Term
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Definition
uses: prevent migraines, treat allergic rhinitis and asthma
actions: reduce smooth muscle and vascular spams, decrease prostaglandin synthesis
safety: only use products free of unsaturated pyrrolizidine alkaloids (harms liver and carcinogenic), avoid if allergic to Asteraceae plant family (sunflowers) |
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Term
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Definition
uses: prevent migraines (2nd line therapy), treat dysmenorrhea, arthritis, psoriasis
actions: prevents prostaglandin synthesis, platelet aggregation, serotonin release, macrophage function, vascular smooth muscle contraction, pain transmission
safety: GI, HA, insomnia, anxiety muscle stiffness, avoid in patients allergic to Asteraceae plant family (sunflower), antiplatelet meds, warfarin/anticoagulants |
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Term
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Definition
uses: Alzheimer's disease, vascular dementia, impaired cognition, tinnitus, limited use in patients with normal cognitive function.
actions: potent platelet activating factor antagonist, antioxidant
safety: GI, HA, dizziness, allergic skin reactions, bleeding, seizures, avoid use in patients with allergy to poison ivy, antiplatelet meds, wafarin/anticoagulant, HTNs meds, trazodone (CYP450 mediated) |
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Term
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Definition
uses: insomnia, jet lag
actions: naturally occurring in the body, stimulates the body's sleep regulation cycle, sexual development and ovulation, immune system, antioxidant
safety: N/V, HA, tachycardia, dysrhythmia, irritability, hangover, depressive symptoms worsen
Rx interactions: MAOi, TCAs, benzodiazepines, valproate, verapamil, BC, caffeine, nifedipine, immunosuppresants. |
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Term
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Definition
uses: depression, anxiety, OCD, pain, premenstrual syndrome
actions: modulates serotonin, NE, and dopamine activity, antagonize adenosine, benzodiazepine, GABA, ATP receptors
safety: HA, nausea, dry mouth, agitation, skin reactions, photosensitivity, sexual dysfunction, withdrawal symptoms, inducer of CYP3A4, inhibit p-glycoprotein, CYP2C9, CYP1A2, SSRIs. |
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Term
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Definition
uses: alleviate insomnia, anxiety
actions: GABA-A receptor actions, barbiturate like propteries
safety: HA, excitability, paradoxical insomnia, hangover, cardiac disturbances, benzodiazepine-like withdrawal, hepatotoxicity, effects on CYP450, avoid use in patients who drink alcohol or use CNS depressants. |
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Term
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Definition
uses: cardiovascular diseases, parkinson's disease, prevent migraines
actions: rate limiting cofactor for the production of ATP, regeneration of antioxidants, stabilizes cell membranes, vasodilation, inotropic effects
safety: nausea, GI, anorexia, HA, irritability, dizziness, avoid use in patients on wafarin/anticoagulants, statins, chemotherapy |
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Term
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Definition
uses: hyperlipidemia, hypertension, type 2 diabetes mellitus, prevent cancer
actions: contains allicin, antiplatelet, anti-infective, antioxidant, hypotension, lipid lowering
safety: N/V, heartburn, bad breath, body odor, allergic reactions, avoid use in patients on anticoagulants, antiplatelets, may interact with CYP450 and p-glycoprotein |
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Term
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Definition
uses: lower triglycerides (20-40%), decrease LDL/decrease total cholesterol/increase HDL 5%, hypertension, inflammatory conditions.
dose: 2mg-4mg
actions: associated with docosahexenoic acid (DHA) and eicosapentaenoic acid (EPA), increases anti-inflammatory cytokines and decreases pro-inflammatory cytokines, decreases intestinal absorption of cholesterol
safety: belching, bad breath, GI, avoid use in patients on antiplatelet or anticoagulant |
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Term
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Definition
uses: decrease LDL 21-33%, decrease total cholesterol 13-26%, decrease triglycerides 13-34%.
actions: analogue of lovastatin, monacolin K
safety: GI, bloating, flatulence, heartburn, allergic reactions, HA, monitor liver function tests, avoid in patients taking statins, heavy alcohol intake, pregnancy category X |
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Term
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Definition
uses: motion sickness, GI disease, GI spasm, inflammatory disease, dermatologic disease, anxiety, insomnia, hemorrhoids, skin/mucous membrane inflammation.
