Symptoms in the Pharmacy - Childhood Conditions Flashcards
At what age do children start to teeth?
4-12 months
have full set of teeth around 2-3 yrs
How many days before each tooth eruption does pain start/teething?
3-5 days
What is the first line for 4-12 months when teething?
direct them to the Cry-sis website for useful info
What kind of symptoms?
mild and local; pain in specific place
increased biting
chewing, dribbling, gum-rubbing
sucking
irritability
wakefulness
ear-rubbing
decreased appetite and disturbed sleep
swollen gums and red flushes on cheeks and face
Pulling on ear = more than just a toothache; e.g infection
Teething - referral to GP infomation
may cause mild temperature elevation (less than 38C)
if patient suffers severe distress
systemically unwell
change in passage of stools
Treatments and dosage for teething
paracetamol 120mg in 5ml SUGAR-FREE oral suspension - 100ml - 1 pack - 2 suggested episode per year
Ibuprofen 100mg in 5ml SUGAR-FREE suspension - 100ml - 1 pack -2”
What is the limit for ibuprofen and paracetamol for infants?
not for children 3 months or under/ less than 5kg
(they are not expected to teeth until 4 months)
advice for patient how to resolve or manage teething
teething ring ( contain liquid - freezer, cold to numb the gums)
clean, cold , wet flannel
things that help teething
sugar-free drinks, cool
gels - containing salicylates
Threadworms - describe
thin and small, white thread-like worms about 2-13mm long
females worms lay tiny eggs, around anus
too small to cause itching
treatment can take up to 6 weeks
treatment for threadworms
Mebendazole (Vermox) - 30ml via PGD - 1 ep per year
Mebendazole 6 via PGD -
The whole family will most likely have it - there should be a sufficient amount for everyone
What if child has threadworms and under 6 months?
cannot give any medication
hygiene measures only
advice for patients
hygiene measures should be undertaken for 2 weeks combined with Mebendazole treatment for 6 weeks if used aone
enviromental measures; wash, sleepwear, bed linen, towels
vaccum lamp
clean bathroom
warnings threadworms
avoid shaking any material that may be contaminated with eggs, such as clothing or bedsheets
strict personal hygiene measure for all treated individuals for 2 weeks if combined with drug treatment or for 6 weeks if used alone:
wear close fitting underpants at night
cotton gloves (mittens) to help prevent stretching at night
bath or shower each morning
general personal hygiene measures - advice not treatment
- wash hands first thing in the morning
- discourage nail biting
- keep toothbrushes in closed cupboard and rinse them thoroughly
- don’t eat in bedroom
What is Colic?
Infantile colic is a SELF-LIMITING condition which is defined clinically as repeated episodes of excessive and inconsolable crying infant
GP referral colic
weak, high pitched, continuous
floppy
vomits
is not feeding
fever
seizure
turns blue
Head lice
head lice are small , or white-grey insects
white eggs visible behind neck or ears
What is the first line of treatment for Head lice?
Wet comb - from routes, pull down till end of hair
Condition child’s hair thoroughly
split hair into small sections - covered all of head
Referral to GP and treatment
Detection comb
2nd line treatment. Dimeticone 4% lotion (Hedrin) - can leave over night (LONG CONTACT HRS). Not suitable for children under 6 months
How long to carry out the treatment for? hedrin
Until you can wet comb the hair three times and it’s CLEAR
= end treatment.
Nappy rash - common causes?
mild, restricted to the area of nappy
- prolonged contact with urine or faeces
- redness
- candidal fungal infection
first line Treatment offered for nappy rash:
1) Zinc and castor oil cream 100g - form barrier/ does not allow urine to penetrate through
Metanium 30g
2) causing discomfort - Hydrocortisone 0.5% cream 15g NOT OINTMENT - (s/e; thinning of the skin)
only given on prescription (or if you have a PDG - contract when you can prescribe specifically the med for certain person and age)
3) Candida infection- Clotrimazole 1% 20g
Wales medicines strategy group - nappy rash section
- clean and change the child as soon as possible after wetting or soiling
- use water, fragrance free, alcohol-free wipes
- dry gently after cleaning
- avoid vigorous rubbing
- bath child daily/ no soaps
Oral thrush
cause discomfort or be asymptomatic
loss of taste or impleasent taste in mouth
white patches
How to confirm oral thrush?
Wipe the tongue
white should come off of tongue and leave a very red tongue
oral thrush treatment
first line - miconazole oral gel - 80g (via PGD)
[do not give to interacting medicines = Warfarin, nystatin]
apply gel directly to affected area with clean finger and leave in contact with the mucosa for as long as pos
Nystatin oral suspension - 30ml (via PGD) - for patients taking meds that interact. Usual dos is 1ml x4 a day for adults and children from 4 weeks)
what is Erythema?
Redness of skin or mucous membranes
how to aintain oral thrush
good dental hygiene
stop smoking
counsel if person is on corticosterioud inhaler
smaller patients - don’t look at back of mouth to reduce the risk of choking
test your knowledge:
slide 16/17
What is the risk of giving salicylate-containing gel for a 6 year old boy?
Do not give medicines containing choline salicylate to children under 16 years. It’s linked to a rare condition called Reye’s syndrome, which can be fatal
MHRA - does not recommend
What is the 1st line treatment for threadworms for a 4 years old child. What else should you do
comb wet hair
wash bed sheets
tie hair up (pon-tail, plates)
e.g. question on conselling
Counsel mum on the co-application of both zinc & castor oil as well as hydrocortisone 0.5% cream for nappy rash.
Explain the patient suitability and differences between Miconazole and nystatin for the treatment of oral thrush
