Midterm Study Deck Flashcards
(89 cards)
1
Q
For which of the following conditions would a patient be more likely to self-medicate?
- Bacterial Infection
- Insomnia
- Diabetes
- Hypertension
A
Insomnia
2
Q
True or False:
More potent prescription meds are being reclassified to non-prescription status.
A
True - Example: Zantac, Voltaren, Aleve
3
Q
What is self-medicating?
A
Component of Self-Care which involves selection of suitable drug and non-drug measures (therapies) for the prevention and treatment of diseases and symptoms
4
Q
What are some reasons a patient would choose to self medicate?
A
- Quick
- They have more control
- For a recurrent minor aliment
- It’s familiar
- Fear/lack of trust in doctor/hcp
- less expensive (especially if no coverage)
- View issue as being minor
5
Q
What are the positive and negative ways self-medicating impacts the HCS?
A
Good:
- Cheaper then doc/ER visit
- Reduces # of visits to the doc/ER
- Rx drugs are more costly
Disadvantages:
- Patient could choose wrong product
- Patient could misuse drug
- Risk of over/under dosing
- Miss drug/food interaction
6
Q
What patient populations might need special attention when attempting to self-medicate?
A
- ESL
- Children
- Geriatric
- Illiterate
- Physically challenged
- Chronic diseases
- Emotional
7
Q
What are the RPh’s goals w/ patient non-rx counselling?
A
- Avoid interactions
- Increase knowledge
- Benefit patient’s health
- Proper dosing and compliance
- Reduce side effects
- Provide opportunity for follow up
8
Q
What are the 3 possible recommendations from Pharmacist when counselling non-Rx patient?
A
- Assure patient that drug therapy is not necessary
- Suggest non-drug measure and/or non-Rx drug treatment
- Refer patient to appropriate medical personnel
9
Q
What is the the role of the Pharmacy Technician?
A
- Direct customers to appropriate section
- Alert pharmacist to patients requiring recommendations or advice
- Answer questions related to technical aspects of medications & self-care (Where, pricing, comparing classes/ingredients, clarifying information on labels)
10
Q
What is Allergic Rhinitis?
A
Hay fever
- common chronic allergic airway disease that is common in childhood and decreases in severity with age
- Seasonal or Perennial
11
Q
What are the common symptoms of Allergic Rhinitis?
A
- Rhinorrhea
- Congestion
- Sneezing
- Nasal Pruritus
- Allergic Salute
- Allergic “Shiner”
- Red, itchy eyes and photo-phobia
- Morgan’s Dennie’s Lines
12
Q
What causes Allergic Rhinitis?
A
- Contact with allergenic substances causes IgE antibody production
- When re-exposed allergen is recognized by antibody causing allergic reaction and histamine release
- Nasal Priming: less allergen needed to trigger on subsequent exposures
13
Q
Non-Pharmacologic for Allergic Rhinitis
A
- Avoid allergen
- Vacuum
- Use dehumidifier
14
Q
How many baby teeth do most children have?
A
20
15
Q
How many adult teeth do most people have?
A
32
16
Q
What are the symptoms of teething?
A
- Inflammation, biting and drooling
- Fever and irritability
- Occurs in 2/3 infants 4 days before tooth eruption with worst 1-2 days before
17
Q
What are some complications of teething?
A
Cysts and abscess (infection)
18
Q
How is teething treated non-pharmacologically?
A
Frozen facecloth or teethers cooled in fridge or freezer
19
Q
What is a pharmacologic therapy for teething?
A
Acetaminophen or Ibuprofen (not under 6 months)
- infant drops are stronger concentration then children’s version
- dosing based on weight is more accurate
- Baby orajel is no longer recommended
20
Q
What is plaque?
A
- Gel-like matrix that builds up on tooth surfaces
- can be above or below the gum line
- leads to caries, gingivitis or periodontal disease
21
Q
What are caries and how do they form?
A
Caries (cavities) are formed as a consequence of plaque formation. Bacteria turns sugar into an acid that causes enamel to demineralize and decay (pitting, fissures). If bacteria gets into the dentin/roots it can cause a bacterial infection.
22
Q
What is gingivitis and who does it impact?
A
Gingivitis is the inflammation of the marginal gingiva (gums) by bacteria. It affects up to 50% of adults and can lead to loose teeth/tooth loss.
23
Q
How is does calculus differ from plaque?
A
- Calculus is the calcification of existing plaque deposits.
