Skin, Dental/Oral, and Smoking Cessation

Which of the following statements about acrinol is correct?

1. It is highly irritating and tends to sting an injured area, so caution is needed in use.
2. It is a colorless pigment that does not stain clothing or the like if it contacts it, and any stain that does occur is easy to remove.
3. It is a yellow pigment that shows germicidal action against some general bacteria (streptococci, Staphylococcus aureus, and other suppurative organisms), but has no effect against fungi, tuberculosis bacteria, or viruses.
4. It is a yellow pigment considered to show broad germicidal action not only against some general bacteria (streptococci, Staphylococcus aureus, and other suppurative organisms) but also against fungi, tuberculosis bacteria, and viruses.

Which of the following statements about oxydol (hydrogen peroxide solution) is correct?

1. Its action is oxidation by the active oxygen generated as hydrogen peroxide decomposes, and the physical cleansing effect of bubbling from the oxygen produced, so its effect is not long-lasting and its tissue penetration is also low.
2. Through the action of the active oxygen generated as hydrogen peroxide decomposes, it shows broad germicidal action against general bacteria (including tuberculosis bacteria), fungi, and viruses, and this action is persistent.
3. It has highly persistent action and excellent tissue penetration, so it can be expected to be effective even on deep wounds.
4. Because it is non-irritating, it can also be used around the eyes.

Which of the following statements about iodine-based antiseptic/germicidal ingredients is incorrect?

1. Even when used as an external medicine, a rare but serious systemic side effect such as shock (anaphylaxis) can occur.
2. Through the oxidizing action of iodine, they show germicidal action against general bacteria including tuberculosis bacteria, as well as fungi and viruses.
3. Povidone-iodine is formulated so that iodine is bound to a carrier called polyvinylpyrrolidone (PVP), making it water-soluble, and iodine is gradually released to show germicidal action.
4. Because the germicidal power of iodine increases under alkaline conditions, combined use with soap is effective.

Which of the following statements about antiseptic/germicidal ingredients for wounds is correct?

1. Chlorhexidine gluconate shows comparatively broad germicidal action against general bacteria and fungi, but has no germicidal action against tuberculosis bacteria or viruses.
2. Benzalkonium chloride is a cationic surfactant ingredient that shows germicidal action against general bacteria and fungi, and its germicidal effect does not decrease even when mixed with soap.
3. Iodine tincture has weak skin irritation and is suitable for use on a suppurating area or on mucous membranes.
4. Disinfectant ethanol is recommended to be soaked into absorbent cotton or gauze and applied to the affected area, and is suitable for use on mucous membranes and around the eyes.

Which of the following statements about steroidal anti-inflammatory ingredients in external skin medicines is incorrect?

1. They are compounds artificially synthesized to have a chemical structure (steroid skeleton) in common with adrenocortical hormone, and include dexamethasone, prednisolone acetate, and hydrocortisone, among others.
2. As an undesirable action, they also suppress immune function in peripheral tissue.
3. They are intended for widespread skin symptoms and for chronic eczema or dermatitis.
4. For chickenpox, athlete's foot, ringworm, or a suppurating affected area, use should be avoided because it may worsen symptoms.

Which of the following statements about the use of an external skin medicine containing a steroidal anti-inflammatory ingredient is correct?

1. There is no need for a professional involved in selling medicines to caution a customer who buys in bulk or purchases frequently.
2. For a product containing more than 0.025 mg per 1 g or 1 mL in terms of cortisone, long-term continuous use should especially be avoided.
3. Even with short-term use, a person whose affected area is widespread may apply it to the entire affected area without limiting the area of application.
4. For a suppurating affected area, it is actively used because it has an immune-enhancing effect.

Which of the following statements about photosensitivity associated with an external skin medicine containing ketoprofen is correct?

