pharm 2 exam 1

how often should you wash your face everyday, especially for treating acne vulgaris

Instruct patients to gently cleanse skin twice daily with nonabrasive, antibacterial soap

-(do not over scrub/ scrub harshly)

-do it in the morning and at night

-Emphasize avoiding vigorous scrubbing and overwashing, which can irritate skin, worsen acne, and potentially cause infection

what are non pharmaological treatments for acne vulgaris

-Recommend regular shampooing to decrease oiliness

-Advise keeping hair away from the face

-Educate about using water-based cosmetics instead of oil-based products that clog pores

-Encourage a well-balanced diet low in fat and sugar, avoiding excessive carbohydrates

-decreasing emotional stress and increasing emotional support

what medication is used to treat mild acne

benzoyl peroxide

what medication is used to treat mild to moderate acne

topical retinoids (antiinflammatory MOA)

what medication is used to treat moderate to severe acne

-stronger dosage of benzoyl peroxide

-topical antibiotics

-topical corticosteroids (antiinflammatory MOA)

what is important pt education for pt taking a retinoid

educate about sunscreen and limiting sun exposure because there is an increased risk of sunburns

what type of infections will retinoids not work on

bacterial infections

how long should you expect to take benzoyl peroxide before seeing any resolution in acne vulgaris

4-6 weeks

what is isotretinoin

also known as accutane and a systemic antiacne drug that works by decreasing sebum formation and secretion

-has antiinflammatory and antikeratinizing effects

when is isotretinoin used

Isotretinoin is used for treatment of severe cystic acne that is not responsive to conventional therapy .

what is the priority education to teach the pt starting isotretinoin

they have to sign the iPledge that is a contract saying they will used 2 forms of birth control

what are side effects of isotretinoin

-conjuctivitis

-pruritus

-myalgia

-hair thinning

-photo sensitivity

-depression

-suicidal thoughts

what is psoriasis

Psoriasis presents as scaly, erythematous plaques or scales

what are some examples of systemic drug treatment for psoriasis

-methotrexate

-cyclosporine

what is important pt education if a pt is taking methotrexate

it is an immunosuppresant so educate about preventing infections

what are side effects of cyclosporine

-hypertension

-fatigue

-hypertrichosis (excessive hair growth)

-nephrotoxicity

-cephalgia (headache)

-myalgia (muscle pain)

-arthralgia (joint pain)

-paresthesia (tingling)

-asthenia (weakness)

what are life threatening signs and symptoms of drug induced dermatitis

-steven johnson syndrome

-erythema multiforme

-toxic epidermal necrolysis

-discoid lupus erthematosus

-exfoliative dermatitis

what is steven johnson syndrome

life-threatening skin condition that causes the skin and mucous membranes to blister, peel, and become damaged.

S/S:

-fever

-affects

what is contact dermatitis

inflammatory response that occurs when the skin is exposed to irritants or allergens

what are non-pharmacological measures for contact dermatitis

-Avoid direct contact with the causative irritant or allergen

-Protective gloves or clothing if chemical is work-related

-Immediately cleanse and dry skin that has been in contact with irritant

-Oatmeal baths to relieve discomfort

**Patch testing may be needed to determine the causal factor

what are pharmacological measures for contact dermatitis

-burow solution dressing

-zinc oxide lotions

-oral antihistamine

-topical corticosteroids

what is the primary cause of sunburn and sun cancers

UVB Radiation:

what type of sunscreen protects you from both UVA and UVB radiation

Broad-spectrum sunscreen

what level of SPF should everyone use

>30 SPF that is water resistant

what are complications of extensive burns

dehydration,

hypovolemic shock

infection

sepsis

what is the priority nursing action for a kid with a burn that covers >10% of their surface body area

fluid resuscitation

what is also important to keep in mind for children receiving fluid resuscitation due to burns

the fluids will have dextrose (sugar) in it because kids require it

what are non pharmacological treatments for burns

-cool wet compress

-gentle cleansing

-keep burn area clean

-debride necrotic tissue

-encourage fluids

-encourage high protein diet

DO NOT PUT ICE ON BURN

what is silver sulfadiazine and what is it used for

it is an antibiotic cream that is used for burns

-prevents and treats infections in burns

where can you not place sulfadiazine on the body

face and genitals

what are side effects of sulfadiazine

-photosensitivity

-skin discoloration (because of the silver by product in the drug)

-burning

-rash

-erythema multiforme

-skin necrosis

-leukopenia

what is an androgen

testosterone

what do androgens do

controls development/maintenance of sexual processes, accessory sexual organs, cell metabolism, and bone/muscle growth

what are the different types of administration for androgens

-buccal

-nasal

-transdermal

-parenteral (IM)

why would someone need to take an androgen

-androgen deficiency

-hypogonadism

-replacement therapy (for testicular failure in adult males)

-delayed puberty

what is important pt education for a young male adolscent taking androgens due to delayed puberty

it will take 3-4 years to achieve sexual development

what is hypogonadism

involves testicular failure to produce adequate testosterone, sperm, or both . It can be primary (testicular abnormality) or secondary (hypothalamic or pituitary failure)

what health care conditions do you have to be cautious about with androgens and why

-HTN

-CAD

-Seizures

because there is an increase in RBC production it creates more fluid volume that the heart has to pump harder

what are some drug interactions with androgens

-oral anticoagulants (Androgens can increase the anticoagulant effect of oral anticoagulants, particularly warfarin.)

