Term
|
Definition
1rst - enlarged
2nd - fall out but auto return
3rd - fall out; manual return
4th - stuck out of the butt |
|
|
Term
| Goals of treating for anorectal disorders |
|
Definition
1. soft stools
2. less straining
3. cure and prevent symptoms |
|
|
Term
|
Definition
1. hydrate
2. 20-30g fiber per day
3. don't lift heavy
4. avoid: alcohol, caffeine, citrus and spice
5. < 120 deg Sitz bath QID for 20min |
|
|
Term
| Pharm treatments for anorectal |
|
Definition
-Local anesthetics
-Vasoconstrictors
-Protectants
-Astringents
-Keratolytics
-Coticosteroids
-Analgesics/anesthetics/antipuritics |
|
|
Term
|
Definition
<12yo
Ulcerative colitis/crohns
FH of colon cancer
Dx-ed or potential serious disorders
Severe symptoms |
|
|
Term
| How long can we treat anorectal disorders OTC |
|
Definition
|
|
Term
| Medical referral req. anorectal disorders |
|
Definition
pain
bleeding
seepage
change in BM pattern
Prolapse
Thrombosis |
|
|
Term
| 2 problems with using local anesthetics? |
|
Definition
Mask pain - hide serious problem
Can cause an allergic rx in distinguishable from anorectal symptoms |
|
|
Term
| T/F Use local anesthetic on open sores? |
|
Definition
|
|
Term
| Name some local anesthetics ending in "caine" used in anorectal Tx |
|
Definition
|
|
Term
| Name some local anesthetics ending in "ine" used in anorectal Tx |
|
Definition
|
|
Term
| Name the remaining local anesthetics used in anorectal Tx |
|
Definition
|
|
Term
| List the 2 vasoconstrictors used in anorectal Tx |
|
Definition
|
|
Term
| List 3 astringents used in anorectal Tx |
|
Definition
calamine
Zinc oxide
Witch hazel |
|
|
Term
| Keratolyics used in anorectal Tx |
|
Definition
|
|
Term
| Analgesic/anesthetics/pruitics used in anorectal Tx |
|
Definition
|
|
Term
| Astringents, protectants, keratolytics, and analgresics/anesthetics/antipruritics, and some local anesthetics are used how many times per day in anorectal tx? |
|
Definition
|
|
Term
| Vasoconstrictors. hydrocortisone and some local anesthetics are used how many times per day in anorectal tx? |
|
Definition
|
|
Term
| Which pts should avoid using vasoconstrictors to tx anorectal |
|
Definition
DB
Heart disease
HTN
Antidepressants
Thyroid disease |
|
|
Term
| T/F Witch Hazel can be used internally? |
|
Definition
|
|
Term
| T/F Keratolytics (acloxa, resorcinol) can be used internally? |
|
Definition
|
|
Term
| T/F Hydrocortisone can mask symptoms of bacterial/fungal infection |
|
Definition
|
|
Term
| Onset of hydrocortisone is |
|
Definition
| 12hr, but longer duration |
|
|
Term
| T/F Using too much or eating analgesics/anesthetics/antipruritics (aka: Camphor, Junipor tar [phenol], menthol) can cause death |
|
Definition
|
|
Term
| Active ingredient in all Perp H formulations |
|
Definition
| phenylephrine aka: vasoconstrictor |
|
|
Term
| Active ingredient in TUCKS fromulations with the exception of the protectant which uses witch hazel only is: |
|
Definition
|
|
Term
| Pregnant people and anorectal therapy |
|
Definition
| Any external products, and protectants int/ext which are all oily greasy and disgusting messes |
|
|
Term
| How to stick a drug in you butt |
|
Definition
left side
fetal
insert
wait 15-20 |
|
|
Term
| For the most part OTC tx of anorectal disorders is limited to |
|
Definition
| burning, itching, discomfort, swelling, and irritation |
|
|
Term
| Which anorectal protectant to use? |
|
Definition
| Always select the anorectal protectant tx with the fewest ingredients |
|
|
Term
| How to use ORS in vommiting |
|
Definition
wait 10 min after spew
5mL/5min thereafter for peds
15mL/5min adults |
|
|
Term
| Which antihistamines are used off-label to treat motion sickness |
|
Definition
Doxylamine (Once daily)
Dimenhydrinaete (Q6h)
Diphenhydramine (Q4h) |
|
|
Term
| What is the only FDA approved drug for treating vomiting? |
|
Definition
|
|
Term
| Use meclizine in children <12yo? |
|
Definition
|
|
Term
| Seek medical attention for vomiting if |
|
Definition
dehydrated
more than 5 pcs doses |
|
|
Term
|
Definition
| Phosphorated carbohydrate solution |
|
|
Term
|
Definition
| Nausea due to over eating |
|
|
Term
| T/F H2RA (cimetidine, ranitidine, famotidine) are also approved to treat Nausea due to over eating |
|
Definition
|
|
Term
| What normally causes diarrhea |
|
Definition
Rotavirus - kids
Norovirus - adults |
|
|
Term
| Where do adults catch the norovirus? |
|
Definition
| Restaurants, cruise ships, LTC facs... |
|
|
Term
|
Definition
|
|
Term
| Four clinical classes of diarrhea |
|
Definition
Osmotic - viruses, e coli...
