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Pre Reg > Chaper 11-15 BNF (Eyes, Ear Nose and Oropharynx, Skin, Vaccines and Anasthesia) > Flashcards

Chaper 11-15 BNF (Eyes, Ear Nose and Oropharynx, Skin, Vaccines and Anasthesia) Flashcards

1
Q

What advice should patients be given if taking 2 or more eye application?

A

space out by 5 mins

apply ointment last

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2
Q

what time of day is best to apply eye ointment?

A

at night

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3
Q

What are the expiry dates of eye applications in different settings?

A 
Home = 28 days 
hospital = 1 week
outpatient/surgery = single application
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4
Q

Which preservative is used in eye applications and is likely to cause stinging and irritation

A

Benzalkonium chloride

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5
Q

Which lenses can be kept on during eye application and which lenses should be removed?

A

Hard lenses = can still use drops

Soft lenses = remove before use

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6
Q

which eye applications should patients never wear lenses during the use of?

A

ointments and oily eye drops

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7
Q

which drugs stain contact lenses?

A

rifampicin and sulfasalazine

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8
Q

which eye drops are mast cell stabilisers?

A

sodium cromoglicate

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9
Q

which eye drops are antihistamine

A

antazoline

azelastine

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10
Q

which eye drops are vasoconstrictors (reduce redness)

A

xylometazoline

naphazoline

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11
Q

what eye drops can be used for dry eyes?

A

Carmellose

Hypromellose

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12
Q

Which medication can be used for eye inflammation?

A

Topical corticosteroid

pred forte

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13
Q

what are the risks with ophthalmic corticosteroids

A

glaucoma and cataracts

increased risk of infection and exacerbation of infection

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14
Q

whats the treatment for corneal ulcer (possible blindess)

A

ciprofloxacin

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15
Q

What is first line in glaucoma and raised intraocular pressure?

A

prostaglandin - latanoprost (contraindicated in asthma)

beta blockers -betaxolol (Long eye lashes and darker iris colour)

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16
Q

what is second line in glaucoma?

A

sympathomimetics - brimonidine

carbonic anhydrase inhibitors - brinzolamide, dorzolamide eye drops

oral acetazolamide

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17
Q

what are the symptoms of closed-angle glaucoma?

A

cloudy eye
n and v
intense eye pain
rainbow-coloured rings around

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18
Q

what are the properties of different skin formulations?

A

Ointments - greasy, most hydrating
Creams - less greasy, dry out quicker
Gels - high water content suitable for scalp face application
lotions - cooling effect, best for large hairy areas

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19
Q

which excipients should be avoided in neonates ?

A

salicylate

benzyl alcohol

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20
Q

Whats the MHRA on emollients?

A

fire hazard with paraffin based emollients

21
Q

advice on emollients?

A 
apply as often as possible 
apply in direction of hair growth
apply after washing/ bathing 
bath emollients are slippy
soak for 10-20 minutes
22
Q

Which topical corticosteroids are mild?

A

Hydrocortisone <2.5%

23
Q

which Topical corticosteroid are moderate?

A

Clobetasone

Betamethasone 0.025%

24
Q

which topical corticosteroids are potent?

A

betamethasone 0.1%

hydrocortisone butyrate mometasone

25
which topical corticosteroids are very potent?
Clobetasol
26
Whats the dose of topical corticosteroids?
apply thinly no more than twice a day
27
How should steroids be applied with emollients?
apply emollient then wait 30 mins for maximum absorption
28
What is the treatment of Rosacea?
6-12 week course Topical: metronidazole, azaelic acid, ivermectin Oral: oxytetracycline, tetracycline, erythromycin Redness; Brimonidine
29
what are the MHRA alerts on Brimonidine?
Cardiovascular effects exacerbation of Rosacea
30
Whats the ideal method of contraceptions for patients taking Retinoids?
barrier plus COC for 1 month before and after treatment POP is not effective
31
When and how often should the pregnancy test be taken for retinoids ?
first 3 days of menstrual cycle or up to 3 days before treatment repeat every months and for 5 weeks after stopping
32
What are the rules of the pregnancy prevention programme?
2 tests to exclude pregnancy Rx valid for 7 days, 30 days supply Emergency supply requires negative pregnancy test
33
What are the side effects of Isotretinoin?
``` Hyperglycaemia Hypertriglyceridaemia high cholesterol pancreatitis hepatotoxicity ``` Skin peeling, dryness
34
What is the MHRA report on isotretinoin?
Rare reports of erectile dysfunction and decreased libido
35
What are the counselling points with retinoids?
Avoid wax epilation or dermabrasion/laser treatment during or 6months after Photosensitivity STOP if psychiatric reactions occur
36
What vaccines are given at 2 months?
First 5 in 1 Rotavirus Pneumococcal MenB
37
What vaccines are given at 3 months?
second 5 in 1 | Rotavirus
38
What vaccines are given at 4 months?
Third 5 in 1 Pneumococcal MenB
39
What vaccines are given at 12-13 months?
First MMR boosters MenB, Pneumococcal Hib/MenC
40
What vaccines are given in primary school? 3 years 4 months 2-6 years
3yrs4mnths - Second MMR, 4 in 1 (minus Hib) 2-6 years - Annual Flu Vaccine
41
What vaccines are given in Secondary school? 12-13 years girls 13-18 years
12-13 years: HPV 13-18 years: 3 in 1 (minus hib and pertussis), Men ACWY
42
What are the paracetamol doses for post immunisation fever?
60mg asap 60mg 4-6 hours later No more than two doses in 24 hours (Max 4 doses in 24hours in 4 months)
43
What are the ibuprofen doses for post immunisation fever?
50mg after vaccine 50mg 6 hours later no more than two doses in 24hours
44
When are 3 doses of paracetamol allowed in post immunisation fever?
Men B at 2 months and 4 months (only give paracetamol in this case)
45
What patients are eligible for the Pneumococcal vaccine?
65 years
46
what patients are eligible for the shingles vaccine?
70 years
47
Drugs which can exacerbate psoriasis?
``` Lithium chloroquine hydroxychloroquine beta blockers NSAIDs ACE inhibitors ``` BLANCHe
48
Immunisation dose of Paracetamol for 4 month year olds?
60mg initially then 60mg every 4/6 hrs MAX 4 doses

Pre Reg (37 decks)

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