Self Care P2 Year

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burxguy
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253743
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Self Care P2 Year
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2013-12-19 01:33:35
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Self Care P2 Year year Butler university butler
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These flashcards contain objectives/highlights of self care options for common ailments and medical conditions
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  1. Pure Food and Drug Act of 1906
    Established standards of strength, quality, and purity
  2. Federal Food Drug and Cosmetic (FD&C) Act of 1938
    Established drug safety
  3. FD&C Amendment of 1951
    Established the two classes of medications: prescription and OTC
  4. FD&C Amendment in 1962
    Required drugs to be safe and effective
  5. Federal Trade Commission
    Regulates supplement advertising
  6. Fish Oil Uses
    • Hypertriglyceridemia (cardiovascular protective - stronger evidence for secondary prevention)
    • Inflammatory conditions
    • Hypertension
  7. Fish Oil Safety Concerns
    • Bleeding (>3g/day)
    • Vitamin E deficiency
    • Vitamin A+D overdose
    • Prostrate cancer
  8. Niacin Uses
    • Cardiovascular (Increases HDL, lowers LDL and TGs)
    • 1000-3000mg daily
  9. Niacin safety concerns
    • Flushing (pretreat with aspirin, slow dose titration, take w/ meal, use ER form, take before bed)
    • Hepatotoxicity (d/c if LFT >3x ULN)
    • Myopathy
    • Hypothyroidism
    • hyperuricemia
    • Hyperglycemia
  10. Red Yeast Rice Uses
    • Lower Lipid Concentrations
    • Is illegal in US; contains Monocolin K (lovastatin)
  11. Garlic Uses
    • Hyperlipidemia (weak data; small benefit)
    • Hypertension
  12. Garlic concerns
    • Bleeding (may raise INH by 65%)
    • Contraindication with birth control
    • Heartburn
    • Body odor
    • GI problems
  13. CoQ10 Uses
    • Cardiovascular benefits (angina, cardiomyopathy, infarction, CHF - only NYHA class I + II benefited)
    • Parkinson's
    • Migraine prevention
  14. CoQ10 safety concerns
    • Well tolerated
    • Rash
    • GI complaints
  15. Drugs that deplete CQ10 (should use CoQ10 when taking these)
    • Statins!!!
    • Sulfonylureas
    • beta blockers
    • TCAs
    • diuretics
  16. Glucosamine Sulfate Uses
    • Arthritis (synthesis of articular cartilage)
    • May be as effective as NSAIDs, but NSAIDs work faster (may take 4-8 wks to see benefits from glucosamine)
  17. Glucosamine safety concerns
    GI problems
  18. Chondroitin Sulfate uses
    • Osetoarthritis (formation of joint matrix)
    • Osteoporosis
    • Hyperlipidemia
    • Ischemic Heart Disease
    • ALL HAVE MIXED EFFICACY RESULTS (always recommend use with glucosamine for OA)
  19. Chondroitin Safety Concerns
    • Bleeding (esp. w/ warfarin)
    • GI problems
    • DOES NOT INCREASE GLUCOSE
  20. Methyl Sulphonyl Methane Use
    Arthritis (inhibits degenerative changes in joints)
  21. Ginkgo Uses
    • Main action on CNS
    • Improved sex function (blood flow relaxant)
    • Memory (some improvement initially, but long term not sustained)
    • PVD
    • Raynaud's
    • Veritgo
    • Sexual dysfunction
  22. Ginkgo safety concerns
    • Bleeding
    • Seizures
    • Allergic Reactions
    • GI problems
    • Inhibits CYP 450 enzymes
  23. St. John's Wort Uses
    Mild depression (NOT major depression)
  24. St. John's Wort safety concerns
    • Vivid dreams
    • Dry mouth
    • photodermatitis
    • dizziness, irritability
    • GI problems
  25. St. John's Wort Drug Interactions
    • Is a CYP 3A4 inducer (cyclosporine, contraceptives, digoxin, HIV meds)
    • Anything that affects serotonin
  26. Melatonin Uses
    • Insomnia
    • Sleep enhancement
    • Jet Lag
  27. Melatonin safety concerns
    • Drowsiness
    • Dizziness
    • Hormonal effects
    • Seizure (rare)
    • Headache
  28. Echinacea Uses
    • Upper respiratory tract infections (must take at onset, then continue for 7 days)
    • More likely to stimulate immune system (does not kill bacteria)
  29. Echinacea Interactions
    • Immunosuppressants
    • Increases caffeine concentrations
  30. Ginger Uses
    • Chemo-induced N/V 
    • Motion Sickness
    • PONV
  31. Ginger Safety
    • Bleeding
    • Heartburn
    • GI problems
  32. Biblerry Uses
    Ocular conditions
  33. Milk Thistle Uses
    • Liver health
    • Mushroom poisoning in other countries
  34. Soy Isoflavones (Genistein + Daidzein) Uses