- Yellowish color and close to gumline, salivary glands
- Needs to be scaled by a professional
24
Q
What is the best way to control plaque buildup using mechanical methods?
A
- Tooth brushing with soft rounded bristle toothbrush
- Flossing (mechanical) daily
- Interdental brush for bridges, braces, wide spaces
- Denture brush
- End-tufted brush (crowns)
- Sulcus Brush for inflamed/sensitive gums
- Orthodontic brush to remove plaque around wire/braces/teeth
- Gum stimulator
25
What is the role of toothpaste?
1. Reduce plaque/tartar accumulation
2. Strengthen enamel
3. Remove food debris/stains
4. Freshen mouth
26
What ingredients are usually included in toothpaste?
1. Na fluride 0.11-1.1%
2. Na monofluorophosphate (whitening)
3. +K nitrate, triclosan, zinc (antibacterial)
4. Ca phosphate hydroxide 10% (Reminerlization)
5. Zylitol 25% (Kids - helps with ph levels)
27
What are some chemical methods to control plaque?
Mouth Rinses
HIGH Plaque & Gingivitis reduction: Chlorhexidene (RX only), sodium benzoate, SLS, sodium salicylate, thymol, menthol, eucalyptol (no kids/Listerine antiseptic original)
MODERATE reduction: Cetylpyridinium chloride
(antiseptic)
28
Why is hydrogen peroxide (Peroxyl) not recommended as a mouth rinse?
Can cause burns to oral mucosa, decalcification of teeth and generally doesn't work as well as other safer rinses
29
What ingredient is commonly used in oral topical analgesics?
Benzocaine 10-20%
30
What is the difference between an analgesic and an antipyretic?
Analgesics are for pain relief and antipyretics provide fever reduction
31
What symptoms are typical of a Tension Type Headache?
- triggered by stress/tension
- Dull/deep/steady pain that is BILATERAL
- Tightening sensation around forehead/temple
- Pain in neck
- Lasts 30 min - 7 days
- NOT aggravated by activity
- NO nausea or vomiting, but may not feel like eating
32
What symptoms are typical of a Migraine Headache
- triggers are specific to individual and has an inherited/genetic component
- Moderate or Severe/pulsing/throbbing/pounding pain that is UNILATERAL
- Lasts 4 - 72 hours
- YES aggravated by activity
- YES nausea and vomiting
- Sensitivity to light and noise
- Can have aura
33
What are symptoms that are typical of a Cluster Headache?
- Men > Women
- Lasts 120 min and occurs in clusters (2-4x daily) for 1-2 weeks
- Severe pain that is UNILATERAL
- Behind the eyes causing tearing, sweating, swelling, congestion
- NO nausea or vomiting
- NO lying down or bending over
34
What are some prevention strategies for headaches?
Avoid triggers when possible
35
What are some non-pharmacologic strategies for Migraines?
- Rest in dark/quiet room
- Cold cloth/ice pack
- Biofeedback, chiro, acupuncture, hypnosis, nerve block, homeopathic remedies
36
What pharmacologic therapies are usually used to treat moderate TTH, Mild/Moderate Migraines and Cluster headaches?
1. Muscle relaxants: clorzoxazone, methocarbamol
2. Stimulants: Caffeine
3. NSAIDs: Ibuprofen, naproxen
4. Analgesics: ASA, Acetaminophen, Codeine
37
Which analgesics also act as fever reducers?
- ASA
- Acetaminophen
- Ibuprofen and Naproxen
38
What are the basic properties of ASA?
- NSAID (salicylate)
- Starts working in 30 min (fast dissolved in water, slow with food) and lasts 4-6 hours
- Usually 325 mg dose or 81 mg low dose (daily) taken with full glass of water
- Comes in plain, buffered, or enteric-coated forms
39
What are some side effects of ASA?
- Hard on GI (ulcers/bleeding)
- Thins the blood
- Some people are sensitive to salicylate class drugs
- Can cause tinnitus or Reye's Syndrome
- Not for children under 18
40
What are the basic properties of Acetaminophen?
- Non-NSAID analgesic
- Usually 325-500mg dose every 3-4 hours to a MAXIMUM of 4g/day for healthy adults
- As effective as ASA but with fewer side effects (safe for children over 6 months)
41
Does Acetaminophen have any side effects?
- Can cause severe liver/renal damage if overdosed
- always check to make sure you are not consuming too much as it is in many OTC products
42
What are the basic properties of Ibuprofen & Naproxen?
