Exam 2

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leo25
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141252
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Exam 2
Updated:
2012-04-01 22:56:29
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Self Care
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herbals, fungal infections, wounds, nicotine, pain relief, women's junk, acne
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  1. What is tinea corporis?
    fungal infection on the body
  2. What is the most common type of vaginal infection?
    bacterial vaginosis
  3. What is stored in the epithelial cells of the vagina?
    glycogen
  4. What is glycogen's purpose in the vagina?
    to interact w/ lactobacillus to make lactic acid
  5. What does lactic acid do in the vagina?
    makes the pH acidic
  6. What are some of the normal flora in the vagina?
    • Corynebacteria
    • Staph epidermidis
    • Gardnerella vaginalis
    • peptostrep
    • ecoli
    • lactobacillus
  7. What are some factors that affect the vaginal environment?
    • aging
    • disease
    • meds
    • douching
    • # of sex partners
    • hormone flux
  8. What is vulvovaginal candidiasis aka?
    • VVC
    • yeast infection
  9. What is the most common cause of a yeast infection (VVC)?
    use of antibiotics
  10. What are the risk factors for VVC?
    • pregnancy
    • broad spectrum antibiotics
    • menopause
    • menses
    • IUD
    • vaginal sponge
    • immunosuppressant drugs
  11. What does VVC discharge look like?
    • thick
    • whitish
    • cottage cheese like
  12. What are the S&S of VVC?
    • dysuria- painful urination
    • normal pH
    • will occur before menses and get better during
    • itching
    • redness
    • vulvar edema
  13. What non-pharm treatment is there for VVC?
    • yogurt
    • probiotics
    • d/c antibiotics but probably not likely
    • stop oral contraceptives
    • stop sex
    • d/c immunosuppressant
  14. Who would be a candidate to self treat VVC?
    • her vaginal symptoms are infrequent (less than 3 in a year's time)
    • she had at least one previous episode that was medically diagnosed
    • her symptoms are mild to moderate w/ non-malodorous discharge
  15. The azoles are used to treat what?
    VVC
  16. What are some azoles for VVC?
    • miconazole
    • butoconazole
    • clotrimazole
    • tioconazole
  17. T/F: all of the azoles for treating VVC are equally efficacious.
    true
  18. What is the MOA of azole antifungals?
    imidazole compounds alter the fungal membranes resulting in lysis
  19. These drugs are approved for local treatment and external itching/irritation associated w/ a VVC infection?
    azole antifungals
  20. What are the most common side effects of the azole antifungals?
    • headache
    • initial burning
    • itching/irritation
  21. What drug interactions should you watch for when using an azole antifungal?
    warfarin
  22. What are the dosage regimens for the vaginal antifungals?
    1, 3, or 7 days
  23. What are the pros and cons of Vagisil?
    • it has benzocaine in it
    • it is only for external use
    • it doesn't treat the infection
  24. T/F: Yeast-gard (a homeopathic) is advantageous over azole antifungals.
    false
  25. T/F: yogurts or other lactobacillus preps are not effective against post-antibiotic VVCs.
    true
  26. Would you recommend a sodium bicarb sitz bath for someone with a VVC?
    yes
  27. Would you recommend douching, like ever?
    no
  28. T/F: girls less than 12 can self treat w/ an azole antifungal.
    false
  29. Which drugs can predispose a woman to VVC?
    • corticosteroids
    • anti-cancer
  30. What diseases can predispose a woman to VVC?
    • diabetes
    • HIV
  31. If a woman has had a vaginal infection in the past 2 months, can she self treat?
    no
  32. What are 2 herbal therapies for VVC?
    • garlic
    • tea tree oil
    • gentian violet
    • boric acid
  33. What is in garlic that makes it useful antibac or antifungal for VVC?
    allicin
  34. What is the problem w/ using gentian violet?
    it has alcohol in it
  35. Which product is useful for non Candida albicans VVC infections?
    boric acid
  36. Which drug for VVC can be fatal if ingested orally and should not be used by preggo women?
    boric acid
  37. What is the usual course of VVC w/ treatment?
    should improve in 2-3 days and completely resolve within 1 week of treatment
  38. Which infection is caused by more than one organism (is polymicrobic)?
    bacterial vaginosis (BV)
  39. Which organisms cause BV?
    • anaerobic*
    • peptostrep
    • mycoplasma hominis
    • decreased lactobacillus
  40. Which infection may be protected by oral contraceptives or condoms?
    BV
  41. Who is predisposed to getting BV?
    • black women
    • IUD
    • douching
    • antibiotic use
    • tobacco use
  42. What does BV smell like?
    fishy
  43. What does BV look like?
    • watery
    • white, gray, yellow or green
    • increased volumes
  44. 1/3 to 1/2 of women are asymptomatic who have this?
    BV
  45. Can you treat BV w/ OTC agents?
    • no probably not
    • need RX antibiotics
  46. You should almost always refer if a woman has what?
    BV
  47. What are the s& s of trichomoniasis vaginalis?
    • yellow, gray, green discharge
    • frothy
    • foamy
    • dysuria
    • irritation
  48. This infection is transmitted via sex?
    trichomoniasis
  49. Can we treat trich with OTCs?
    no, need an RX
  50. Which virus do we need to treat the sex partners too?
    trich
  51. T/F: we should always refer a woman with trich?
    true
  52. What happens if we don't treat BV and trich?
    • increased risk for:
    • PID
    • UTI
    • cervicitis
    • endometriosis
    • tubal infertility
    • preterm labor and premees
    • premature membrane rupture
    • transmit HIV or other STIs
  53. What product might help reduce the inappropriate use of antifungals?
    self-testing pH devices like Fem-V or Vagisil screening kit
  54. What can lead to inacurrate results of a pH test kit?
    • menses
    • sweat
    • too soon after sex
  55. Which of the 3 vag infections can be treated OTC?
    VVC
  56. Do we need to treat sex partners of VVC or BV?
    no
  57. What is dyspareunia?
    painful sex
  58. What are the 2 common ingredients in lubricants?
    • glycerin
    • propylene glycol
  59. T/F: you should wait 6-8 hours after sex if you are going to douch, but you really shouldn't
    true
  60. What is the one most distinguishing factor b/w VVC and BV or trichomoniasis when diagnosing?
    VVC does not have a bad odor
  61. t/f: during menses and menopause the vaginal pH increases.
    true
  62. what does a pH greater than 4.5 in the vagina indicate?
    not VVC, but BV or trich
  63. t/f: you can use antifungal creams on your period.
    true
  64. When should we refer a woman w/ atrophic vaginitis (5 things)?
    • bleeding
    • painful sex
    • severe vaginal dryness
    • personal lubricants not helping
    • pain is not localized
  65. t/f: daily intake of yogurt can help prevent VVC.
    true
  66. what two menstrual disorders can women treat for?
    • primary dysmenorrhea
    • PMS
  67. what 4 things can cause pain of primary dysmenorrhea?
