Travel Medicine Flashcards
Travel to malaria area in less than 1 week
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
- Atovaquone/Proguanil 250/100mg PO daily
Start: 2 days before
End: 1 week after - NVD
Abdominal pain
Headache
3. Take daily Take with food Start 2 days before, end 1 week after return frm trip Non pharma
- CrCl <30
Pregnancy / Breastfeeding
Child <5kg
Travel to malaria area in one months time, patient known with epilepsy.
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
- Atovaquone/Proguanil 250/100mg PO daily
Start: 2 days before
End: 1 week after - NVD
Abdominal pain
Headache
3. Take daily Take with food Start 2 days before, end 1 week after return frm trip Non pharma
- CrCl <30
Pregnancy / Breastfeeding
Child <5kg
Travel to malaria area. Known with GAD
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
- Atovaquone/Proguanil 250/100mg PO daily
Start: 2 days before
End: 1 week after - NVD
Abdominal pain
Headache
3. Take daily Take with food Start 2 days before, end 1 week after return frm trip Non pharma
- CrCl <30
Pregnancy / Breastfeeding
Child <5kg
Travel to malaria area in one months time, patient known with psoriasis.
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
- Atovaquone/Proguanil 250/100mg PO daily
Start: 2 days before
End: 1 week after - NVD
Abdominal pain
Headache
3. Take daily Take with food Start 2 days before, end 1 week after return frm trip Non pharma
- CrCl <30
Pregnancy / Breastfeeding
Child <5kg
Travel to malaria area in one months time, patient known with CKD (CrCl < 30).
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
1. Hydroxychloroquine Start treatment 1 - 2 weeks before travel Load: 400mg PO twice, 6 hours apart. then 400mg PO weekly Until 4 weeks after travels
- GIT: NVD, Bitter taste
Derma: Hair and skin depigmentation, Alopecia
MSK: Myopathy
Optom: Reversible corneal opacity, Photophobia, Retinopathy
NB: Hypoglycemia
Rare: Deafness
3.
Non Pharma
Start 1 - 2 weeks before travel, continue until 4 weeks after travel
Take with food
If DM - test blood glucose more frequently
Retinal toxicity - if take more than 5 years. Screen for retinal changes
- Psoriasis
Epilepsy
Psych
Travel to malaria area in one months time, patient is pregnant
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
1. Defer travel Hydroxychloroquine Start treatment 1 - 2 weeks before travel Load: 400mg PO twice, 6 hours apart. then 400mg PO weekly Until 4 weeks after travels
- GIT: NVD, Bitter taste
Derma: Hair and skin depigmentation, Alopecia
MSK: Myopathy
Optom: Reversible corneal opacity, Photophobia, Retinopathy
NB: Hypoglycemia
Rare: Deafness
3.
Non Pharma
Start 1 - 2 weeks before travel, continue until 4 weeks after travel
Take with food
If DM - test blood glucose more frequently
Retinal toxicity - if take more than 5 years. Screen for retinal changes
- Psoriasis
Epilepsy
Psych
Travel to malaria area in one months time, patient is a child.
- Medication name, dose, route and frequency
- Side effects
- Advice
- Contraindications
1. Defer travel Hydroxychloroquine Start treatment 1 - 2 weeks before travel Load: 400mg PO twice, 6 hours apart. then 400mg PO weekly Until 4 weeks after travels
- GIT: NVD, Bitter taste
Derma: Hair and skin depigmentation, Alopecia
MSK: Myopathy
Optom: Reversible corneal opacity, Photophobia, Retinopathy
NB: Hypoglycemia
Rare: Deafness
3.
Non Pharma
Start 1 - 2 weeks before travel, continue until 4 weeks after travel
Take with food
If DM - test blood glucose more frequently
Retinal toxicity - if take more than 5 years. Screen for retinal changes
- Psoriasis
Epilepsy
Psych
Organisms responsible for Travellers Diarrhoea
1. BACTERIA: EnteroToxigenic E. Coli EnteroAggregative E. Coli Campylobacter Salmonella Shigella
Viruses:
Norovirus
Astrovirus
Rotavirus
Protozoa:
Giardia
Cryptosporidium
Prevention of Travellers Diarrhoea:
- Non-Pharmacological
- Pharmacological
- “BOIL it, COOK it, PEEL it or FORGET it”
- Only drink boiled or bottled water
- Avoid ice in drinks
- Only eat recently and well cooked food
- Avoid street vendors
- Avoid leftover or opened condiments
- Avoid salads and raw vegetables
- Only eat fruit if it has been washed in clean water and peeled
- Regularly wash hand with soap and water
- Reassess need for PPI
- Bismuth Subsalicylate
Class: Intestinal adsorbent
SE: Black stools
CI: Anticoagulant or salicylate use, Young kids
- Vaccine: Dukoral
Treatment of travellers diarrhoea
MILD:
Fluids
Loperamide
Bismuth Subsalicylate
MOD: Oral Rehydration Therapy Loperamide 4mg Stat then 2mg after each loose stool Antibiotics - Ciprofloxacin 500mg PO BD x 3 days
SEVERE: (Dysentery) Oral Rehydration Therapy Antibiotics - Ciprofloxacin 500mg PO BD x 3 days \+/- Loperamide
How to make ORT
Half a teaspoon of salt (2,5ml)
6 teaspoons of sugar (30ml)
in 1L of safe water
Treatment of travellers diarrhoea in a pregnant patient
ORT
Loperamide 4mg PO stat the 2mg PO after each loos stool
Azithromycin 1000mg PO single dose
NOT Bismuth or Fluoroquinolone
Non-pharmacological management and advices when travelling to a malaria area
- Bed nets (impregnated with Permethrin)
- Avoid dusk and dawn activities
- Clothes covering exposed skin
- Sleep in screened & air conditioned room
- Mosquito coils or aerosolised insecticides
- Insect repellant with DEET
- DEET 30% (works for 6 hours)
- Picaridin 20% (works for 8 hours) less greasy