- NSAID
- Usually dosed at 200 and 400mg
- As effective as aspirin for pain, inflammation and fever
- Coated tablets, liquid gel capsules, liquid suspension
43
What are some side effects of Ibuprofen and Naproxen?
- Can cause N&V
- Heartburn
- Hard on stomach (take with food/milk)
44
What is a fever and what causes it?
- Fever is elevated body temperature
- Could be caused by infection, inflammatory diseases, immune responses
- Body uses fever to help fight infection
45
What temperature would be considered a fever in a child?
Rectal temperature over 38 degrees Celsius (normal clothes and resting)
46
Where could temperature be measured?
- Rectally (under 5yr)
- Orally (over 5 yr)
- Axillary
- Tympanic (over 2yr)
- Transcutaneous
47
What are the two types of thermometers?
1. Electric (digital) - takes 30-60 sec
2. Analogue (mercury, galinstan) - takes 4-10 min and needs to be manually reset by shaking down
48
What are some NON-pharmacologic therapies for Fever?
- sponging with tepid water 30 min after antipyretic
- removing excess clothing/bedding
- increasing fluid intake
- keeping RT between 20-21
- resting
49
What is Cerumen Impaction?
When ear wax builds up in the ear causing partial hearing loss, pain, vertigo, pressure or fullness
50
What is ear wax?
Mixture of sweat and sebaceous gland secretions with skin cells
- protects ear from bacteria, water, dirt
51
What are some NON-Pharmacologic treatments for Cerumen Impaction?
- syringe ear with tepid water or oil (4-6 drops/bid/4 days)
52
What are some Pharmacologic treatments for Cerumen Impaction?
- Oil of terebinth, chlorbutol, paradiclorobenzine (Cerumol)
- Carbamide peroxide (Murine Ear)
53
Which direction do you pull ear to administer drops in child vrs. adults?
Child: down
Adult: up and back
54
When would you NOT use a syringe to clean the ear?
- Pain
- History of ear drum perforation, surgery or recent infection
- Discharge
55
When would a pharmacist refer a patient to urgent care for their ears?
Always!
- Objects in the ear
- Drainage
- Tinnitus
- Perforated Eardrum
Sometimes!
- Ear pain
- Hearing loss
- Swimmer's Ear
56
What are some some pharmacologic treatments that Pharmacist can recommend for minor ailments of the ear?
- Antipyrine/benzocaine products for the ear
- Isopropyl alcohol drops to dry the ear
- Antibiotic drops containing polymyxin B/Gramicidin
57
What is "in-scope" for a RPhT when talking to patients?
- Can help patient select a diagnostic or monitoring test when recommended by the pharmacist or doctor by providing benefits/risks and identifying options
- Refer to pharmacist for all therapeutic questions, can answer technical questions and collect information for pharmacist consult
58
What is "in-scope" for a RPh?
- Advise and assist patients to make informed choices, identify available options, explain care plan, health conditions, and provide referrals
59
When would a patient NOT want to self-medicate for an eye condition?
- Pain/inflammation
- Injury/bleeding
- Excessive discharge
- Change in vison
- Glaucoma
- Macular degeneration
- Cataracts
- Diabetic retinopathy
60
What eye conditions could a patient self-medicate for?
- Dry eye
- loose foreign material
- Eyestrain
- Burning sensation
- Itching/stinging
- Milk tearing
61
What are some common eyeLID conditions?
Hordeolum
Blepharitis
Chalazion
62
What is Hordeolum (Stye) and how is it usually treated?
- ACUTE eyelid gland infection (eg. sweat gland blockage)
- UNILATERAL, with swelling, pain, redness
- TREAT with warm compresses 10-15min, TID-QID
- Will resolve on own most of the time within 48hrs-1wk
- Refer to MD if severe for prescription antibiotic
63
What is Blepharaitis?
- CHRONIC inflammation of the eyelid margin
- BILATERAL with scaling, burning and itching
- TREAT with warm compresses 5-10min
- Use eyelid scrub to gently clean lid margin
- Refer to MD if sever for RX antibiotic
64
What is Chalazion?
- CHRONIC inflammation of a gland
- UNILATERAL with swelling, redness and rubbery nodule (NO pain)
- TREAT with warm compresses
65
What are some common eyeBALL conditions?
- Conjunctivitis (inflammation of the conjunctiva)
- Dry Eye
66
What are the three types of conjunctivitis?
Bacterial, viral, and allergic
67
What does bacterial conjunctivitis look like?