    • Has SERM effects
    • Premenopausal women - anti-estrogen effect
    • Postmenopausal women - weak estrogenic effect
  35. Soy Isoflavones for Menopause
    • Hot flashes - mixed results 
    • Vaginal dryness - likely ineffective
    • Osteoporosis - likely ineffective
    • Cardiovascular - likely ineffective
  36. Soy Isoflavones safety concerns
    • Premenopausal - longer periods
    • Hormone sensitive malignancies
    • Endometriosis 
    • Migraine
    • Blood clot risk
    • Allergy risk
  37. So Isoflavones Interactions
    • Antibiotics
    • Estrogens + SERMS
    • Antiestrogens 
    • MAO-Is
  38. Red Clover Uses
    • Likely no better than placebo for menopausal symptoms
    • Ineffective for CV, cancer, osteoporosis
  39. Red Clover Safety Concerns
    • Rash
    • Myalgia
    • Nausea
    • Vaginal Spotting
  40. Red Clover Drug Interactions
    • Anticoagulants, NSAIDs
    • Estrogen or anti-estrogen agents
  41. Black Cohosh Uses
    • MOA: unknown - does not bind to estrogen receptors; may be partial agonist at serotonin receptors
    • May reduce hot flashes + mood symptoms
  42. Black Cohosh Safety Concerns
    • Seizure
    • Hepatotoxicity
    • Use caution with ASA allergy
    • GI problems
    • Rash
    • Headaches
    • Cramping
    • Breast tenderness
    • Weight gain
    • Spotting
  43. Black Cohosh Drug Interactions
    • SERMs/ estrogen therapy
    • Hepatotoxic drugs
  44. Cranberry Uses
    Prevention of UTIs (interfere with bacteria's ability to adhere to urinary tract wall)
  45. Cranberry safety concerns
    • ASA allergies
    • Kidney stones
  46. Fenugreek Uses
    Increased breast milk production
  47. Fenugreek safety concerns
    • GI problems
    • allergic reactions
  48. Saw Palmetto Uses
    • BPH - likely ineffective
    • MOA: may inhibit 5-alpha reductase
    • DOES NOT REDUCE PROSTATE SIZE
    • May inhibit COX and lioxygenase
  49. Saw Palmetto Concerns
    • GI problems
    • Cholestatic hepatitis
    • Antiplatelet effects questionable
    • NO EFFECT ON PROSTATE SPECIFIC ANTIGEN (PSA) (used for testing prostate cancer)
  50. Horny Goat Weed Uses
    Increased fertility
  51. Horny Goat Weed safety concerns
    • CV disease
    • Nosebleeds
    • bipolar disorder
    • Immune function disorders
  52. Tribus Terrestris Uses
    • Performace enhancer
    • Increases testosterone
    • Increased LH
    • Increased DHEA
  53. Yohimbe Uses
    • Not appropriate for Self-care
    • Causes fatal seizures, renal failure, and CV effects
  54. Bitter Orange (synephrine) uses
    • Weight loss (CNS stimulant)
    • Synergistic effect when combined with caffeine
  55. Caffeine Sources
    • Guarana
    • Green Tea extract
    • Yerba Mate
    • Kola Nut, Cocoa Nut
    • Guta Cola 
    • Coffee extracts
  56. CNS stimulants (synephrine/caffeine) adverse effects
    • CV effects (tachycardia, hypertension...)
    • Ringing in ears
    • Hypokalemia
    • Hyperthermia
    • Tolerance + withdrawal possible
  57. Caffeine drug interctions
    • Fluconazole & Verapamil decrease clearance
    • Cimetidine decreases clearance
    • Contraceptives decrease clearance
  58. Hydroxycitric acid uses
    Weight loss ( may inhibit lipogenesis) - mixed results
  59. Hydroxycitric acid safety
    • Serious liver injury/ hepatotoxicity (FDA issued a 2009 recall)
    • Seizure
    • Rhabdomyolysis (muscle breakdown)
    • Renal failure
    • Serotonin increase
  60. Chromium Uses
    • Glucose metabolism
    • May only have an effect in those with a chromium deficiency
  61. Conjugate Linoleic Acid uses
    • NOT likely to decrease BMI
    • May be beneficial for overall body composition (fat loss, muscle gain)
    • NOT beneficial in young, healthy people who do resistance training
  62. Conjugated Linoleic Acid safety concerns
    • Burp Back
    • Diarrhea/ loose stools
    • Nausea
  63. Chitosan Uses
    Fiber source to block fat absorption (marketed as a "fat trapper") - likely ineffective for weight loss
  64. Chitosan Safety Concerns
    • Steatorrhea
    • Decreased absorption of vitamin A, D, E & K
    • Avoid with shellfish allergies
  65. Psyllium, glucomannan, methylcellulose, pectin Uses
    • Bulk forming laxatives for weight loss - possibly effective 
    • Increased satiety
  66. Whey Protein Uses
    • Increase muscle protein synthesis
    • Decrease muscle protein breakdown
    • Take within 30 minutes of workout
    • Contraindicated in: milk allergy + renal insufficiency
  67. Creatine Uses
    • Improvements in weight lifting perfromance
    • DOES NOT IMPROVE AEROBIC EXERCISE/ENDURANCE