1. On a day with bad weather, there is no risk of UV exposure, so outdoor activity is fine even during use.
2. Because serious photosensitivity can occur during use or for a while after use, outdoor activity should be avoided regardless of weather during use and for a while after use, and the applied area should also be covered with clothing, a supporter, or the like during ordinary outings to avoid UV exposure.
3. The applied area should be covered with something poorly breathable, such as plastic wrap, to avoid UV exposure.
4. Because photosensitivity stops occurring immediately once use of the causative medicine is discontinued, outdoor activity should be avoided regardless of weather during use, but UV precautions such as covering the applied area with clothing or a supporter are unnecessary after use.

Which of the following statements about ketoprofen is correct?

1. A person sensitized by a substance such as tiaprofenic acid, suprofen, fenofibrate, oxybenzone, or octocrylene has an elevated risk of also reacting allergically to ketoprofen, because of its similar molecular chemical structure, so a person who has previously had an allergic reaction to one of these ingredients should avoid using ketoprofen.
2. Photosensitivity is a known serious side effect of ketoprofen, but anaphylaxis and contact dermatitis are not.
3. Tiaprofenic acid, suprofen, fenofibrate, oxybenzone, and octocrylene are all active ingredients of prescription medicines, and even a person who has previously had an allergic reaction to one of these can use ketoprofen, since its chemical structure differs.
4. Unlike ketoprofen, piroxicam and suprofen are not known to cause photosensitivity as a side effect.

Which of the following statements about non-steroidal anti-inflammatory ingredients (indomethacin, ketoprofen, felbinac, piroxicam, diclofenac sodium) used for muscle pain, joint pain, and the like is incorrect?

1. Excessive use does not increase the analgesic effect, and safety in that case has not been confirmed.
2. A person who has previously had an asthma attack should avoid using them.
3. A pregnant woman, or a woman who may be pregnant, should avoid use out of concern for effects on the fetus.
4. Because they have a germicidal action, they are effective against skin infections such as athlete's foot and ringworm.

Which of the following statements about external skin medicine ingredients and their action/use is correct?

1. Methyl salicylate is an antifungal ingredient that acts on the cell membrane of dermatophyte fungi to suppress their proliferation.
2. Because efficacy and safety in children have been confirmed, an external skin medicine with indomethacin as its main ingredient can be used on a child under 11 regardless of age.
3. Ibuprofen piconol is used exclusively as an acne treatment, for its effect of suppressing the redness and swelling of skin associated with pimples as well as suppressing the enlargement of a pimple (comedo).
4. Ufenamate is a non-steroidal anti-inflammatory ingredient used for its analgesic effect, penetrating to the skeletal muscle or joints in the deeper layers of the skin, for muscle pain, joint pain, low back pain, and shoulder pain associated with stiff shoulders.

Which of the following statements about ingredients used to protect a wound is correct?

1. Pyroxylin (nitrocellulose) is a tissue-repair ingredient that promotes repair of damaged skin tissue.
2. Allantoin is a vasoconstrictor ingredient that suppresses bleeding from a wound surface.
3. Zinc oxide binds with protein in the affected area to form a film, protecting the skin.
4. Zinc oxide is suitable when the affected area is oozing or suppurating.

Which of the following statements about blood-flow-promoting ingredients and the like in external skin medicines is correct?

1. Naphazoline hydrochloride is an adrenergic ingredient included in external skin medicines that produces a hemostatic effect by dilating the blood vessels of a wound surface.
2. Heparinoid promotes local blood flow at the affected area and also promotes blood clotting, so it is also suitable for a person who bleeds easily, a person whose bleeding is slow to stop, or a person diagnosed with a hemorrhagic blood disorder (hemophilia, thrombocytopenia, purpura, etc.).
3. Heparinoid promotes local blood flow at the affected area and is also expected to have anti-inflammatory and moisturizing effects; a person diagnosed with a hemorrhagic blood disorder (hemophilia, thrombocytopenia, purpura, etc.) should avoid using it.
4. Vitamin A oil is an ingredient that suppresses the growth of dermatophyte fungi and bacterial proliferation by making the affected area acidic.

Which of the following statements about local stimulant ingredients in external skin medicines is correct?

