermatitis?
Non-allergic reaction to substance (concentration and duration dependant)
- Reaction due to direct damage and not sensitization
- Common irritants include: fibreglass, cacti, hot peppers, SLS, adhesives, benzoyl peroxide, cinnamon
86
What are some important things to note about ALLERGIC contact dermatitis?
Triggered by exposure of sensitized individuals to contact allergens
- SENSITIZATION 5-21 days
- RE-EXPOSURE 12-48hrs
- Itching/swelling
- Common contact allergens include: poison ivy, poison oak, poison sumac, latex, nickel, synthetic rubber, ethylenediamine, paraphenylenediamine (black hair dye)
87
What non-pharmacologic therapy is recommended for treatment of Atopic Dermatitis?
- Control triggers
- Choose cotton
- Avoid fabric softener/bleach
- Restrict bathing (warm water)
- Keep air cool/moist
88
What non-pharmacologic therapy is recommended for treatment of Contact Dermatitis?
- Decrease exposure to irritant/allergen
- Protect damaged skin
- Avoid soaps, detergents, bleaches, moist vegetables
- remove rings
- avoid rubber gloves
- saline or tap water compresses
89
What are compresses and how are they used to treat skin conditions?
- Cool/dry the skin through evaporation
- Decrease inflammatory blood flow
- used to treat ACUTE conditions with OOZING/CRUSTING
- Gauze/thin cloth soaked in room temperature solution, wrung and applied to skin
- remove, remoisten and reapply every few min for 20-30 mins, 4-6 times a day
90
What are soaks and how are they used to treat skin conditions?
- Softens hardened crusts (scaling conditions)
- Hydrates skin
- NOT for acute, exuding dermatitis
- Saturated cloth is applied for 15-20 minutes
91
What pharmacologic therapies are effective for dermatitis?
Mineral Oil: apply during/after bath
Antiitching agents: Calamine
Antihistamines: Diphenhydramine
Anti-inflammatory corticosteroid: Hydrocortisone
Skin Protectants: Colloidal oatmeal
92
What is Psoriasis?
Chronic conditions that has large genetic component
- Cell turnover rate is 10-20 times faster then normal
- Plaque psoriasis is the most common
- Itchy silvery-white scales that itch/burn/sting
- Scalp, sacral, knees, elbows
- nail disfigurement
- Cold weather worsens symptoms
- Triggers: Strep throat, URT infection, meds, stress, alcohol
93
Non pharmacologic treatments for Psoriasis?
- Avoid triggers
- DON'T REMOVE SCALES
- Bathing
- Cool air humidifier
94
What are some pharmacologic treatments for Psoriasis?
- Petrolatum
- Keratolytics: Salicylic Acid, coal tar
- Anti-inflammatory: Hydrocortisone
95
How many pregnancies in Canada are unplanned?
61%
96
What are some reasons why a woman would want to avoid conception
- Have underlying disease states
- Sexually active - not in a relationship
- Couple opting to delay starting a family
97
Why would someone choose to purchase contraceptives at the pharmacy?
- Convenience (no appt)
- can choose where to go
- confidential/anonymous
98
How is the FAM used as a contraceptive?
Use basal temp, cervical mucus and calendar to keep track of fertile and non-fertile days
- Abstain from sex 3-4 days before ovulation, 3-4 days after ovulation
Advantages: Free
Disadvantages: Need regular cycles, highly disciplined, and has 25% failure rate
99
What are the advantages/disadvantages of the male condom as a contraceptive?
Advantages:
- Protects against STI
- Easy, convenient, cheap
- Can be used with spermicide to increase effectiveness
Disadvantages:
- Interrupts coitus/reduced sensation
- Allergic reaction
- Difficult to use correctly and can break or slip off
- Some stigma around purchasing
100
What types of male condoms are available?
Latex: can trigger allergies, more constricting, water-based lubes only
Polyurethane: hypoallergenic, less constricting, oil lubes are ok, more prone to breakage
Lambskin: no HIV protection, allergies to wool
101
What are the different vaginal barrier devices that can be used for contraception?
- Diaphragm: fitted and placed before sex, use with spermicide
- Sponge: absorbs sperm, contains nonoxynol-9 (spermicide)
- Cervical Cap
- Female Condom: one size/use, expensive, higher failure rate, skill to use
102
What is the "Morning after" pill?
Emergency contraceptive that consists of 1.5mg levonorgestrel that is taken up to 72hrs of unprotected sex
- Stops release of egg from ovary
- prevents fertilization
- prevents fertilized egg from implanting in uterus
- will not harm fetus if already pregnant
NOT TO BE CONFUSED WITH ABORTION PILL!
103
What schedule is Plan B?
Schedule III when sold as an emergency contraceptive
104
What can cause vaginal dryness?
Low estrogen
- Menopause
- Post-partum
- Right after your period
- Long term Breast Cancer survivors
- tampons
- stress/fatigue/exercise
- Endo
- Meds (antihistamines, TCA, SSRI, antipsychotics)
- oral contraceptives
105
What are vaginal moisturizers?
- Liquid/gel/ovule that contain either water-soluble lubricants (glycerin - short acting) or bioadhesive polymers (Replens - longer acting)
106
Healthy vaginal environment is maintained through the balance of:
Local bacterial flora, hormones, epithelial cells
107
Vaginal products include the following:
Liquid: Massengil, summer's eve (vinegar/water)
Spray: Summer's eve deodorant spray
Wipe: Vagisil wipes, summer's eve cleansing cloths
Vaginal capsule: Vagicare (probiotic)
Cream: Vagisil (benzocaine, resorcinol)
108
What is a douche?