Secretory - c diff
Inflammatory - UC, Chron's
Motor - IBS, DB neuropathy |
|
|
Term
|
Definition
Viral
Bacterial
Food-borne
Traveler's
Food induced |
|
|
Term
| Causes of food induced diarrhea |
|
Definition
|
|
Term
| Causes of travelers diarrhea |
|
Definition
|
|
Term
| Goals of therapy in diarrhea and vomitting |
|
Definition
1. Correct fluid balance
2. Control symptoms
3. ID and treat cause
4. Reduce death and other morbidities |
|
|
Term
| Refer diarrhea pts to hospital after... |
|
Definition
|
|
Term
| Treat diarrhea with loperamide |
|
Definition
| 4mg initial 2 mg after 2 more lose stools. Max dose is 8mg/day |
|
|
Term
|
Definition
Loperamide
Bismuth subsalicylate
Lactase |
|
|
Term
| Bismuth subsalicylate for kids <12? |
|
Definition
|
|
Term
| Bismuth subsalicylate products |
|
Definition
kaopectate
Maalox
epto bismol |
|
|
Term
| Bismuth subsalicylate dosing |
|
Definition
| 525 every 30-60min max 8 doses or 4200mg |
|
|
Term
| Mainstay of diarrhea therapy is |
|
Definition
| ORS - Only acute patients with moderate diarrhea are candidates for anything else |
|
|
Term
|
Definition
|
|
Term
| Constipation treatment goals |
|
Definition
1. Relief
2. Diet/exercise
3. Safe use of Lax |
|
|
Term
|
Definition
7days of OTC Tx
14 days of symptoms |
|
|
Term
| Exclusions for OTC treatment of constipation |
|
Definition
Lots of farting
Lots of Ab pain
Signs of disease like ever, vomiting...
Blood...Dark tarrys... |
|
|
Term
| Examples of bulk forming laxatives |
|
Definition
anything "fiber"
Citrucel
Metamucil |
|
|
Term
| Onset of actions for constipation meds |
|
Definition
Peg 33550 12-72hr
Docusate 12-72hr
Bulk-forming 12-24hr
Senna/Bisacodyl 6-10hr
Saline Lax 0.5-6hr
Glycerin 15min |
|
|
Term
| Two hyperosmotic agent for constipation tx...and how they are dosed |
|
Definition
PEG 3350 - 17g/day
Glycerin - 1 supp. |
|
|
Term
|
Definition
|
|
Term
| List emollient agents related to the tx of constipation...and how they are dosed |
|
Definition
| Docusate - up to 300mg daily divide at will |
|
|
Term
|
Definition
| Magnesium or sodium anything... |
|
|
Term
|
Definition
electrolytes
Mg tox = hypotension, fatigue |
|
|
Term
| T/F Senna turns pee pink? |
|
Definition
|
|
Term
| Stimulant agents for the tx of constipation |
|
Definition
senna 34.4mg/day max (8.6/17.2 tabs)
bisacodyl 1-3 5mg tabs per day - or supp. |
|
|
Term
| Patients should separate oral meds from bulk-forming lax by how many hours? |
|
Definition
| 2hrs - b/c of absorption effects |
|
|
Term
| T/F DB pts should use bulk-forming lax with caution bc of sugar content? |
|
Definition
|
|
Term
| T/F Docusate and mineral oil can be used together |
|
Definition
| NOOOOOOO - causes absorption |
|
|
Term
| Major problem with mineral oil is |
|
Definition
| everything, but more specifically lipid pneumonia b/c of aspiration |
|
|
Term
|
Definition
1. Bad for electrolyte balance
2. Drug to drug interactions
3. Not for Renal pts
4. Not for heart pts |
|
|
Term
| T/F Senna turns your anus brown |
|
Definition
|
|
Term
| Senna has a bunch of complication like |
|
Definition
1. absorption probs
2. protein loss
3. dehydration
4. CRAMPING |
|
|
Term
