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PHRM4012 > OTC > Flashcards

OTC Flashcards

1
Q

What are the symptoms of a bee sting? 🐝

A

Instant sharp burning pain, red welt in the area, slight swelling around the sting

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2
Q

What are the main referral points/questions for a bee sting? 🐝

A

Anaphylaxis, abdominal pain/vomiting

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3
Q

What are the 2 main treatment options for a bee sting? 🐝

A
  1. Corticosteroid cream 1% (apply to affected area 1-2 times daily) or 0.5% (2-3 times daily)
  2. Non-sedating antihistamine
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4
Q

What are some counselling points/advice for a bee sting? 🐝

A
  • provide advice on how to remove the sting
  • clean the area and ice to help relieve discomfort (no more than 15 mins)
  • use an effective insect repellent when outdoors (containing DEET)
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5
Q

What are the symptoms for chicken pox? 🤒

A

Malaise, low grade fever, headache, runny nose, cold
Rash with small blisters

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6
Q

What is the progression of a chicken pox rash?

A

Starts on body and progresses to head and limbs

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7
Q

What are the 4 main referral points for chicken pox?

A
  1. Suspected measles (rash appears around ears and face then progresses to trunk and limbs; fever)
  2. Suspected rubella (rash starts on the face and quickly progresses to the trunk; swollen glands; cold like Sx)
  3. Meningitis (rash on trunk and limbs; fever; lethargy; stiff neck) - non blanching rash
  4. Pregnant women (need a blood test to determine levels of antibodies - can cause miscarriage or foetal varicella syndrome)
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8
Q

What is the treatment for chicken pox?

A

No required treatment options for healthy individuals
- Solugel for blisters to prevent scarring
- Antihistamines to help with itch
- Paracetamol for temperature 🤒

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9
Q

For which common OTC condition do you need to ask about vaccination status?

A

Chicken pox

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10
Q

What are some common counselling points for chicken pox?

A
  • gloves when sleeping
  • keep hydrated
  • loose clothing
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11
Q

What is the exclusion period for chicken pox?

A

Until blisters have dried and at least 5 days after the onset of symptoms
(No need to exclude contacts - except pregnant women - unless they are displaying symptoms)

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12
Q

Opioids, diets, trauma and pregnancy are some of the causes for which commonly encountered diagnosis?

A

Constipation

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13
Q

What are some of the questions to ask when confirming a diagnosis of constipaton?

A

Change of diet/routine, pain on defection, presence of blood, duration, lifestyle changes

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14
Q

When to refer for a constipation diagnosis?

A
  • black tarry stools
  • systemic symptoms
  • alternating constipation/diarrhoea
  • lasting over 2 weeks with no identifiable cause
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15
Q

What are black tarry stools indicative of?

A

Upper GI bleed

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16
Q

What is an appropriate treatment option for constipation for a child 1-5 years old?

A

Movicol Jr.
(1 sachet per day dissolved in 60mls of water)

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17
Q

What is an appropriate treatment option for constipation for a child 6 years old or over?

A

Movicol Jr. (2 sachet in 120mls water daily)

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18
Q

What is the MOA of movicol?

A

Macrogol 3350 exerts an osmotic action in the gut which induces a laxative effect.

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19
Q

What are some counselling points for child constipation?

A
  • increase dietary fibre
  • hydration
  • avoid caffeine
  • encourage good toilet hygiene
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20
Q

What are some of the symptoms/diagnostics that you would consider for headlice?

A
  • itching at the scalp, back of neck or behind ears
  • diagnosis should be made on the presence of live lice
  • note that patients may be asymptomatic (no itch)
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21
Q

When to refer for headlice

A
  • if diagnosis unclear
  • signs of secondary infection
  • treatment failure
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22
Q

What are some products you could recommend for the treatment of headlice?

A
  • KP24 (medicated and natural)
  • Moov range (natural)
  • ban lice (medicated)
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23
Q

What is the wet combing technique for removal of headlice?