- BILATERAL/ UNILATERAL
- LOW itching
- YELLOW discharge
- CRUST formation
- REDNESS
- Lasts 2 weeks, 1-3 days with treatment
- Pharmacist can prescribe Polymyxin B/Gramicidin eyedrops (qid x 7-10 days)
68
What does viral conjunctivitis look like?
- BILATERAL/UNILATERAL
- LOW itching
- LOTS of CLEAR/WATERY discharge
- REDNESS
- Resolves on its own but very contagious for 7 days
- Can use ocular decongestant/lubricants for help with symptoms
69
What does allergic conjunctivitis look like?
- BILATERAL
- Triggered by allergens
- SEVERE itching
- MODERATE clear discharge
- REDNESS and SWELLING
- Avoid allergen and use can use oral allergy meds, ocular decongestants, antihistamines, lubricants
70
Oral antihistamine for EYE
Diphenhydramine
71
Ocular Decongestants
Phenylephrine
Naphazoline
Oxymetazoline
Tetrahydrozoline
72
Ocular Antihistamine (usually paired with decongestant)
Antazoline (ANTA - antihistamine)
Pheniramine (ends in MINE - histamine)
73
Ocular Lubricants
Methylcellulose/polyvinyl alcohol
74
Specialty Eye Drop for Allergies
Cromolyn - Sodium Cromoglycate
75
What is "Dry Eye"?
- SYNDROME that causes tear-film instability
- Causes: tear deficiency, dry air, vitamin A deficiency, medication, contact lenses
- Tear create three layer film that protects, stabilizes and is antibacterial
- Avoid smoke, use humidifier, cool washcloth
76
What types of eye drops are used to treat DRY EYE?
Artificial Tears
- Cellulose Derivitives that have carboxymethylcellulose or hydroxypropylmethylcellulose (hypromellose)
- Polyvinyl Polymers like polyvinyl alcohol
Ointments
- Petrolatum, mineral oil, lanolin
- last longer, apply at bedtime as they can cause blurry vison
77
When would the Pharmacist always refer the patient to the ER for an eye concern?
- Foreign body in the eye
- Ocular trauma
- Infections of eye AND surrounding skin
- Flash burns
78
What is an OTC prevention for allergies?
Comolyn Sodium eye drops: stabilize mast cells, preventing symptoms
- take 1 week before allergy season starts
79
What is the difference between first and second generation antihistamines?
First generation: Sedating effect, anticholinergic
- diphenhydramine, chlorpheniramine, pheniramine, dexbrompheniramine, promethazine
Second Generation: generally non-sedating
- loratadine, desloratidine, fexofenadine, ctirizine
80
What are oral nasal decongestants?
- Nasal congestion with no effect on other allergy symptoms
- Weaker then topical sprays, but no rebound congestion risk
- Stimulating
- Pseudoephedrine, phenylephrine
81
What are topical nasal decongestants?
- topical spray for adults and drops for kids
- Faster acting
- Can cause rebound congestion if used longer then 3 days
- phenylephrine, oxymetazoline, xylometazoline, sale
82
What is the common cold?
ACUTE self-limiting VIRAL infection
- Nose and throat
- Sneezing, rhinorrhea, fever, malaise, dry cough, sore throat
- 1-2 weeks
83
What is the flu?
ACUTE infection that occurs in epidemics in the fall/winter
- Same symptoms as the cold but with FASTER ONSET and MORE SEVERE
- Chills, GI symptoms
- 10 days with fatigue lingers for a couple weeks after
- Higher risk of complications with other chronic disorders, nursing home, elderly
84
What is Sinusitis?
- Inflammation of the sinuses in response to infection or allergy that can cause headache/pain, impaired taste and smell
85
What is pharyngitis (sore throat)?
- Inflammatory syndrome that can be bacterial or viral
- Can present with cold, allergic rhinitis or sinusitis
- If viral, it usually lasts 3 days
86
What are some non-pharmacologic therapies for cold, flu, sore throat and sinus infection?
- Bed-rest
- Drinking lots of water
- Humidifier
- Eating healthy food
- Saline nose spray
- Petrolatum to protect nasal area
87
What are some pharmacologic therapies for respiratory conditions?
- NSAIDS to reduce pain and fever
- Local anesthetics (benzocaine lozenges)
- Antihistamines
- Decongestants (not with high blood pressure)
88
What the three types of cough?
1. Congested and productive - treat with water only
2. Congested and Non-Productive - Expectorant with Guaifenesin
3. Dry & Non-productive - Antitussive with Dextromethorphan or Codeine
89
What does DM-D-E indicate for Benylin products?
