NIT-PICKERS
RASH DECISIONS
REAR WINDOW
METAL DETECTOR
Over the Counter, Under the Age Limit
100

This is the main route of head lice transmission.

What is head-to-head contact?

100

This is the only category considered safe and effective for self-treating diaper dermatitis.

What are skin protectants?

100

Hemorrhoids arising above this landmark are painless.

What is the dentate line?

100

Separate iron and calcium from this thyroid drug by this long.

What is levothyroxine; 4 hours?

100

Give the manufacturers' "do not use" age for cough and cold products, and FDA's age.

What is <4 years; <2 years?

200

Nits are found within this distance of the scalp, and a hatched louse must feed within this time.

What is 4 mm; 24 hours?

200

Give the monograph range for zinc oxide, and Desitin Maximum Strength's concentration.

What is 1–25%; 40%?

200

Name the only OTC anorectal steroid and its maximum strength.

What is hydrocortisone; 1%?

200

Al/Mg antacids decrease the efficacy of this antihistamine.

What is fexofenadine?

200

Give the minimum OTC age for loperamide and for bismuth subsalicylate.

What is 6; 12?

300

This is the only OTC pediculicide approved for pubic lice, and allergy to this flower contraindicates it.

What are synergized pyrethrins; chrysanthemum?

300

Spell out APhA's ABCDE mnemonic.

What is Air, Barrier, Cleansing, Diaper, Education?

300

For an allergy to an anorectal anesthetic, switch to this structurally different agent.

What is pramoxine?

300

Bismuth is trivalent. Take tetracyclines this long before bismuth subsalicylate, and stop it entirely with this antibiotic class.

What is 2–3 hours; fluoroquinolones?

300

Give the minimum age for OTC NRT and for caffeine, and the ages at which insomnia patients are referred.

What is 18; 12; <12 or ≥65?

400

Rank by youngest labeled age: permethrin 1%, pyrethrins, ivermectin 0.5%.

What is permethrin (2 mo), ivermectin (6 mo), pyrethrins (2 y)?

400

Explain why to avoid hydrocortisone and topical analgesics in infants.

What is occlusion increases absorption (HPA suppression); infants can't report altered sensation?

400

Of phenylephrine, epinephrine, glycerin, zinc oxide and pramoxine, only these two may be used intrarectally.

What are phenylephrine and zinc oxide?

400

Magnesium hydroxide is avoided from this long before to this long after azoles, fluoroquinolones, tetracyclines and levothyroxine.

What is 4 hours before; 3 hours after?

400

Give the age to avoid DEET, oil of lemon eucalyptus, and sunscreen without a doctor.

What is <2 months; <3 years; <6 months?

500

This agent went OTC in October 2020. It is applied to DRY hair, not shampooed out for 24 h, used once, needs no nit comb, and acts on this target.

What is ivermectin 0.5% lotion; glutamate-gated chloride channels?

500

A baby has papules and pustules at the rash margins and in skin folds after 5 days of zinc oxide. Name the complication and plan, and explain why an OTC clotrimazole "diaper cream" isn't the answer.

What is Candida; refer; products with antifungals can't legally claim to treat diaper dermatitis?

500

A man with BPH on phenelzine wants phenylephrine 0.25%. Give the concern and a safer choice.

What is MAOI potentiation of the vasoconstrictor (hypertensive risk); an external protectant, witch hazel or hydrocortisone 1% instead?

500

Fennel lowers this antibiotic by chelation, and peppermint reduces absorption of this supplement. Charcoal also won't bind that supplement in overdose.

What is ciprofloxacin; iron?

500

Give the age to avoid honey, α-galactosidase, tetracyclines and benzocaine.

What is 1; 4; 8; 2?