A

Using conditioner, comb through hair thoroughly every 2 days until no lice are found for 10 consecutive days (physical removal method). Can do in addition to using treatment

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24
Q

What are some counselling points for headlice?

A
  • hot wash pillow cases and hair brushes/bands
  • avoid contact with others hair (particularly for school aged children)
  • check other family members for head lice
  • tie back long hair
  • reassure parents that it is not a hygiene issue
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25
Q

What is the exclusion period for headlice?

A

None required, just ensure that patient is treated

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26
Q

What are the symptoms or differentiating features of nappy rash?

A
  • rash confined to the areas with direct contact (skin folds generally unaffected)
  • burn like rash around the nappy area
  • may itch/sting/burn and be generally sore
  • redness
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27
Q

When to refer for nappy rash?

A
  • severe rash
  • signs of secondary infection
  • frequent recurrence
  • involvement of other body areas
  • no treatment response
  • skin is broken
  • baby is generally unwell
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28
Q

What is a treatment option for nappy rash and how is it used?

A

Sudocream (ZnO) - apply a thin coat evenly after each nappy change or as often as required

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29
Q

What is a good adjunctive therapy you may recommend for nappy rash?

A

Soap free washes (QV baby as an example)

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30
Q

What are some counselling points for nappy rash?

A
  • regular nappy changes (if they have a dirty nappy, don’t wait to change it)
  • avoid wipes that are scented or contain alcohols
  • nappy free time
  • reassure patient that this will likely resolve quickly and refer if it doesn’t
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31
Q

Which OTC condition is caused by a mite?

A

Scabies

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32
Q

Intense itching of the skin which is typically worse at night and after showering is associated with condition?

A

Scabies

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33
Q

What are some of the symptoms of scabies?

A
  • intense itching of the skin
  • visible burrows on the skin between the fingers and in skin creases
  • bumpy/pimply rash
  • clear fluid filled lesions
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34
Q

What are some of the differentiating features of scabies?

A
  • location (finger webs, wrists, side of fingers)
  • worse at night
  • no history of allergies reduces the likelihood of it being contact dermatitis
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35
Q

Referral points for scabies

A
  • signs of bacterial infection
  • treatment failure
  • infants (<6 months) and elderly
  • extensive broken skin due to itching
  • if itch persists for more than 1 month
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36
Q

What is the first line treatment option for scabies and what directions would you give?

A

Lyclear (permethrin - paralyses and kills mites and their eggs)
Directions
- 1 tube per person (maybe 2 for a larger person)
- apply after showering and drying
- apply to the whole body paying careful attention to creases and crevices (including under the nails)
- wash treatment off after 8 hours
- do not apply after a hot bath as this increases absorption and removes drug from treatment site
- all household members and close contacts should be treated

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37
Q

If a patient is allergic to permethrin, what could you suggest as an alternative treatment for scabies?

A

Benzyl benzoate (Ascabiol)
Eurax (for infants under 6 months)

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38
Q

What are some counselling points for scabies?

A
  • itch may continue for several weeks (offer an antihistamine to help with the itch, maybe even sedating to help with sleep)
  • soap free moisturiser
  • secondary infection is common (try not to itch)
  • wash all bedding/soft toys/clothes in a hot wash or store in a sealed bag for 3 days
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39
Q

What is the exclusion period for scabies?

A

Until the day after treatment has commenced

40
Q

What are the symptoms of haemorrhoids?

A
  • pain on defecation
  • pain when sitting
  • dull ache
  • localised itching
  • bright red blood
41
Q

What are some differential diagnoses to be aware of for haemmharoids?

A
  • anal fissures (intense pain on defecation)
  • dermatitis (itching)
  • threadworm (itching)
  • ulcerative colitis and chrons
  • upper GI bleed
  • cancer
42
Q

When to refer for haemmhaorids?

