Community Flashcards
What is the organism causing RING WORM?
Tinea Corporis
A patient presents with the following at your pharmacy. They ask for some Brolene eye drops. What do you do?
This is a subcojunctival haemorrhage
Ask them if it is painful- any pain then refer
Ask them if they are on WARFARIN- if yes seek medical attention ASAP
Have you had any injury to the eye recently?
If no to the above- reassure the patient that it is self limiting, usually better within 2 weeks and no OTC products are recommended
What kind of medication is Guaiphenesin?
Cough EXPECTORANT
These claim to make the coughing easier while enhancing production of mucus and phlegm.
Other example: Acetylcysteine, ammonium chloride
Not effective in children
What kind of medicine is Dextromethorphan?
Cough suppressant (antitussive)
What antihistamine do we usually give to children?
Chlorphenamine maleate
Suitable for 1 year and over
What age are steroid nasal sprays e.g. beconase, flixonase, not suitable in?
Under 18’s
What drugs can be given on instalment prescriptions (FP10MDA) Other than Methadone?
Schedule 2 Controlled Drugs;
Buprenorphine;
Buprenorphine/naloxone (Suboxone); and
Diazepam
How is payment for Instalment precriptions worked out?
Payment is based on each occasion the pharmacist provides an instalment to the patient; i.e. each time the patient collects their drug from the pharmacy
Pharmacy needs to fill out back of prescription each time the patient picks up an instalment
What formulations have more potential for abuse by addicts?
Sugar free
Syrup base less liable to abuse
Is it pharmacologically rational for a cough/cold remedy to contain dextromethorphan and guanefenesin? What about dextromethorphan and ammonium chloride?
No:
Dextromethorphan is a cough suppressant so person coughing less
Guanefenesin and ammonium chloride both cough expectorants which means they make it easier to cough things up: work against eachother
What is the medication causing drowsniess usually included in cough/ cough rememdies to help people sleep?
Diphenhydramine
A sedating antihistamine, found in things like Night nurse.
Also found in sleep aids such as sominex
What is cinnarazine and what is it used in?
characterized as an antihistamine and a calcium channel blocker
Used for travel sickness and vertigo and tinnitus (problems with inner ear)
Very sedating
Found in Stugeron- 2 tablets 2 hours before travel
If a specific brand is stated on a prescription (e.g. Losec capsules- Omeprazole) can you give the generic if you run out of the branded?
No
Must legally prescribe that brand unless you ask the prescriber to change the Rx to generic
What does sodium Citrate do to the pH of urine?
Cystitis sachets
It increases the pH- makes urine more alkaline
Acidic urine in cystits- hence the burning feeling
Can pseudoephidrine cause drowsniess?
Can guaifenesin cause drowsiness?
Can dextromethorphan?
No
Remember pseudoephidrine (SUDAFED) can be abused- stimulating- side effects include restlessness and insomnia, and hallucinations!
Guaifenesin does not cause drowsiness
Dextromethorphan can cause a little bit of drowsiness
Children under __ should not be given cough and cold medication OTC containing PSEUDOEPHEDRINE
PHENYLEPHRINE
DEXTROMETHORPHAN
PHOLCODINE
GUAIFENESIN
Chlorphenamine, brompheniramine, diphenhydramine, doxylamine, promethazine and triprolidine.
Children under 6 years old
Medicines containing:
ANTITUSSIVES (suppressants) (DEXTROMETHORPHAN
PHOLCODINE)
Expectorants (GUAIFENESIN, ipecacuanha)
Nasal decongestants (pseudo, phenylephrine, ephedrine, oxymetazoline, xylometazoline)
Antihistamines: Chlorphenamine, brompheniramine, diphenhydramine, doxylamine, promethazine and triprolidine.
For use in 6-12 years they should be SECOND LINE and be used for no more than 5 DAYS
A patient with a productive cough for the last week requests a product containing dextromethorphan because they have heard good things. What do you do?
They may have requested Benylin Dry Cough
Similar product: Benadril Tickly Cough containing Pholcodine
These are cough SUPPRESSANTS
Should NOT suppress a productive cough- need to get the mucous out- so recommend an expectorant (Guaiphenesin)
It is recommened people include oily fish in their diet to help reduce CV risk. Can you think of any examples of these?
Mackerel
Salmon
Sardines
What is the organism causing athletes foot? How is athletes foot treated?
TINEA PEDIS
Topical imidazole (Miconazole) can be used- Apply twice daily and continue for 10 days after the lesions have healed
Bnf states under topical antifungals: to prevent relapse these should be continued for 1-2 weeks after healing
Could also consider Griseofulvin
Amorolfine (Curanail, Loceryl) can be used for fungal nail infections. What is the directions for this?
Apply 1-2 times a week for:
6 months for finger nails
9- 12 months for toe nails
Apply after filing and cleansing
BNF age limit: 12, OTC age limit: 18. 3 ml pack is a P
Why has the safety of using medicines containing codeine to treat coughs and colds in children younger than 18 been reviewed?
Because of the potential for serious problems like slowed or difficult breathing.
Children, especially those who already have breathing problems, may be more prone to these effects
Differences in metabolism of codeine: codeine is converted to Morphine in the body, this cause cause respiratory difficulties.
This use in under 18’s only applies to codeine linctus for colds/ cough; codeine containing products for pain relief can still be used in > 12 years, sold to > 16 years.
What do we use to treat Oral thrush?
Topical Miconazole gel- Daktarin oromucosal gel
(Nystatin 2nd line, Fluconazole 3rd line if topical preps can’t be used/ patient has a dry mouth)
What is Lyme disease caused by? What does the rash present as?
Caused by bacterial infection from Tick bites
An early symptom of this condition is a characteristic “bulls eye on a dartboard” rash (called erythema migrans) that isn’t itchy
Usually treated with Doxycycline, amoxicillin or cefuroxime for 2-4 weeks
Is sunlight a good cure for cold sores?
Sunlight can trigger cold sores so direct sunlight should be avoided and sun screen should be applied.
What presents as the following image accompanied by sore throat, headache, high temperature?
Scarlet fever
Antibiotics needed- refer
With treatment, most people recover in about four to five days and can return to school 24 hours after starting antibiotic treatment. Without treatment, you’ll be contagious for one to two weeks after symptoms appear.
What condition presents with a rash, white coating of the tongue, plus headache and fever leading up to it?
Scarlet fever
