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196 Cards in this Set
- Front
- Back
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Analgesic
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Something which relieves pain without causing loss of consciousness or anesthesia
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Salicylate
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salt or ester of salicylic acid
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Tinnitus
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ringing or buzzing sound heard in the ears
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Prostaglandin
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a substance ( a fatty acis) released by tissues. I t has a variety of roles in the body, depending on its site. When released in nerve tissues it sensitizes the sensory nerves to the perception of pain
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apap aka --->
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n-aceTYL p-aminophENOL, acetaminophen, Tylenol
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somatic pain
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arises from the musculoskeletal system or skin
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visceral pain
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arises from the organs or viscera of the thorax and abdomen. It results from ischemia, chemical damage, spasm, or distention of the visceral structure
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Neuropathic pain
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results from injury to or chronic changes in somatic sensory pathways
may develop and persist without obvious tissue injury may be accompanied by sensory loss, muscle weakness, burnng, aching, jabs of sharp pain, or an exaggerated response to touch. |
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referred pain
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visceral pain cannot generally be recognized as coming from a specific organ. Instead, the brain may interpret it as coming from various areas of the skin. Such pain is called referred pain because it is referred to various body surface areas
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referred pain picture box
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afferent visceral and peripheral nociceptors converge on the same spinal pain projection neurons at the anterolateral tract axon
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Patient assessment: PQRST
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P: what provokes or palliates ( makes it better) the pain
q: what is the quality ( burning, dull, sharp, pressure, etc) r: is ti spreading or radiating or is it in one place s: how sever is the pain t: how long does time influence the pain ? Early morning, after exercise, middle of night |
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Names selected conditions responsive to nonprescription analgesics
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HA, tension HA, HA of ocular origin, periarticular pain, cluster, SINUS, myalgia,
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can Arthralgi, neuraligia, and Migraines be treated with OTC
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No need stronger drugs
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what are the non-pharmacologic approaches to pain contril?
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Cold, Heat, Exercise, Diversion, Pleasant activities
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Name the nonprescription analgesics,
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1) aspirin and other salicylates, Tartrazine
nonacetylated salicylates: 1) acetaminophen 2) ibuprofen 3) naproxen sodium ( aleve), 4) Ketoprofen |
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aspirin MOA
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inhibit prostaglandin synthesis
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aspirin
Dose: max: |
adult oral: 325 to 500 mg q 3 h or 650 to 1000mg q 6 h while symptoms persist not to exceed 4 grams in 24 hrs
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Name 4 considerations for use of aspirin: 1+3 (=
HUGA |
1) impaired platelet aggregation and hematologic effects- aspirin only irreversible inhib PL aggregation
do not use in tonsillectomy, dental extractions, surgery ( d/c 1 week before surgery) |
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Name 4 considerations for use of aspirin:
HUGA |
2) impaired uric acid elimination: 1 to 2 g per day may increase uric acid levels and worsen gout attack
3) GI irritation or bleeding 4) aspirin intolerance- ss hives, edema, breathing prob, etc CROSS REACTION RATE FOR IBUPROFEN IS AS HIGH AS 97% |
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Tartrazine dyes
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up to 15 % of aspirin intolerance pt may cross react when exposed to T DYES ( found in drugs, soda, colored candy, colored puddings and frosting ex Yellow dye #5
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Aspirin for pregnos and breast feeding
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crosses the placenta-- DONT GIVE---can cause maternal morbidity and fetal morbidity
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Aspirin can cause an acute potentially fatal illness occurring primarily in children and young adults
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REYE'S SYNDROME ss- vomiting progressive CNS damage hepatic injury and hypoglycemia
onset post viral enfluenza or vaicella-zoster |
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How dose Aspirin cause EDEMA
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prostaglandins play an important role in renal blood flow
prostaglandins inhib tend to cause fluid accumulation in the body prostaglandins also inhib ADH |
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aspirin and 6 drug interactions
Va, S, UU, E,W,C, |
Valroic acid-depakote inc tox of Depa
sulfonylureas enhansed with ASA uricosuric effect antagonized by asa ethanol, GI EROSIVE warfarin, inc bleeding risk capoten dec by asa |
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Cinchona products ( Quinidine and Quinine) NSAIDS cause
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Additive toxicity when used with ASA
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overdoes
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hyperventilation --> resp.
