Pharmacy management of common parasites

Question 1

How can basic communication help diagnose, treat and advise about common human parasites presented in a pharmacy (2)

Answer 1

1. Reassurance – remember this can be a very embarrassing condition for the patent
2. Remove stigma. No medical hazard or indication of uncleanliness

Question 2

How a pharmacist can help patients with threadworms (2)

Answer 2

1. Mebendazole 100mg
2. treat the whole household

Question 3

How a pharmacist can help patients with lice (3)

Answer 3

1. Only treat if live louse is found, all in the household are to check.
2. The choice of treatment depends on personal preference, contraindications and previous experience.
3. Or we combing using a ‘nit comb’.

Question 4

How a pharmacist can help patients with scabies (6)

Answer 4

1. Permethrin cream first choice
2. Malathion lotion as option if allergic to chrysanthemums or permethrin failure
3. Two applications a week apart
4. Treat all household members and close contacts within 24 hours
5. Provide symptom relief for itching
6. Refer for antibiotics if suspect infection

Question 5

How a pharmacist can help patients with pubic lice (6)

Answer 5

1. Malathion lotion suitable for everyone. Remember patient preference
2. Permethrin cream suitable for over 18 years old and not pregnant or breastfeeding
3. If resistance change to other class of insecticide
4. Apply to whole body except eyes twice one week apart and leave on for specified period
5. Simple eye ointment BP may be used for eyelash infections. Twice daily for eight to ten days
6. Treat close contacts at the same time

Question 6

How a pharmacist can help patients with bed bugs

Answer 6

Bites generally don’t require treatment, but symptomatic relief of itching can be provided

Question 7

What specific advice is there to help prevent threadworms in the community. (5)

Answer 7

1. Wash hands using technique.
2. Wash and change underwear regularly and wash clothes to.
3. Minimise unnecessary direct contact with infected contact.
4. Take regular showers.
5. Heat and cook food properly.

Question 8

What specific advice is there to help prevent lice in the community. (2)

Answer 8

1. Must follow product instructions carefully. Incorrect use will lead to treatment failure.
2. Check treatment success by detection combing at two/three, or nine/ten days after completing the treatment course

Question 9

What specific advice is there to help prevent scabies in the community. (6)

Answer 9

1. Itching may take weeks to clear – patient expectation!
2. Whole body treatment including face and scalp. Special attention to finger and toe gaps
3. Don’t apply after a hot bath
4. Avoid close contact with others until they have been treated
5. Hot machine wash clothes towels and bed line on first day of treatment
6. The Health Protection Team (NHS England) should be informed of outbreaks in schools, nursing homes, etc.

Question 10

What specific advice is there to help prevent pubic lice in the community. (5)

Answer 10

1. Must follow product instructions carefully. Incorrect use will lead to treatment failure.
2. Avoid close contact with others until they have been treated
3. Condoms do not protect against infection
4. Consider referral to genito-urinary medicine (GUM) clinic for screening for other sexually transmitted infections
5. Hot wash clothing bedding and towels

Question 11

What specific advice is there to help prevent bed bugs in the community. (4)

Answer 11

1. Remove stigma. Not medical hazard or indication of uncleanliness
2. Be wary of old mattresses.
3. If you find bedbugs at home, you should contact your local council or pest control service.
4. Bed bugs are incredibly difficult to get rid of by yourself and are often resistant to many standard insecticides.