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Inori Pre Reg > OTC > Flashcards

OTC Flashcards

1
Q

When to refer pt who has vaginal thrush?

A 
Yellow green discharge
More than 2 attacks in the past 6 months
First occurance of symptoms
Pregnancy
Previous history of STD
Under 16 or over 60
Blood
Lower abdominal pain
No improvement within 7 days of treatment
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2
Q

Treatment of vaginal thrush?

A 
Clotrimazole pessary or cream or combo
Fluconazole caps (for males as well if gf has thrush)
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3
Q

Counselling points on vaginal thrush?

A 
Oral treatment may take 12-24hrs
Treatment of sexual partner with cream to apply to the penis is recommended
Avoid nylon underwear, wear cotton
Loose fitted clothes
Avoid deodorants and perfumes
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4
Q

When do pts with mouth ulcers need to be referred?

A

If longer than 3wks. Need to referred urge tly to a specialist to exclude oral cancer

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5
Q

Treatment of oral ulcers?

A

Feirst line: Topical corticosteroids, hydrocortisone muco adhesive tavs should be allowed to dissolve in contact with ulcer QDS

Can combine with local analgesics like benzydamine

Choline Salicylate gel like bonjela can be applied 3hrly max 6 times a day to avoid Salicylate poisoning

Antiseptics like chlohexidine (can stain teeth so brush teeth after)
Max 14 days to prevent iodine absorption

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6
Q

Licensing age of benzydamine mouthwash?

Benzydamine spray?

A

12 plus

6 plus

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7
Q

Constipation accompanied by weight and appetite loss may indicate?

A

Carcinoma

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8
Q

Constipation with weight gain, Lethargy, coarse hair or dry skin suggests?

A

Hypothyroidism

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9
Q

Examples of drugs that can cause constipation?

A 
Opioids
Clozapine
Antimuscarnics
SSRIs
TCAs
Iron
Bendroflumethiazide
Propranolol
Aluminium
CCB
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10
Q

Licensing age of isphagula husk?

A

6 plus

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11
Q

Licensing age of Bisacodyl?

A

10 plus

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12
Q

Licensing age of macrogol?

A

12+

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13
Q

Licensing age of Docusate?

A

12+

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14
Q

What is Docusate?

A

Stool softener

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15
Q

Practical tips on constipation?

A

Plenty of fluids and fibrr
Reduce caffeine
Increase exercise

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16
Q

Referral of diarrhoea?

A

Babies under 3 months is immediately
Children under 1 if longer than a day
Children under 3 if longer that 2 days

People with diabetes if longer than 1 day
Adults and children if longer than 3 days

N&V and fever all increase the risk of dehydration

Signs of dehydration

Change in bowel habit for over 50 with concurrent weight loss

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17
Q

Signs of faecal impaction?

A

Alternating constipation and diarrhoea

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18
Q

Drugs that can cause diarrhoea?

A 
Theophylline
Metformin
Lithihm
SSRIS
NSAIDS
antibiotjcs
Ciclosporin
Digoxin
Magnesium
Diuretics
Iron
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19
Q

What’s the drug group of magnesium hydroxide as a laxative?

Licensing age

A

Osmotic

6+

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20
Q

Signs of dehydration?

A 
Dry skin
Sunken eyes
Dry tongur
Drowsiness
Less urine
Weakness
Cold hand and feet
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21
Q

Management of diarrhoea?

A

First line is oral rehydration therapy for all ages
(make up with water and taken after each loose stool, keep in fridge for 24hrs)

Second line is loperamide for 12 plus non pregnant or bf women

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22
Q

What drugs need to be temporarily withheld during diarrhoea? And why?

A 
ACEi
NSAIDs
Diuretics
Metformin 
To prevent AKI
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23
Q

About babies food and diarrhoea?

A

Formula feeds for babies should be diluted to quarter strength and built back up to normal over 3 days.
During period of diarrhoea, babies should be fed more frequently than normal and feeds supplemented with ORT

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24
Q

What drugs can cause the symptoms of indigestion and heartburn?

A

TCAs
CCBs
NSAIDS
Caffeine

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25
Q

When to refer with indigestion and heartburn?