    • prostaglandins
    • leukotrienes
    • vasopressin
    • nitric oxide
  68. Which two drugs are most recommended for treating dysmenorrhea?
    • naproxen
    • ibuprofen
    • (nonsalicylate NSAIDs)
  69. Which supplements could be used to treat dysmenorrhea?
    • sweet fennel extract
    • vitamin E
    • vitamin B1
    • magnesium
  70. When does a woman experience PMS?
    the 5 days prior to period
  71. What is thought to be the cause of PMS?
    low levels of serotonin caused by drops in estrogen and progesterone
  72. What supplements can we take for PMS?
    • vitamin B6 (pyridoxine)
    • calcium and vitamin D
    • magnesium
  73. What OTC drugs can we take for PMS?
    • NSAIDs
    • caffeine and other diuretics?
    • ammonium chloride
    • pamabrom
    • these are in things like Midol, Aquaban and Pamprin
  74. Chastetree berry, ginkgo, saffron and St. John's Wort have been thought to be effective for what syndrome?
    PMS
  75. What adverse effect can ginkgo have?
    increased bleeding due to antiplatelet activity
  76. Which bacteria is most responsible for causing TSS?
    staph aureus
  77. t/f: you can use egg whites as lubrication for sex.
    true....gross
  78. Why is the contraceptive sponge a trifecta?
    • contains spermicide
    • mechanical barrier
    • absorbs semen
  79. t/f: spermicides can increase the risk of getting an STI.
    true
  80. t/f: aspirin is an NSAID
    true, but it is a salicylate too
  81. Name all of the Salicylates.
    • aspirin
    • magnesium salicylate (Doan's/Percogesic)
    • salsalate
    • bismuth salicylate (Pepto)- no analgesic props
  82. What are COX-1 and COX-2 responsible for?
    • 1: protection/physio fxns
    • 2: inflammation
  83. What is COX-1 protecting in the body?
    • stomach
    • kidney
    • intestine
    • platelets
    • endothelium
  84. What is COX-2 inducing in the body?
    inflammation at inflammatory sites
  85. In general which one is good and which one is bad out of COX-1 and COX-2?
    • 1: good
    • 2: bad
  86. What do NSAIDs and salicylates inhibit?
    • COX-1
    • COX-2
  87. What does aspirin inhibit?
    • COX-1
    • barely COX-2
  88. t/f: NSAIDs affect platelets but they bind them reversibly, so not much effect.
    true
  89. What binds platelets irreversibly?
    aspirin
  90. You will need a much higher dose of what drug to relieve pain?
    aspirin
  91. Aspirin has antiplatelet (cardio) activity at what dose?
    81- 325 mg/day
  92. What molecule does aspirin most strongly block?
    • PGE2 (endothelium)
    • TXA2 (platelets)
  93. What dose of aspirin would you take for pain relief?
    325-650 mg/day or more
  94. Are NSAIDs selective or non-selective at inhibiting COXs?
    non-selective
  95. Why do NSAIDs have no cardio benefit?
    b/c they reversibly inhibit TXA2
  96. What are the 3 pharmacologic effects that NSAIDs have?
    • analgesic
    • anti-inflammatory
    • anti-pyretic
  97. How do NSAIDs have an analgesic effect?
    • decrease prostaglandins that sensitize nociceptors to inflammatory mediators in the brain
    • cause vasoconstriction = decrease headache
  98. How do NSAIDs have an anti-pyretic and anti-inflammatory effect?
    • decrease prostaglandins that are responsible for elevating hypothalamic set point for temperature
    • decrease vasodilator prostaglandins (PGE2) which means less vasodilation and less edema (swelling)
  99. t/f: ibuprofen, aspirin, and naproxen are all non-selective for COX 1 and 2.
    true
  100. This drug is antipyretic and analgesic, but has little anti-inflammatory activity?
    tylenol (APAP)
  101. NSAIDs work to decrease pain in the ________, while APAP works to decrease pain in the _________?
    • NSAIDs: peripherally, all over
    • APAP: in the brain
  102. Which pain relief drug is available as a suppository?
    APAP
  103. What is the best pain reliever to use in someone who is taking warfarin?
    APAP (even though it may enhance anticoag effect of warfarin) still the recommended one
  104. What is the max dose of Tylenol in one day?
    • 3-4 grams (FDA says 3)
    • 1 gram q 6hrs okay
  105. How many grams of tylenol at one time is considered non-toxic to the liver?
    less than 6 g
  106. How many grams of tylenol will cause severe liver necrosis?
    more than 10 g
  107. t/f: chronic alcoholics can take tylenol.
    false
  108. How much tylenol should a geriatric patient have in one day?
    3 grams
  109. What toxic metabolite is tylenol made into?
    NAPQI
  110. t/f: NSAIDs are hepatotoxic just like tylenol.
    false
  111. t/f: NSAIDs should be avoided in alcoholics
    true
  112. What could happen if a patient w/ liver cirrhosis takes NSAIDs?
    • variceal hemorrhage
    • impaired renal function
    • diuretic resistant ascites
  113. What is considered to be the toxic dose of tylenol?
    more than 6 grams
  114. If someone wants a recommendation about taking tylenol, what two questions should you ask first?
    • how much alcohol do you drink?
    • what other drugs are you taking (are they potentially hepatotoxic)?
  115. What diseases do we need to watch if we are going to recommend NSAIDs?
    • chronic/recurrent GI ulcers
    • allergy
    • asthma/nasal polyps
    • high BP
    • heart failure
    • anticoags
    • gout
    • kidney disease
    • liver disease
    • pregnancy
    • kids <15
  116. what is the #1 problem caused by aspirin and NSAIDs use?
    GI disturbances
  117. What is misoprostol (Cytotec)?
    for peptic ulcers
  118. t/f: all NSAIDs and aspirin can hurt your gut.
    true
  119. t/f: NSAIDs can increase BP in normal and hypertensive people, but only by 2-3 mmHg
    true
  120. Which pain reliever is the safest to take if patient has high BP and might be taking anti-hypertensives?
    • *aspirin
    • tylenol (inconclusive data)
  121. How do NSAIDs increase BP?
    inhibit COX-2 in kidneys which reduces sodium excretion, which increases intravascular volume, which increases BP
  122. Which pain reliever makes you retain water?
    NSAIDs
  123. If a patient has heart failure, which drug should they take and which should they not take?
    • take: aspirin
    • do not take: NSAIDs
  124. Which of the two NSAIDs is most likely safer for heart disease (even though neither should really be taken)?
    naproxen safer than ibuprofen
  125. What are the top 4 choices for pain relief in a patient whith cardio disease?
    • tylenol
    • aspirin
    • tramadol
    • narcs
  126. A patient with pain and asthma should take what drug?
    tylenol
  127. An allergy is a _____ reaction, whereas a pseudoallergy is a _______ reaction?
    • allergy: immune
    • pseudo: non-immune
  128. t/f: allergies and pseudoallergies can have the same symptoms.
    true
  129. What are some symptoms of an allergic reaction to NSAIDs?
    • rhinoconjunctivitis
    • bronchospasm
    • urticaria (itching)
    • anaphylaxis
    • angioedema (lips, throat)
  130. t/f: aspirin induced asthma is an allergic reaction
    false: it is a pseudoallergy (type 1)
  131. How does aspirin cause an allergic reaction like asthma?
    it inhibits PGE2 which increases the amount of leukotrienes
  132. t/f: NSAID induced urticaria/angioedema is an allergic reaction
    false: it is a type 2 pseudoallergy
  133. Patients with an allergy to NSAIDs should avoid which NSAIDs?
    COX-1 inhibitors
  134. How long does it take for an aspirin allergy to manifest?
    30 minutes
  135. How long does it take for an NSAID allergy to manifest?
    1-3 hours
  136. Patients with a pseudoallergic reaction should avoid _______, while patients with a true allergic reaction should avoid ________?