1. Menthol and camphor are warming stimulant ingredients that dilate peripheral blood vessels to promote blood flow at the affected area.
2. A patch with a warming stimulant ingredient as its main ingredient should be removed one hour before bathing, and applied only after the skin's warmth from bathing has subsided.
3. The effect of a patch containing a warming stimulant ingredient as its main ingredient is enhanced by warming the application site with a device such as a kotatsu or electric blanket.
4. For an acute condition such as a bruise or sprain accompanied by swelling and a hot sensation, an external analgesic medicine containing a warming stimulant ingredient is suitable.

Which of the following statements about the mechanism of action of antibacterial ingredients used for acne and suppurative skin disease is correct?

1. Bacitracin is an ingredient included in medicines for suppurative skin disease that shows antibacterial action by inhibiting bacterial protein synthesis.
2. Fradiomycin sulfate and chloramphenicol both show antibacterial action by inhibiting bacterial protein synthesis.
3. Sulfa drugs such as sulfadiazine, homosulfamine, and sulfisoxazole show antibacterial action by inhibiting bacterial cell wall synthesis.
4. Sulfa drugs show antibacterial action by interfering with bacterial respiration and metabolism.

Which of the following statements about choosing a dosage form for athlete's foot/ringworm medicine is correct?

1. In general, an ointment is considered suitable for an affected area that is oozing and moist.
2. A liquid has low penetration of its active ingredient but is mild in its irritation to the affected area.
3. For skin that is thick and keratinized, an ointment or cream, rather than a liquid, is suitable.
4. For an affected area that is oozing and moist, a liquid, whose active ingredient has high penetration, is considered suitable.

Which of the following statements about the use of athlete's foot/ringworm medicine is incorrect?

1. A liquid has high penetration of its active ingredient but is characterized by strong irritation to the affected area.
2. When it is unclear whether a condition is eczema or a fungal skin infection, using a medicine containing an antifungal ingredient is not appropriate.
3. A liquid is suitable for skin that is thick and keratinized.
4. Using an ingredient with antifungal action on eczema speeds up its healing.

Which of the following statements about antifungal ingredients in athlete's foot/ringworm medicine is correct?

1. Because pyrrolnitrin has a strong action of suppressing proliferation by impeding production of a component of the fungal cell membrane, it is considered to be included alone rather than combined with another antifungal ingredient.
2. Undecylenic acid is an ingredient that suppresses the growth of dermatophyte fungi by making the affected area alkaline.
3. Ciclopirox olamine is an ingredient that shows antibacterial action by inhibiting bacterial DNA synthesis.
4. Imidazole-based antifungal ingredients such as oxiconazole nitrate and miconazole nitrate suppress the proliferation of dermatophyte fungi by impeding production of a component of the fungal cell membrane or by altering cell membrane permeability.

Which of the following statements about hair-growth medicines (ingredients acting on the scalp/hair roots) is correct?

1. Efficacy/effect claims naming a specific disease such as "androgenetic alopecia" or "alopecia areata" are permitted not only for medicines but also for quasi-drugs.
2. Cashu is a crude drug derived from the rhizome of Panax japonicus (Araliaceae) and is used for its expected effect of promoting scalp blood flow and removing excess sebum.
3. Carpronium chloride shows an action similar to acetylcholine in peripheral tissue (cholinergic action) and is used for its expected hair-growth effect of dilating blood vessels in the scalp to promote blood flow to the hair roots; side effects such as sweating and accompanying chills, trembling, and nausea can occur.
4. Estradiol benzoate is a type of male hormone ingredient, included because hair loss is considered partly due to reduced male hormone activity, and can be safely used even by a pregnant woman or a woman who may be pregnant.

Which of the following statements about ingredients that improve skin keratinization and roughness is correct?

1. A callus (uonome, or corn) is simply a thickened part of the stratum corneum with no core, and normally causes no pain even when pressed; it is also called a tako (callus).
2. Salicylic acid shows a keratin-softening action by dissolving keratin components, and is also expected to have antibacterial, antifungal, and anti-inflammatory action, and is sometimes included in acne medicines.
3. Urea is considered to show a keratin-softening action by denaturing keratin, which makes up the stratum corneum, and is also expected to have antibacterial, antifungal, and anti-inflammatory action.
4. Sulfur is an ingredient that shows a keratin-softening action by dissolving keratin components.