actions: anti-inflammatory, antibacterial, CNS neurotransmitter effect
safety: well tolerated, avoid use in patients with ragweed allergy/Asteraceae family, antiplatelet meds, anticoagulants, alcohol, CNS depressants, may decrease CYP1A2, 2E1, 3A4 |
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Term
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Definition
uses: N/V, indigestion, colic, arthritis
actions: antiemetic due to anti-5-hydroxytriptamine, anti-inflammatory due to inhibition of COX and lipoxygenase, inhibit platelet thromboxane
safety: heartburn, belching, dermatitis, avoid use in patients on anticoagulants, antiplatelets, hypoglycemic meds, no risk for major malformations during weeks 4-14 of pregnancy. |
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Term
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Definition
uses: thioctic acid for diabetes
actions: cofactor for several enzymatic processes of glucose metabolism, antioxidant, chelating agent
safety: HA, nausea, allergic reaction, avoid use in patients with hypoglycemic medications, thyroid disorder/thyroid supplements. |
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Term
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Definition
uses: same as baking spice, blood glucose lowering
actions: increase insulin sensitivity to receptors, antimicrobial, antifungal
safety: minimal ADR with the supplement or extract (not oil formulation), no long term safety data |
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Term
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Definition
| recurrent vulvovaginal candidiasis infection (> or = 4 infections/year) occurs in this % of women |
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Term
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Definition
uses: prevent and treat urinary tract infections
actions: inhibit bacteria from adhering to bladder, kidney, and urethra
safety: diarrhea, possible increased risk of kidney stones, Rx interactions: warfarin, alkaline meds, antacids |
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Term
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Definition
uses: treat benign prostate hyperplasia, similar efficacy to finasteride
actions: **inhibit 5-alpha reductatse**
safety: GI, avoid use in patients on antiplatelet meds, warfarin, alcohol, androgenic meds, pregnancy category X |
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Term
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Definition
uses: treat symptoms of menopause including hot flashes and night sweats
actions: no evidence of estrogen activity
safety: GI, rash, HA, weight gain, hepatotoxicity, Rx interaction: tamoxifen, doxorubicin |
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Term
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Definition
uses: treat symptoms of menopause including hot flashes and night sweats
actions: derived from soy, estrogenic activity
safety: GI, HA, allergic reaction, avoid use in patients on antiplatelet, warfarin, Hx of estrogen dependent cancer, may inhibit CYP1A2 activity |
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Term
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Definition
uses: treat and prevent viral respiratory infections
actions: effects non specific cellular immune system
safety: GI, HA, tingling sensation on tongue, avoid use in patients allergic to asteraceae family, asthma, allergic rhinitis, HIV/AIDS, autoimmune disorders, immunosuppresants, may inhibit CYP3A4 |
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Term
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Definition
uses: antibiotic associated diarrhea, allergies, atopic dermatitis
actions: repopulation GI bacterial flora
safety: bloating, flatulence, diarrhea, avoid in patients that are immunocompromised, separate doses from antibiotics by several hours. |
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Term
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Definition
uses: enhance performance, prevent CV disease, prevent cancer, prevent liver disorders
actions: primary stimulating therapeutic agent is caffeine
safety: N/V, diarrhea, insomnia, irritability, cardiac stimulation, avoid use in patient on theophylline, caffeine containing products, stimulants, warfarin, may inhibit the effects of sedating meds. |
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Term
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Definition
uses: knee and hip osteoarthritis
actions: natural product in the body used to build cartilage, inhibits leukocyte elatase (primary enzyme involved in cartilage breakdown)
safety: GI, nausea, avoid use in patients on antiplatelets or warfarin, some produces made from cows. |
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Term
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Definition
uses: osteoarthritis
actions: natural product in the body used to build cartilage, inhibits breakdown of cartilage
safety: GI, avoid use in patients with shellfish allergy, DM patients monitor sugars closely, dyslipidemia patient get a lipid panel 1 month after initiation. |
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Term
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Definition
uses: arthritis, allergies
actions: produce supply of sulfur (keep to building cartilage
safety: HA, nausea, diarrhea, itching |
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Term
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Definition
decongestant
may dilate pupil (vasoconstrictor)
may cause rebound congestion of conjunctiva if used chronically
AEs uncommon
caution in CVD and DM
Rx interactions with atropine, MAOIs, TCAs, resperine, methyldopa |
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Term
imidazoles (naphazoline, tetrahydrozoline, oxymetazoline)
rebound congestion less with naph and tetra |
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Definition
decongestants
constrict conjunctival vessels
excessive use can lead to systemic absorption (cardiovascular disease AEs)
may cause abnormal dryness with prolonged use |
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Term
pheniramine maleate and antazoline phophate
more stinging, burning and discomfort with pheniramine |
