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OTC test 3
most important info for test 3
| Question | Answer |
|---|---|
| APAP and ASA recommended dosage and Max DD | 650-1000mg q 4 to 6 h MDD(4g) |
| Ibuprofen recommended dosage and MDD | 200-400mg q 4 to 6 h with 1200mg MDD |
| ketoprofen recommended daily dose | 12.5-25 mg q 4-8 h with NMT 25mg in 4-6h and 75 daily |
| naproxen sodium recommendations | 220-440 mg initially; then 220 mg q 8-12 hours NMT 660mg daily |
| side affects of NSAIDS | GI symtoms (upset stomach, vomiting, HB, abdominal pain, diarrhea, constipation, anorexia) CNS (HA, dizziness) take with food to decrease GI side effects |
| APAP and effecacy in dysmenorrhea | not inhibit PGs, may help HA and backpain, contraindicated for liver disease and drinking alot, use if allergic to ASA |
| what is the recommended dose of calcium for PMS | 1200mg of calcium daily in divided doses with no more than 500mg at one time |
| what are some common side effects of calcium | may cause stomach upset or constipation, it this occurs take with food |
| what is the recommended dose of magnesium for PMS. there is little evidence because of small trial. (5HT) | take 360 mg of magnesium dialy during the premenstrual interval only (luteal phase) |
| what is a common side effect of magnesium | diarrhea |
| how much vitamin E should be taken to relieve PMS symptoms | 400 IU daily |
| what is the dosage of pyridoxine (vitamin B6) | take 100mg dily and do not exceed because neurological symptoms from toxicity may occur |
| what are the neurologica symptoms of B6 toxicity | pricking, tingling, or creeping on teh skin, bone pain, muscle weakness; stinging, burning, or itching sensations |
| nondrug measure to help with PMS | avoid stress, learn relaxation tech, exercise, reduce salt, caffeine, chocolate, and alcoholic beverages |
| what food might reduce your symptoms of PMS | eating foods rich in carbohydrates and low in protein during the premenstrual interval |
| when should you recommend they see a doc | persistent symptoms or when symptoms disrupt personal relationships or ability to engage in usual activities or function productively at work, symptoms don't improve, or worsen |
| which bacteria is the greastest cause of TSS | Staphylococcus aureus |
| what things beside tampons are associated with TSS | tampons, barrier contraceptive, diaphragms, cervical caps, cervical sponges, IUDs |
| PMS/PMDD symptoms typically begin or intensify when | a week prior to the onset of menses, peak the day before or on the first day of menses and resolve within several days after the beginning of menses |
| what two hormones diminish in menopause | estrogen and FSH (natural age 40-58) avg 50 |
| what are triggers of hot flashes | alcohol, caffeine, hot or spicy foods, stress, hot drinks, warm environment |
| what are the nonvasomotor symptoms of menopause. (remember the vaso ones are night sweats and hot flashes) | vaginal dryness, insomnia/tiredness, headaches, joint pain, anxiety, irritability, mood swings, depression, loss of libido, difficulty with memory, concentration, decision making |
| the three most common vaginal infections are caused by what organism | bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis. (65% of women who experience vag symp have one of these) |
| the ecosystem of a normal vagina has or is influenced by | pH 4-4.5, hydrogen peroxide, lactobacillus, glycogen concentration, hormons, aging, DM, medications such as BC, hormones, antibiotics, douching, sex partners) |
| normal discharge (leukorrhea) is how much fluid daily and what should it be like | 1.5grams/day should be odorless, clear or white, and viscous or sticky |
| when is a increase in vaginal secretions normal | during ovulation, pregnancy, following menses, and with sexual excitment or emotional flares |
| which organisms are associated with PID, urinary tract infections, cervicties, endometriosis, and tubal infertility inaddition to the facilitation of transmisson of HIV | BV and trichomoniasis |
| the symptom most apt to differentiate a candidal vaginal infection from that of bacterial vaginosis and trichomoniasis is | the absence of an offensive odor of the vaginal discharge |
| what are some suspected causitive factors contributing to yeast infections | high dose OC, pregnancy, ERT, DM, pH increase, glycogen increase or decrease, broad spectrum antibitotics, systemic corticosteroid, antineoplastic, immunosuppressant drugs (HIV or transplant receipents), IUD, vaginal sponge, foods that inc urinary sugar |
| things that DON"T contribute or show consistent association | tight fitting, nonabsorbent clothing, pantyhose, low dose contraceptive, number of sexual partners, frequency of sexual intercourse |
| symptoms of thin, off white or green, gray, tan, foamy discharge, fishy unpleasant odor that increase after sexual intercourse or elevated vaginal pH could be what infection | bacterial vaginosis (vaginal irritation, dysuria, itching, absent of odor not really associated with it) |
| vaginal irriation, dysuria adn itching is more commonly found with what infections | VVC or trichomoniasis |
| increase vaginal discharge or wetness is more common with what | BV |
| erythema and vulvar edema can occur with what infections | trichomoniasis |
| copious malodorous yellow green or discolored discharge pruritus, vaginal irritaiton dysuria | trichomoniasis |
| thick white cottage cheese discharge with no odor normal pH | VVC |
| smoking interactions with beta blockers causes what | antihypertensive effects opposed due to increase HR associated with smoking |
| benzodiazepines and smoking | diminish the sedaive effect of benzo due to stimulatory action of nicotine |