A 
Children
Over 55 with new symptoms
ALARM
Previous ulcers
Taking antidispepsia for 4wks but no Chnage
Pts with liver disease
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26
Q

Drugs that has alginates?

A

Gaviscon

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27
Q

OTC licensing on ranitidine?

A

over 16 years (provided packs do not contain more than 2 weeks’ supply, (max. single dose 75mg, max. daily dose 300mg).

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28
Q

Important PPI interaction?

A

Increase conc of
Warfarin
Phenytoin
Diazepam

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29
Q

Which PPI can be sold OTC?

A

Omeprazole

Esomeprazole

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30
Q

OTC licensing of omeprazole and esomeprazole?

A

O= 10mg for over 18 years, max. daily dose 20mg for max. 4 weeks, and a pack size of 28 tablets.

E= 18 plus for 2wks

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31
Q

Common side effects of H2 receptor antagonists?

A

Headache
Dizziness
Diarrhoea

Skin rash rare

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32
Q

Common side effects of PPIs?

A 
Headache
Abdominal pain
Constipation
Diarrhoea
Flatulence
N&V
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33
Q

What antacids are recommended for preg women, elderly and hypertention pts with heartburn?

A

A sodium free or low sodium antacid containing an alginate

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34
Q

When to refer with IBS?

A

Children
Adult over 45 presenting with symptoms for the first time
ALARM
Fever
Rectal bleeding may indicate IBD, gastric ulcer or carcinoma

If not had IBS diagnosed, refer them

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35
Q

Lifestyle advice on IBS?

A 
Exercise
Increase fluid intake
Increase fibre
Low fat and caffeine
Avoid smoking and alcohol
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36
Q

Pts taking what drugs need to be referred when selling orlistat?

A 
Ciclosporin as can decrease conc.
Warfarin
Oral Anticoagulants
Amiodaronee
Acarbose

Caution
Orlistat can reduce the effectiveness of oral contraceptives
Can reduce levothyroxine

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37
Q

Age licensing of Topical corticosteroids for haemorrhoids?

A

Plus 18

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38
Q

Another name for mouth ulcers?

A

Aphthous ulcers

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39
Q

When to refer mouth ulcers?

A 
Persist longer than 3wks
Ulcers bigger than 10mm in diameter
More than 5
Weight koss
Recurrent diarrhoea
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40
Q

What drugs can cause mouth ulcers?

A 
Nicorandil
NSAIDS
Cytotoxic drugs
Sulfasalazine
Herbal remedies like feverfew
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41
Q

What can contribute to developing oral ulcers?

A

Deficiency of iron, folate, zinc or vit B12

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42
Q

What local analgesics can be used in oral ulcers?

A

Benzydamine

Choline Salicylate

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43
Q

Licensing age of Choline Salicylate

And its contra indication?

A

It’s for 16+

Those taking methotrexate and Anticoagulants

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44
Q

What can Untreated gingivitis lead to?

A

Gingivitis is gum disease

Leads to periodontitis which includes bad breath (halitosis), unpleasant taste in mouth, loose teeth, gum abscesses

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45
Q

When to refer with gingivitis?

A 
When it is acute necrotising ulcerative gingivitis
Symptoms include
Bleeding, painful gums
Painful ulcers
Receding gums between teeth
Bad breath
Metallic taste in mouth
Excess saliva in mouth
Dysphagia
Fever
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46
Q

Management of gingivitis

A

Good oral hygiene

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47
Q

When to refer pts with oral thrush?

A

Recurrent infection

Symptoms unresponsive to treatment

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48
Q

Treatment of oral thrush?

A

Miconazole (Daktarin oral gel) applied to plaques QDS after food.

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49
Q

Age restriction on miconazole 2% cream

A

4 months plus

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50
Q

Miconazole gel and breast feeding?

A

Reinfection from mother’s nipples during BF or from contaminated bottles might happen so warn

Use is safe in P and BF

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51
Q

Treatment duration of miconazole for oral thrush?

A

Continued for at least 1wk after sympt. S have disappeared

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52
Q

When to refer pts with cold?

