Term
| Ephedra is possibly effective against what? |
|
Definition
| obesity ---banned in the US |
|
|
Term
| what kind of tea lack both therapeutic and toxicity effect of Ephedrine |
|
Definition
|
|
Term
|
Definition
| Ma huang is an extract that comes primarily from ephedra sinica plant |
|
|
Term
| ephedrine (extract of ephedra) could be used for what other than weight loss? |
|
Definition
| it could be used as nasal decongestant as it releases NE from the sympathetic nerve endings. |
|
|
Term
| ephedrine is contraindicated in who? |
|
Definition
| those who suffer from insomnia becz it is a CNS stimulant |
|
|
Term
this substance comes from pepper plant and used in polynesia as a ceremonial drink. it is a anxiolytic - may be equivalent to benzos.
what is the name of it?
what is the onset? |
|
Definition
Kava.
it takes 4-8 weeks for pt to respond. |
|
|
Term
| what plant leaves reduces HA, Nausea, in pt who suffer from Migraine? |
|
Definition
| Feverfew -- plant name(tanacetum parthenium) |
|
|
Term
| what is the side effect of Kava? |
|
Definition
| exfoliation on the palms of the hands and soles of the feet. |
|
|
Term
| main use of St. john's wort |
|
Definition
Effective in depression-- could also be effective in somatization disorder, menopausal sx, wound healing
take it in morning |
|
|
Term
| what drug is very similar to St. john's wort? |
|
Definition
| Fluoxetine (prozaco)(shit i need to take one for peds) |
|
|
Term
498. A 78-year-old female presents to your office for follow-up. She has a
history of paroxysmal atrial fibrillation and takes warfarin and digoxin for
this problem. Her complaints today are a recent 5-lb weight loss, daily
fatigue, and loss of interest in her usual activities. She states she doesn’t feel
like getting up in the morning. Her spouse adds that she has started taking
some alternative therapies from the health food store in an attempt to boost
her energy level. On exam, the patient is less animated than usual, and her
pulse is irregular at 120/min. She has clear lungs and 1+ edema of the
lower extremities. You examine the bag of pills the spouse has brought
from the medicine cabinet at home. Which medication is most likely contributing
to patient’s problem with rapid heart rate?
a. Ginkgo biloba
b. Multivitamin with minerals
c. St. John’s wort
d. Soy estrogen
e. Ginseng |
|
Definition
498. The answer is c. (Gaster, pp 152–156.) The patient is attempting to
self-treat her depressive symptoms with St. John’s wort, which has been
reported to interact with certain prescription medications, including
digoxin. St. John’s wort may lower levels of digoxin by 25%. Another interaction
that could be important in this case is bleeding, which has been
reported in patients taking warfarin and Ginkgo biloba. |
|
|
Term
| pt present to you with complain of insomnia, vivid dreams, anxiety, agitation, irritability, GI discomfort, and dec libido--- what drug use SE present like this? |
|
Definition
| St. John’s wort -- due to all this side effect take it in morning so it could wear off by night |
|
|
Term
| this drug has some value in Female pt with SLE. |
|
Definition
| DHEA (dehydroepiandrosteron) |
|
|
Term
| Premenopausal female put on this drug suffer from acne & hirsutism. |
|
Definition
|
|
Term
| my Postmenopausal Female pt has Hx of breast cancer, lupus, and 2 months ago suffered from MI. she is back at home and still recovering. what drug i want to avoid giving her? (hint: 4 letter drug) |
|
Definition
| DHEA: SE: , postmenopausal women with high levels of DHEA are at great risk for both cancer & cardiovascular morbidity |
|
|
Term
| good drug to tx ciradian sleep disorder like jet lag. |
|
Definition
|
|
Term
| my patient has prostate cancer who got sunburn yesterday at beach. what drug could i give him otc? |
|
Definition
Melatonin -- (id think it would be on test but just incase)
Possibly effective
• Benzodiazepine or nicotine withdrawal
• Jet lag
• Cluster headache
• Insomnia or delayed sleep phase syndrome
• Thrombocytopenia
• Prostate cancer or solid tumors
• Sunburn
• Preoperative anxiety & sedation |
|
|
Term
| my promiscuous 18 year old present with cottage cheese secretion from her Vagina and no she appears to also have common cold. -- with anti-fungal what herbal would i recommended? |