A
  • worsening or no improvements after 1 week on tx
  • increased bleeding
  • been more than 3 weeks
  • abdominal pain
  • blood in stools (not bright red)
  • systemic Sx
  • cancer Sx (over 40 with changes in bowel habit and bleeding or family Hx)
43
Q

What is an appropriate treatment option for haemorrhoids and what are the directions?

A

Anusol ointment
- clean area before application
- use twice daily (morning and night after a bowel motion)
- use externally for external haemorrhoids and use applicator and apply internally for internal haemorrhoids

44
Q

Which OTC product is inappropriate for haemorrhoids but commonly used for anal fissures?

A

Rectogesic

45
Q

What is an alternative treatment for haemorrhoids to Anusol ointment?

A

Proctosedyl ointment

46
Q

List some counselling points for haemorrhoids.

A
  • avoid straining when having a bowel motion
  • use baby wipes rather than toilet paper
  • ensure good toilet hygiene
  • warm baths/cold compresses may help relieve
  • use a doughnut shaped cushion when sitting
  • good diet/hydration
47
Q

This condition is common in the third trimester of pregnancy

A

Haemorrhoids (note - treatment options are safe)

48
Q

Which condition is not a disease within itself but rather a symptom of an underlying problem?

A

Diarrhoea

49
Q

What is the common viral cause of diarrhoea?

A

Rotavirus

50
Q

What is the common cause of bacterial diarrhoea?

A

Contaminated food or drink

51
Q

What is a common medication resulting in diarrhoea?

A

Laxatives

52
Q

What bug do you suspect if a patient returns from overseas with diarrhoea?

A

Giardias

53
Q

When should you refer a patient with diarrhoea?

A
  • over 50 years
  • alternating with constipation
  • blood or musous in stools
  • severe sx (8-10 in 24 hours)
  • longer than 2-3 days in elderly or children
  • infants
  • pregnancy
  • recent overseas travel
  • signs of dehydration
54
Q

What is a an appropriate treatment option for diarrhoea?

A

Loperamide (Gastro stop)
- 2 capsules with water and 1 after each loose bowel motion (max 8 per day)

Note: anti cholinergic and opioid agonist - consider ADRs

55
Q

What are counselling points for diarrhoea?

A
  • MUST maintain hydration (give hydrolyte)
  • eat a balanced diet (avoid sweet/spicy/fatty foods)
  • increase fibre and starch foods
  • ensure good hand hygiene
56
Q

What conversation might you have with a patient when they present with diarrhoea?

A

Recommend to let diarrhoea run its course, however can give drugs if the patient needs to work/go out etc.

57
Q

What are the symptoms of dyspepsia?

A
  • vague abdominal discomfort above the umbilicus associated with belching
  • bloating
  • flatulence
  • full feeling
  • nausea and vomiting
  • heartburn
58
Q

What are some of the questions you may ask to determine the diagnosis of dyspepsia?

A
  • age of patient
  • location and nature of pain
  • radiation
  • severity
  • associated symptoms
  • aggravating or relieving factors
  • social/medication history
59
Q

When would you refer a patient presenting with dyspepsia?

A
  • suspected CVD event
  • ALARM Sx
  • Medication induced
  • waking at night from pain
  • pain worse on an empty stomach
  • Tx failure
  • Frequent Sx
60
Q

What is an appropriate short term treatment option for dyspepsia?

A

Nexium
- 1 tablet daily for 7 days

Note: give one week of supply and reassess before you give a second week then REFER

61
Q

What is an alternative treatment for dyspepsia (other than PPIs)?

A

Gaviscon - 20mls up to 4 times per day

62
Q

What are some counselling points for dyspepsia?

A
  • low fat diet
  • reduce alcohol intake
  • stop smoking
  • decrease weight
  • reduce caffeine
  • avoid trigger foods
  • stay upright after eating
  • eat smaller meals
  • elevate head in bed
  • avoid eating or drinking before exercise
63
Q

What is the typical definition of colic?