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Definition
antihistamines
indicated for rapid relief of seasonal or atopic conjunctivitis
AEs: burning, stinging, discomfort
do not use in patients with narrow angle glaucoma
only available as combo products with deconjestants |
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Term
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Definition
cerumen softening agent
after 4 days flush with water |
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Term
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Definition
used for dermatitis
aluminum acetate 1:40 solution |
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Term
| photosensitizing medications |
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Definition
antidepressants (esp older agents)
antihistamines (all types)
tetracyclines (esp democycline)
HTN meds (ACEi, Ca channel blockers, methyldopa)
thiazide diuretics
griseofulvin
estrogens/progestins (contraceptive, postmenopausal)
NSAIDS
antipsychotics
sulfonylureas
tretinoins (very important due to typical age of users) |
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Term
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Definition
bacteria that predominates in the vagina (up to 95%)
produce hydrogen peroxide (acts as an antimicrobial agent)
produces lactase |
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Term
| factors that decrease H2O2 production |
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Definition
days 1-5 of the menstrual cycle
current oral antibiotic therapy (especially gram +)
medroxyprogesterone therapy (depo-provera)
presence of semen
douching
postmenopausal women
genetic predisposition |
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Term
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Definition
an abnormal increase in vaginal secretions with inflammation of vaginal mucousa and adjacent vulvar skin
caused by proliferation of bacteria already present in the vagina |
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Term
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Definition
pH >4.5
whiff test positive
clue cells present
hyphae or blastospores absent
causes 40-50% of vaginal symptoms
causes: increased Gardnerella vaginalis, decreased lactobacilli, new sexual partner, AA, douching, smoking, 1st week of menstrual cycle.
Rx only: metronidazole, no need to treat male partner |
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Term
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Definition
pH <4.5
whiff test negative
clue cells absent
hyphae or blastospores present
20-25% of vaginitis cases
recurrent infections (>4 per year) occurs in <5% of women
caused by: candida albicans
risk factors: AA, pregnancy, high dose estrogen, changes in vaginal pH, diabetes, antibiotic therapy (tetracycline, PCNs, other broad spectrum), immunosuppressant therapy (corticosteroids, post-transplant, chemotherapy), immunocompromised states (HIV/AIDs), receptive oral sex
possible risk factors: nonoxynol-9 spermicide, low dose estrogen, non cotton underwear, wet swimwear, dyed toilet paper, toilet paper technique, vaginal use of antibiotic soap, douching, tampons
symptoms: abnormal discharge, itching, burning, redness, inflammation, pain with intercourse or urination |
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Term
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Definition
pH >4.5
whiff test variable
clue cells absent
hyphae and blastospores absent
15-20% of vaginitis cases
causes: trichomonas vaginalis, multiple sex partners, new sex partner, no barrier method, other STDs
greater than 50% asymptomatic
Rx only: metronidazole, treat male partner |
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Term
| exclusions from self treatment - vaginitis |
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Definition
1st episode
pregnancy or breastfeeding
girls <12 yo
predisposing medical disorder (diabetes, HIV)
predisposing medications (immune modulating: antineoplastics, corticosteroids)
recurrent VVC (>3/year) |
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Term
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Definition
preferred antifungal for VVC
give quicker relief of itching than systemic agents (creams, ointments, suppository) |
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Term
boric acid suppository
gentian violet application |
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Definition
| non azole treatments for VVC |
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Term
| vagisil, yeast-guard, vaginex |
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Definition
| non specific vaginal preps that are NOT recommended for VVC, only mask symptoms |
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Term
within 72 hours of applying vaginal medication
withing 48 hours of sexual intercourse or douching
during or withing 5 days of menstrual bleeding |
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Definition
| when can a vagisil kit not be used? |
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Term
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Definition
sun radiation not responsible for sunburn (in lower concentrations)
increases rate of melanoma
oxidizes melanin already in skin |
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Term
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Definition
primarily responsible for sunburn
contributes to melanoma and non melanoma skin cancers
needed for synthesis of vitamin d
stimulates melanin production |
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Term
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Definition
| use an SPF of ____ in patients with lupus |
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Term
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Definition
| use an SPF of _____ in patients on photosensitizing drugs |
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Term
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Definition
| retains SPF for 40 minutes underwater |
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Term
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Definition
| retains SPF for 80 minutes underwater |
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