induce vomiting |
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pros and cons of Ecotrin
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pros: enteric coated
cons: delayed effect salicylate containing product |
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pros cons alka Seltzer
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rapid abs due to disintegration but NO EVIDENCE that raid or effective analgesia then solid drugs
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WHY not give pt on salt restriction ASA
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ASA has large amount of NA not for heart failure renal failure and hypertension
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ASA used for MI prophylaxis give examples
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TIA MI CABG LOW DOSE ASA
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Magnesium Salicylate
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Similar reduction in objective pain score as compared to asa
NONACETYLATED SOLICYLATE RENAL PAT AVOID MG!!! |
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APAP used as
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nalgesic and anipyretic
its a WEAK anti inflammatory as it has littl eperipheral effect |
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APAP
DOSE MAX |
325-620 q 4 h or 325 to 500 mg q 4 h or 650 to 1000mg q 6 h MAX 4 g in 24 hrs
NMT 2 g in pts with Coumadin |
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Drug as 1st line or alternative analgesic is
how is it observed |
APAP
rapid in GI |
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Therapeutically significant drug interaction
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ETOH, COUMADIN
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OVERDOSE with APAP
is there an antidote |
HEPATIC NEROSIS oversode or over time
yes, Nacetylcysteine ( Mucomust) oral when liver is overworked it produces a toxic metabolite due to dlutathione depletion: mucomyst binds to toxic metab via sulfhydryl group ETOH inc change os this tox met ot be maid |
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what is Ibuprofen used ofr
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analgesic, antipyretic, antiinflammatory
give for chick pox |
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Ibuprofen dose
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200 to 400 q 4 to 6 h max 1200 mg/ 24hrs
300-600 q 4 to 6 h is the anti inflam dose don't take for pain > 10 days or fever > 3 days |
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asa or ibuprofen more 3.5 times more potent and last 6 hrs
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ibuporfent
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for dental pain what is best
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ibuprofen
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ibuprofen gi ss
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heartburn, nausea, anorexia, epigastric pain
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At what dose will ibuprofen inhib platelet aggregation
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600 to 1800 mg / 24 hrs its REVERSIBLE unlike asa within 24 hrs
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what labs may be inc when on ibuprofen
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BUN Scr important if pt has renal prob or CHF
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ibuprofen and pregnos
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3rd trimester= NO
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ibufrofen and drug interactions
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antagonizes antihypertensive drugs like diuretics, bb, C acting anti BP drugs
also increases lithium plasma levels |
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ibuprofen over dose
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min toxicity rarely fatal most is seen abd pain
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ALEVE Naproen Sodium dose and directions for max
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220 mg 200 nap 20 na
take with full glass of h2owith each dose / tk with food h2o or milk if over 65 yo don't tke more then 2 per day |
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beofer using aleve as 3 things**********
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coumadin? gi drugs ( zantac, prilosec Levsin, bentyl carafate) ? Do you have stomach probs?
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Ketoprofen ( Orudis KT) dose
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12.5 mg tabs
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Antipyretics____ noraml body temp is
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98.6 f
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defervescence
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diminishing or disapearance of a fever
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Name drugs and doses
Ibuprofen child advil suspentions |
Ibuprofen 200 mg qd,
child advil suspentions 100 mg / 5 ml |
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BC powders
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aspirin salicylamide caffeine
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Bufferin
and Extra Strength |
asa 325 with antacids ( calcium and MG)
asa 500 " " " |
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Doan's Regular strength
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Mg salicylate
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ecotrin reg
" max ' Low |
asa 325 mg in an enteric coat for ASA therapy users
500 ec 81 ec |
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alka-seltzer original blue box
Anacin asa |
alka-seltzer original blue box 325/nabicarb 1916 mg tab
Anacin asa:400 mg caffeine 32( 1/2 grai) per tab |
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Excedrin
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asa 250 mg apap 250 mg caffeine 65 mg
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Goody's powders
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asa apap caffeine
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momentum
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mag salicylate
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Motrin IN
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Ibuprofen 200 mg
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child motrin suspention
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100 mg per 5 ml
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Orudis KT
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Ketoprofen 12.5 mg
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Percogesic
" extra s |
apap 325 mg plus Phenyltoloxamine 30 mg
apa 500 mg plus DIPHENHYDRAMINE HCL 12.5 mg |
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Tylenol Arthritis
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650 mg extended cap
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tylenol susp
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160 mg/ 5 ml
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tylenol drops
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100 mg /ml
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tylenol adult liquid
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500 mg / 15 ml
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counterirritation
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paradoxical pain relieving effect acheived by producing less severe pain to counter a more intense pain
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Rubefacient
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a substance such as a counterirritant which when applied to the skin causes a redness or erythema
