LECTURE 75 - OTC primer Flashcards

(72 cards)

1
Q

Describe the cause of lice

A

The head louse (pediculus humanus capitus) transmitted via direct contact

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2
Q

Describe common reactions caused by lice

A

Itching / scratching
Redness
Small wounds

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3
Q

List considerations for lice

A

Often overtreated:
Requires distinction between inactive & active forms of lice

Low threshold for referral:
Recurrent, age < 2 YO, involvement in hair outside of scalp

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4
Q

Describe the cause of sunburn

A

continuous exposure to UV radiation

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5
Q

What is the typical timeline for resolution of sunburn?

A

normally < 7 days

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6
Q

List options for the prevention of sunburn

A
  • Sunscreen/block
  • Clothing or hats
  • Limiting sun exposure
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7
Q

Describe common reactions caused by sunburn

A

Pain
Redness
Blistering
Peeling
Itching

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8
Q

List the indications for referral of a patient with sunburn

A
  • Extensive burns (> 20% BSA affected with blistering)
  • Intense pain
  • Infants
  • Severe blistering (swelling, pus, yellow/red blisters)
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9
Q

List the indications for referral of a patient with minor wounds

A
  • Wound from a bite
  • Bleeding > 5 minutes that won’t stop
  • Signs of infection
  • Contains foreign matter
  • Deep / Acute / Chronic wounds
  • Immunocompromised and/or diabetes
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10
Q

Describe the cause of warts

A

Damaged skin that allows HPV to enter the body

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11
Q

What is the timeframe for resolution of warts without treatment?

A

months - even years

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12
Q

Describe potential ways to prevent warts

A

adequate hygiene

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13
Q

Describe common reactions to warts

A

Pain
Impact on foot functionality
Social stigma

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14
Q

List the indications for referral of a patient with warts

A
  • Warts on face or genitalia
  • Several warts
  • Warts that burn, itch, or bleed
  • Concerned that the growth is not a wart
  • Immunocompromised and/or have diabetes diagnosis
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15
Q

Describe the cause for corns/calluses

A

Dead skin that hardened by constant friction, typically seen in shoes that do not fit appropriately

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16
Q

Describe the presentation of calluses

A

Can appear anywhere
Typically on a larger area

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17
Q

Describe the presentation of corns

A

Typically small & on the tops/sides of toes or balls of feet

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18
Q

Describe the cause of athlete’s foot

A

fungal infection

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19
Q

List potential ways to prevent athlete’s foot

A
  • Good hygiene
  • Moisture-wicking shoes/socks
  • Foot powders
  • Proper footwear
  • Treatment of hyperhidrosis
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20
Q

Describe common reactions to athlete’s foot

A

Ulcers
Foul odor
Erosions
Secondary infections

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21
Q

List the indications for referral of a patient with athlete’s foot

A
  • Recurrent
  • Failed a prior tx
  • Infection has spread
  • Genitalia involved
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22
Q

Describe the cause of hemorrhoids

A

increased pressure in the lower rectum

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23
Q

What is the typical resolution timeframe for hemorrhoids?

