self care final special notes

constipation

- cannot self treat under 2

- bulk forming laxative: not under 6

- PEG: not under 17

- stimulant laxative: not under 6 between

- 2-6: can cause docusate or magnesium hydroxide ("milk of magnesia")

- no magnesium products with kidney problems

- no sodium with heart problems

- never choose: magnesium citrate, sodium phosphate, mineral oil, castor oil

nausea, vomiting

- pregnancy: vitamin B6 is 1st line treatment

- Emetrol (phosphorated carbonate): not under 2

- meclizine: must be over 12 and under 65; anticholinergic effects

- loperamine: not under 6; initial dose is 4mg, follow with 2mg, max of 8mg

- bismuth salicylate: not under 12

lice

permethrin:

- not under 2 months

- wet hair

- leave on for 10 minutes (not overnight)

- chrysanthemum allergy

ivermectin:

- not under 6 months

- CAN use with pregnancy

- dry hair

- leave on for 10 minutes (not overnight)

pyrethrin:

- not under 2 years

- dry hair

- leave on for 10 minutes (not overnight)

fever

- cannot self treat under 3 months

- greater than 100 degrees is considered a fever; can make recommendations

- greater than 104 degrees: refer

- under 2 with fever for at least 24 hours: refer

- over 2 with fever for at least 3 days: refer

- ibuprofen / naproxen: not under 6 months

- kids: (weight in pounds / up 2 ) * 10

- ibuprofen: max 1200mg; round kids down

- acetaminophen: max 3000mg; round kids up

- naproxen: 220mg every 12 hours; max 660mg

tobacco cessation

- craving within 30 minutes: 4mg lozenge/gum

- craving after 30 minutes: 2mg lozenge/gum

- NO pregnancy

- greater than 10 cigs a day: 21mg patch

- less than 10 cigs a day: 14mg or 7mg patch

insomina

- cannot self treat under 12 or over 65

- experiencing symptoms for over 3 months: refer

- waking up over 3 times a week: refer

reproductive health

- 2+ yeast infections in 2 months: refer

- 3+ yeast infections in 1 year: refer

essential nutrients pt. 1

- vitamin B12: deficiency caused by lack of animal protein intake, metformin, PPIs

- ferrous sulfate: may cause constipation, abdominal pain, nausea; take on empty stomach

- riboflavin (B2): causes a yellow-orange discoloration of the urine

- vitamin c: increases the absorption of iron

- niacin: increases good cholesterol, take aspirin 30 minutes before to prevent face flushing

- vitamin A: teratogenic

- folic acid: if pregnant take at least 400mcg to prevent neural tube defects

- orlistat: decreases the absorption of fat soluble vitamins

- calcium: must be taken with vitamin D; citrate is the preferred formulation = no drug or food consideration; carbonate requires an acidic environment to work

- fish oil: can freeze to reduce side effects

- turmeric: can cause liver damage

complementary medicine pt. 2

- ashwagandha: no pregnancy

- glucosamine / chondroitin: shellfish allergy; make take up to 6 weeks to work

- echinacea: do not use with autoimmune conditions; for colds

- elderberry: do not use with autoimmune conditions; for flu

- red yeast rice: do not use with statins

- green tea: can decrease blood pressure and cause bleeding

- coenzyme q10: can cause clotting

- milk thistle: ragweed allergy

- melatonin: can cause hypotension

- creatine: can cause edema

- cinnamon: coumarin content can cause hepatotoxicity

- garlic: increased risk of bleeding

- st john's wort: serotonin syndrome

Warts

- common wart treatments: 17% salicylic acid or 20 seconds of cryotherapy

- plantar wart treatments: 40% salicylic acid or 40 seconds of cryotherapy

Water in Ear

- isopropyl alcohol; instill 4 drops and allow to remain for 1-2 minutes

-pain/inflammation: an exclusion

CAM Claims

- health: "reduce"

- structure/function: "maintain"

- nutrient: "contains"

Dermatitis

- cannot treat under 2

Cough and Cold

- pseudoephedrine: cannot be used with pregnancy

Allergy

- cannot treat new onset with pregnancy

- loratadine: 5mg / day for kids

- budnesonide: not under 6

Sunscreen

- not under 6 months

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