A

Cries for more than three house a day for more than three days a week for more than 3 weeks (this is generally reduced in practice however)

64
Q

What are some of the symptoms of colic?

A
  • excessive and inconsolable crying
  • facial flushing and drawing up of the legs
  • may be more common in the evening
  • infant will generally be healthy
  • on/off pattern
65
Q

What are some of the DDx questions you can ask about colic?

A
  • age and weight of patient
  • are they generally healthy (eating well, gaining weight, wet nappies)
  • ask about symptoms
  • consider: acute infection, intolerance to cows milk, GORD
66
Q

When to refer for colic?

A
  • projectile vomiting
  • blood/green tinge in vomit
  • diarrhoea
  • fever
  • loss of appetite or weight
  • decreased alertness
  • distressed parent or child
67
Q

What is an appropriate treatment option for colic?

A

Infacol wind drops (simethicone)
- 1 dropper full in the back of the babies tongue up to 12 times per day after feeding

Note: limited evidence for benefit but doesn’t hurt to try

68
Q

What are some counselling points for colic?

A
  • MUST reassure that the baby will be OK, symptoms will subside over time (generally by 3-5 months)
  • If bottle fed, reduce teat size to prevent swallowing air
  • warm baths
  • gentle tummy massage
  • support the mother
  • refer if necessary
69
Q

What symptoms would you expect for a mouth ulcer?

A
  • roundish grey/white in colour
  • small with a raised rim
  • clearly defined margin
  • pain is the key presenting symptom
  • consider trauma ulcers
70
Q

When to refer for mouth ulcers?

A
  • young children (herpes)
  • more than 2 weeks
  • painless ulcer
  • systemic Sx
  • large and multiple ulcers in back of mouth
  • eye involvement
  • ulcer causing great difficulty eating or drinking
71
Q

What is the first line treatment for mouth ulcers?

A

Kenalog in orabase (help with pain and inflammation) - S3!!!!!!!!!!
- Apply a small quantity to the affected area before bed (do not rub in)
- can be used 2-3 times per day

72
Q

What is an alternative treatment option for mouth ulcers?

A

SM33 gel
Apply to the affected area every 3 hours

73
Q

What are some counselling points for mouth ulcers?

A
  • Avoid touching the area or wash hands well if you do
  • soft toothbrush
  • salt water
  • avoid hard/sweet/salty/fatty/acidic foods
  • avoid hot foods or drinks
  • use anaesthetic lozenges
  • give preventative advice
74
Q

Cold sore symptoms

A
  • burning/tingling/itching/pain 3-6 hours before the development of the cold sore
  • begins as a small group of pamphlets that progress to create a small, thin walled vesicle
  • most common site in the boarder of the lip
75
Q

DDx for cold sores

A
  • impetigo
  • angular chelates (corners of mouth become cracked)
76
Q

When to refer a cold sore?

A
  • Suspected eye infection
  • recurrent infections
  • immunocompromised patients
  • systemic Sx
  • signs of bacterial infection
  • lesions present in other areas
  • treatment failure
77
Q

What is a first line treatment option for cold sores?

A

Zovirax (Aciclovir)
- apply at first sign of a tingle or blister
- apply a small amount to the affected area 5 times per day for 4 days

78
Q

What are some counselling points for cold sores?

A
  • avoid sharing items (towels/razors/utensils)
  • avoid triggers
  • clean cold sores with warm water and keep dry
  • use lip balm or moisturisers to keep lips moist
  • avoid chocolate during outbreak
79
Q

What are some of the symptoms associated with having water in the ears?

A
  • pain
  • itch
  • reduced hearing
  • noises in the ear such as buzzing or humming
80
Q

Referral/DDx questions for water in the ear?