A

Under 2 have increased risk of contracting pneumonia so refer if more unqell than normal with SOB,cyanosis
Earache not resolving with Analgesia (most resolve self limitingly within 3 days)
Long term conditions like COPD, asthma, kidney, diabetes, compromised immune system

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53
Q

Names of oral decongestants?

A

Pseudoephedrine

Phenylephrine

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54
Q

MoA of pseudoephedrine?

A

Constructs blood vessels

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55
Q

restriction on pseudoephedrine?

A

6yrs plus for 5 days

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56
Q

Who nerds to avoid pseudoephedrine ad ephedrine?

A 
Hypertensive pts
DM
Bbs
MAOIs
Preganant (BF safe)
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57
Q

Age restriction on phenylephrine?

A

12yrs plus

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58
Q

What is oxymetazoline?

A

Decongestant

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59
Q

Age restriction on oxymetazoline?

A

12 plus

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60
Q

Age restriction on xylometazoline?

A

6 plus

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61
Q

What’s diphenhydramine and why is it usdd in cold?

A

An antihistamine

Relieves runny nose and sneezing by anticholinergic effect

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62
Q

Age restriction on diphenhydramine?

A

6 plus

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63
Q

Who needs to avoid antihistamines?

A

Pts with prostatic hypertrophy
Epilepsy
Glaucoma
Bc antimuscarnic effect increase urinary retention, seizures and pressure

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64
Q

When to refer coughs?

A 
Longer than 3wks
Coloured sputum
Blood in sputum (if pink, suggests HF)
Condition
Harsh barking cough (croup)
SOB
Difficulty breathing
Wooping cough
Night time cough
ACEi
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65
Q

What’s used for dry irritation non productive coughs?

A

Cough suppressants

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66
Q

What drugs work as cough suppressants?

A

Demulcents = simple linctus, honey and lemon, (good for any cough), Glycerol

Anti tussives = codeine and dexomethrophan

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67
Q

Whats used for productive chesty coughs?

A

Expectorant like guafenacin (best)
Ammonium chloridr
Ipecacuanha
Squill

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68
Q

How can antihistamines be used for coughs?

A

Drys up secretions that may be triggering the cough

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69
Q

Guafenacin licensing?

A

200mg QDS for 6+

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70
Q

Pholcodeine licensing?

A

6 plus

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71
Q

Simple linctus age licensing?

A

1 months plus

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72
Q

How long can pholcodeine be used for?

A

No longer than 5 days

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73
Q

When to refer sore throats?

A

Longer than 10 days
Dysphagia
Red and swollen tonsils or and lymph glands

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74
Q

What analgesics can be used for sore throat?

A

Paracetamol
NSAIDS
Flurbiprofen (strefen) lozenges

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75
Q

Flurbiprofen (strefen) otc licensing age and duration?

A

12+

For 5 doses per day 3 days max

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76
Q

Local anaesthetics used for sore throat?

A

Benzocainr
Lidocaine
Sprays or lozenges

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77
Q

Licensing age and duration for Benzocaine lozenges? Spray?

A

3+ for max 5 days

6+ for max 5 days

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78
Q

Local antiseptic used for sore throat?

A

Benzalkonium in lozenges

79
Q

What is benzydamine and its licensing age?

A

An inflammatory DIFFLAM! for sore throat
Rinse for 12+
Spray for 6+

80
Q

What pollen is major in April?

A

Tree pollen

81
Q

What pollen is major in May-July?

A

Grass pollen

82
Q

Examples of intranasal corticosteroids?

A

Beclomethasobe
Budesonide
Fluticasone
12hrs onset with max efficacy reached after few days
Begin treatment 2-3wks before the allergic season and continue throughout
Max 3 months for 18+

83
Q

What’s first choice OTC product for child with seasonal allergy?

A

Sodium cromoglicate

84
Q

What OTC drug is not permitted for athlete’s in competition?

A

Ephedrine

85
Q

What OTC drug is not permitted for athlete’s in competition?

A

Ephedrine

86
Q

Honey is contraindicated in what age?

A

Under 12 months

Use simple linctus instead for 1 months plus

87
Q

Licensing age for sodium cromoglicate eye drops?

Nasal?

A

6+

5+

Safe in preg as well

88
Q

Licensing age for acrivastine?