|
Definition
• Echinacea
Possibly effective
• Common cold
• Vaginal candidiasis |
|
|
Term
|
Definition
| Potentially decrease in male & female infertility |
|
|
Term
| american Ginseng has two uses |
|
Definition
• Type 2 diabetics
o Reducing post-prandial glucose levels in type 2 diabetics
• Respiratory tract infections |
|
|
Term
| my 23 yo diabetic pt is lacing math skills in his college performance. Now, he present to the office with c/o ED. what is a best herbal drug for him..? |
|
Definition
Panax
• Cognitive function
• Type 2 diabetes
• Erectile dysfunction
• Premature ejaculation
• Might improve abstract thinking, mental arithmetic skills, & reaction times in healthy, middle-aged people (but does not seem to improve memory when used alone)
• Decrease fasting glucose levels & A1C levels
• Improve sexual function in men with ED
• Applying a multi-ingredient cream preparation containing Panax, angelica root, cistanches deserticola, zanthoxyl species, torlidis seed, clove flower, asiasari root, cinnamon bark, & toad venom (SS cream) to the penis one hour prior to intercouse & washing off immediately before intercourse seems to improve ejaculatory latency in men with premature ejaculation |
|
|
Term
| what is panax? what should pt avoid while taking it |
|
Definition
Panax ginseng is one of the most commonly used and highly researched species of ginsen
o Interactions with food: Alcohol, Coffee/tea |
|
|
Term
| 18 yo comes in with c/o of " i come before even i put it in" -- he refuse to take SSRIs but is ready to take herbal.. |
|
Definition
Panax --
• Applying a multi-ingredient cream preparation containing Panax, angelica root, cistanches deserticola, zanthoxyl species, torlidis seed, clove flower, asiasari root, cinnamon bark, & toad venom (SS cream) to the penis one hour prior to intercouse & washing off immediately before intercourse seems to improve ejaculatory latency in men with premature ejaculation |
|
|
Term
| antidiarrheals should not be used if diarrhea is accompanied what? |
|
Definition
| >101 F fever or blood or mucus in stool |
|
|
Term
|
Definition
o Adverse reactions
Drowsiness, insomnia, irritability, anxiety, palpitations, tachy, HTN, HA, edema, mania |
|
|
Term
my pt with hx of HTN and atherosclerotic disease got a bad Tinea infection (cruris and pedis). He was in mountain for 18 weeks when he got bitten by Tick.
what herbal crap could he use? |
|
Definition
• Garlic
o Effectiveness
Possibly effective
• Atherosclerosis
• Colorectal cancer
• Gastric cancer
• Hypertension
• Tick bites
• Tinea infections (corporis, cruris, & pedis) |
|
|
Term
| my pt is taking warfarin what herbal (there lot but) from our list should he avoid. |
|
Definition
| Garlic :o Adverse reactions: Breath & body odor, heartburn, gas, N, V, D, -------- increase risk of bleeding, allergic reactions |
|
|
Term
| ok so you know aspirin cant be given to kids but what else is it CI in? |
|
Definition
o Aspirin & other NSAIDs
Avoid in active PUD, certain platelet disorders, & pts taking oral anticoagulants |
|
|
Term
| what does OTC nasal decongestant spray use cause ...SE? |
|
Definition
| o Rebound congestion : decongestant nasal spray use >3days (.....no spray name given) |
|
|
Term
| complication of long term antacid use. |
|
Definition
| o Constipation/Impaction or hypophosphatemia |
|
|
Term
| complication of long term laxative and analgesics with and w/o caffeine. |
|
Definition
laxative - o Abdominal cramping or fluid & electrolyte disturbances
o Rebound headaches : analgesics containing caffeine
o Interstitial nephritis: : analgesics
side note: from GI CMS:
Laxative abuse causes a condition called Melanosis coli |
|
|
Term
| give non-sedating anti-histamine for rhinorrhea (3 of them) --which one is least sedating |
|
Definition
Loratadine (less sedating), Cetirazine and Fexofenadine
(Zyrtec is more sedating because it crosses the BBB, but it is more effective because of this as well) |
|
|
Term
| what are some Nasal spray for rhinorrhea? |
|
Definition
| cromolyn and saline (ocean spray) |
|
|
Term
| what is a good antihistamine for rhinorrhea in preg? |
|
Definition
| o Chlorpheniramine = antihistamine of choice in pregnancy |
|
|
Term
systemic decongestant (2)
topical decongestant (4) |
|
