POM to P Supply of Infections in Community Pharmacy Flashcards
What is amorolfine 5% nail lacquer used for?
For mild fungal infections affecting the tips/sides of up to 2 toenails only
When should you refer a patient who wishes to buy amorolfine 5% nail lacquer?
Diabetic
Immunocompromised
<18 years old
If >2 nails are affected
If the whole nail/bottom of the nail is affected
What is the presentation of a fungal infection of a toenail?
Crumbly/flaky nail
Thickening of nail
Discolouration
Nail separating from nail bed
Yellow/white colour
Brittle
What happens to amorolfine 5% nail lacquer when it is applied?
The solvent evaporates and leaves a highly conc. deposit which penetrates into the nail
What is the mechanism of action of amorolfine?
It is a topical antifungal which inhibits sterol synthesis. preventing the fungal cell membrane from forming
What is the dosing of amorolfine 5% nail lacquer?
Must be applied ‘like nail polish’ once a week at the same day for a min. of 9 months
What are some counselling points to consider for amorolfine 5% nail lacquer?
Nail must be filed down/cleaned before application
Do not wipe any excess nail lacquer onto the neck of the bottle to avoid contamination
Avoid contact with eyes/ears
Applicator must be cleaned after every use
Debris from the infected nail can restart another infection e.g. athletes foot - treat with e.g. terbinafine/clotrimazole
What are some contraindications for the use of amorolfine 5% nail lacquer?
<18 years old
Avoid if pregnant/breastfeeding
If any allergies to amorolfine
What is chloramphenicol used for?
Acute bacterial conjunctivitis for >2 years old
What is the dosing of chloramphenicol?
1 drop every 2h for the first 2 days, then 1 drop every 4h for the next 3 days.
How many times a day should a patient apply chloramphenicol eye ointment?
3-4 times a day
When should you refer a patient who wishes to buy chloramphenicol?
<2 years old
Pregnant/breastfeeding
Photophobia
Blurred/cloudy vision
Pain
Bloody discharge/bloodshot eye
No response after 2 days of treatment
Distorted pupils
Swelling of eye
Using other eye drops
Restricted eye movement
Bone marrow suppression present
If they wear contact lenses
What are the counselling points for chloramphenicol?
Bathe eyes in lukewarm water to remove discharge
Condition is self-limiting
Use 1 bottle per infected eye
Avoid sharing bottles if >1 person affected
Avoid sharing towels/facecloths/eye cosmetics
Wash/dry hands before/after using eye drops
Store in fridge and discard after 5 days
What are the symptoms of acute bacterial conjunctivitis?
Inflamed watery pink eye
Burning/gritty around the eye (no pain)
Dried crusts when waking up
Yellow/sticky discharge
What are the symptoms of malaria?
Fever
Sweats/chills
Muscle pains
Lethargy
Diarrhoea
Vomiting
What is contained in Maloff Protect?
Atovaquone 250mg and proguanil hydrochloride 100mg
How should Maloff Protect be taken for malarial prophylaxis?
1 tablet daily 1-2 days before travelling, during travel, and 1 week after travel
How should you take the Maloff Protect tablet?
At the same time everyday with food/milky drink
What should a patient do if they vomit within 1h after taking Maloff Protect?
Take another tablet immediately
What are the contraindications for Maloff Protect?
<18 years old
<40kg
Travelling for >12 weeks
Renal/hepatic impairment
Pregnant/breastfeeding
What is contained in avloclor?
Chloroquine 250mg
How should avloclor be taken for malarial prophylaxis?
1 tablet weekly before travel, during travel, and 4 weeks after travel
What is contained in paludrine?
Proguanil hydrochloride 100mg
How is paludrine taken for malarial prophylaxis?
1 tablet daily for 1 week, during travel, and 4 weeks after travel
How is doxycyline taken for malarial prophylaxis?
1 tablet daily 2 days before travel, during travel, and 4 weeks after travel
What specific counselling point should you remember with doxycyline?
Photosensitivity
How is malarone taken for malarial prophylaxis?
1 tablet daily 1-2 days before travel, during travel, and 1 week after travel
How is mefloquine taken for malarial prophylaxis?
1 tablet weekly 2-3 weeks before travel, during travel, and 4 weeks after
Which specific patients should you avoid giving mefloquine to?
Epileptics
Depressive patients
Patients with TB
This is because it can increase the risk of seizures
What travel advice can you give for a patient?
Vaccinations
Rehydration sachets
Water purification tablets
Bite avoidance
First aid kit
What group of drugs do malarial prophylactic drugs interact with?
Enzyme inducers (remember CRAPPS)
Carbamazepine
Rifampicin
Alcohol (chronic)
Phenytoin
Phenobarbital
St Johns wort