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Sprain
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a partial or complete rupture of a ligament
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Bruise
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a rupture of tissue resulting in hematoma
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strain
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a partial tear of muscles
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Liniment
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solutions or maxtures of various substances in oil alcoholic solutions of soap or emulsion applied with MASSAGE
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GELS LOTIONS AND OINTMENTS you better know
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look on page 2 if you don't under analgesic products
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how do counterirritants work
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they stimulat cutaneous receptors to induce sensation such as cold warmth and sometimes itching = distraction from deep seated pain in muscle
** applying cold warm works same also rubbing or massaging |
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Methyl Salicylate aka
WHY EXTREME CAUTION |
oil of wintergreen-- not for kids or younger REYE's syndrome
high salicylate count even 4 ml has caused death in children if ingested |
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Menthol
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topical prep 0.1% to 1% antipruritic
1.25% to 16% it acts as counterirritant moa: stimulates nerves to feel cold not pain (= |
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Camphor dose
max |
0.1% to 3 % topical analgesic anesthetic and antipruritic
Max over 11% |
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Histamine Dihydrochloride
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category 1 in a 0.025% to 0.1% VASODILATION
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Methyl Nicotimate
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0.25% to 1% counterirritant
q 3 to 4 times per day vasodilation and elevation of skin temp |
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Allyl Isothiocyanate aka
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Volatile oil of mustard
causes redness and irritation |
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Capsicum preparation
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deplete substance P
0.025% and 0.075% relief of pain diabetic neuropathy app qid 4 to 6 weeks to see results may cause irritation |
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Name types of dermatitis aka eczema ( inflammation of the skin
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atopic derm, contact dem, hand derm,
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Hand dermatitis aka cause, KNOW ALL
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dishpan hand
causes: metals, Lanolin, parabens, Deodorants are particularly sensitizing in many individuals Benzocaine, benadryl, iodine containing products, sulfonamides, neomycin |
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What are astringent products:
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these retard the oozing discharge or bleeding of dermatitis wet to dry
they form thick coagulum on the S of lesion --> reducing local edema |
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Burow's Solution
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Aluminum acetate 5% the solution must be diluted 1:10 to 1: 40 with h2o befor euse
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Witch Hazel
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astringent made from Hamamelis virginiane it contains tannins, volatile oils and 14 to 15 % alcohol
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Zinc oxide
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astringent a white powder active ing in calamine lotion
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Cetaphil Moisturizing lotion
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dry sensitive skin treatment
glycerin, oil, emollients, humectants |
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Cetaphil Skin Cleanser
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used in sub of soap propylene glucol and Na lauryl sulfate a surfactant
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Cortaid Cream and Ointment
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Hydricirtusibe cream 0.5% ro 1%
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Cortizone 10 plus moisturizing cream
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hydrocortisone cream 1% plus moisturizers
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cortizone 10 ointment
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hydrocortisone 1 % in White Petrolatum
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Hydrocortisone generic
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cream ointment lotions 0.5% to 1%
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SArna Anti itch lotion
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Camphor 0.5% Menthol 0.5 % emollients, petrolatum
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CLARITIN HIVES RELIEF tabs
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10 mg loratadine block histamine at the receptors to relieve itching NONSEDATING 24 hrs duration
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products for dry skin
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if its dry wet it if its wet dry it
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Bath Oil
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app at end of bath and don't rub off just dry
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Oatmeal products
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contain starch protein and small amount of oil its soothing and antipruritic and has a lubricating effect
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Cleansers
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contain Na and K salts alkali high phin combo with h2o become surfactants
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USE DOVE
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good soap ph 7 for dry skin
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Glycerin soaps
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have caster oil and have neutral ph
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Cetaphil Skin Cleanser
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good sub for soap its soapless cleanser
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Emollient / moisturizers
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leave oil film on skin promotes h2o retention contain petrolatum, lanolin, mineral oil, and silicanes such as dimethicone a liquid silicone protectant
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PPetrolatum Vaselin
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seems to be the most effective occulusive agent and has been given CAt 1 q
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Humectants
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hydrating agents draw water from the dermis or atmosphere
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Keratin-Softening Agents
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urea 10-30% is a mild keratolytic alters the keratin layer and soften the skin removes scales
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Lactic acid:
and Allantoin |
an alpha-hydroxy acid used in 2 to 5 % for treating dry skin
______________________________ ( 0.5 to 2% softens keratin by disrupting its structure MEGGOTS |
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name two types of antipruritics for skin