Which of the following statements about external toothache medicine is correct?

1. Using a toothache medicine repairs the tooth decay (cavity), so there is no need to visit a dentist.
2. Antiseptic/germicidal ingredients such as phenol and eugenol, which suppress bacterial growth in a decayed area, cause no mucosal irritation, so it is considered fine for them to contact oral mucosa other than the teeth, or the lips.
3. Sanshishi (gardenia fruit, sanshishi) is a crude drug used for its expected antiseptic/germicidal action on the pulp exposed by decay.
4. Local anesthetic ingredients such as ethyl aminobenzoate, dibucaine hydrochloride, and tecaine are used to relieve pain by blocking the transmission of sensory nerves running through the pulp exposed by decay.

Which of the following statements about ingredients in periodontal disease medicine is correct?

1. Carbazochrome may be included for its expected effect of suppressing bleeding from inflamed periodontal tissue.
2. Sodium copper chlorophyllin is a hemostatic ingredient included for its expected effect of suppressing bleeding from inflamed periodontal tissue.
3. An oral periodontal disease medicine must not be used together with an external medicine.
4. Vitamin C (ascorbic acid, etc.) is an ingredient included for its expected effect of promoting blood flow in periodontal tissue.

Which of the following statements about mouth ulcer medicine is correct?

1. Shikon is a crude drug derived from the flower head of chamomile (Asteraceae) used for its expected anti-inflammatory action.
2. Because a mouth ulcer or glossitis never resolves spontaneously, one must visit a medical institution for treatment immediately upon noticing symptoms.
3. Sodium azulene sulfonate (water-soluble azulene) may be included for its expected effect of promoting repair of oral mucosal tissue.
4. A steroidal anti-inflammatory ingredient applied within the oral cavity may be used continuously long-term without concern, provided the product's content is low.

Which of the following statements about how to use a chewable smoking-cessation aid (gum) is incorrect?

1. Chewing it like an ordinary piece of gum causes excessive saliva production, causing nicotine to be swallowed along with the saliva and insufficiently absorbed through the oral mucosa, so it should be chewed slowly and intermittently.
2. A person with a jaw joint disorder should avoid using it.
3. Because using a large amount speeds up smoking cessation, it is good to use two or more pieces at once.
4. Because nicotine absorption decreases when the oral cavity becomes acidic, use should be avoided for a while after consuming a food or drink that makes the oral cavity acidic, such as coffee or a carbonated beverage.

Which of the following statements about the use of a smoking-cessation aid is incorrect?

1. A pregnant woman, a woman who may be pregnant, or a woman who is breastfeeding should avoid use, since the nicotine absorbed may affect the fetus or infant.
2. A person who has been diagnosed with depression should avoid use, since withdrawal symptoms upon quitting smoking may worsen depressive symptoms.
3. A person diagnosed with high blood pressure should avoid use, and cannot use it even after consulting a doctor or pharmacist.
4. A person with an underlying condition such as acute-phase cerebrovascular disorder (cerebral infarction, cerebral hemorrhage) or serious heart disease (a myocardial infarction within the past three months, or a diagnosis of serious angina or arrhythmia) should avoid use, since it may seriously adversely affect the circulatory system.

Which of the following statements about interactions of smoking-cessation aids is correct?

1. Nicotine has an action of stimulating the sympathetic nervous system, and combined use with a medicine containing an adrenergic ingredient (antitussive/expectorant medicine, nasal medicine, hemorrhoid medicine, etc.) may strengthen that action.
2. Because nicotine may strengthen the blood-sugar-lowering action of insulin, a person receiving insulin treatment for diabetes should pay particular attention to whether symptoms of hypoglycemia appear.
3. A smoking-cessation aid is meant to be used in parallel with smoking while gradually reducing the amount smoked.
4. Nicotine has an action of stimulating the parasympathetic nervous system, and combined use with a medicine containing an anticholinergic ingredient that suppresses parasympathetic activity (antitussive/expectorant medicine, nasal medicine, gastrointestinal antispasmodic, etc.) may weaken that action.