A
  • systemic symptoms
  • clear/watery discharge (normal)
  • need to ask about grommets or recurring pain/infections
81
Q

What is an appropriate treatment option for water in the ear?

A

Ear clear for swimmers ear - instill 4-6 drops one ear and keep head tilted for 1 minutes. Repeat in other ear

82
Q

What are some counselling points for water in the ear?

A
  • need to provide advice regarding the instillation of drops
  • Wear ear plugs when swimming
  • dry ears thoroughly after swimming
  • avoid putting fingers into the ears - prevent infection
  • can use the ear drops after swimming in a prophylactic manner
83
Q

Thick white discharge, odourless, intense itching/burning and painful irritation are symptoms of which condition?

A

Vaginal thrush

84
Q

When to refer for vaginal thrush?

A
  • If under 16 or over 60 years old
  • Recurrent episodes
  • Pregnancy
  • Abdominal or pelvic pain
  • Urinary symptoms
  • Diabetes, Cushing’s HIV, iron deficiency
85
Q

What is an appropriate treatment option for vaginal thrush for a PREGNANT woman?

A

Canesten Thrush (Pessary and Cream 6 day treatment pack)
- Insert pessary deeply into the vagina gently before bed (DO NOT USE APPLICATOR)
- Use in conjunction with cream which may be applied 2-3 times daily around the area to help with the itch (partner may also use this cream)

86
Q

What are some counselling points for vaginal thrush?

A
  • Vagisil have itch relief wipes and creams
  • Avoid tight fitting, non-absorbent clothing
  • Not an STI
  • Wipe from front to back
  • Avoid using soap in the genital area
  • Avoid perfumed toilet papers and menstural products
  • Sometimes partners may also develop an itch however this is NOT an infection and should resolve when the female is treated
87
Q

Symptoms of bacterial vaginosis?

A
  • thin, white or grey discharge which has a fishy odour
  • odour is worse during sex and periods
  • absence of itching and soreness
88
Q

What is a treatment option for bacterial vaginosis?

A

Fleurstat BV Gel (S3!!!!!)
- use 1 applicator full at bedtime for 7 nights (complete the course)

89
Q

Counselling points for bacterial vaginosis

A
  • can take a women’s health multivitamin
  • wipe front to back
  • avoid using soap in genital region
  • avoid perfumes TP and period products
90
Q

What are the symptoms of bacterial conjunctivitis?

A
  • present in both eyes but often one eye affected first by 24-48 hours
  • purulent discharge
  • gritty feeling
  • generalised and diffuse redness
91
Q

Questions to ask for bacterial conjunctivitis

A
  • discharge present?
  • vision disturbances?
  • pain/discomfort/itch?
  • location of redness?
  • duration?
  • photophobia?
92
Q

First line Tx for conjunctivitis

A

Chlorsig eye drops (S3!!!!!!!!)
1-2 drops in each eye every 2-6 hours for up to 5 days

Chlorsig eye ointment (S3!!!!!!!!!!)
1.5cm ointment every 3 hours for up to 5 days

NOTE - weird directions, most resources say different things

93
Q

What are the counselling points for eye drops?

A
  • instillation of eye drops
  • ensure good hand hygiene
  • bathe eyes in Luke warm water to remove nay discharge
  • avoid wearing contact lenses until the infection has cleared
  • highly contagious
94
Q

What is the exclusion period for bacterial conjunctivitis?

A

Until discharge from eyes has ceased

95
Q

What are the symptoms of allergic conjunctivitis?

A
  • present in both eyes
  • thin watery discharge
  • generalised redness (inside eyelid)
  • itchy
  • rhinitis
96
Q

What is an appropriate treatment option for allergic conjunctivitis?

A

Zaditen eye drops
1 drop in each eye twice daily (morning and night)

97
Q

Counselling points for allergic conjunctivitis

A
  • counsel on eye drop use
  • avoid triggers where possible
  • consider an oral antihistamine?

PHRM4012 (6 decks)

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