A

12+

Avoid in preg and BF

89
Q

Licensing age jn Cetirizine and Loratadine?

A

2+

Avoid in preg and BF

90
Q

Licensing age in Chlorphenamine?

A

1+

Safe in preg

91
Q

How to take hyoscine hydrobromide?

A

Take tabs 30mins before travel to last for 6-8hrs

92
Q

How to take antihistamines for motion sickness?

A

Cinnarizine, promethazine, meclozine

Take 2hrs before and effective for 8hrs

93
Q

Non drug treatment for motion sickness?

A

Ginger

Accupressyre bands

94
Q

Headache referral?

A

First episode of migraine over the age of 40
Any headache that doesn’t respond to OTC within a day
Dull pain that is deep seated and Aggravated by lying down or pain that is worse in the morning and improved during the day may indicate raised intracranial headache
Women on COC
Headache longer than 4hrs
Under 12
Neck stiffness
Flowing recent trauma

95
Q

Why is caffeine included in headache preparations?

A

Can improve the absorption of analgesics but caffeine can cause withdrawal headaches

96
Q

Why is codeine not recommended in migraine?

A

Can reduce gastric motility and has an emetic action so may worsen nausea

97
Q

What drugs can potentially cause insomnia?

A 
Fluoxetine
MAOIS
phenytoin
Theophylline
Corticosteroids
98
Q

When to refer insomnia?

A

Suspected depression

Under 16

99
Q

Antihistamine is contraindicated in?

A

Glaucoma

Prostatic hypertrophy

100
Q

What antihistamine are used for insomnia and their licensing age?

A

Promethazine
Diphenhydramine
16+

101
Q

What’s the name of Head lice?

A

Pediculus capitis
Grey brown 1-3mm long
Female lays eggs on the hair shaft near scalp surface
Egg is firmly affached and not washed awag
Hatches in 7 days and leave shell/nits
Nymph lice take 12/7 to adulthood

102
Q

Names of insecticides used for head lice?

A

Permethrin and malathion

103
Q

MoA of dimeticone?

A

Different to insecticides

Traps and suffocated the lice

104
Q

How to apply insecticides?

A

Apply once and leave on hair for 12hrs
Then apply another 7 days after
Average hair requires 50mls

105
Q

Alcohol formulations are preferred in head lice treatment except for who?

A

Asthmatic

Severe eczema where aqueous formulations are safer

106
Q

How to apply alcohol liquids for head lice?

A

Allow to dry naturally and avoid swimming as chlorine in activates

107
Q

How to apply alcohol liquids for head lice?

A

Allow to dry naturally and avoid swimming as chlorine in activates

108
Q

How to apply dimeticone (hedrin)

A

Leave on for 8hrs and reapply again after 7 days

109
Q

How to wet comb head lice?

A

Wet hair renders lice motionless so they can be removed
Repeat every 4 days over a 14 days period until no lice seen on 2 consecutive occasions
Best option for preg and BF and under 2yrs

Electric comb exists as well when electric current kills lice but not eggs

110
Q

Who needs to be treated with head lice?

A

Only those in the household who ate affected and apply on the same day to avoid reinfestation

111
Q

Headline advice to pt?

A

Products can stain clothes, bedding, pillow cases and can have strong smell

112
Q

What is scabies?

A

Scabies mites burrow beneath the skin surface to cause allergic reaction.
Very intense itching especially at night
Fine silvery Rash appears when female burrows into skin and lay eggs

113
Q

When to refer scabies?

A

Babies and children. Red flag if baby under 2
Sexondary infection of skin
Treatment failure
Unclear diagnosis

114
Q

What’s the treatmrnent of scabies?

A

Everyone in the household must be treated even if asymptomatic

First line is premethrin 5%
Second line is malathion 0.5% (first line in preg or Bf)

115
Q

Premethrin age licensing?

A

2yr plus

116
Q

How to apply premethrin and malathion?

A

Apply all over the body and wash off after 8-12hrs for permethrin
24hrs for malathion
Reapply 7 days after
Do not apply after hot bath as increase systemic absorption

117
Q

How to apply malathion in BF women?