    • pseudo: take a weak COX-1 or just take a COX-2 or tylenol
    • allergy: avoid specific drug and same chemical group
  137. Who is likely to get a medication overuse headache?
    use analgesics for more than 2-3 days a week
  138. Which drugs can cause rebound headaches?
    • opioids
    • butalbitals
    • aspirin/APAP/caffeine combos (excedrin)
    • triptans (migraines)
    • NSAIDs
  139. Which drug has the lowest potential for causing rebound headaches?
    NSAIDs
  140. t/f: you should not take aspirin and NSAID together
    false, you can
  141. t/f: people can become resistant from taking aspirin too long
    true, may need to switch to plavix
  142. If a patient must take both aspirin and NSAIDs together, how should they do it?
    take aspirin first, then take NSAID 2 hours later (to avoid platelet interactions)
  143. t/f: patients can take warfarin and aspirin or an NSAID together
    true, but increases risk of bleeding
  144. which pain reliever can cause or exacerbate gout?
    aspirin
  145. Is a low, moderate, or high dose of aspirin more likely to exacerbate gout?
    moderate (therapeutic doses) -- strange
  146. t/f: a patient can take an ACE inhibitor and an NSAID together.
    true, but need to monitor kidney function
  147. How do NSAIDs cause acute interstitial nephritis?
    inhibiting COX converts arachidonic acid to leukotrienes which activate T helper cells, which could attack kineys
  148. How do NSAIDs + ACE inhibitors cause renal failure?
    • ACEs dilate the vessels going OUT of kidney, but NSAIDs constrict vessels going INTO kidney = problem
    • drops glomerular pressure
  149. Which problems caused by NSAIDs are reversible?
    • hemodynamically mediated acute renal failure
    • acute interstitial nephritis
  150. Which problems caused by long term, high doses of NSAIDs (or tylenol) are irreversible?
    damage to vascular endothelial cells = tubular necrosis
  151. In relation to the kidney, which pain reliever is considered safest to take long term in therapeutic doses?
    aspirin
  152. Use of what 2 drugs together greatly increases the risk for nephrotoxicity?
    aspirin + tylenol
  153. What is the best advice for a pregnant or breastfeeding woman for a pain reliever?
    tylenol > NSAID > aspirin
  154. what problems might a prego woman see if she takes NSAIDs?
    • in utero: premature contraction of the ductus arteriosus
    • hypertension in baby
    • may inhibit labor
  155. t/f: enteric coated aspirin prevents GI bleeding
    false, only prevents nausea
  156. If taking a fecal occult blood test, when should you stop aspirin?
    3 days prior
  157. If having surgery, when should you stop aspirin?
    7 days (2-7)
  158. What are the best pain relievers for kiddos?
    tylenol and ibuprofen
  159. What is the typical dose of tylenol for a child?
    10-15 mg/kg
  160. What is the typical dose of ibuprofen for a child?
    7.5 mg/kg (half the dose of tylenol)
  161. who is not recommended to take naproxen?
    kids less than 12
  162. Why can kids not take aspirin?
    reye's syndrome
  163. What is the leading cause of acute liver failure in the U.S?
    tylenol
  164. Which pain reliever can/should you take with food, milk or antacids?
    NSAIDs
  165. What are the symptoms of tylenol toxicity?
    • N/V
    • drowsiness
    • confusion
    • abdominal pain
    • or nothing at all in some people
  166. What is overdose of aspirin aka?
    salicylism
  167. What are symptoms of salicylism?
    tinnitus, vertigo, N/V, headache, confusion, decreased hearing
  168. What are the signs of salicylate poisoning?
    • vomiting
    • hyperventilation
    • resp depression
    • coma
  169. What condition did people most commonly use alternative/complementary medicines for?
    back pain
  170. This alt med is a building block of tendons, cartilage, ligaments, synovial fluid, blood vessels and heart valves?
    glucosamine/chondroitin
  171. What is best indication for glucosamine/chondroiton?
    mild to moderate OA, not severe
  172. t/f: chondroitin or glucosamine are not effective when used alone
    true
  173. t/f: patients taking warfarin can also take glucosamine/chondroitin.
    false: may increase bleeding
  174. Do not recommend these alt meds for muscle or neuro pain, only for joint pain?
    glucosamine/chondroitin
  175. t/f: since glucosamine/chondroitin comes from marine exoskeletons and cow or shark cartilage, patients w/ shellfish allergy should not take them.
    false, it's okay
  176. What is the safe dosage and length of treatment for MSM?
    2.6-6 grams per day for 12 weeks
  177. This drug is thought to have a link to pain by sulfur deficiency but that is not proven?
    MSM
  178. Where is MSM found?
    • algae
    • plants
    • fruits
    • veggies
    • milk
    • urine
  179. What is MSM thought to help?
    OA pain
  180. What natural anti-inflammatories have similar side effects to NSAIDs? (GI upset, caution with anticoags)
    • bromelian
    • cat's claw
    • devil's claw
    • ginger
  181. This natural med thought to be comparable to diclofenac and reducing mild knee pain?
    bromelian
  182. This natural med thought to reduce knee pain?
    cat's claw
  183. This natural med thought to similar to Vioxx for back pain and has been validated for OA pain?
    devil's claw
  184. What is ginger thought to do for pain?
    relieve OA pain
  185. What are all of the natural anti-inflammatory meds?
    • willow bark
    • stinging nettles
    • turmeric
    • phellodendron
    • ginger
    • devil's claw
    • cat's claw
    • bromelian
  186. Which natural anti-inflammatory might actually work for pain associated with RA (according to Onysko)?
    turmeric
  187. What are some anti-depressant-like natural meds?
    • L-tryptophan
    • 5-HTP
    • St. John's Wort
    • SAMe
  188. What natural med is thought to be good for fibromyalgia, but not headaches?
    5-HTP
  189. Which natural med is thought to be as effective as NSAIDs for pain, but is expensive and has poor product quality?
    SAMe
  190. These two natural meds look promising for helping with nerve pain in diabetics or for increasing blood flow?
    • Acetyl-L-carnitine
    • Alpha-lipoic acid
  191. These two natural meds decrease substance P in the sensory nerves which decreases pain (also cause irritation and stimulation of nervous tissue)?