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anesthetics BENZOCAIN and antihistamine Benadryl
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Protectant for skin
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zinc oxid ( 1 to 25% ) widely used as a protectant astringent and antiseptic
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Topical Hydrocortisone
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concentration of 0.5% to 1% applied x 4 per day
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Dry skin products
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11 of them
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alpha keri oil, spray bar
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surfactants perfumes additives
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Daily moisturizing bath
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aveeno oatmeal
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complex 15 lotion and cream
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lecithin glycerin in lotion or cream base *******15 molecules of h2o*****
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Cetaphil Moisturizing Lotion
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Glycerin, emollients, humectants, oils
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Eucerin cream
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Petrolatum miner oil waxes
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Keri lotion
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Mineral oil, propylene glyol, lanolin, fragrances, surfactants
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Oilatum soap
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Mineral oil, stiffening agents, glycerin
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Lubriderm lotion
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Mineral oil, petrolatum, lanolin, emulsifiers
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Neutrogena bar soap
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glycerin stiffening agents
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Noxzema
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camphor menthol eucalptus oil PEG
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Oilatum soap
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Vegetable oil stiffening agetns glycerin
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Vaseline intensive care lotion
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dimethicone water glycerin cetyl alcohol oils
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Dandruff
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accelerated epidermal cell turnover YEAST PTYROSPORUM OVALE PROLIFERATES in presence of dandruff
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SElenium sulfide
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selsun blue 1% OTC or 2.5 RX shampoo selenium is absorbed by the cells and its antimitotic agent
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Pyrithione Zinc ( 1 to 2%) shampoo
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cytotoxic agent reducing epidermal tumover rate
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Nizoral A-D Shampoo
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1% ( Keroconazole) shampoo for 1 min , rinse don't scratch scalp with fingernails) shampoo 5 to 10 ml of selenium sulfide or pyrithione zinc sit for 5 min then rinse out repeat 2 times per week for 1 month
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Alternatives for dandruff
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salicylic acid shampoos, coal tar products, sulfur, topical hydrocortisone 0.5 to 1% anti inflammatory
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SEBORRHEIC Dermatitis
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affects sebaceous glands read more pg 9 derm
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DHS
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Water Lauryl Sulfate Surface acting agents
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Head and Shoulders
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Pyrithione Zinc 1 % surfactants
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Scalpicin Regular
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Salicylic acid 3% menthol propylene glycol alcohol water
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Scalpicin Max Strength
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Hydrocortisone
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Tegrin cream shanpoo
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coal tar solution surfactants fragrances
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T/gel shampoo
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Coal tar in a shampoo formula
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Zincon Shampoo
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Pyrithione zinc 1% surfactants
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Diaper rash and prickly heat products
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due to urin and feces make sure to change soiled diaper change promptly WE DONT WANT TIGHTLY fitting diapers
CANDIDA ALBICANS is most frequent complication |
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Prickly Heat Miliaria
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Intertriginous area in infents red papules may get pustular and are usually at the sites of occlusion
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WHAT ACID SHOULDN'T BE USED ON BABY
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BORIC ACID
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A and D ointment
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53.4% lanolin 15.5% skin protectants
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Ammens Medicated Powder
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Zinc Oxid Talk cornstarch
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Balmex Ointment
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Zinc oxide Peru Balsam mineral oil waxes Bismuth subnitrate and other ingredients
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Desitin
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40% zinc oxid talc cod liver oil vit a and d
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Desitin cream
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zinc Oxide 10% with aloe and vit E
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Vaseline
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petrolatum forms an occlusive convering to protect the skin from moisture feces and urine
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Zeasorb powder
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no starch!!! absorbes swweat and other secretions
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Can all uv rays cause cancer
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yes, UVC, UVB, UVA
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substantivity
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the ablity of a sunscreen to remain effective during prolonged excercise sweating and swimming
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6 skin typer
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1 always burns, fair skin
2 always burns minimal 3 burns moderately burns minimally rarely burns never burns dark pigments |
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Chemical suncreeens work by
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absorbing and blocking the transmission of UV radiation to the epidermis
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UVB promarily
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anthranliates