A

Remove from nipple before feeds and then reapply

118
Q

Pt advice on scabies?

A

Wash everything at 50 degrees to kill

Itch will continue for 2-3 wks even after treatment

119
Q

When to refer threadworm?

A 
Appetite loss=weight losee
Insomnia due to itchiness
Recent travel abroad
Failed treatment
Children under 2
120
Q

Treatment of threadworm?

A

Mebendazole 100mg STAT repeat after 14 days if reinfection susoected

All memebers of the family should be treated

121
Q

Licensing on mebendazole?

A

2yr plus

Not for preg or Bf

122
Q

Practical tips on threadworm?

A 
Close fitting oj bottoms to avoid shedding eggs
Shower first thing in the morning
Cut fingernails short
Good hygiene around toilet and food prep
Wash bedding and towels daiks
Vaccum daily
123
Q

Symptoms of cystitis?

A

Dysuria
Urgency to urinate
Cloudy and smelly urine

124
Q

When to refer cystitis?

A 
Children
Men
Preg
Blood in urine
Vaginal discharge
Fever, N&V
Loon pain
Longer than 2 days
Failed treatment
125
Q

Treatment of cystitis?

A

Potassium or sodium citrate for 2 days

126
Q

Potassium citrate should not be used in pts with?

A

Pts taking K sparing diuretics

ARB or ACEi

127
Q

Sodium citrate should not be given to pts with?

A

Hypertention
Pts with heart disease
Pregs

128
Q

Symptoms of dysmenorrhoea?

A

Lower abdo, pelvic pain that can radiate to back and thighs before or during menstruation
Most severe ar the start of period and can include headache, N&V, dizziness

129
Q

When to refer dysmenorrhoea?

A 
GI bleed
Hypersensitivity to NSAIDs
Asthmatics
HF, kidney and liver djsease
Preg or BF
130
Q

Naproxen licensing for OTC?

A

For 15-50
500mg STAT then 250mg 6-8HRS later

No more than 3 tabs each day
No more than 3 days treatment in any one month

131
Q

What drug is available OTC for Menorrhagia?

A

Tranexamic acid

132
Q

Licensing age of tranexamic acid?

A

18+

Women with regular 25-35day cycle with no more than 3 days individual variability in cycle duration

133
Q

Dose of tranexamic acid?

A

Start taking once heavy bleeding has started.
2 tabs TDS for max 4 days
Max 4g per day

If no improvement within 3 Menstural cycle, stop using

134
Q

Drug names of artificial tears usdd for dry eyes?

A

Hypromellose PRN
Discard after 28 days

Carmellose
Polyvinyl alcohol
Carbomer gel
Wool fats

135
Q

Drugs of lubricant ointment/ tear substitute used for dry eyes?

A

Lacrilube
Prolonged lubrication of the eye so good to use ON
Transient blurring and so not for use while wearing contact lenses

136
Q

What preservatives are usdd in eye drops?

A

Benzalkonium chloride

Can cause eye irritation so use preservative free

137
Q

Symptoms of blepharitis?

A 
Itchy sore red eyelids
Stick stogerthrr
Eyelashes become crusty
A burning gritty sensation
Increased sensitivity to light (photophobia)
Abnormal eye lash growth or loss

Both eyes tend to be affected

138
Q

When to refer blepharitis?

A 
Unresponsive to treatmebt
Concurrent coniunctivitis
Stte
Eye pain
Worsening vision
139
Q

If blepharitis doesn’t responsed to gentle cleaning with warm soaked cotton, what can be used?

A

OTC eye drop/ointment containing dibrompropamidine isetionate
Or
Propamidine isetionate

Called Golden eye or Brolene ointment

140
Q

When to refer ear wax ears?

A

Unusual discharge from the ear
Persistent pain from within the ear
Tinnitus (ringing in the ear)
Unresolved after 3 days

141
Q

How to manage ear wax?

A

soften ear wax with cerumenolytics (urea hydrogen peroxide which hydrates the was allowing it to be removed)
Or Glycerol, Salicylate (softeners)
Docusate (surfactant)

Apply and lie with ear uppermost for 5-10mins

142
Q

When to refer otitis externa?