    • camphor
    • capsaicin (capsicum/cayenne pepper)
  192. Patients should use these two natural meds for 3 days and multiple applications to see pain relief at fullness?
    • capsaicin
    • camphor
  193. Which 4 natural meds are most safe AND effective to recommend for pain relief?
    • camphor
    • capsaicin
    • glucosamine sulfate
    • SAMe
  194. Which 4 natural meds should not be recommended for pain relief?
    • St. John's wort
    • L-tryptophan
    • marijuana
    • 5-HTP
  195. How do non-selective NSAIDs cause GI bleeds?
    inhibit protective prostaglandin PGE2 in endothelium
  196. Inhibition of which COX causes GI bleeding?
    COX 1
  197. Inhibition of which COX increases cardio risk?
    COX 2
  198. Inhibition of which COX decreases inflammation?
    COX2
  199. What is the amount of risk when taking an NSAID and getting GI complications vs. someone who is not taking an NSAID?
    50-100% increased risk
  200. Which antihypertensive does NSAID not interfere with?
    calcium channel blockers
  201. If patient reports with an allergic reaction to both aspirin and naproxen, does patient have allergy or pseudoallergy?
    pseudo which is related to COX 1 inhibition
  202. What problems might a patient have that would make them be at higher risk for aspirin-induced asthma?
    • urticaria
    • nasal polyps
    • severe asthma
    • chronic rhinitis
  203. Very low and high doses of aspirin do what in a gout patient?
    help excretion of uric acid = good
  204. Which OTC analgesic is only contraindicated in the 3rd trimester of pregnancy?
    NSAIDs
  205. Which analgesic should not be used in pregnancy or breastfeeding?
    aspirin
  206. Where do tension headaches occur?
    • over top of head
    • extend to base of head
    • both sides
  207. Where do migraines occur?
    one side usually
  208. avoiding known triggers is the best way to avoid which type of headache?
    migraine
  209. At what temp should you treat a fever in an adult?
    >106 or if they are uncomfortable
  210. Which method of measuring temp is best in kids?
    rectal, but others are okay if proper technique used
  211. Combining NSAIDs or aspirin with alcohol increases risk of what?
    GI bleed
  212. What is RICE?
    • rest
    • ice
    • compression
    • elevate
  213. What is the difference between fever and drug-induced hyperthermia?
    • fever= over 100 degrees
    • DIH= 102-104 sometimes as high as 108
  214. Which usually causes a higher temp, bacteria or virus?
    bacteria
  215. t/f : a child less than 6 months old with a rectal temp of 101 or higher can be self treated.
    false
  216. t/f: magnesium salicylate is usually used to treat back pain
    true
  217. Which drug is used mostly for OA pain, fever, and mild to moderate pain?
    tylenol
  218. For a child older than 6 months what should we recommend for fever?
    ibuprofen or tylenol
  219. Tylenol + Alcohol =
    increased hepatotoxicity
  220. NSAIDs/aspirin + alcohol =
    increased risk of GI bleed
  221. tylenol/NSAIDs/aspirin + warfarin =
    bleeding risk
  222. aspirin + NSAID =
    • bleeding risk
    • decreased cardio benefit from aspirin
  223. NSAIDs/salicylates + antihypertensives =
    • increased BP
    • hyperkalemia
  224. What are some examples of complemetary medicine?
    • massage
    • support groups
    • biofeedback
    • hypnosis
  225. What is alternative medicine?
    • no reimbursed by thirdparty payers
    • lacks evidence for effectiveness
    • therapy not provided in hospital or taught in American med schools
  226. t/f: Homeopathic meds must be approved by FDA
    true
  227. t/f: homeopathic medicine is often compared to vaccines
    true
  228. Use of what meds usually requires vigorous shaking?
    homeopathics
  229. Dilutions of 1 to 10 are designated as ?
    X
  230. Dilutions of 1 to 100 are designated as ?
    C
  231. t/f: the more dilute a homeopathic med is, the stronger it is
    true
  232. 1X=
    1: 10
  233. 3X=
    1:1000
  234. 6X=
    1:1,000,000
  235. 1C=
    1: 100
  236. 3C=
    1:1,000,000
  237. Dilutions of what strength have zero active ingredient molecules in them?
    more than 24X or 12C
  238. t/f: dietary supplements are required to be safe, but not effective
    true
  239. What is required to be on a natural medicine label?
    • product name + the word supplement
    • quantity
    • manu. name and location
    • directions for use
    • facts panel with serving size
    • plant-based product has to include scientific name
  240. Which natural med product claim is not required by the FDA to be on the label?
    structure-function claim
  241. This group verifies that a product contains the labeled ingredients and that contaminants and unlisted ingredients are not present in a natural med?
    NSF (national sanitation foundation intl)
  242. This is an independent company that tests products?
    consumer lab
  243. Which population (race) uses CAM the most?
    American Indians and Alaskans, then whites
  244. What natural meds are used for cardio system?
    • garlic
    • hawthorn
    • CoQ10
    • omega-3
    • red yeast rice
  245. what are the uses for CoQ10?
    • statin-induced myopathy
    • aids immune function in HIV
    • may lower BP
    • heart failure
  246. This natural supp is a vitamin-like compound, acts as an antioxidant, membrane stabilizer, cofactor for ATP?
    CoQ10
  247. t/f: odorless garlic products are inactive
    true
  248. What is in garlic that makes it pharmaco effective?
    • allicin
    • ajoene
  249. This natural supp may cause smooth muscle dilation by activating NO and reduces oxidative stress and inhibits LDL oxidation?
    garlic
  250. What would you use garlic for?
    • atherosclerosis
    • hypertension
    • tick bites
    • ringworm
    • jock itch
    • athlete's foot
  251. Pregnant women or someone taking aspirin or warfarin should not take this cardio supp?
    garlic
  252. what type of fatty acids are omega 3 and omega 6?
    polyunsaturated
  253. Why do we want more omega 3 than 6?
    b/c 6 has pro-inflammatory effects
  254. Where do we get omega 3 fa from?
    • soy
    • canola oil
    • flaxseed
    • walnuts
    • nuts
    • fatty fish oils (long chain, EPA/DHA)
  255. What type of omega 3 do we want for a cardio benefit?
    long-chain polyunsaturated w/ EPA and DHA (but focus is on EPA)
  256. What is a good protective dose of fish oil against cardiac events?
    1 gram/day
  257. What is a good treatment dose of fish oil for lowering TGs?
    3-4 grams/day
  258. What is a good dose of fish oil for decreasing atherosclerosis and antiarrhythmic?
    1-2 grams/day
  259. t/f: there is enteric coated fish oil
    true
  260. t/f: contaminants like mercury in fish oil are a major concern
    false
  261. t/f: Eating a diet with 1-2 servings of oily fish per week is enough to have cardiac protection
    true
  262. Is flaxseed a long or short-chain omega 3?
    short
  263. What is found in short chain omega 3?
    alpha-linolenic acid
  264. Why do we not recommend flaxseed as a supplement?
    • has too many calories
    • can increase TGs by 10%
  265. Which cardiac supp is absolutely contraindicated in pregnancy?
    red yeast rice
  266. What prescription drug is red yeast rice similar to?
    statins
  267. This supp has cholesterol lowering effects?
    red yeast rice
  268. How does hawthorn work?
    increases membrane perm for calcium and inhibits PDEs, increases cAMP, increases coronary blood flow, increases vasodilation
  269. t/f: it is best not to recommend hawthorn
    true
  270. the flowers and leaves of this cardiac supp contain chlorgenic acid and flavonoids?
