Diabetes. Immunizations. Alcohol Consumption. Demographics. Colon Screening. HIV Testing Diabetes. 1. Ever been told you have diabetes? Variable=diabetes …
Study Questions
Pharmacy 412 Nonprescription Drug Therapeutics
Section IX - Other Medical Disorders
Diabetes mellitus, Insomnia, Drowsiness, Nicotine Addiction
Section XI - Alternative Therapies
Herbal remedies
Chapter 41 - Diabetes Mellitus
Note: Diabetes will be covered in depth in Therapeutics required for
everybody Year 3 and self-monitor blood glucose SMBG meters are better
covered in Devices also elective However, diabetes is common and health
care providers dont do the best job at getting the most from therapy So,
what I would like to hold you for in this section is a basic understanding
so that you can properly deal with the other OTC modalities that we have
discussed this quarter for a patient with diabetes ie, corns and
calluses to an upper respiratory tract infection
Table 41-1 is a great summary and represents a good basic understanding
If you know this table, youre fine If not, review the following areas
briefly:
Etiology, pathophysiology, signs and symptoms, complications, and general
treatment approach of diabetes mellitus, type 1
and type 2 Dont worry
about specifics
Review drugs that can cause hypo- and hyperglycemia Table 41-9 -
particularly those that you recommend OTC eg, sympathomimetic amines
Be able to counsel a patient with diabetes regarding travel such that
problems that arise are adequately covered
Provide advice for a patient with diabetes on a sick day ie, when a
patient with diabetes asks for advice on an OTC product for a self treat
illnessassess and advise re: management
|Home Management of Illness |
|Manage in medical facility if: |
|? BG persistently 400 mg/dL |
|? Large ketones 6 hours |
|? Persistent vomiting |
| Indadequate telephone contact |
|If BG 240 mg/dL and ketones negative-small |
|? Maintain usual insulin/oral agent schedule |
|? Increase non-caloric fluid intake water,
broth, diet soda, tea |
|? Monitor BG and urine ketones every 2-4 hours |
|? Call MD/PharmD/RN/CDE if BG 240 mg/dL and/or moderate-large ketones |
| If nausea/vomiting persists, discuss need for antiemetic trial or IV hydration |
|If BG 240 mg/dL and ketones moderate-large |
|? Maintain usual insulin/oral agent schedule |
|? Supplement Regular insulin 10 total daily dose every 2-4 hours as recommended |
|by MD/PharmD |
|? Increase non-caloric fluid intake water, broth, diet soda, tea |
|? Monitor BG and urine ketones every 2-4 hours |
|? Call MD/PharmD/RN/CDE Q2H |
| If nausea/vomiting persists, discuss need for antiemetic trial or IV hydration |
42 - Insomnia
Define insomnia in terms of sleep latency and sleep efficiency
Describe appropriate situations where OTC sleep-aids can be recommended
What type of patients would you be more cautious with their use?
Are there
any safe and effective alternative therapies melatonin,
valerian, alcohol, l-tryptophan?
Practice discussing sleep-inhibiting factors and proper sleep hygiene with
patients
Recognize insomnia as one of the many subtle somatic complaints of
depression
Chapter 43 - Fatigue and Drowsiness
Review the caffeine equivalent dosages for the OTC products for drowsiness
and fatigue and several common dietary sources of caffeine
Finals are coming Time is short Are there any safe options for pulling
an all-nighter?
Chapter 44 - Nicotine Addiction
Recognize disease states that are adversely affected by smoking such that
smoking cessation advice and counseling can be customized
Describe the 5-As of a comprehensive smoking cessation plan and relate
them to your own future practice situation
Describe the characteristics of a smoker who will receive the most benefit
from nicotine substitution therapy
Compare and contrast the various nicotine substitution modalities Which
one will you recommend most often? Why? When will you use the rest?
For a smoker with a low Fagerstrom Test, which modality will you recommend?
Chapter 47 - Herbal Remedies
Understand and be able to explain why
the pharmacists role to counsel
patients on the safe and effective use of herbals and the avoidance of drug-
herb interactions is so difficult What resources will you utilize to
manage this conundrum?
Source:co.asotin.wa.us