A 
Deafness
Persistent pain from within the ear
Tinnitus
Vertigo
Blocked ears
Discharge
Bleeding
N&V
Children under 12
143
Q

Management of otitis externa on pharmacy?

A

Refer to doctor to confirm diagnosis

But could use acetic acid 2% spray for 12+

144
Q

Acetic acid pt advice?

A

Use should be stopped and medical advice sought if no improvement is seen within 2 days of treatment

145
Q

Chicken pox symptoms?

A

3ish days of fever, headache, sore throat and malaise
Then small red limps rapidly develop and develop into vesicles/blisters in about 12hrs ish usually on the face, scalp and trunk
Vesicles burst forming crusted spots over a few days then healing over the next 1-2wks

146
Q

What causes chickenpox?

A

Varicella zoster

147
Q

What causes shingles?

A

Reinfection by the varicella zoster virus

148
Q

Symptoms of shingles?

A

An infection of the nerve and skin around it. Usually when older, stressed, taking meds that weaken the immune system, has weak immune system from HIV etc
Usually affects a specific area on one side of the body and does not cross over the midline of the body

149
Q

Measel symptoms?

A

After 2 or 3 days of fever, cold symptoms and malaise, the typical rash of red, confluent, blotchy begins at the hairline and progresses down to cover the whole body and lasts for 3 days.
Complications include otitis media, laryngitis, pneumonia and rarely fatal progressive encephalitis

It’s a dangerous disease because of its complications

150
Q

Treatment of measles?

A

Paracetamol
Hydration
Clean eyes with damp cotton swabs to help with crusting around the eyes
Stay away from school for about 4 days after rash appears

151
Q

What is MMR vaccine and who gest it?

A

Measles, mumps and rubella

Offered to 12_13 months

152
Q

Treatment of mumps?

A

Paracetamol or ibuprofen for symptomatic relief
Keep hydratrf
Avoid citrus juices as may worsen the oaun
Stay away from school for about 5 days after the swelling appears

153
Q

What causes mumps?

A

Paramyxovirus

154
Q

Complications of mumps?

A

Enceohalitis
Pancreatitis
Orchitis (infection of the testes in post oubertial males may cause infertility)

155
Q

Rubella symptoms?

A

Cold fever and then 7 days later ish, macula rash appears on the face and spreads to trunk and limvs
BLANCH with pressure
Spots do not become confluent like measoes
Rash lasts for 3 to 5 days
Swollen glands may be present

In adults, rubella may be associated with painful joint

156
Q

Complication of rubella?

A

High risk of damage to the foetus if contracted in early oregnancy

157
Q

Treatment of rubella?

A

Hydration
Paracetamol or ibuprofrn
Stay away from school for 6 days after rash appears

158
Q

When is the vaccine for whooping cough done?

A

2 months baby

159
Q

What can cause a bacterial meningitis?

A

Neisseria meningitis

Streptococcus pneumonia

160
Q

What causes viral meningitis?

A

Enteroviruses

Herpes simplex virus

161
Q

What is cradle cap?

A

Seborrhoeic dermatitis seen on the scalp
Red sharply marinated lesions with greasy looking scales
Caused by malssezia ocale
Chronic condition rgaf will flare and remit
Scales are yellow brown in colour

162
Q

Treatment of cradle cap?

A

Regularly wash scalp with baby shampoo with soft brush to loosen scales
Can use oild followed by shampoo
Could suggest ketoconazole 2% shampoo twice a week

163
Q

Colic symptoms?

A

Excessive crying in an otherwise well baby
At least 3hrs/day, 3days/week for at least 3wks
Usually from a few weeks to 4-5months

High pitches crying
Same time each dag
Swollen tummy
Red in face

164
Q

When to refer colic?

A

Weight loss

165
Q

Drugs that contain simeticone?

A

Infacol
Dentinox
COLIEF

166
Q

When to refer nappy rash?

A 
Yellow crusts or weeping as it may indicate a bacterial infection
Broken skin
Symptoms for longer that 2wjs
Concomitant oral thrush
Other body areas affected by rash
167
Q

Treatment of nappy rash?

