HACK ATTACK
Vicks VapoRub contains the only two FDA-approved topical antitussives. Its eucalyptus oil adds the medicinal smell but isn't one of them.
What are camphor and menthol?
This is the "gold standard" barrier for irritant contact dermatitis.
What is petrolatum?
This yeast drives dandruff and seborrheic dermatitis.
What is Malassezia?
Condoms made of this material don't protect against HIV or HBV.
What is lambskin?
Primary dysmenorrhea usually starts within this many months after menarche, and occurs only in this type of cycle.
What is 6–12 months; ovulatory cycles?
A patient's INR drops after he spends a cold sucking on these all day.
What are menthol cough drops?
Petroleum jelly, hemorrhoid ointments and azole creams all weaken this type of condom.
What is latex?
Give the OTC strength of selenium sulfide, and why patients rinse 2–3 times.
What is 1%; to prevent discoloration of light or dyed hair?
Since 2007, labels on this spermicide must say it doesn't protect against HIV or STIs.
What is nonoxynol-9?
Thin gray-white discharge, a "fishy" odor after intercourse or menses, and a vaginal pH above 4.5 point to this condition. OTC azoles won't treat it.
What is bacterial vaginosis (refer)?
This centrally acting antitussive is an alkylamine derivative that returned as an OTC in 2009. It's sold only in combination with dexbrompheniramine, and takes about 4 hours to reach maximal effect, compared with 30 minutes for codeine.
What is chlophedianol?
Name the two conditions where APhA discourages oily or petrolatum-type products: one because they plug pores, one where water-soluble lubricants are preferred.
What are prickly heat; atrophic vaginitis?
Give the ketoconazole 1% shampoo regimen.
What is twice weekly for 4 weeks, ≥3 days apart, then weekly?
Besides latex, oil-based lubricants degrade condoms made of this material.
What is polyisoprene?
For atrophic vaginitis, recommend this type of lubricant and avoid this one.
What is water-soluble (Replens, K-Y); petroleum jelly?
Dextromethorphan misuse ("robo-tripping") reaches Plateau 1, restlessness and euphoria, at this mg/kg range. Plateau 4, complete dissociation, occurs above this dose. Nearly half of states restrict sales to people at least this age.
What is 1.5–2.5 mg/kg; >15 mg/kg; 18?
In anorectal products, give how often petrolatum may be used, the daily limit for other protectants, and the protectant that is external only.
What is as often as needed; 6 times/day; glycerin?
Turnover is about 2× in one condition, ~3× in another, and ~8× in a third that shows Auspitz sign. Name them in order.
What are dandruff; seborrheic dermatitis; psoriasis?
Gardasil 9: give the number of doses if started at 16 versus before 15.
What is 3 doses; 2 doses?
This diuretic is a theophylline derivative. It's in Midol and Pamprin Multi-Symptom and may be taken up to this dose. APhA says PMS bloating is usually a fluid shift, not true retention.
What is pamabrom; 50 mg four times daily?
A parent plans to warm camphor/menthol ointment in the microwave and dab it under her 18-month-old's nose. Name three errors, and give APhA's approximate lethal oral dose of camphor for infants.
What is: children under 2 need a provider's OK first; never heat or microwave it (it can splatter and burn); never apply it in or under the nostrils (use on the chest and throat instead); about 70 mg/kg?
For comparison, the lethal dose is 0.5–1 g in children and about 4 g in adults.
For mineral oil, give the minimum age for oral use, the interacting stool softener, and the skin problem if it isn't washed off in the diaper area.
What is 6 years; docusate; folliculitis?
Name three drug triggers of psoriasis, and how long to avoid sun after applying coal tar.
What are beta blockers, lithium, antimalarials, NSAIDs, interferons, or systemic steroid withdrawal (any 3); 24 hours?
A patient who is allergic to latex wants protection against STIs and is also using a vaginal miconazole cream. Choose the condom material, explain why lambskin won't work, and explain why FDA limits this synthetic material to latex-allergic users.
What is polyurethane (oils and azole creams don't degrade it); lambskin has pores that let HIV and hepatitis B through, so it only prevents pregnancy; synthetic condoms have higher breakage and pregnancy rates?
Douching is linked to these four problems, and is contraindicated in pregnancy.
What are PID, ectopic pregnancy, BV and preterm delivery?