OTC topics Rx Meds Flashcards
Meds for bacterial vaginosis
pref:
Metronidazole PO - GI, urine burning/discol - safe in pregnancy, dont breastfeed 24h after 2g single dose
Metronidazole PV - leakage, yeast inf
Clindamycin PV - after menses, dec condom efficacy
alt:
Clindamycin PO - GI, C Diff
Meds for cold sores
Acyclovir within 1h 5/day F5D
Valacyclovir within 2h BID F1D
Famciclovir within 1h BID F1D
No A/E
Dukurol counselling
Prevents diarrhea caused by ETEC
Refrigerate, 2 doses 1w apart, finish 1w before travel
Insomnia benzos counselling
Avoid in 1st trimester
Use intermittently, and if more than 2 7-day trials, refer to specialist
Isotretinoin/Accutane counselling
-teratogenic need 2 forms of BC
-duration 12-16week then 8 weeks off
-s/e: dry mouth/eye/nose, muscle/joint/headaches,
-wear sunscreen, monitor for mood changes
-rare: SJS/TEN, mood disorder, pseudomotor cerebri
-no vit A, alcohol
Topical retinoids counselling
Apply 30 min after cleansing and moisturizing before bedtime
Start with small quantity and increase slowly to prevent redness, irritation
Use moisturizer and sunscreen bc photosensitizing
Use BPO in morning, DDI
Tacrolimus, Pimecrolimus
use, considerations, s/e
Calcineurin inhibitors for dermatitis
immunomodulators, anti-inflammator, fungicidal
less effective than mod-high corticosteroids
safe for face/folds
s/e: irritaition
Flamazine
silver sulfadiazine 1% cream for burns
antibacterial
may irritate skin so patch test first
apply thick layer daily
may cover with dressing
discard in 7 days
Rosacea treatment algorithm for papules/pustules
1st line
topical azaleic acid, metronidazole, or ivermectin
2nd line
oral tetra or doxycycline
3rd line
isotretinoin low dose
trial each for 8-12 weeks
azaleic acid 15% gel s/e scaling, irritation
Rosacea treatment algorithm for erythema
topical brimonidine 0.33% gel applied BID
s/e: may reveal telangiectasia, cause burning, headache
Calcitriol, calcipotriol
Use, considerations, s/e
vitamin d derivatives for psoriasis
CI: face, folds
s/e: irritation
1st line meds for psoriasis
non-pruritic, silvery scaling plaques, red folds
-topical corticosteroids
-anthralin
-vit d derivatives calcitriol, calcipotriol
-tazarotene
-sal acid
-calcineurin inhibitors tacrolimus, pimecrolimus
2nd line for severe: immunosuppressives
Nystatin suspension
use, considerations, s/e
1st line for oral candidiasis
swish and swallow QID x7-14d
AE: n/v/d/r - not absorbed systemically
2nd line are azoles PO
Triptans
use, considerations, s/e
-used for migraines in ages 12 and up
-CI: CVD, sustained HTN,
-most can be repeated in 2h and max 2 doses in 24h but 2nd dose likely ineffective if no relief from 1st
-s/e: chest/throat discomfort, drowsiness, numbness, nausea
-naratriptan fewest s/e but slowest onset repeat in 4h not 2
-sumatriptan po most effective, nasal fastest onset, sc repeat in 1h
-SL may take without water: zolmitriptan ODT, rizatriptan wafer
Ergots
use, considerations, s/e
dihydroergotamine nasal spray or injectable for migraines
1 spray ien repeat in 15m if needed
s/e: rhinitis, nausea, taste disturbance
CI: CVD, PUD, renal/liver dx, CYP3A4 inhibitor