    hawthorn
  271. What supps might we use for the nervous system?
    • ginkgo
    • melatonin
    • SJW
    • valerian
    • 5-HTP
    • chamomile
    • riboflavin (B2)
    • CoQ10
  272. Which nervous system supp contains flavonoids, terpenoids, and organic acids?
    ginkgo
  273. This NS supp has antioxidant props and neural and retinal protective effects?
    ginkgo
  274. t/f: ginkgo is only recommended for folks who already have dementia or memory loss.
    true
  275. t/f: healthy elderly patients probably should not take ginkgo
    true
  276. What uses does ginkgo have other than for dementia?
    • intermittent claudication
    • PMS
    • diabetic retinopathy
    • vertigo
    • glaucoma
  277. t/f: roasted or fresh ginkgo seeds are safe to use
    false
  278. What drug should you not take with ginkgo?
    warfarin (bleeding)
  279. Which supp naturally regulates circadian rhythm, endocrine secretions, an sleep patterns?
    melatonin
  280. _______ inhibits melatonin secretion?
    light
  281. This supp is effective for jet lag, the blind, mentally retarded, autistic, or other CNS disorders?
    melatonin
  282. What dose of melatonin should you take for eastbound jet lag?
    0.5-5 mg at local bedtime
  283. Women who are trying to get prego should not take this NS supp b/c will inhibit ovulation or decrease gonadal development?
    melatonin
  284. What does 'wort' mean?
    plant
  285. t/f: SJW may contain melatonin
    true
  286. Hyperforin and adhyperforin are found in which NS supp and these modulate the effects of serotonin, dopamine, and NE?
    SJW
  287. This supp can be considered a good option for mild, short-term depression?
    SJW
  288. This supp is often used in conjunction with SJW for menopausal women?
    black cohosh
  289. This NS supp is used for insomnia, sedative-hypnotic, anxiolytic, antidepressant, anticonvulsant and antispasmodic effects?
    valerian
  290. This NS supp may bind directly to GABA receptors?
    valerian
  291. What is the typical dose of valerian when used for insomnia?
    400-900mg 2 hours before bedtime
  292. This NS supp can reduce time to sleep onset and improve sleep quality?
    valerian
  293. T/F: some people may not see sedative effects from valerian (flippers) and may actually get excited
    true
  294. This NS supp seems to be effective for depression and fibromyalgia, but can also cause EMS (eosinophilia myalgia syndrome)?
    5-HTP
  295. What is chamomile used for?
    • oral mucositis
    • dyspepsia
    • anti-inflammatory
    • anti-bacterial
    • depression?
  296. This NS supp contains a flavonoid called apigenin which is similar to BZD ligand?
    chamomile
  297. Which NS supp which is a vitamin might help ameliorate migraines?
    riboflavin (B2)
  298. What NS effect would CoQ10 potentially have?
    helps migraines
  299. What supps would we use for digestive health?
    • B6
    • ginger
    • milk thistle
    • peppermint
    • senna
    • probiotics
    • chamomile
  300. What digestive supp is considered the first line treatment for N/V in prego women?
    B6 (pyridoxine)
  301. What is the dose of B6 for N/V in prego women?
    25 mg q 8 hours
  302. Which digestive supp is similar to Zofran and may increase GI motility and act on serotonin receptors?
    ginger root
  303. What is the dose of ginger to be used for N/V/morning sickness in prego?
    250 mg QID
  304. What two conditions is ginger likely effective for and what condition is it likely ineffective for?
    • effective: morning sick, post op N/V
    • ineffective: motion sick
  305. t/f: pyridoxine may be safer than ginger for prego women
    true
  306. What is most commonly used part of milk thistle used?
    seeds
  307. What do we use milk thistle for?
    • dyspepsia
    • diabetes
    • alcohol related liver disease
    • laxative?
  308. this digestive supp has silymarin in it, which is a potent inhibitor of TNF, blocks cytotoxicity, inflammation and apoptosis, is an antioxidant, and is especially selective for liver cells?
    milk thistle
  309. This digestive supp may inhibit histamine release, is an antispasmodic due to direct relaxing effects on GI smooth muscle, and if applied topically can inhibit pain receptors b/c it contains menthol?
    peppermint
  310. What do we use peppermint for?
    • dyspepsia
    • enema related colon spasms
    • tension headaches
  311. This digestive product can be used orally, topically or rectally?
    peppermint
  312. Since peppermint can cause heartburn, what should we tell the patient?
    take enteric coated
  313. This digestive supp is used for patients on long term opioid therapy.
    senna
  314. What do we use senna for?
    • constipation (esp w/ opioids)
    • bowel preparation before colonoscopy
  315. These digestive supps are prodrugs that get activated by bacterial enzymes in the colon.
    senna
  316. t/f: prego women can use senna
    true
  317. This digestive supp can cause ab pain, cramps, bloating and depletion of electrolytes?
    senna
  318. What supps do we use for the endocrine system?
    • alpha lipoic acid
    • ginseng
    • DHEA
  319. What do we use alpha lipoic acid for?
    • diabetic neuropathy
    • peripheral neuropathy (pain, numbness, burning)
  320. What do we use ginseng for?
    • diabetes to reduce post prandial glucose in Type 2 DM
    • resp tract infections (colds, flu)
  321. Should we use ginseng with warfarin?
    no
  322. What do we use DHEA for?
    • adrenal insufficiency
    • ED
    • aging skin
    • osteoporosis
    • schizophrenia
    • SLE
  323. What are some side effects of DHEA?
    • hirsutism
    • acne
    • hair loss
    • insomnia
    • voice deepening
  324. This supp was banned by NCAA for stimulant-like activity?
    DHEA
  325. This supp has had quality control problems and is endogenously produced from our adrenal glands and liver?
    DHEA
  326. t/f: DHEA is possibly unsafe when taken orally in high doses for a long time
    true
  327. Name some immune stimulants/performance enhancers.
    • echinacea
    • green tea
    • probiotics
  328. What is the most commonly used natural supplement?
    echinacea
  329. What do we use echinacea for?
    • reducing symptoms of cold
    • not prophylaxis
  330. What substances does green tea contain?
    • caffeine
    • flavonoids, flavonols
  331. What do we use green tea for?
    • anti-inflammatory in airway
    • diuretic effect
    • mental alertness
    • genital warts
    • hyperlipidemia (lowers TG and cholesterol)
