Josh's Complete OTC Handbook Flashcards
Is there a PSA self-care card for acne?
Yes
What are 2 over-the-counter treatment options for acne?
- Azelaic acid
- Benzoyl peroxide
What is a product containing azelaic acid?
Azclear lotion
How should Azclear lotion be used?
Apply to the affected area(s) TWICE daily
What are 2 products containing benzoyl peroxide?
- Benzac Gel
- Benzac AC Wash
What 3 strengths is Benzac Gel available in?
- 2.5%
- 5%
- 10%
How should Benzac Gel be used?
Apply to the affected area(s) once or twice daily, beginning with a lower strength and increasing up to 10% after 3 to 4 weeks if tolerated and acne is still not well controlled.
How should Benzac AC Wash be used?
Wet the treated area then wash the face with Benzac wash solution and leave to soak for 30 seconds before washing off. Do this once or twice daily.
Describe the use of azelaic acid in pregnancy
The safety of azelaic acid in pregnancy is unknown
Describe the use of azelaic acid in breastfeeding
Azelaic acid is safe to use in breastfeeding
Describe the use of azelaic acid in children
Azelaic acid is safe to use in children over 2 years old
Describe the use of benzoyl peroxide in pregnancy
Benzoyl peroxide is safe to use in pregnancy
Describe the use of benzoyl peroxide in breastfeeding
Benzoyl peroxide is safe to use in breastfeeding
Describe the use of benzoyl peroxide in children
Benzoyl peroxide is safe to use in children over 2 years old
What are 10 pieces of non-pharmacological advice to provide with acne?
- Acne usually gets worse before it gets better
- Gradual improvmenet should be seen over time with treatment, usually within 8 to 12 weeks of therapy
- Ensure a good face wash/skin care routine
- Use a moisturiser to minimise dryness
- Avoid using toner
- Avoid squeezing or picking lesions
- Avoid waxing treating areas
- Avoid wearing heavy oil-based makeup and clean makeup off thoroughly each night
- It is important to wear sunscreen
- Exercise regularly and eat a healthy diet with many fresh food and water
List 4 practice points to remember with azelaic acid
- Azelaic acid can bleach dark skin complexions
- Azelaic acid products contain propylene glycol
- Gel is a good formulation for greasy skin
- Lotions are easier to apply on hairy areas
List 3 practice points to remember with benzoyl peroxide
- Can bleach clothing and linen
- Gel contains propylene glycol
- 5% Benzac gel appears as effective as the 10% but is but less irritating
What are the directions of Differin 0.1% gel (Adapalene)?
Adult, children >12 years: Apply to clean, dry skin every second night at bedtime for 2 weeks and apply every night thereafter. Wash the product off in the morning to reduce the risk of photosensitivity. If irritation occurs, reduce the frequency of treatment, or stop treatment for a few days before restarting.
Describe the use of Differin 0.1% gel (Adapalene) in pregnancy.
Differin 0.1% gel (Adapalene) is in Pregnancy Category D: Avoid use
Describe the use of Differin 0.1% gel (Adapalene) in breastfeeding.
Differin 0.1% gel (Adapalene) is safe in breastfeeding.
What are 2 practice points to remember with Differin 0.1% gel (Adapalene)?
- Improvement should be noticeable after 6 weeks. Continue for 6 weeks before assessing effectiveness.
- Skin redness, dryness, irritation and peeling generally resolves with continued use of the product.
What are 4 symptoms of head lice?
- Itchy scalp
- Visible moving lice
- Small, pale eggs stuck to the bases of hair strands
- Skin sores on the scalp, caused by scratching
What are 3 red flags for referral with head lice?
- Unclear diagnosis
- Signs of secondary infection
- Topical treatment has failed which was not due to incorrect application or re-infestation
Is there a PSA Self-Care Card for head lice?
Yes (Head Lice)
What are 5 over-the-counter treatment options for head lice?
- KP-24 lotion (Maldison)
- KP-24 shampoo (Maldison)
- Banlice Mousse (Pyrethrins and Piperonyl Butoxide)
- Banlice Aerosol Spray (Pyrethrins and piperonyl butoxide)
- Hedrin 15 (Dimeticone 4%)
What are the directions for KP-24 Lotion (Maldison)?
Adult and Children over 1: Apply to dry hair. Wash hair after 8 to 12 hours and use a fine-tooth comb to remove eggs and dead lice. Repeat after 7 days
What are the directions for KP24 Shampoo (Maldison)?