-antidiabetic agents

what are contraindications of taking an androgen

-pregnancy

-nephrosis

-hypercalemia

-pituitary insufficiency

-hepatic dysfunction

-BPH

-prostate cancer

-history of MI

-men with breast cancer

what are side effects of androgens

-priapism

-gynecomastia

-injection site reaction

-menstrual irregularities

-vocal changes

what is considered delayed puberty

testicular enlargement, penile growth, public hair development that has not begun by age 14

what is sexual dysfunction treated with

Vardenafil, tadlafil, and sildenafil

end in -afil

how does Vardenafil, tadlafil, and sildenafil work

they increase blood flow to the penis

what is important pt education for pts taking Vardenafil, tadlafil, or sildenafil

educate that they cannot take nitroglycerin

-therefore teach the pt exactly what type of medication they are taking and to remember when there last dose was

ex: a male pt comes to the ER complaining of chest pain and could be having an MI, but mentions he takes Vardenafil, tadlafil, or sildenafil. The pt cannot receive nitroglycerin within a certain time frame depending on when the last dose of the drug was taken

what are symptoms of BPH

-bladder fullness sensation

-frequency

-nocturia

-hesitation

-dribbling

-erectile dysfunction

what is the treatment for BPH

Tadalafil (1st line drug therapy)

what is important pt education for pts with BPH (enlarged prostate)

educate to not take anticholinergics, antihistamines, or decongestant

how is HIV spread

through intimate contact with:

-blood

-semen

-vaginal fluids

-breast milk

what are the modes of transmission of HIV

-sexual

-blood

-mother to child

what is considered stage 1 HIV

the acute phase

what are symptoms of stage 1 HIV

-fever

-fatigue

-headache

-pharyngitis

-myalgia

-arthralgia

-night sweats

-lymphadenopathy

how could stage 1 HIV be overlooked and then caught on at late stages

because the symptoms of stage 1 HIV is very similar to a common cold

what is stage 2 HIV

Chronic HIV infection

-the pt may not have symptoms, but can still transmit HIV to others

what is stage 3 HIV

AIDS

when do symptoms of HIV start to appear

2-4 weeks after exposure

why is AIDS so serious/concerning

the immune system is impaired/damaged and these pts have a high risk of getting an infection they can't fight off

what is the treatment for HIV

Antiretroviral therapy (ART)

when is postexposure prophylaxis regimens (PEP) used

when a health care worker has had occupation exposure to HIV

-this process should be initiated within 72 hours of exposure and continued for 4 weeks

what is the first step a nurse should do if she accidentally comes in contact with blood to a HIV pt

immediately wash the area of the body that was exposed and begin PEP

what are symptoms of chlamydia

it is usually asymptomatic

what complications can occur because of chlamydia

-pelvic inflammatory disease (PID)

-ectopic pregnancies

-infertility

what is the treatment for chlamydia

doxycycline (best treatment)

azithromycin

levofloxacin

erythromycin

what is important pt education for a pt taking doxycycline

decrease risk of sun exposure

What are the symptoms of gonorrhea?

males: "the drip"

-greenish/yellow/white discharge

-burning upon urination

women:

-usually asymptomatic

both:

-oral infections

-sore throat

-difficulty swallowing

what is the treatment for gonorrhea

ceftriaxone and doxycycline

what is primary syphilis

painless chancre at entrance site

What is secondary syphilis?

-skin rash

-fever

-fatigue

-sore throat

what is tertiary syphilis

-large sores on skin or inside body

-cardiovascular and ocular syphilis

-neurosyphilis

what is the treatment for syphilis

Benzathine penicillin

what are the symptoms of HPV

asymptomatic

what is the treatment for HPV

-removal of genital warts and precancerous lesions

-cryotherapy

what are the complications of HPV

-cervical cancer

-genital warts

-recurrent respiratory papillomatosis

what are prevention techniques for HPV

the bivalent vaccine

what are symptoms of vulvovaginal candidiasis (yeast)

-pruritis

-vaginal soreness

-dysuria

-thick/curdy vaginal discharge

-vulvar edema

what is the primary treatment for vulvovaginal candidiasis

fluconazole

how is fluconazole administered

suppository style into the vagina

explain the difference in discharge for males who have chlamydia v.s. gonorrhea

Clear, mucous discharge (chlamydia) vs. purulent discharge (gonorrhea)