  332. What 3 strains of bacteria do we have the most evidence of probiotic effectiveness for?
    • lactobacillus
    • bifidobacteria
    • saccharomyces boulardi
  333. What functions does the flora in our GI have?
    • prevent overgrowth of bad bacteria
    • produces vitamins B and K
    • break down food
    • absorb nutrients
  334. Which probiotic found in Activia helps improve slow intestinal transit?
    bifidobacteria
  335. Which probiotic is the most effective?
    lactobacillus (Acidophillus) (Culturelle)
  336. Which probiotic is most effective at treating C. diff?
    saccharomyces boulardi (Florastor)
  337. t/f: probiotics are safe in pregnancy and breastfeeding
    true
  338. t/f: probiotics are safe to use in the immunocompromised
    false
  339. Which supp may decrease symptoms of the flu by 0.28 days?
    oscillo
  340. What are the potential harms of cleansing?
    • dehydration
    • electrolyte imbalances
    • fecal incontinence
    • bowel perforation
    • N/V
    • cramps
    • infection
  341. Who should absolutely avoid cleansing?
    • diverticulitis
    • ulcerative colitis
    • Crohn's
    • hemorrhoids
    • recent bowel sx
  342. What 2 supps do we use for kidney, urinary and prostate health?
    • cranberry
    • saw palmetto
  343. t/f: cranberry acidifies the urine
    false
  344. t/f: cranberry capsules are effective
    false; use juice
  345. What chemicals does cranberry contain?
    • tannins (proanthocyanidin): interfere w/ bacterial adherence to urinary tract epithelial cells
    • salicylic acid: anti-inflammatory and anti-platelet
  346. t/f: cranberry can be used to treat UTIs
    false; only to prevent
  347. t/f: cranberry can interact with warfarin
    true
  348. Which product was thought to decrease prostate growth/inflammation?
    saw palmetto
  349. What 2 supps do we use for skin and mucous membrane health?
    • aloe vera
    • tea tree oil
  350. What do we use tea tree oil for (in relation to skin)?
    • acne (less irritating even though slower acting)
    • onychomycosis (fungal toenail infection)
  351. What 2 non-herbal OTCs is tea tree oil comparable to?
    • 1% lotrimin
    • 5% benzoyl peroxide
  352. What do we use aloe vera for?
    • sunburn/other burns
    • constipation
    • psoriasis
  353. this skin supp could cause menstruation and abortion if taken in too high of an oral dose?
    aloe vera
  354. What is the most common supp used for hot flashes?
    black cohosh
  355. Do not use this supp b/c of estrogen-like effects, possible liver damage and miscarriage of pregnancy?
    black cohosh
  356. Should we recommend phytoestrogens like soy, red clover isoflavonem, genistein, or daidzein?
    no could cause breast cancer
  357. Does soy work to treat hot flashes?
    no
  358. What are the 3 ways to evaluate the significance of drug-supplement interactions?
    • Criterion 1: severity
    • Criterion 2: likelihood
    • Criterion 3: level of evidence
  359. Where does grapefruit inhibit CYP3A4?
    in the gut
  360. Which supplement has the most documented drug interactions?
    SJW
  361. What supplement increases the activity of all prodrugs?
    SJW
  362. What are the top 10 drugs that cause undesirable drug interactions?
    • grapefruit
    • SJW
    • garlic
    • calcium
    • pomegranate juice
    • ginkgo
    • bitter orange
    • noni juice
    • kava
  363. If have to take calcium and levothyroxine what is the rule of thumb?
    take 4 hours apart
  364. Which supplement can lower the seizure threshold?
    ginkgo
  365. Use SJW with caution with what 3 drug classes?
    • Plavix
    • HIV protease inhibitors
    • oral contraceptives
  366. Use calcium with caution with what 3 drug classes?
    • bisphosphonates
    • levothyroxine
    • antibiotics
  367. Use ginkgo with caution with what 6 drug classes?
    • wellbutrin
    • antibiotics
    • narcotics
    • warfarin
    • plavix
    • aspirin
    • *seizures*
  368. This supplement has replaced Ephedra as a weight loss supp?
    bitter orange
  369. Which supp should you not take with anti-arrythmics b/c might cause QT prolongation?
    bitter orange
  370. What supp could cause hyperkalemia if taken with ACE inhibitors or spironolactone or in patients with renal dysfunction?
    noni juice
  371. this supp is linked to hepatoxicity especially when combined with other hepatotoxic drugs like statins, ketoconazole, lamisil, methotrexate and tylenol?
    kava
  372. Which two supps should the elderly avoid if they are on warfarin or aspirin?
    • ginkgo
    • garlic
  373. Why is black cohosh bad for inducing labor?
    causes heart failure in neonates
  374. What is the biggest opponent to the tobacco control efforts?
    tobacco industry itself
  375. Who has the highest rate of tobacco use?
    • American Indians
    • Alaskans
  376. t/f : nicotine is the addictive component of tobacco products, but it does not cause the ill health effects
    true
  377. t/f: there are safer levels of second hand smoke
    false
  378. What are some major health consequences of smoking?
    • cancers
    • cardiovasc diseases
    • pulmonary diseases
    • reproductive effects
    • cataracts
    • osteoporosis
    • periodontis
    • poor surgical outcomes
  379. t/f: separating smoking areas, cleaning the air, and using ventilation are effective at protecting non-smokers from second hand smoke
    false
  380. What are the major health consequences of using smokeless tobacco?
    • periodontal disease: bone attachment loss, dental caries, gum recession
    • Oral leukoplakia: white spots
    • cancer: oral, pharyngeal
  381. t/f: there is no statewide law regarding smoke-free workplaces in wyoming
    true
  382. where is the lowest tax placed on cigarettes?
    virginia
  383. Where is the highest cost for one pack of cigarettes?
    New York
  384. About how much sooner do cigarette smokers die than non-smokers?
    10 years earlier
  385. What are the different types of tobacco?
    • cigarettes
    • cigars
    • bidis
    • cloves
    • hookah
    • pipes
    • chew, snuff
  386. Among folks who continue to smoke, how many will die due to a tobacco-related disease?
    about half
  387. How many adults are current smokers?
    1/5
  388. What is the most common form of tobacco used in the U.S?
    cigarettes
  389. What is the amount of nicotine contained in each cigarette?
    1-2 mg
  390. t/f: snuff smokeless tobacco is on the rise
    true
  391. What does the risk of smoking tobacco look like for pipes, cigars, cigarettes?
    cigarettes> cigars = pipes
  392. Which form of tobacco has twice the tar and nicotine of a standard cigarette?
    cloves
  393. Which form of tobacco has three times higher levels of carbon monoxide and nicotine and five times higher levels of tar than a standard cigarette?
    bidis
  394. What does PREPs stand for?
    Potentially reduced exposure products
  395. What are some noncombustible tobacco products?
    • ariva
    • marlboro snus
    • stonewall
    • camel snus
  396. Do PREPs reduce the risk of developing tobacco-related disease?
    no
  397. Where do we get the highest absorption of tobacco?
    in alkaline media
  398. At what pH is nicotine readily absorbed?
    physiological
  399. What is the pH of the mouth?
    7
  400. What kind of effects does nicotine predominantly have?
    stimulatory
  401. t/f: nicotine is readily absorbed across skin and small intestine
    true
  402. how long does it take nicotine to get to the brain?
