Common OTC infections Flashcards
How does the discharge change in certain conditions?
Watery, grey, fishy smelling discharge- Bacterial vagnosis
Yellow/green foul smelling- Trichmonas vaginitis
Cottage cheese texture, no smell- Thrush
Pus, mucus, milky, can be yellow and a bit smelly- Chlamydia
What is prescribed for treatment of trichmonas vaginitis and bacterial vagnosis?
Prescribe oral metronidazole 400–500 mg twice a day for 5–7 days, or metronidazole 2 g as a single oral dose
What fungi causes vaginal thrush?
Candida albicans
Is thrush common?
Very common, 20% of sexually active women have naturally occuring candida albicans in the vaginal canal. When there is a change in conditions, it can cause an overgrowth of the fungi.
What are some of the risk factors of vaginal thrush?
Pregnancy
Diabetes Melluitis
Contraceptives
Tight fitting clothing
Cleansers
Perfumed products
What are some of the symptoms of thrush in women and in men?
Women:
Pain during or after sex
Cottage cheese discharge
White plaques on the vaginal wall
Men:
Itching, burning and redness
Yellow discharge
What are some of the treatments for thrush for a pregnant women?
For acute infection:
Prescribe clotrimazole pessary 500 mg intravaginally at night for up to 7 consecutive nights first-line
For recurrent infection:
For induction, prescribe topical imidazole therapy (such as clotrimazole pessary 500 mg intravaginally at night) for 10–14 days according to symptom response.
For maintenance, prescribe a clotrimazole pessary to be used one night a week for 6 months
Could also prescribe clotrimazole 1% or 2% cream applied 2–3 times a day.
Ensure that for pregnant women, do not use an applicator when inserting the pessary, only use fingers.
What are some of the available over the counter options for thrush treatment?
150mg fluconazole capsule
2% Canesten external cream
Once 10% internal Canesten cream
Topical imidazoles
Pessaries to be used at night
What are some of the red flag referral symptoms for thrush?
Under 16 or Over 60
Thrush is recurrent (4 times in 12 months)
If you have thrush for the first time
Treatment has not worked
Which enzyme does Fluconazole inhibit?
Fluconazole inhibits cytochrome P450 which increases serum concentrations of drug that are metabolised by that cytochrome. This includes drugs such as statins and warfarin.
What are some of the causes of oral thrush?
Breast feeding where the breast tissue contains fungal spores, poor fitted denatures, broad spectrum antibiotics, side effect of anti-cholinergics (dry mouth, no presence of saliva increases the risk of infections), immunosuppressed and inhaled steroids
What are some of the signs of oral thrush?
White plaques that if removed are red and raw and inflammed underneath
What are some of the referral symptoms of oral thrush?
Still present after more than three weeks
Are they spread out or together
Lesions greater than 1cm
What are the recommended treatments for treating oral thrush in children?
Miconadazole 2% gel
4-24 months: 1.25 mL of gel applied four times a day after meals.
Above 2 years: 2.5 mL of gel applied four times a day after meals.
Continue for 7 days after the plaques have disappeared.
Nystatin suspension
1ml (100,000 units) dropped into the mouth four times a day, usually for 7 days
Continue for 48 hours after the plaques have resolved
What is the normal treatment for oral thrush in adults?
For mild and localised prescribe as you would for children with Micondazole gel and Nystatin.
2% Micondazole gel
Above 2 years: 2.5 mL of gel applied four times a day after meals.
Continue for 7 days after the plaques have disappeared.
Nystatin suspension
1ml (100,000 units) dropped into the mouth four times a day, usually for 7 days
Continue for 48 hours after the plaques have resolved
For extensive and widespread infection:
50mg Fluconazole once a day for at least 14 days
