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28 Cards in this Set
- Front
- Back
what are the two pathways of urticaria? define each what is urticaria? |
immunologic- allergic mast cell degranulation or type 1 hypersensitivity from igE and mast cell degranulation nonimmunologic- degranulation without interacting IgE a skin rash |
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what is a main causitive factor of urticaria? what can cause chronic urticaria? what is current pharmacological treatment for urticaria? |
Upper respiratory infection physical stimuli, stress, autoimmune disease, medical diseases antihistamines, leukotriene inhibitors, corticosteriods, cyclosporine |
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what are two diets that can help in urticaria? |
elimination diet and antiinflammaotry diet |
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how does the elimination diet work? does this diet work? when should you use it? |
remove histamine rich and antigenic foods from diet and evaluate urticaria after 3 weeks yes, use it when the causative agent of the urticaria is not found, or if patient is on conventional therapy and looking for additional benefit |
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how does the antiinflammatory diet work? does it work? when would you use it? |
eat foods rich in omega 3s does not have proof that it works, can try as a last resort if urticaria is not caused by omega 3 foods and already on conventional therapy |
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what botanicals are used for urticaria? |
quercetin, butterbur, sarsaparilla, stinging nettle, peppermint, ginko biloba, and valrian root |
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what can taking a lot of quercetin cause? who should you avoid using this product? is it efficacious? would you use it? |
nephrotoxicity pregnant and lactating no studies done for urticaria do not reccommend, but can add to conventional therapy for short term |
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what patients should not use butterbur? why? what is the safer form of butterbur? who should not use it? what age group is it safe for? |
patients with liver disease, it can cause hepatox rhizome extracts free of hepatoxic pyrrolizidine alkaloids pregnancy and lactation children |
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does butterbur work for urticaria? what should be monitored in patients that take this? would you reccomend butterbur? when would you use it? |
no, possilby ineffective for derm reactions liver function no, it is ineffective for treatment for urticaria can add to conventional therapy |
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what can happen if you get too much sarsparilla? who should not take it? is it efficacious? what is it available in? would you reccomend it? when would you? |
GI irritation or kidney impairment pregnant and lactation not enough evidence tea, liquid extract, root no, can add to conventional therapy if they dont have kidney problems, pregnant, lactation |
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what disease states can stinging nettle worsen? how can it affect BP? who should avoid using it? is it efficacious? would you reccomend it? when would you? |
glucose control in diabetics lowers BP and acts like a diuretic pregnant, lactation, children not enough info no, can add to conventional therapy as long as there are no exceptions |
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what disease state can peppermint worsen? who should avoid it? who can use it safely? is it efficacioius? would you reccomend it? when would you ? |
GERD pregnant, lactation children insufficient evidence no, add to conventional therapy (who dont have GERD) |
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what form of ginko is unsafe? who should avoid it? what drug class does it interact with and what is the effect? is there any efficacy? would you reccomened it? when would you? |
roasted, fresh seed, or crude ginko plant prenant and lactation anticoagulants, increases bleeding risk may be useful in cold induced urticcaria no, can add on to conventional therapy |
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who should avoid valrian root? what type of induced urticaria is it supposed to be used for? is it efficacious? how can it affect the body? would you reccomend it? |
pregnant and lactation stress induced insufficent evidence acts as a sedative on the brain and nervous system no, can add on to patients conventional therapy |
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why is hypnosis used for urticaria? should you reccomend hypnosis? is the elimination diet effective? |
to reduce stress that triggers or excarebates flares yes for chronic urticaria, no ses, especially for people that are hypnotizable yes! |
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what are some histamine rich foods? what are some histamine releasing foods? |
avocados, fermented drinks, cheese, fish, processed meat, tomatoes, jams, sauerkraut, spinach, sour cream, vinagar, yeast, yogurt alcohol, banans, chocolate, eggs, milk, nuts strawberries, tomatoes, papaya, shellfish |
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what are some first gen antihistamines? second generation? what are some leukotriene inhibitors? what two other drugs are used in urticaria? |
diphenhydramine, hydroxyzine, promethazine fexofenadine, cetiraczine, loratdine zafirlukast, montelukast, zileuton corticosteriods and cyclosporine |
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what gland is affected in acne vulgaris? what are the causes of acne? |
pilosebaceous gland increase androgens impaired desquamation of keratinocytes of follicle pore increase sebum production p acnes infection local anti inflammatory process |
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what causes rosacea? |
invasion of organisms that trigger immune hyperactivity from demodex folliculorum (face mite) or h pylori structural functional dysregulation of low stomach acid, extreme temps, stress |
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what medications induce or exacerbate acne? |
androgens, glucocorticoids, corticotropin, lithium, phenytoin, phenobarbital, isoniazid, cyclosporin, azathioprine, disulfuram, iodides, bromides, epidermal growth factor |
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what are the topical conventional therapies used for roscacea and acne? what systemic preparations are used? what other conventional therapies are used? |
azalaic acid, salicyclic acid, retinoids antibiotics, retinoids, oral contraceptives phototherapy, laser therapy, surgery |
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what is the first thing you should reccomend for an acne patient to do? what other non pharm therapy can be done? |
hygiene management: rinse face with lukewarm water and non soap non oil based cleaner without scrubbing stess managment with biofeedback, breathing excercises, meditation, massage |
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what botanicals are used for acne? |
brewers yeast, zinc, vitamin A, tea tree oil |
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what drug interaction can occur with brewers yeast? who should avoid this product? what can this product be confused with? is it efficacious? would you reccomend it? when would you? |
MAOIs leading to HTN pregnant and lactation bakers yeast, nutrional yeast, or torula yeast has a bitter taste worked in one study, but insuffient evidence no, add to conventional therapy for short term |
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what can taking zinc for a long time cause? any unusually side effects? is zinc efficacious? would you reccomend this? |
copper deficency, sideroblastic anemia, neutropenia increased heart rate, agitation yes yes |
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at what dose does vitamin A become unsafe? what is unique about the kinetics of vitamin A? should you reccomend this? |
10,000 units/day it is absorbed quickly and slowly elminated no, can easily get hypervitaminosis A |
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is tea tree oil safe orally? is it efficacious? is it relateable to any drug? how is it different than this drug? should you reccomend it? |
no, only use it topically yes, comparable to benzyl peroxide slower onset, but better tolerability yes |
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what should you do to prevent acne? |
maintain proper skin care: rinse gently BID, dont pick lesions reduce psychoemotional stress: sleep, mediatation, massage Diet: more protein and omegas low carbs and fat, organic meats to lower exposure to androgens Limit exposure to meds that cause acne avoid extreme tempreatures |