A

a few weeks or months

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24
Q

List options for prevention of hemorrhoids

A

Adequate fiber intake
Staying hydrated
Avoid strain during bowel movements

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25
List common reactions to hemorrhoids
Pain Itching / Irritation in anal region Swelling Bleeding Hard Lumps
26
List the indications for referral of a patient with hemorrhoids
- No relief after 1 week of OTC treatment - Severe pain - Bleeding - Sensitivity to OTC medications - Change in bowel patterns - Family history of IBD
27
List the steps of treatment for treating minor wounds
1 - irrigate 2 - topical antibiotics 3 - bandage 4 - monitoring
28
Describe the options for irrigation for the treatment of minor wounds
Soap & water, chlorhexidine, hydrogen peroxide, saline
29
Describe the role of topical antibiotics for the treatment of minor wounds
Used to prevent infection
30
Describe role of bandaging for the treatment of minor wounds
Important to not tear the scab/healing skin Could consider waterproofing
31
Describe monitoring for the treatment of minor wounds
- Change the dressing prn - Continue to ensure it does not begin to demonstrate an infection
32
Describe the steps of treatment for treating sunburn
1 - clean 2 - cool compress 3 - topical agents 4 - potential bandaging 5 - pain relief
33
Describe the options for cleaning for the treatment of sunburn
mild soap & water
34
Describe options for topical agents for the treatment of sunburn
Could consider using aloe vera, calamine lotion, etc.
35
Describe the indications for bandaging for the treatment of sunburn
Blisters may require bandaging
36
Describe options for pain relief for the treatment of sunburn
PO medications
37
List OTC options for the treatment of lice
- Rid (pyrethrin + piperonyl butoxide) - Nix (permethrin) **along with wet combing**
38
Describe the regimen of "Rid" for the treatment of lice
Treatment must be repeated in 7-10 days
39
Describe the regimen of "Nix" for the treatment of lice
Treatment must be repeated in 7-10 days (fully dependent on initial clinical response)
40
Describe the correct way to wet comb for the treatment of lice
Should be used with fine-tooth comb (comes in majority of OTC lice tx packages) Repeat every 2-3 days to assess for dead lice
41
List other non-pharmacological considerations for patients with lice
- Wash bedding 7 clothes - Soak comb/brushes in hot water for 5-10 minutes - Vacuum **Children do NOT have to be kept out of school after treatment**
42
List options for treatment of warts
salicylic acid (many formulations) tape (usually placed over tx) OTC "cryotherapy"
43
List the steps of treatment for corns/calluses
1 - soak 2 - file/scrape 3 - moisturize 4 - shoes 5 - toenails
44
Describe the "soak" step of treatment for corns / calluses
soak in warm water for 5-10 minutes
45
Describe the "file / scrape" step of treatment for corns / calluses
file / scrape dead skin using a pumice stone or scraper
46
Describe the "moisturize" step of treatment for corns / calluses
Lotion, ointment, or cream
47
Describe the "shoes" step of treatment for corns / calluses
Will need to wear shoes that fit properly, if applicable
48
Describe the "toenails" step of treatment for corns / calluses
ensure that the pt continuously keeps their toenails clipped
49
Describe options for the treatment of athlete's foot
ANTIFUNGALS !! - Zeasorb (miconazole) - Lotrimin (clotrimazole) - Lamisil (terbinafine) - Tinactin (tolnafate)
50
List the options for the treatment of hemorrhoids
- Eat fiber rich foods - Stool softener or fiber supplement - Increased water intake - Use of topical treatments - Soak in warm bath / sitz bath - Take PO pain relievers
51
List options for topical treatments that can be used for the treatment of hemorrhoids
- Anesthetics - Dibucaine or Pramoxine (preparation H) - Astringents - Witch Hazel (TUCKS pads) - Corticosteroids - Hydrocortisone 1% - Vasoconstrictive agents - Phenylephrine topical ointment
52
Describe the role of astringent topical treatments for hemorrhoids
Dries / soothes / relieves irritation
53
Describe the role of corticosteroid topical treatments for hemorrhoids
Relieves itching **hydrocortisone 1% also available in suppository formulation**
54
Describe the role of vasoconstrictive agent topical treatments for hemorrhoids
Constricts the tissue to relieve discomfort **phenylephrine also available in suppository formulation**
55
Describe the uses for fish oil
Hypertriglyceridemia
56
Describe considerations for the use of fish oil
SE → GI upset, heartburn, indigestion, “fishy” taste Caution with: anticoagulants/platelets, active bleed, PUD
57
Describe the uses for saw palmetto
BPH → does NOT decrease the prostate size or PSA
58
Describe the considerations for the use for saw palmetto
Can cause GI upset
59
Describe the uses for niacin
Dyslipidemia (will increase HDL & decrease TG)
60
Describe the considerations for the use of niacin
Flushing occurs with ~80% of pts → noted improvement after 2 weeks of cont. use
61
Describe potential ways for prevent flushing with the use of niacin
- Slowly increase dose - Pretreat with aspirin - Take with meals - Use ER formulation - Take at bedtime
62
Describe the uses for ginger
Typically used for N/V No use in CINV or motion sickness
63
Describe the considerations for the use of ginger
ADRs seen with higher doses → > 3 g/day Typically well tolerated Can increase bleeding risk
64
Describe the uses for st. john's wort
Treatment of MILD-MOD depression Extensive usage, some efficacy
65
Describe the considerations for the use of st. john's wort
SEs: Vivid dreams, headache, dizziness, GI upset, dry mouth, photodermatitis Significant drug interactions !! CYP inducer/PGP inducer, Digoxin, HIV meds, Warfarin
66
Describe the uses for cranberry
Used for prevention of UTI Thought to interfere with bacteria’s ability to adhere to the urinary tract wall
67
Describe the consideration for the use of cranberry
Caution with aspirin allergy → small amount of salicylic acid Can cause kidney stones
68
Describe the uses for Echinacea
Some evidence that it can decrease UTRI by 1 day Must be started at onset of symptoms, then taken for 7 days
69
Describe the considerations for the use of Echinacea
SEs: GI upset, rash, allergic reaction (contains ragweed, marigold, daisies)
70
Describe the uses for melatonin
Insomnia Shift disorder or jet lag
71
Describe the considerations for the use of melatonin
Recommended to be taken ~2 hours prior to bedtime
72
List 5 helpful tips for the usage of supplements and/or OTC treatments
- Drug labels - Resources - Drug interactions - Appropriate responses - Never guess !!