    10-20 seconds
  403. What is the half life of nicotine?
    2 hours
  404. How is nicotine excreted?
    • kidney
    • breast milk
  405. What are the 3 main contributing factors to tobacco use?
    • physiology
    • pharmacology
    • environment
  406. Which pathway in the brain does nicotine activate?
    dopamine reward pathway
  407. What drugs may have a decreased effect due to induction of CYP1A2?
    • bendamustine
    • caffeine
    • clozapine
    • erlotinib
    • fluvoxamine
    • olanzapine
    • ropinirole
    • tacrine
    • theophylline
    • irinotecan
  408. Which drug will have an increased effect if used while smoking?
    Plavix
  409. t/f: smoking decreases the efficacy of oral contraceptives
    false
  410. Which women are at a significantly increased risk of stroke, MI, or thromboembolism?
    • 35 or older AND
    • smoke at least 15 cigarettes per day
  411. What are the 5 A's of smoking cessation?
    • Ask
    • Advise
    • Assess
    • Assist
    • Arrange
  412. What are the most effective ways to quit smoking?
    counseling + medications
  413. What are the 3 FDA approved drugs for smoking cessation?
    • partial nicotinic receptor agonist
    • psychotropics
    • nicotine replacement therapy
  414. What prego category are wellbutrin and chantix?
    C
  415. What prego category is NRT?
    D
  416. t/f: NRT should be recommended for smokeless tobacco user
    false
  417. How much does NRT affect quit rates?
    doubles quit rates
  418. t/f: patients should stop using all forms of tobacco upon initiation of the NRT regimen
    true
  419. Who needs to be supervised when using NRT?
    cardio disease
  420. Which NRT is most like smoking a cigarette?
    Nicotrol NS nasal spray
  421. What doses does nicotine gum come in?
    2 and 4 mg
  422. How many cigarettes would someone smoke if you are going to give a 2 mg nicorette gum?
    less than 25/day
  423. What dosage of nicorette gum would you recommend for someone smoking more than 25 cigs per day?
    4 mg
  424. What is in the resin complex of nicorette gum?
    • nicotine
    • polacrilin
  425. What is max number of pieces of gum you can chew in a day?
    24
  426. Do not eat or drink for how long before using nicorette gum or a lozenge?
    15 minutes
  427. What is Commit and Nicotine Mini?
    lozenges
  428. Which NRT delivers ~25% more nicotine than the equivalent gum dose?
    lozenge
  429. What is the max number of lozenges to be taken per day?
    20
  430. When should you use a 2 mg lozenge?
    if you smoke more than 30 minutes after waking up
  431. To improve chances of quitting, how many pieces of gum or lozenges should you have daily during the first 6 weeks?
    9
  432. what are the dosages of nicotine patch (NicoDermCQ)?
    • 7
    • 14
    • 21 mg
  433. How do we decide what dose of a nicotine patch to give?
    • less than 10 cigs/day: 14mg for 6 weeks, 7 mg for 2 weeks
    • more than 10 cigs/day: 21mg for 6 weeks, 14 mg for 2 weeks, 7 mg for 2 weeks
  434. What should we remove before an MRI?
    nicotine patch
  435. One dose of nicotrol NS nasal spray contains how much nicotine?
    1 mg
  436. How many doses are in a bottle of nicotine nasal spray?
    100 per nostril so 200 sprays
  437. How much nicotine does the nicotine inhaler have?
    4 mg of vapor
  438. What is the min and max amount of cartridges of the nicotine inhaler you should use?
    • 6
    • 16
  439. t/f: the mouthpiece for the nicotine inhaler can be reused
    true but wash it
  440. How long is an open cartridge of nicotine inhaler good for?
    24 hours
  441. Which NRT avoids food/drink problems?
    the patch
  442. Patients should begin therapy of what drug 1 to 2 weeks prior to quit date?
    wellbutrin
  443. Patients should begin therapy of what drug 1 week prior to quit date?
    chantix
  444. Dry mouth and insomnia are common side effects of what cessation drug?
    wellbutrin
  445. Seizure risk is increased when taking what cessation agent?
    wellbutrin
  446. What is the half-life of chantix?
    24 hours
  447. Patients might become agitated, depressed, hostile or have changes in behavior when taking which cessation agent?
    chantix
  448. Patients taking this cessation drug might give you GI upset or vivid dreams or insomnia?
    chantix
  449. What natural herbal could be used for smoking cessation?
    lobeline
  450. How does lobeline work?
    • like chantix
    • partial nicotinic agonist
  451. What grade of acne can patients self-treat for?
    grade 1
  452. What are the 5 main causes of acne?
    • proliferation of P. acnes
    • excessive sebum production
    • inflammatory response
    • hormones
    • abnormal follicular desquamation
  453. What medications can cause acne?
    • phenytoin
    • isoniazid
    • moisturizers
    • phenobarbital
    • lithium
    • ethionamide
    • steroids
  454. What are the pharmacological treatments for acne?
    • benzoyl peroxide
    • salicylic acids (beta-hydroxy acids)
    • alpha-hydroxy acids
    • sulfur products
    • tea tree oil
    • oral zinc
  455. tinea capitis
    scalp infection
  456. tinea corporis
    • any where on body
    • under fat folds
  457. tinea pedis
    athlete's foot
  458. tinea unguium (onychomycosis)
    toenail fungus
  459. tinea cruris
    jock itch
  460. What is an immediate exclusion to self care of treating fungal infections?
    Candida or other yeasts
  461. What is the most common type of tinea pedis?
    chronic intertriginous
  462. What is favus?
    • patchy areas of hair loss, yellow crusts and scales
    • can lead to scalp scarring and permanent hair loss
    • (seen in tinea capitis)
  463. What are the most common agents used to treat fungal infections?
    • butenafine
    • clotrimazole
    • miconazole
    • terbinafine
    • tolnaftate
  464. Which antifungal can be used as a preventative measure?
    Tuff Actin Tinactin (Tolnaftate)
  465. What is a salt of aluminum that is used to treat fungal infections? (also can also be used for ears)
    Burrow's solution
  466. t/f: you can apply tolnaftate to broken skin
    true
  467. What does fungistatic mean?
    prevents bacterial growth
  468. Which antifungal medication is not fungicidal?
    Tolnaftate
  469. What are the 3 phases of wound healing?
    • inflammation
    • proliferation
    • maturation/remodeling
  470. How many stages of wound depth are there?
    4
  471. What is another term for whitehead?
    closed comedone
  472. What is another term for blackhead?
    open comedone
  473. Can we self treat papules, pustules or cysts on the skin?
    no (unless they are not inflamed)