| smoking will decrease what drug levels or effectiveness which will cause a problem if stop smoking because then levels become to high | benzos, beta blockers, caffeine, chlorpromazine, clozapine, flecainide, fluvoxamine, haloperidol, heparin, insulin, mexiletine, olanzapine, opiods such has propoxyphene, pentazocine), oral contraceptives, propranolol, tacrine, theophylline |
| smoking causes a p/kinetic effect due to induction of cyp1a2 with what drugs | increased metabolism of olansapine, caffeine, and theophylline (tacrine fluvoxamine) drugs ending in 'ine' except mexiletine that is decrease by glucronidation and oxidation |
| drugs that have a pharmacodynamic effect with smoking are | oral contraceptive, opioids such as propoxyphene, pentazocine, beta blockers and benzos |
| which drugs have increase clearence due to smoking | propranolol, mexiletine, haloperidol, and flecainide |
| for those who quit smoking, when is circulation, cilia, and their risk of stroke reduced to that of nonsmokers | circulation 2 weeks, cilia in lungs 1 moths, reduced risk in 5 years |
| withdrawal symptoms of smoking cessation | chest tightness, constipation, stomach pain, gas, cough,dry throat, nasal drip, cravings for cig, diff concentrating, dizz, fatigue, hunger, insomnia, irritabilty |
| which withdrawal symptoms diminish within days | dizziness due to increased oxygen, craving for a cig are frequent for 3 days but can happen longer, cough dry throat nasal drip from getting rid of mucus, and chest tightness |
| which withdrawal symptoms last weeks | constipation up to 2 weeks, difficulty concentration few weeks, fatigue 2-4 weeks, hunger several weeks, insomnia about a week, irritability 2-4 weeks |
| which nicotine delivery system most resembles that of a cig | nasal spray |
| pharmacotherapy options availble are | 7 available three OTC and 4 RX for first line treatment. ( gum lozenge, patch OTC) (spray, inhaler, bupropion, chantex RX) 2nd line not FDA approved for use are nortriptyline and clonidine |
| gum and lozengers peak concentration are achieved when | 15-30 mins |
| nicotine related adverse effects (toom much nicotine) are | nausea, vomiting, hypersalivation, perspiration, abdominal pain, dizziness, weakness, palpitation |
| a person who smokes fewer than 35 cigs a day should start with what strength of gum? 2 or 4 mg | 2mg and heavier 4 mg (chew 1 piece every 1 to 2 hours hile awake so about 9 pieces a day) do this for the first 6 weeks |
| how many chews before parking the first time | 15 |
| about how long does the taste or tingle go away and need to chew and park again | 1-2 mins |
| park in same spot or rotate | rotate to reduce irriation |
| on average one piece of gum last how long | 30 mins |
| what is the max amont of gum in one day a person should use | 24 |
| you should not eat or drink how many mins before or after using the gum | 15 mins before or after. if acidic drinks have been consumed, rinse mouth |
| what will happen if the gum is chewed to quicly | too much nicotine is saliva and if swallowed may cause effects like excess smoking such as nausea, throat irritaiton, lightheadedness, hiccups |
| if someone would usually smoke within 30 mins of waking what should there dosage of nicotine lozenge be | during the initial 6 weeks, patients should use 1 lozenge every 1 to 2 hours while awake |
| what is the max amount of lozenge per min and per day | 5 in 6 hours or 20/day |
| what are the side effects associated with lozenge | mouth irritation, nausea, hiccups, cough, heartburn, HA, flatulence, and insomnia |
| lozenge last app how long | 25-30 mins if slowly dissolve, rotate in mouth to reduce irritation |
| if a patient experiences side effects such as dizziness, perspiration nausea, vomiting, diarrhea, HA what should this suggest | the dose is to high consider a lower NRT |
| to dose the patch a heavy smoker is one who smokes over 10 cigaretts a day. those who have strong morning craving just should consider wearing the patch at night. WHAT IS THE CORRECT DOSING | 21 mg during the initial 2 week. eight weeks of nicotine patch therapy has been shown to be as effective as longer durations and no evidence suggest tappering over cold turkey |
| if smoke less than 10 cigs a day then you should start with what patch | < 14 mg/day times 6 weeks |
| what strengths does the nicoderm CQ patch come in | 7, 14, 21mg |
| what are some side effects with the patch | local skin reactions: erythema, burning, and pruritus, (rotate site). less common side effects include vivid or abnomal dreams, insomnia, and headache |
| by using a NRT replacement therapy what is you chances of remaining absent compared with placebo | 17% compared with 10% for placebo |
| if somke continuosly throughout the day what might be better choice | patch because continues but more importantly reguallar dosing not just PRN |
| proper guidlines for using patch | clean dry hairless area of upper body or outer arm, never use same spot in one week, hold for ten sec while you apply |
| what should you treat site if itching, burning or redness | hydrocortisone cream |
| MRI | remove patch, metal backing, going through airport security |
| intermittent smoker usually prefer | short acting gum and lozenges, they more closely resemble there old intake of nictotine |
| patient who have difficultly taking multiple doses or who need simplifed | will prefer patch |
| those who want the desire to titrate nicotine levels to manage withdrawal symptoms | gum lozenge |
| some may find need oral substitue | gum lozeng or inhaler |
| if worried about weight gain which product might be helpful | gum because has shownto delay weight gain after quitting |
| if patient has DM you can only recommend | patch |
Created by:
lainylaina