Adult and Children over 1: Apply to dry hair (use a little water if required). Rinse out after 30 minutes and use a fine-tooth comb to remove eggs and dead lice. Repeat after 7 days
What are the directions for Banlice Mousse (Pyrethrins and Piperonyl Butoxide)?
Adult and children over 2: Apply to dry hair and massage in until wet. Leave for 10 minutes, then wash out with shampoo. Use a fine-tooth comb to remove eggs and dead lice. Repeat after 7 days
What are the directions for Banlice Aerosol Spray (Pyrethrins and Piperonyl Butoxide)?
Adult and children over 2: Apply on dry hair. Moisten whole scalp by spraying in short bursts (2 to 3 seconds); leave for 30 minutes (do not cover head), then rinse out with warm water. Use a fine-tooth comb to remove eggs and dead lice. Repeat after 7 days. Use in a well-ventilated area
What are the directions for Hedrin 15 (Dimethicone 4%)?
Adult and Children over 6 months: Apply to dry hair, ensuring it is completely covered from scalp to tip. Leave on for 15 minutes, then use a fine- tooth comb to remove eggs and dead lice. After combing, rinse out with water. Repeat after 7 days.
Describe the use of maldison in pregnancy.
Maldison is in Pregnancy Category B2 (Avoid use)
Describe the use of Pyrethrins and Piperonyl butoxide in pregnancy.
Pyrethrins and Piperonyl butoxide is in Pregnancy Category B3 (Avoid use)
Describe the use of topical dimeticone in pregnancy
Topical dimeticone is Safe in pregnancy
Describe the use of maldison in breastfeeding
Maldison is safe in pregnancy
Describe the use of Banlice® (Pyrethrins and Piperonyl Butoxide) in pregnancy
Banlice® (Pyrethrins and Piperonyl Butoxide) is safe in pregnancy
Describe the use of Differin 0.1% gel (Adapalene) in pregnancy
Differin 0.1% gel (Adapalene) is safe in pregnancy
What are 10 pieces of non-pharmacological advice for
headlice?
1. Check other family members for head lice. Treat only if live lice are found
2. Use gloves when handling the products or wash hands thoroughly afterwards
3. Apply insecticide to hair without conditioner or hair products in it
4. Ensure to repeat the application after 7 days
5. Do not use hair dryer to dry hair after insecticide treatment because the heat can inactivate the drug
6. This is a treatment not a prevention. Overuse can lead to irritation and resistant lice
7. Soak combs and hairbrushes in hot water (>60°C) for 30 seconds and wash pillowcases in hot water or put in a clothes dryer for 15 minutes.
8. Items that cannot be washed should be placed in airtight bags for 3-4 days.
9. Avoid sharing hats or combs or towels
10. Children can be sent back to school after the first successful treatment.
What are 6 practice points relating to headlice?
- Moving lice must be found to confirm infestation (wet combing is better than visual inspection for doing this). Itching or the presence of eggs (nits) does not necessarily indicate active infestation
- Eggs >1 cm from scalp are empty casings or dead. Viable eggs are close to scalp(~6mm) and pop when squashed between fingers
- Lice can range from nearly colourless (when they hatch) to reddish brown (after feeding), and are about 1 to 4mm long
- Maldison lotion is generally preferred to shampoo as the contact time is longer and shampoo may be diluted during use, reducing efficacy. However, shampoo may be preferred in asthmatic patients and small children to avoid ethanol vapour from the lotion
- Resistance is common for neurotoxic insecticides but unlikely for physical insecticides
- Treatment failure can be due to resistance, incorrect application, or re-infestation
What are 4 symptoms of scabies?
- Intense itching, especially at night or after a hot shower
- Visible burrows on the skin, typically finger webs, armpits, genitals (i.e., skin creases)
- A bump or pimple-like rash that is difficult to see
- Small, clear, fluid-filled spots or lesions
What are 5 red flags for referral with scabies?
- Children under 2 years.
- Immunosuppressed patients.
- Signs of secondary infection for example, yellow discharge, crust on skin.
- Treatment failure.
- Unclear diagnosis.
Is there a PSA Self-Care card for scabies?
Yes (Scabies)
What are 2 over over-the-counter treatment options for scabies?
- Lyclear® Cream (Permethrin 5%)
- Benzoyl benzoate
What is the first line over-the-counter treatment option for scabies (including in pregnancy)?
Lyclear® Cream (Permethrin 5%)
What are the directions for Lyclear® Cream (Permethrin 5%)?
