Random Flashcards
Non-bullous impetigo treatment
Topical: hydrogen peroxide or fusidic acid (if around the eyes)
Bullous impetigo (not systemically unwell)
Topical or oral antibacterial equally effective
oral: flucloxacillin
topical: fusidic acid
Bullous impetigo and non-bullous impertigo in those who ARE systemically unwell
oral antibacterial
first line: flucloxacillin
alternative: clarithromycin, erythromycin (pregnancy)
Human and animal bites
First line: Co-amoxiclav
alternative or if penicillin allergy; doxycycline + metronidazole
seek specialist advice in pregnancy
CURB 65 definition
severity score for CAP
C = confusion
U = urea blood nitrogen is raised (above 7 mmol/L)
R - raised respiratory rate (30 breaths/min or more)
B - blood pressure is low (systolic less than 90, diastolic of 60 or less)
65 - 65 years old or older
Heirachy of evidence
1) Systematic reviews
2) Randomised control trials
3) cohort studies
4) case controlled studies
5) case studies, case reports
6) editorials, expers opinion
INR of 5-8 and minor bleeding
Omit warfarin
Give IV pytomenediaone
Repeat if INR is still high after 24 hours
restart when INR is <5.0
INR greater than 8 and minor bleeding
omit warfarin
give IV pytomediaone
repeat if INR still high after 24 hours
restart warfarin when INR is <5.0
INR 5-8 and no bleeding
withod 1-2 doses, REDUCE maintenance dose, measure INR after 2-3 days
INR > 8 and no bleeding
omit warfarin
give oral pytomenidianoe
repeat dose if INR is still high after 24 hours
restart when INR is < 5.0
Lithium toxicity treatment
volume resucitation with normal saline
severe toxcity - haemodialysis
sodium bicarbonate (limited evidence to support use)
Digoxin toxicity treatment
DigiFab
Iron toxicity treatment
Desoferroxiame (chelating agent)
cyanide poisoning
Hydroxycobolamin
Paracetamol poisoning
N-acetylcysteine
activated charcoal (if ingested less than 1 hour ago)
Heparin toxicity
protamine sulfate
Warfarin toxicity
Vitamin K
Prothrombin complex
Benzodiazipines toxicity
Flumanezil
salicylate toxicity
urinary alkalization with IV bicarbonate
haemodialysis
TCA toxicity
IV bicarbonate
Beta blockers toxicity
bradycardic - atropine
resistant cases - glucagon
opioid/opiates toxicity
Naloxone
Ethylene glycol and methanol toxicity
ethanol
fomepizole (first line)
refractory cases - haemodialysis
Potent corticosteroids
Beclometasone dipropionate (0025%)
Betnovate (betamethasone valerate 0.1%)
Elocon
Synalar
Mild corticosteroids
Hydrocortisone 0.1- 2.5 %
Synalar 1 in 10
Dioderm
Very potent corticosteroids
Dermovate
Nerison Forte
Moderate corticosteroids
Betnovate-RD (betamathasone valerate 0.025%)
Eumovate
Synalar 1 in 4
Very potent + antimicrobials
clobetasol + neomycin + nystatin
why antimicrobials with steroids
useful in inflammatory skin conditions associated with bacterial or fungal infectiosn e.g. infected eczema
mild + antimicrobials
Canesten - HC
Daktacort
Fucidin H
moderate + antimicrobial
Trimovate
benefit of urea with corticosteroid
increases penetration of steroid
benefit of salicylic acid with steroid
increased setroid penetration and absorbption (e.g. diprosalic, a potent steroid with salicyclic acid)
potent + antimicrobials
Betamethasone + neomycin
Betamethasone + clioquinol
Fucibet
Synalar C
Synalar N
Lotriderm