A

Barrier cream like sudocream or metanium to protect skin from faeces and excess moisturr

If fungal infection (small red lesions) antifungal creams BD to TDS for 7-10 days

Could use oik to provide water resistant barrier
Lanolin as an effective emollient
Zinc as soothing agent

168
Q

When tk refer eczema?

A 
Signs of infection
Severe symptoms (cracked, bleeding)
Symptoms unresponsive to tretment
Not been diagnosed and unidentified cause
Symptoms lasting longer than 2wks
169
Q

Urea are used jn cream because?

A

Act as a hydrating agent

170
Q

Licensing age for hydrocortisone 1% cream?

A

Over 10

171
Q

Licensing age for clobetasone 0.05%?

A

12+

172
Q

Whay drugs can cause acne?

A 
Lithium
Phenytoin
Progestogens
Levonorgestrel
Noresthisterobe
173
Q

When to refer acne?

A

If its acne rosacea where middle aged pts present with reddening cheeks and for head alongside pupils and pustules but confined to face only

Symptoms unresponsive to 8wks of treatment

174
Q

Treatment of acne?

A

Benzoyl peroxide use low strength and titrate if necessar

175
Q

When to refer cold sores?

A 
Painless lesions as may indicate cancerous
Babies
Lasting longer than 2wks
Eye affected
Immunocompromisrd
176
Q

Treatment of cold sores?

A

Aciclovir esp effective if started proderomal phase
Applied five times /dat

Hydroxollid patch

177
Q

Where does planter warts (verrucae) appear?

A

Sole and heel

178
Q

Where does plane warts appear?

A

Feca or hands

179
Q

When to refer warts?

A

Facial and genital
Change in appearance (as may suggest cancer)
Bleeding
Itching
Immunocompromisrd
No significant improvements within 3 months of OTC
Diabetes

180
Q

Treatment of warts?

A

Not needed unless causing pain or stress

Salicylic acid to soften and destroy skin
Apply daily and protect surrounding skin

Gutaraldehydte and lactic acid (Bazooka) for 3 months to see if improvement

181
Q

Pt advice on warts?

A

Tretment works better if applied after soaking the affected hands or foot in warm water for 5-10mins

Remove dead skin with the use of emery board

182
Q

Treatment of dandruff?

A

Ketoconazole 2% shampoo is first line used twice a week for 2-4wks

Selenium 2.5% twice weekly for the first 2wks and then weekly for the next 2wks then PRN

Both treatment should be left for 5mins before rinsing

183
Q

Symptoms of psoriasis?

A

Silvery white scales on the extensor surfaces of the elbow and knee and sometimes Lowe back and scalp
Itchy

Tirggered by stress and fingernails might show pitting

184
Q

What drugs can trigger psoriasis?

A

Lithium
NSAIDS
BB
Chloroquine

185
Q

Referral of psoriasis?

A

Pts not being diagnosed yet

Moderate to severe

186
Q

Treatment of psoriasis?

A

Emollien esp in acute flare

POM include tar based, Salicylic, dithranol, calcipotriol

Topical steroids are Not licensed OTC

187
Q

Distinctive symptoms of tinea infection?

A

Has a distinctive active border around the red and scaly rash

188
Q

What can you use to treat tinea pedis?

A

Athlete’s foot
Use cream if soggy skin, ointment if dry
First line is imidazole cream or Terbinafine

Clotrimazole and miconazole Topical are safe in preg and BF

189
Q

How to manage tinea corporis? Or tinea cruris?

A

Ring worm and genitals infection

Imidazole creams or terbjna

190
Q

When to refer impetigo?

A

If first time refer
Self limiting but treat as risk of transmission

First line is 1% hydrogen peroxide the only available OTC product

Keep child away from school until 48hrs after of healing

191
Q

Management of teething in children?

A

Para or ibu
A chilled teething
Petroleum jelly around the mouth and chill will prevent rash and soreness from excessive drubbing

192
Q

When to refer back pain?

A 
Following major trauma
New back pain in unde 20 or over 50
Weight loss
Past history of malignancy
Associated Bladder ot bowel symptoms motor weakness in legs
Fever
193
Q

Treatment of sweat rush?

A

Imidazole

Inori Pre Reg (22 decks)

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