Adults and children over 2 months: Apply from the chin down particularly between fingers, toes and genitalia and wash off with warm, soapy water 8 to 14 hours later. Best applied before bedtime and washed off in the morning. Rinse thoroughly. Repeat after 7 days
What are the directions for benzyl benzoate in adults and children over 12 years?
Adult, children over 12 years: Apply undiluted from chin down and wash off 24 hours later. Repeat after 5 days
What are the directions for benzoyl benzoate in children aged 2 to 11 years?
Dilute with an equal quantity of water and apply from chin down and wash off 24 hours later. Repeat after 5 days
What are the directions for benzoyl benzoate for infants aged 1 month to 2 years?
Dilute with 3 parts of water and apply from chin down and wash off 24 hours later. Repeat after 5 days
What is a practice point for benzoyl benzoate relating to use in children?
For children and infants, use an alternative agent because efficacy is reduced by further dilution
Describe the use of Lyclear® Cream (Permethrin 5%) in pregnancy.
Lyclear® Cream (Permethrin 5%) is safe in pregnancy
Describe the use of Lyclear® Cream (Permethrin 5%) in breastfeeding
Lyclear® Cream (Permethrin 5%) is safe in breastfeeding
How should Lyclear® Cream (Permethrin 5%) be used in breastfeeding?
Wash from nipples before breastfeeding then re-apply
What age range is Lyclear® Cream (Permethrin 5%) appropriate for?
Infants over 2 months
Describe the use of Benzyl benzoate in pregnancy
Permethrin is preferred in pregnancy
Describe the use of Benzyl benzoate in breastfeeding
Permethrin is preferred in breastfeeding
What is the age range for use of benzoyl benzoate?
Infants over 1 month
What are 8 pieces of non-pharmacological advice for scabies?
- Check other family members for scabies. Treat them regardless
- Use gloves when handling the products or wash hands thoroughly afterwards
- Ensure to repeat the treatment after 7 days
- Any clothing, bedding or towels that were in contact with the person in the past 2-3 days should be washed on a hot cycle or dry-cleaned
- Items that cannot be washed should be stored in tightly sealed plastic bags for at least 3 days
- Avoid prolonged physical contact with others to reduce transmission
- Exclude from others until 24hours after appropriate treatment has started
- Avoid scratching the area, an antihistamine may be used to relieve itch.
What are 5 practice points for scabies?
- In scabies, there is usually not many rashes to be seen because the mites bury into the skin. In elderly people, the rash may appear more widespread. In children, areas such as the face, scalp, palms, and soles of the feet are often affected
- Symptoms usually develop two to four weeks after infestation. However, people who have previously been exposed may develop symptoms within 24 to 48 hours, because the immune system takes less time to respond.
- Improvement usually occurs within 1 or 2 days of treatment. The itch may persist for 2-3 weeks after treatment, even if the scabies has been effectively treated. This is because the itch is caused by the body’s immune system responding to the mites and may take time to settle down. Reinvestigate if itch last >4 weeks
- Generally, a person is no longer infectious 24 hours after treatment.
- Sexual partners and family members also require treatment
What are 4 symptoms of Eczema/Dermatitis?
- Red, itchy, and inflamed patches of skin
- Dry, scaly, painful cracks in the skin
- Known cause (irritant and allergic)
- Poorly demarcated
What are the common locations for eczema/dermatitis in infants?
On the face and in the nappy area
What are the common locations for eczema/dermatitis in children?
On the flexures of elbows, knees, hands, feet
What are the common locations for eczema/dermatitis in adults?
On the flexures of elbows, knees, hands, feet, and face
What are 5 red flags for referral with eczema/dermatitis?
- Secondary bacterial infections
- Patch testing for allergens
- Treatment of warts and molluscum contagiosum is difficult in eczema
- Herpes simplex
- Fungal infection
Is there a PSA Self-Care card for eczema/dermatitis?
Yes (Eczema and Dermatitis)
What are 3 over-the-counter treatment options for eczema/dermatitis?
- QV cream (moisturising aqueous cream)
- Dermaid® Cream (Hydrocortisone 1%)
- Eumovate® Cream (clobetasone 0.05%)
What are the directions for QV® Cream (moisturising aqueous cream)?
Adult and Children over 2 years: Apply regularly, at least 2 times daily to rehydrate the skin.
What are the directions for Dermaid® Cream (Hydrocortisone 1%)?
Adult and children over 2 years: Apply to the affected areas 1 to 2 times daily as required for up to 7 days. DO NOT apply to broken skin.