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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
Q

which topical corticosteroids are very potent?

A

Clobetasol

26
Q

Whats the dose of topical corticosteroids?

A

apply thinly no more than twice a day

27
Q

How should steroids be applied with emollients?

A

apply emollient then wait 30 mins for maximum absorption

28
Q

What is the treatment of Rosacea?

A

6-12 week course
Topical: metronidazole, azaelic acid, ivermectin

Oral: oxytetracycline, tetracycline, erythromycin

Redness; Brimonidine

29
Q

what are the MHRA alerts on Brimonidine?

A

Cardiovascular effects

exacerbation of Rosacea

30
Q

Whats the ideal method of contraceptions for patients taking Retinoids?

A

barrier plus COC for 1 month before and after treatment

POP is not effective

31
Q

When and how often should the pregnancy test be taken for retinoids ?

A

first 3 days of menstrual cycle or up to 3 days before treatment

repeat every months and for 5 weeks after stopping

32
Q

What are the rules of the pregnancy prevention programme?

A

2 tests to exclude pregnancy

Rx valid for 7 days, 30 days supply

Emergency supply requires negative pregnancy test

33
Q

What are the side effects of Isotretinoin?

A 
Hyperglycaemia 
Hypertriglyceridaemia 
high cholesterol
pancreatitis
hepatotoxicity

Skin peeling, dryness

34
Q

What is the MHRA report on isotretinoin?

A

Rare reports of erectile dysfunction and decreased libido

35
Q

What are the counselling points with retinoids?

A

Avoid wax epilation or dermabrasion/laser treatment during or 6months after

Photosensitivity

STOP if psychiatric reactions occur

36
Q

What vaccines are given at 2 months?

A

First 5 in 1
Rotavirus
Pneumococcal
MenB

37
Q

What vaccines are given at 3 months?

A

second 5 in 1

Rotavirus

38
Q

What vaccines are given at 4 months?

A

Third 5 in 1
Pneumococcal
MenB

39
Q

What vaccines are given at 12-13 months?

A

First MMR
boosters MenB, Pneumococcal
Hib/MenC

40
Q

What vaccines are given in primary school?

3 years 4 months
2-6 years

A

3yrs4mnths - Second MMR, 4 in 1 (minus Hib)

2-6 years - Annual Flu Vaccine

41
Q

What vaccines are given in Secondary school?

12-13 years girls
13-18 years

A

12-13 years: HPV

13-18 years: 3 in 1 (minus hib and pertussis), Men ACWY

42
Q

What are the paracetamol doses for post immunisation fever?

A

60mg asap
60mg 4-6 hours later
No more than two doses in 24 hours

(Max 4 doses in 24hours in 4 months)

43
Q

What are the ibuprofen doses for post immunisation fever?

A

50mg after vaccine
50mg 6 hours later

no more than two doses in 24hours

44
Q

When are 3 doses of paracetamol allowed in post immunisation fever?

A

Men B at 2 months and 4 months (only give paracetamol in this case)

45
Q

What patients are eligible for the Pneumococcal vaccine?

A

65 years

46
Q

what patients are eligible for the shingles vaccine?

A

70 years

47
Q

Drugs which can exacerbate psoriasis?

A 
Lithium
chloroquine 
hydroxychloroquine 
beta blockers 
NSAIDs 
ACE inhibitors

BLANCHe

48
Q

Immunisation dose of Paracetamol for 4 month year olds?

A

60mg initially then 60mg every 4/6 hrs

MAX 4 doses

Pre Reg (37 decks)

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