    • DOES NOT CAUSE WEIGHT LOSS
    • Should not cause dehydration or cramping, but hydrate well anyways
  68. Bulk Forming Laxatives
    • Wheat Dextran 
    • Calcium polycarbophil
    • Psyllium 
    • Methylcellulose
    • MOA: Forms a colloidal mixture that softens and increases bulk of stool to increase peristalsis
    • Onset: 12 hours - 3days
  69. Surfactant (emollient) laxatives
    • Docusate sodium (Colace)
    • MOA: lowers surface tension to allow water and lipids to penetrate the stool
    • Does NOT increase motility
    • Onset: 1-3 days
    • May be used during pregnancy
  70. Lubricant laxatives
    • Mineral oil
    • Coats stool and allows for easy passage
    • Does NOT increase motility
    • Oral onset: 6-8 hours
    • Rectal: 2-15 minutes
    • Should not use routinely (can aspirate and cause lipid pneumonia)
  71. Osmotic Laxatives
    • Lactulose (1-2 days) 
    • Sorbitol (<1 hr)
    • PEG (12-72 hrs)
    • Glycerin (<30 min)
    • MOA: Cause fluid accumulation that softens the stool and distend colon to enhance peristalsis
  72. Stimulant Laxatives
    • Senna  (6-12 hours orally; 30-120 minutes rectally) - may cause pink or brown urine)
    • Bisacodyl (Dulcolax) (6-8 hrs orally; 15-60min rectally)
    • MOA: directly stimulates peristalsis
    • Can develop dependence (use short term unless using with opioid)
  73. Saline Osmotic Laxatives
    • Magnesium citrate 
    • Sodium Phosphate
    • Magnesium hydroxide
    • MOA: creates an osmotic gradient that pulls water into the intestine
    • Onset: <1 hour
    • May affect electrolyte levels
  74. Chloride channel activator
    • Lubriprostone (Amitiza)
    • MOA: increase fluid secretion 
    • Doesn't cause electrolyte imbalance
  75. Anorectal Local Anesthetics
    • Pramoxine
    • Benzocaine
    • MOA: block transmission of nerve impulses
  76. Anorectal Vasoconstrictors
    • Preparation H
    • MOA: alpha adrenergic stimulation
  77. Anorectal Protectants
    • Cocoa butter
    • Mineral Oil
    • Glycerin
    • Petrolatum
    • Zinc Oxide
    • MOA: prevents irritation and water loss by forming a physical barrier
  78. Anorectal Astringents
    • Witch Hazel
    • Tucks medicated pads
    • Zinc Oxide
    • MOA: promotes tightening of skin cells which protects underlying tissues and dries up excess moisture
  79. Hepatitis A vaccine
    • Havrix 
    • Vaqta
  80. Hepatitis B vaccine
    • Recombivax HB 
    • Enginerix HB
  81. Hepatitis A + B vaccine
    Twinrix
  82. Chronic Insomnia
    Insomnia >3 weeks
  83. Transient Insomnia
    Self-limiting, lasts less than 1 week
  84. Short-term insomnia
    Insomnia that lasts 1-3 weeks
  85. Meds used for Insomnia
    • Diphenhydramine 25-50mg
    • Doxylamine 25mg
    • Use off night dosing (3 on, 1 off)
    • Only used if Transient or short term insomnia
  86. Melatonin
    • 0.3-5mg nightly
    • Used as sleep aid
    • Jet lag
  87. Valerian
    • 400-900mg 1/2 - 2 hours before bed to treat insomnia
    • Avoid in pregnancy 
    • May have withdrawal symptoms
    • Hepatotoxic
  88. Kava
    Should never be recommended for due to liver toxicity
  89. Caffeine
    • Used to treat drowsiness/fatigue
    • Pregnancy: <200mg/day
    • Breast feeding: 200-300mg/day
    • >70yrs old: <300mg/day
  90. Dental Carries
    • Caused by dental plaque
    • Progression may lead to calculus or tartar
    • Saliva and fluoride prevent this
  91. Gingivitis
    • Mild periodontol disease 
    • Causes alveolar bone loss and ulceration
    • Increased risk during hormone changes
    • Treat with cetylpyridinium, triclosan, and stannous fluoride
  92. Halitosis
    • Oral Malodor
    • Caused by poor oral hygiene: dental caries, periodontal disease, oral infections, impacted food/debris
    • Treat with tongue blade, zinc salts, and chlorine dioxide rinses
  93. Tooth Hypersensitivity
    Treat with soft-bristle toothbrush with normal toothpaste that contains fluoride
  94. Canker Sores
    • Caused by stress or local trauma
    • Rule out vitamin deficiencies and HIV beforehand
    • Treat with oral anesthetics
  95. Minor Oral Mucosa Treatment
    • Sodium Bicarbonate solution
    • Saline rinse
    • Topical oral anesthetics
    • Oral protectants
  96. Herpes Simplex
    • Treat with Docosanol 10%
    • Do not use longer than 10 days
  97. Xerostomia (dry mouth)
    • Can cause tooth decay 
    • Treat with artificial saliva 
    • Avoid sodium
  98. Dentifrices
    • Removes dental plaque and stains
    • Reduces dental caries and gum disease
    • lessens mouth odor

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