benzophenones: oxybenzone, others ending in benzone Cinnamates: cinoxate, others ending in cinnamate salicylates: triethanolamine salicylate Homosalate etc |
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UVA Primarily
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Dibenzoylmethane derivatives: Avobenzone
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Coppertone, Banana Boat
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Variour combinations of UVB and UVA
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" sunblockers
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scatter not absorb UV and visible radiation used on nose lips etc PHYSICALLY blocks light from skin
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Zinc oxide, Titanium dioxide, Zinc oxide ointment and paste
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are all Physical blockers all white pastes
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Poison Ivy and Poison oak what do shrubs look like
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3 lobe shaped leaflets
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2 phases of contact dermatitis
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phase 1 urushiol rxt begins
+ phase 2 |
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Burow's solution
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diluted 1:400 al acetate solution whic is an astringent can be effective in soothing pain and itching
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Calamine lotion
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plain and with 1% phenol is helpful as protectant and anesthetic
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topical non rx steroids
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hydrocortisone 0.5 to 1 % have proven safe and eff. DONT USE GREADY OINT WHEN VESICLES AS PREZZZZZZ
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Local anesthetics
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benzocaine diperodon and tetracaine PRAMOXINE
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Antipruritics
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antihistamine, benadryl 2%
counterirritants, menthol phenol 1% or less hydrocortisone anti inflam 0.5 to 1% applied 3 to 4 times a day NOT FOR CHILDREN LESS THEN 2 |
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Antiseptics
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prophylaxis against secondary bact infection benzalkonium chloride, a quatemary ammonium compound seems to be effective but its action can be decreased by anionic compounds such as soaps
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Astringents
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zinc oxide al acetate tannic acid k oermanganate reduce oozing
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AVEENO powder
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for rash
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benedryl cream
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1 to 2 % and spray
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Caladryl lotion
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pramoxine HCL
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caladryl clear
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pramoxine hcl 1% alcohol gragrance comphor glycerin
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calamine lotion
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Regular: 8% calamine powder plus zinc oxide in suspension
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Calamine powder
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composed of 98% zinc oxide ferric oxide
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calamine lotion
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phenolated 1% phenol Carbolic Acid in calamine lotion
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cortaid lotion cream spray
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0.5% to 1% hydrocortisone
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Lanacane cream
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benzocaine 6%
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Lanacane spray
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benzocaine 20%
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PrameGEL
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pramoxine 1% menthol 0.5%
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Gold Bond Medicated Body Powder " Triple Action"
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relives pain, soothes skin, absorbs moisture
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Can DEET be used on kids
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not CNS toxicity seizures death if must use low concentration of 10% on kids
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epinephrine HCL
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1:1000 or 1:2000
epiPen Auton injector and Jr for kids |
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Thiamine hydrochloride vit B
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100 mg tid can repel insects
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Americaine ointment
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Benzoxaine 20%
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Benadryl
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Diphenhydramine 1- 2%
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Cartaid
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Hydrocortisone 0.5- 1%
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Gold Bond Medicated Powder
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menthol zinc oxide
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Lanacort 10 cream
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hydrocortisone 1%
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Nupercainal Ointment
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Dibucaine1%
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corns
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small sharply demarcated hyperkeratotic lesion having a central core yellowish gray color 2 types hard and soft corn
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salicylic acid for corns and celluses
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keratolytic agen
best from 12-40% DON"T USE ONE IRRITATED SKIN not fo rDM or if poor blood circulation |
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Dr Scholl's callus removers
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salicylic acid 40% in a pad
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Freezone Solution corn and Cellus remover
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Salicylic acid 13.6%
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Bunions
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swellings of the bursae can be caused by conditions such as tight fitting shoes over a long period of time
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Warts
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you know how to get them from frogs (= hahaha
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DuoFilm :
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17% in flexible collodion or 40% patch
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Compund W liquid Wart Remover and Wart off
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salicylic acid 17 % collodion with much more shit in it
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wartner and compound W freeze off
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dimethyl ether and propane Freezes the wart which usually falls off within 2 weeks
CAUTION protect area around the wart with vaseline when treating with KERATOLYTICS |