  474. What is grade 1 acne?
    • closed and open comedones
    • less than 10 on the face
    • none on rest of body
    • no scarring
    • no inflammation
  475. t/f: acne medications often make our skin worse before they make our skin better and can take 6-8 weeks to work
    true
  476. What does mild acne look like?
    non-inflammatory papules or pustules
  477. What are some exacerbating factors for acne (not causes)?
    • local irritation/friction
    • oil based beauty products
    • exposures to dirt, chemicals, cooking oil, tar
    • stress/emotional extremes
    • high humidity
    • prolonged sweating
    • increased androgen levels (PCOS, preg, meds)
  478. Does chocolate cause acne?
    no, nor do any other foods
  479. What are some exclusions for self treating acne?
    • moderate to severe acne present
    • drug induced acne
    • contributing disease state present
    • rosacea
  480. What are the adverse side effects of benzoyl peroxide?
    • bleaching
    • photosensitivity
    • contact allergy
    • over-drys skin
  481. What are the OTC strengths of benzoyl peroxide?
    2.5-10%
  482. What are the Rx strengths of benzoyl peroxide?
    10-20%
  483. This acne treatment can be bactericidal and keratolytic?
    benzoyl peroxide
  484. This acne treatment is comedolytic and keratolytic.
    salicylic acid (beta hydroxy)
  485. Who is contraindicated to take salicylic acid?
    • diabetics
    • poor circulation
    • small children
  486. What are the OTC strengths of salicylic acid?
    0.5%- 2%
  487. This acne treatment exfoliates and tingles?
    alpha-hydroxy acids
  488. What are the OTC concentrations of alpha-hydroxy acid?
    4-10%
  489. This acne treatment may only be good for reducing scarring and uses glycolic, lactic and citric acids?
    alpha-hydroxy acids
  490. Which acne treatment should African Americans avoid?
    sulfur products
  491. Which acne product seems to be most efficacious (dosage form)?
    gels
  492. t/f: if baby has acne, we can treat it with drug products
    false; use soap and water BID
  493. What are the organisms most commonly involved in causing funal infections?
    • trichophyton
    • microsporum
    • epidermophyton
    • Candida
    • other yeasts
  494. What is the most prevalent fungal infection?
    tinea pedis
  495. When should you change a wound dressing?
    when it is dirty or no longer intact
  496. t/f: antiseptic is recommended when self treating a wound
    false
  497. What should we use to irrigate wounds?
    • sterile saline
    • soap and water
    • bottled water
  498. What are some examples of antiseptics?
    • hydrogen peroxide
    • ethyl alcohol
    • iodine
    • isopropyl alcohol
    • camphorated phenol
  499. Which topical antibiotic works against gram negative bacteria?
    Polymyxin B Sulfate
  500. Which topical antibiotic might get resistance to develop?
    Neomycin
  501. This topical antibiotic could potentially cause ototoxicity or nephrotoxicity if too much is used?
    neomycin
  502. this topical antibiotic increases rate of hypersensitivity and allergies?
    neomycin
  503. T/F: both neomycin and polymyxin B sulfate work against gram negative bacteria
    true, but neo also on staph
  504. This fungal infection must be treated w/ systemic antifungals or pro nail removal?
    tinea unguium
  505. In general, should we recommend hydrogen peroxide?
    no
  506. Which antiseptic can be used as a douche or wound irrigant and is not irritating?
    povidone/iodine
  507. This antiseptic is effective against protozoa, fungi, bacteria, spores, viruses and yeast?
    iodine
  508. Which topical antibiotic is used to fight gram positive bacteria?
    bacitracin
  509. How many days should you give a wound to heal before you call your PCP?
    5
  510. This type of tinea pedis has fissuring, scaling, or maceration in the inter-digital spaces, bad odor, itching and stinging sensation?
    chronic intertriginous
  511. This type of tinea pedis usually involves the lateral toe webs and typically spreads to the sole or instep of the foot and gets worse in warm, humid environments?
    chronic intertriginous
  512. This type of tinea pedis usually presents on both feet and has mild inflammation, diffuse moccasin-like scaling on the soles of the feet?
    chronic papulosquamous
  513. If patient has tinea pedis and tinea onychomycosis/unguium, what do you treat first?
    onychomycosis
  514. this type of tinea pedis shows small vesicles near the instep or mid-anterior plantar surface and has skin scaling in the toe webs?
    vesicular
  515. This type of tinea pedis is aggravated in summer and dormant in cooler months?
    vesicular
  516. This type of tinea pedis is complicated by bacteria such as proteus and pseudomonas, gives a pungent odor, white hyperkeratosis, maceration, weeping ulcerations on the sole, and may be painful?
    acute ulcerative
  517. This type of fungal infection is not really a medical emergency but shows symptoms like opaque, yellow, thick nails, nail separation, or nail falls off?
    tinea unguium/onychomycosis
  518. What are the symptoms of tinea capitis?
    • lesions around hair shaft
    • hairs turns dull gray, breaks off at scalp
    • pustules
    • kerion
    • itching
    • fever
    • pain
    • enlarged lymph nodes
    • black dot
    • hair loss
    • favus
  519. t/f: we can self treat a nail or scalp fungus
    false
  520. What is the typical duration of therapy for antifungals?
    2-4 weeks
  521. Terbinafine
    Lamisil AT
  522. Clotrimazole and Miconazole
    • Cruex
    • Desenex
    • Micatin
    • Lotrimin
  523. Butenafine
    Lotrimin Ultra
  524. Tolnaftate
    Tinactin
  525. Salts of Aluminum
    Burrow's solution
  526. t/f: salts of aluminum have antifungal properties
    false
  527. What are salts of aluminum approved and most useful for?
    • astringent and antiinflammatory properties
    • dry out soggy tinea pedis'
  528. What dosage form is the most effective antifungally?
    cream
  529. How long does the inflammatory wound healing phase take?
    3-4 days
  530. How long does the proliferative wound healing phase take?
    3-21 days
  531. How long does the maturation wound healing phase take?
    • a long time
    • happens after 3 weeks
  532. What are some disease states that have poor vascularization and may take longer to heal a wound?
    • diabetes
    • hypotension
    • PAD
    • CHF
    • obesity
  533. What are some meds that will slow wound healing?
    • corticosteroids
    • anticoagulants
    • chemo
    • radiation
  534. What factors contribute to good or poor wound healing?
    • age
    • nutrition
    • wound contamination/infection
    • perfusion/oxygenation/blood flow
    • medications
  535. What two factors do we use to classify a wound?
    • severity (acuity)
    • wound depth
  536. What are the main goals of wound care (3)?
    • maintain moisture
    • prevent scarring
    • prevent infection
  537. What products absorb moisture of wounds?
    • foams
    • alginates
    • carbon-impregnated
    • composite dressing
  538. What products maintain moisture of wounds?
    • hydrocolloids
    • transparent film
  539. What products provide moisture to a wound?
    hydrogels
  540. t/f: we should ace this test
    true

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