| I took a bisacodyl enteric coated tab; how long before I can take the rest of my druggie drug drugs? |
|
Definition
|
|
Term
| Pregnancy constipation choices |
|
Definition
|
|
Term
| t/F Phenylketouria pts cannot use sugar-free-bulf-forming lx |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Antacids such as Tums, Mylanta, Rolaids, and Alka-Seltzer can relieve heart burn in as little as ____ minutes |
|
Definition
|
|
Term
| Primary ingredients of antacids |
|
Definition
Sodium bicarb - Alka-Seltzer
Aluminum + Mg /hydro - Mylanta
Bismuth Subsal - Pepto
Calcium carb - Tums/rolaids |
|
|
Term
| Heartburn meds onset of action |
|
Definition
Antacids = 5min
H2RA =30min
PPI = 2-3hr |
|
|
Term
| Short term relief of heartburn is provided by |
|
Definition
|
|
Term
| H2RA duration of action is |
|
Definition
|
|
Term
| PPI duration of action is |
|
Definition
|
|
Term
| List approved H2RAs for OTC heartburn relief |
|
Definition
Tagamet = Cimetidine
Pepcid = famotidine
Zantac = ranitidine |
|
|
Term
| H2RA combos available for OTC are |
|
Definition
| Tums dual action + Pepcid complete = Famotidine/Ca carb/Mg hydrox |
|
|
Term
| Available OTC PPI and dosing |
|
Definition
| Prilosec (Omeprazole 20.6) |
|
|
Term
|
Definition
| 30min before morning meal with glass of water |
|
|
Term
| Max length of OTC heartburn treatment |
|
Definition
| 14days; one time within in 4 months |
|
|
Term
| T/F cimetidine can cause men to grow boobs, decrease libido, and impotence |
|
Definition
| T - weak anti-androgenic effect |
|
|
Term
| PPI Drug-to-drug interactions |
|
Definition
MTX
Clopridigrel
Warfarin
Digoxin |
|
|
Term
| T/F PPI users have a higher risk of c. diff |
|
Definition
|
|
Term
| Pregnancy, breast feeding, and Heartburn |
|
Definition
Everything is safe pretty much:
- Antacids stick with Mg or Ca (Rolaids/Tums)
- No data on PPI and breast-feeding |
|
|
Term
| Heartburn and dyspepsia symptoms |
|
Definition
| post-prandial burning in central to upper abdomen |
|
|
Term
|
Definition
| 2 or more episodes of heartburn per week |
|
|
Term
| Seek medical attention for heart burn if: |
|
Definition
Severe symptoms arise
nocturnal episodes
Have for 3 months or more |
|
|
Term
| Exclusions for self treatment in the exciting world of internal gas |
|
Definition
-If occurring more than 3tims per month for 3 months
-BM change
-Severe AB discomfort |
|
|
Term
| Which product(s)can be used after gas has formed? |
|
Definition
| simethicone Aka: gas-ex, Mylanta-gas |
|
|
Term
| Which internal gas products are taken at the start of meals |
|
Definition
Alpha galactosidase
Probiotics |
|
|
Term
| You can cook with alpha galactsidase? |
|
Definition
| No - inactivates at 130deg |
|
|
Term
| Available products for the treatment of internal gas |
|
Definition
Simethicone = Gas-Ex
Charcoal
Alpha Glacatosidase = Beano
Lactose=lactaid
Probiotics =lactobacillus = yogurt |
|
|
Term
| IBS vs. internal gas in location of pain |
|
Definition
| IBS is only in the lower abdomen, Int gas is everywhere |
|
|
Term
| IBS vs. Int gas in signs and symptoms |
|
Definition
Int gas = belching farting
IBS = pain the ends after pooping...accompanied with diarrhea or constipation. |
|
|
