S2 and S3 Medicines Protocol - Pharmacy Practise Protocols Flashcards
Outline the differences between an S2 and S3 medication
S2 meds:
- within public reach
- stored in front of the dispensary counter (i.e back wall)
- less adverse reactions
- e.g. aspirin 100mg
S3 meds:
- not within public reach
- stored behind the dispensary counter
- significant adverse reactions
- nausetil
What key points do we need to remember when supplying OTC medications
- Two types of requests: symptom-based and direct product
- Gather information by asking specific and required questions –> (e.g. who is it for, any existing medical conditions, pregnant or breastfeeding (if it is a women)
- We do want to provide meds that can trigger any existing medical conditions
4.
Describe the composition of breast milk
Rich macronutrients, vitamins and certain minerals.
1.0% protein, 7% lactose, 3.5% fat and 87% water
List the 3 different types of milk (CTM)
- Colostrum
- Transitional milk
- Mature milk
Describe the composition of colostrum milk
- Creamy yellow in colour
- rich in immunological components (e.g. secretory Iga, lactoferrin, protein, leukocytes)
- low in lactose
Describe the composition of mature milk
- opaque
- higher conc of lactose and fat; relatively low conc. of immunoglobulins, lactoferrin and total protein
List some benefits of breastfeeding for the infant
- enhanced maternal/infant bonding
- Protects the infant against chronic diseases/illnesses (e.g. coeliac disease, atopic disease, asthma,GI infections, respiratory illness)
- Easily digestible
- improved cognitive, speech and jaw development
- Simply provided all-rounded nourishment
Where is milk made in the breast?
It is made in the glandular tissue (alveoli)
What is the role of prolactin?
produces more milk in response to sucking and simulation of nipple nerve endings
What is the role of oxytocin?
ejects milk down the ducts
What is the solution to Sore/Damaged Nipples?
- Application of lanolin cream as a protective barrier to reduce the pain; application of hydrogel dressings for wound healing
- Refer to a lactation consultant
What is the solution to mastitis (inflammation of breast tissue)
- Appy ice and avoid vigorous massages of breast
- Antibiotic treatment should be given promptly as delay can increase the severity of infection
Describe 3 counselling points of infant formula feeding (not BREASTFEEDING)
- A feed should be no longer than 1 hour and any formula left after the feed must be discarded; any formula that has been at room temperature for more than 1 hour should be discarded
- in the case of being left for less than 1 hour it must be stored in the refrigerator for up 24 hours in a sterile container
- A cup can be introduced around 6 months
When are complementary foods delivered?
Around 4 to 6 months
List complementary foods that should be avoided
- Small hard foods (e.g. nuts) in children under 3 years
- No honey to infants less than 12 months as it can cause botulism
- junk food (e.g. confectionary, cakes, biscuits, potato chips) should be limited
- Low fat or reduced milk are not recommended in the first 2 years
- Fruit juice is not recommended for infants under 12 months
Define parasite
an animal or plant that lives on another plant or animal (host)
- depends on the host for nutrients
Describe the characteristics of a threadworm (1) its mode of transmission (2) symptoms (3), alarm symptoms (4) AND lastly non-pharmalogical and pharmacological recommendations (5)
- Approx. 1 cm in length (small spindle shaped)
- Faecal - oral route
- infectious eggs gets lodged onto the fingernails after the toddler scratches his itchy bottom after playing in dirt, if he doesn’t wash his hands before eating it will transfer to this body
Retro-infection
Inhalation - Peri-anal itching especially at night, reduced appetit, disturbed sleep
- passing a worm apron 1 cm in length, severe abdominal pain, nausea and vomiting, low energy levels,
- Pharmacological:
- Mebendazole: 100mg single dose repeat in 2 weeks
- Pyrantel: 10mg/kg single dose; repeat in 2 weeks
- children less than 10 kg: 50mg single dose, repeat in 2 weeks
Non-pharmalogical:
- wash hands with soap and water after going to the bathroom, changing nappies, before preparing and eating food
- wash bed linens, pyjamas in hot water to kill any eggs
- every family member should take the medicine even if they are not experiencing symptoms
Do threadworms only affect humans
YES
What’s the mechanism of transmission of head lice?
Close head-to-head contact
Outline the pharmacological treatment of head lice
- Benzyl alcohol
- Dimethicone
- Isopropyl myristate
- Malathion
- Pyrehtrins
Outline the non-pharmacological treatment of head lice
Electronic combs
Wash pillowcases as well as combs and brushes in hot water, calamine lotion to treat irritated skin, wet combing
What’s the sole function of electronic combs?
It only electrocutes lice but not kill or remove eggs
What’s the mechanism of transmission of scabies?
Close skin to skin contacts between infected individuals.
What’s the symptoms of scabies?
- ‘Maddening itch’ that is worse at night
- burrow/tracks in skin folds (between fingers, armpits, inner parts of the wrist)
- erythema, papules and modules
Medications used to treat scabies? and the preferred treatment
- Permethrin 5% (lyclear
- Benzyl benzoate 25% emulsion
PERMETHRIN 5% lyclear solution
Outline the guidelines for applying scabies solution
- Apply to dry skin from chin down
- Repeat treatment in 7 days
It takes about 6 weeks before breast milk supply is well established. Is this a correct statement?
YES
Treatment options for Breast/Nipple thrush
- Anti-fungal creams
- Paracetomal and Ibuprofen to gradually diminish pain (only at recommended doses)
- Oral flucanazole
How do round worms and hook worms cause mechanical injury to intestines?
- They obstruct intestines
- damage intestines and lead to blood loss
When should the treatment be repeated for threadworms, headlice and scabies
- TW: repeat after 14 days
- Headline: after 7 days
- scabies: after 7 days
What causes the perianal itching at night (a key symptom for threadworm infestation)
SECRETION OF MUCUS
What are the practice points of mebendazole in relation to pregnancy, breastfeeding and children?
- Avoid in first trimester
- may use during BF
- may use if child is more than 6 months
What are the practice points of pyrantel in relation to pregnancy, breastfeeding and children?
- Pregnancy: safe
- Safe
- Children: may use
Whats the MOA of Mebendazole?
Inhibit microtubule polymerisation by binding to beta tubulin in
parasite; blocks glucose uptake – worms starve
Whats the MOA of pyrantel?
Inhibits cholinesterase. ‘Neuromuscular blockade’ paralysis, worm
detachment and expulsion
Head lice is an ectoparasite and so it survives on human host only. Is this is a true statement
Yes
Outline the aietology of head lice
- saliva excreted by head lice causes the itch/allergic reaction
Where should head lice products be applied specifically?
Behind the ears and nape of neck
Outline the aetiology of scabies
Mite proteins and faeces in burrows trigger host immune response (e.g., IgE, IL4 and Th2) - intense
itching and rash
In a scabies event, where do larvae burrow into?
Stratum corneum