Instilling fluid into the vagina to flush cavity and remove discharge
- warm water
- vinegar solution
- not a contraceptive
- not recommended for general/daily use
DO NOT USE if pregnant or menstruating, more then 2 times per week or within 3 days of a pelvic exam
109
What are some concerns regarding vaginal products?
- often contain irritating fragrances, ingrediants
- can disrupt normal flora and increase risk of infection
- delay diagnosis infection
- anaesthetic can mask symptoms of concern
- resorcinol is a hazardous substance
110
What is TSS and how can it be avoided?
Severe, life-threatening condition caused by S. Aureus
- 15-26yr old
- linked to repeated use of super tampons on light days
- change tampons often (4-6 times daily)
- match absorbency to flow/alternate with pads
- don't use tampons until 8 weeks post surgery or childbirth
- if symptoms develop, remove tampon and go straight to hospitol
111
What is TSS and how can it be avoided?
Severe, life-threatening condition caused by S. Aureus
- 15-26yr old
- Sudden high fever, low blood pressure, rash, swelling, fast heartbeat, sore throat, muscle pain, liver/kidney failure, bruising, confusion
- linked to repeated use of super tampons on light days
- change tampons often (4-6 times daily)
- match absorbency to flow/alternate with pads
- don't use tampons until 8 weeks post surgery or childbirth
- if symptoms develop, remove tampon and go straight to hospital
112
What are the symptoms of a vaginal infection and what are the risk factors for developing one?
- Itching, burning, stinging, inflamed, red, abnormal discharge, painful sex, hurts to urinate
Risk factors: Antibiotics, OCs, Age, Immune status, diabetes, sexual activity, hygiene restrictive clothing
113
What are some non-pharmacologic and pharmacologic treatments for a vaginal infection?
Non-pharm: increase intake of yogurt, lower sugar intake, oral probiotics, good hygiene, loose fitting clothing and cotton underwear
Pharm: Nystatin, Imidazoles (clotrimazole, miconazole, fluconazole) Take for 1-3 days, result after 6-7 days, can cause vaginal burning/irritation
- metronidazole is rx only
114
What is dysmenorrhea?
Painful menstration - caused by menstrual cramps or PID
115
What are the treatments for dysmenorrhea?
NON: exercise, warm bath, heating pad, relaxation, lower fat intake
PHARM: Advil - take immediately at onset of pain and for 2 days after, decreases prostaglandins, Tylenol - not effective for prostaglandins, for headache only
116
What are some treatments for bloating associated with menses?
Caffeine, pamabrom, pyrilamine
117
What is PMS?
Premenstrual Syndrome
- Symptoms occur during luteal phase ( after ovulation)
Psychological: Anxiety, irritability, depression, crying, mood swings, cravings, fatigue, forgetfulness, confusion, clumsiness, insomnia, aggression, phobias
Physical: Bloating, swelling, weight gain, BM changes, breast pain, headache, hot flashes, acne, runny nose, palpitations
118
What effect does fluoride have on teeth?
Systemic: decrease acid solubility in pre-eruptive teeth (kids)
Local: Reduces demineralization/promotes remineralization - helps enamal become more resistant to acid
119
Mouth Ulcers/canker sores (Aphthous stomatitis)
Non-infections oral disorder that affects gingival and intraoral soft tissues
- 5-25% of population is affected
- 50% have a 3-month recurrence
120
What are the three types of mouth ulcers?
1. Minor (small ulcers that are recurrent)
2. Major (+1cm, scar, last weeks/months in HIV patients)
3. Herpetiform (uncommon, 2-3mm)
121
What are some prevention strategies for mouth ulcers?
- Address nutritional deficiencies
- Identify allergies
- reduce local trauma
- reduce stress
122
What is the usual treatment for mouth ulcers?
NON-PHARM:
Avoid foods that cause pain (hard, crusty, sharp, spicy, salty, acidic)
Avoid alcohol and chocolate
Gargle with salt water
PHARM:
Local anesthetics (Orajel, kank-a), oral analgesics, protectants (mucosal adherent), antiseptic
123
What is Herpes Labialis?
Cold sores due to recurrent herpes simples virus around the mouth
- painful lesion on border of lip and nostrils
- weep liquid with crusting/healing within 7-10 days
- sun exposure can trigger recurrences
- Prodromal tingling 2-24 hours of appearance
124
How is herpes labials treated?
NON-PHARM:
Keep sore clean and do not touch with hands
PHARM:
Protectant (petrolatum, zinc, benzyl alcohol)
Anesthetic (benzocaine)
Analgesic (menthol)
Antiviral (docosanol - ABREVA)
Amino Acid (lysine)
Bee resin (ColdSore FX)
Anticoagulant (Lipactin)
Essential oil
125
What is halitosis?
Bad breath
Physiologic halitosis: caused by food ingested or dry mouth
Pathologic halitosis: disease or malfunction of the mouth
126
What are some non-pharmacologic treatments for BB?
- Good oral hygiene
- Clean mouth after eating/drinking dairy, meat, fish and drink lots of water
- Increase saliva
- clean tongue
127
What are some pharmacologic treatments for BB?
- Use mouth rinse with lowest possible alcohol content
- address underlying causes
128
Xerstomia - dry mouth
Decreased saliva production or quality
129
What are some treatments for dry mouth?
- Dental care
- Reduce sugar
- stimulate saliva (xylitol)
- use a saliva substitute
Products:
Biotene gel, moi-stir spray, mouth note, sialor