Definition
o Systemic decongestants
phenylephrine (Sudafed PE)
pseudoephedrine (Sudafed)
o Topical decongestants (limit to 3-5 days)
oxymetazoline (Dristan)
phenylephrine (Afrin, Vicks, Neo-Synephrine)
xylometazoline (Otrivin)
nasal saline (Ocean spray) |
|
|
Term
| ok so if pt has any shit like HTN, hyperthyroid, Heart disease, BPH do not give them typical decongestant...my personal experience and it is not in notes but they can take this one |
|
Definition
|
|
Term
| what is the difference between Guaifenesine and dextromethorphan? |
|
Definition
guaifenesin is expectorant and protoussive
Dextromethorphan is antitussive and cough suppressant |
|
|
Term
| what else is good cough suppressant other than dextromethorphan? |
|
Definition
|
|
Term
| when should u give anti-tussive? and when should not? |
|
Definition
| o Expectorants change the consistency of mucus and increase the volume of expectorated suputm; antitussives should not be taken by pts with productive coughs unless absolutely necessary (ie exhaustion from lack of sleep). Products containing both an expectorant and a cough suppressant are irrational and should be avoided. |
|
|
Term
|
Definition
| camphor and menthol produce cooling sensation --muscle topical analgesic and antipyretic |
|
|
Term
|
Definition
| incites irritation w/o rubefacation ( idk abt this one it should suppress irritation) |
|
|
Term
| trolamine salicylate job? |
|
Definition
muscle topical analgesic and antipyretic
job:o Salicylate is a rubefacient that produces vasodilation of cutaneous vasculature producing reactive hperemia= increased blood flow=increase skin temperature |
|
|
Term
| o __________ contains an H2 blocker & an antacid CaCO3 & MgOH |
|
Definition
|
|
Term
| PPI should not be use for long than >__ weeks and under <___ years of age. |
|
Definition
|
|
Term
this pt is IBS and she might have to go on chronic laxative use ..what is the safe laxative that could be used for longer period of time.
give 3 name of the drugs |
|
Definition
o Bulk formers and stool softeners are the safest laxatives for chronic use
o Bulk formers
polycarbophil (FiberCon)
psyllium (Metamucil)
methylcellulose (Citrucel) |
|
|
Term
| the o Stool softners soften the fecal material via detergent action that allows water to penetrate stool-- what is the only one that OTC? |
|
Definition
| o Emollients/softeners- docusate (Colace) |
|
|
Term
| what are some Saline laxatives and stimulants that may be used acutely but not chronically? |
|
Definition
MagCitrate (Citroma)
MgOH (Milk of Mag)
MgSO4
NA2PO4
2NAPO4 (Fleet Phosopho) |
|
|
Term
| Bismuth subsalicylate helps with Diarrhea but it also helps with what other two things? |
|
Definition
|
|
Term
| who cant take Bismuth? and why? |
|
Definition
| do not use in kids or teens recovering from Flu or chicken pox due to Reyes |
|
|
Term
| pt present with black tongue and said he is suffering from chronic abd pain. what is the hx question you should ask? |
|
Definition
| are you taking Bismuth (pepto)? |
|
|
Term
| this is a very safe drug with low SE and low CNS penetration for Diarrhea. it is a synthetic opioid. what is it and how does it work? |
|
Definition
| Loperamide. it works on the intestine smooth muscle to dec motility allowing for absorption of H2O and electrolyte. |
|
|
Term
| 5 drugs you can use for Jock itch, Athlete's foot and ringworm |
|
Definition
butenafine
terbinafine
tolnaftate
clotrimazole
miconazole |
|
|
Term
| what is good for yeast infection? |
|
Definition
Clotrimazole
butaconazole
tioconazole ...AZOLES |
|
|
Term
| Diabetic 35 yo female present with cottage cheese discharge and itching in her private parts. she has no insurance. what OTC do you recommend? |
|
Definition
| Candida albicans (yeast infections)---only clotrimazole and miconazole) |
|
|
Term
| 16 yo male cant get a date and his classmate call him looser. His 2/3 of face is covered with acne and ofcourse he is broke. what OTC do you recommend. give name for keratolytic and comedolytic |
|
Definition
keratolytic - Salicylic acid and sulfur
this both are also comedolytic |
|
|
Term
| one of the most effective acne preparations --cause inc turnover rate and inc sloughing and antibac activity. |
|
Definition
|
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