POM to P supply Flashcards
What is amorolfine nail lacquer?
treatment indicated for mild cases of fugal infection
- beneath the tips and sides of nails
- caused by dematophytes, yeast, moulds
- affecting up to two nails
What is onychomycosis?
infection of the nail apparatus by fungi
- dermatophytes, yeasts and moulds
dermatophytes can cause athlete’s foot (tinea pedis) and ringworm (tinea corporis)
What are risk factors for fungal infection?
diabetes mellitus
psoriasis
immunocompromised patients
increasing age
smoking
How does amorolfine work?
is a topical broad spectrum antimycotic agent
- has fungicidal effect
= inhibits sterol synthesis and disrupts the fungal cell membrane leading to cell death
evaporates on the nail surface to leave a highly concentrated deposit of amorolfine in an occlusive film on the nail
- acts as a depot from which amorolfine penetrates and diffuses through the nail plate over the next 7 days
What are counselling points for amorolfine?
surface of the nail should be cleansed and degreased
affected areas of the nail should be filed down
- debris can be source of reinfection
should be applied on the same day each week
- weekly treatment
nail disorders are common alongside treatment
- nail discolouration, broken nails, brittle nails
What are counselling points for chloramphenicol use for acute bacterial conjunctivitis?
bathe the eyes with tepid water to remove discharge
avoid sharing towels, face cloths and discard eye cosmetics
- eye infections tend to spread easily
blurring of vision may occur after administration
- avoid driving or operating machinery until clear
How does chloramphenicol work?
is a broad spectrum bacteriostatic antibiotic
- binds to bacterial ribosomes and inhibits bacterial protein synthesis
What are the symptoms of infective conjunctivitis?
inflamed, watery and red/pink eyes
eye discomfort/itching
- burning or gritty, lid swelling
eye discharge
When should patients be referred with infective conjunctivitis?
vison changes
photophobia
pain or swelling in/around the eye and face
contacts lens use
patient already using other eye drops or ointment
suspected foreign body in the eye or eye injury
pupil looks unusual - torn, irregular, dilated or non-reactive to light
cornea looks cloudy
eye movement is restricted
history of glaucoma or dry eye syndrome
history of bone marrow problems
pregnant or breast feeding
no improvement despite use
When is chloramphenicol contraindicated?
hypersensitivity reactions
- angioneurotic oedema, anaphylaxis, urticaria, fever, vesicular and maculopapular dermatitis
myelosuppresion during previous exposure
- bone marrow activity is reduced
family history of blood dycrasias
children <2 years
What are the types of OTC, P and POM treatments for malaria?
OTC
- maloff = proguanil 100mg / atovaquone 250mg tablets
P
- malarone = proguanil 100mg / atovaquone 250mg tablets
- avloclor = chloroquine 250mg tablets
- paludrine = proguanil hydrochloride 100mg
POM
- mefloquine
- doxycycline
Who should not be given mefloquine?
What is the counselling for doxycycline?
mefloquine
- should not be given if the patient has epilepsy or depression
= associated with neuropsychiatric reactions
doxycycline
- must avoid sunlight = can cause phototoxicity
- must be given to those >12 years
What is the duration of treatment for the following malaria treatments?
chloroquine
proguanil hydrochloride
mefloquine
atovaquone with proguanil hydrochloride
doxycycline
started 1-2 days before travelling
- atovaquone with proguanil hydrochloride (Maloff)
- doxycycline
started 1 week before travelling
- chloroquine
- proguanil hydrochloride
started 2-3 weeks before travelling
- mefloquine
continued 1 week after leaving the area
- atovaquone with proguanil hydrochloride
continued 4 weeks after leaving the area
- doxycycline, chloroquine, proguanil hydrochloride, mefloquine
What are the symptoms of malaria?
fever
sweats and chills
headaches
muscle pains
lethargy
diarrhoea and vomiting
What is travel advice for malaria?
travel first aid kit
rehydration sachets
anti-diarrhoea medicine
water purification tablets
travel sickness tablets
insect bite cream
antihistamine
sun protection cream and DEET
