PAEDIATRIC OTC Flashcards by Vivian Grigoriou

Medicine at school

medicine must be labelled with full details
may be able to change dosing schedule to avoid administration at school

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pyrexia and fever

forehead thermometers are not sufficiently accurate to be recommended

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pyrexia/fever is caused by

resulting from viral or bacterial infections causing the body to increase the set body temperature

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important questions

age we can NOT manage under 3 months
how is the child
what other symptoms present (uti for eg)

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treatment and licensing

paracetamol from 2 months for post-immunisation
LICENSED from 3 months for general pyrexia and pain
Ibuprofen
LICENSED FROM 3 MONTHS OF AGE AND >5KG

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atopic eczema onset

2-6months of age usually with family history of “atopy” eg eczema, asthma and hayfever

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atopic eczema diagnosis

an itchy skin condition in the last 12 months, usually visible flexural eczema

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atopic eczema presentation

lesions may be moist or weeping
skin may be thickened lichen field
scratch marks are often evident
atopic children ->prone to infection with herpes simplex

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differential diagnosis

seborrhoeic dermatitis
proriasis (adult condition)
hives/allergy
contact dermatitis

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treatment for atopic eczema

chlorphenamine antihistamine from 1year
e45 cream >1month (as much and as regular as possible)
hydrocortisone 1% cream
apply BD for a MAX of 7 days
avoid triggers

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cough and cold preparations for chldren under 12 years preparations

tixylix baby syrup (glycerol)> 3months
calpol saline nasal drops >from birth

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teething

from 3 months to 3 years

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teething symtoms

pain
swollen gum
red,hot cheeks
excessive dribbling
nappy rash

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teething otc tx

1st line treatment: paracetamol suspension >3months
anbesol teething gel (lidocaine) >5 months

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abnesol teething gel application

pie-size amount to a clean finger on the affected area, max of 6 times a day. For NO more than 7 days

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When do colic occur

from about three weeks to 4 months of life
unknown cause
more common in evenings

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colic tx

dentinox colic drops
dimeticone § surface active agent
you add it to babys milk

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constipation in children

fairly common in children and often related to changes in diet/hydration

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constipation treatment

senna +12 years
glycerol suppositories
diet changes

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threadworms transmission

transmission via
- faecal -oral route
-retro infection
-inhalation

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threadworms typical presentation

noctural perianal itching
possible observation of worms on the stools
retro infection ->continuous re infection

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threadwroms refer

treatment failure
secondary infection

treadworms treatment

mebendazole (ovex) tablets or suspension >2 years
take one tablet chewed or swallowed.
second tablet taken after 2 weeks to avoid reinfection.
WE NEED TO TREAT THE WHOLE FAMILY

counselling

nails kept sort and clean
srub nails and hands after each toilet use and before meals
wash bed linen daily if possible
wear underwear under night clothes to prevent scrathcing

head lice

eggs laid at the top of the scalp treatment encapsulates the lice and sufficates it. we can NOT penetrate the eggs.

headlice treatment

hedrin 4% repeat after 7 days to ensure you have killed any eggs that might have been laid. leave it on the head for as long as possible and then wash off. use detecting comb-> no gaps in the comb

treat only if

itchy head and via seeing live louse

transmission if head lice

transmission via head to head contact we do NOT have to treat the whole family

impetigo presentation

small red lesions which weep and form yellow yellow crust touch causes spread of infection

impetigo treatment

hydrogen peroxide 1% cream apply BD or TDS for 5 days

counselling

easy to pass infection make sure they use own towels and face cloths keep away from school until rush clears

slapped red syndrome-> viral incfection

Paravirus B19 bright red rask on cheeks slight fever runny nose flu like symptoms

treatment

Paracetamol it can clean in 5-7 days

hand, foot and mouth presentation

fever soar throat coughing spotting blister or mouth ulcers

treatment

self limiting 7-10 days paracetamol fluids

sraclet fever symptoms

white coating of the tongue ->strawberry tongue flu like symptoms high fever blanching rash appears 12-48hrs after

scarlet fever caused by

streptococcus pyogenes

scarlet fever treatment

REFER for penicillin QDS for 10 days

scarlet fever counselling

if NO antibiotics can spread for 2-3weeks after symptoms onset

measles

dangerous disease but is notifiable disease ->patients can get post measles encepgalopathy

suspected measles

immediate referral REQUIRED

Measles incubation period

7-14 days

what can help with diagnosis?

the patient feels unwell systemically and has kopliks spots in the mouth and body

german measles

not as severe as measles

germal measles incubation period

14-21 days with a prodromal phase of 5 days

chickenpox cause by

varicella zoster virus

incubation period

15-18 days and until rush scabs over is infectious

chickenpox tx

Antihistamines -chlorphenamine >1year analgesia paracetamol AVOID NSAIDS calamine lotion or E45 cream

in immunocompromised patients

aciclovir POM

counselling for chickenpox

stay away from school and work until blister becomes scabs bath with cool water and pat dry cut nails to stop scratching drink plenty of fluids avoid sharing towels

whats shingles

reactivation of the chickenpox virus varicella zoster

shingles counselling

antihistamine e45 cream or hydromol rest paracetamol or ibuprofen

shingles red flags

pregnant immunocompromised above 50 years eyes afffected

meningitis symptoms

severe headache phtophobia skiff neck drowsy rash stomach/joint/muscle pains