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OTC flashcards

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1
Q

Chloroquine

A 
Avoclor
Any age
2 tablets weekly
1 week before
4 weeks after
Side effects: GI, visual, seizures, psoriasis
AVOID in: epilepsy, cyclosporin, digoxin, amiodarone, citalopram, mefloquine
Fine in pregnancy

Give with proguanil

14 tablets for 2 weeks holiday

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2
Q

Proguanil

A 
Paludrine
Any age 
1 week before 
4 weeks after 
Side effect: diarrhoea
Safe in pregnancy

Give with chloroquine

98 tablets for 2 weeks

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3
Q

Traveller’s diarrhoea

A

Caused by e.coli
Follow strict hygiene measures
NO LOPERAMIDE

GSL:
Dioralyte, all ages
Dioralyte relief: over 3 months

Prepare with 200ml of water, once reconstituted store in fridge. Use within 24 hours

Boil before use

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4
Q

Travel sickness

A

Antihistamines and anticholinergics are equally effective

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5
Q

Antihistamines for travel sickness

A

Cyclizine- POM
Cinnarizine- OTC, 5 and over

Promethazine- most sedative, phenergan, not for under 6s OTC

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6
Q

Anticholinergic for travel sickness

A 
Hyoscine hydrobromide (Kwells)- not for under 10s 
Kwells kids- not for under 4
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7
Q

Hayfever

A

Allergic rhinitis
Loratadine first line
Nasal saline for runny nose
Don’t routinely recommend sedating antihistamines
If loratadine fails, sodium cromoglicate eye drops and nasal corticosteroid

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8
Q

Systemic antihistamines

A 
Cetirizine- 6+
Loratidine- 2+- least sedative
Acrivastine (benedryl)- 12+
Chloramphenamine tablets 6+
Piriton liquid 1+
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9
Q

Chloramphenamine

A

Inhibits phenytoin metabolism
MAOI enhances effect
Not for use in pregnancy

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10
Q

Ocular antihistamines

A

Antolazine 5+

AVOID in MAOIs and glaucoma

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11
Q

Nasal antihistamines

A

5+

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12
Q

Nasal corticosteroids

A 
Beconase
Flixonase 
18+
Side effects: bitter taste, nasal irritation
Avoid in pregnancy
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13
Q

Ocular and nasal mast cell stabilisers

A

sodium cromoglicate eye drops 6+

Fine in pregnancy

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14
Q

Insect bites and stings treatment

A

Local irritation: hydrocortisone 10+
Antihistamine
Analgesia

AVOID: calamine lotion
vinegar

Topical antihistamines- causes sensitisation

Systemic infection: refer

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15
Q

UVA

A

skin ageing and wrinkling
tanning ray
no damage to the epidermis

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16
Q

UVB

A

sunburn and redness
more damage to epidermal layers
skin cancer cause

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17
Q

Signs to look out for moles

A

asymmetry
border- jagged edges
colour- varying shade
diameter- 7mm or more

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18
Q

Suncreams

A

UVB only

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19
Q

Moles referral criteria

A

facial lesions over 40
itchy, irritated or bleeding
a mole that’s changed

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20
Q

Prickly heat

A 
Milaria rubia
Itchy rash, smalled raised spots
Usually few days after sun exposure
Develops when someone sweats more than normal
sweat glands become blocked
Use calamine lotion
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21
Q

Cystitis referral symptoms

A 
soreness in child under 16
recurrent
burning in men
dark, cloudy urine
more than 7 days
generally unwell
flank pain
haematuria
immunocompromised
women over 70
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22
Q

recurring cystitis

A

three episodes in a year

2 in 6 months

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23
Q

Risk factors of cystitis

A

young women
diabetes
tampon use
pregnancy

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24
Q

Treatment of cystitis

A

potassium citrate- alkalise urine
sodium bicarb and citrate- cautioned in HTN
cranberry juice prophylaxis

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25
Referral warts and verrucas
``` anogenital multiple or widespread diabetes lesions on face over 50 first time bleed or itch without provoking ```
26
Referral corns and calluses
impaired peripheral circulation pain or difficulty walking diabetes treatment failure
27
Treatment for warts
salicyclic acid-2+ use vaseline around healthy skin every day for 12 weeks or longer
28
Referral for chillblains
``` severe/recurring dont improve fever swollen glands swelling and pus forming ```
29
Compression stocking
``` Class 1: pregnancy and early vaccine class 2: medium varicose and prevention of ulceration class 3: severe varicose and treating ulcers ```
30
Headlice
only treat affected 2 applications 7 days apart permethrin, malathion and dimeticone- 6 months+ Apply to dry hair
31
Treatment for crabs
malathion and permethrin | apply twice with 7 days apart
32
Jock itch
miconazole and clotrimazole
33
Referral threadworms
recent travel abroad under 12 cannot be treated OTC broken skin pregnant
34
Threadworms
mebendazole 2+ side effects: abdo pain, rash avoid with phenytoin, carbamazepine and cimetidine avoid in pregnancy piperazine- > 3months
35
Seasonal allergic conjunctivitis
same time each year | usually both eyes
36
perennial allergic conjunctivitis
daily symptoms of conjunctivitis throughout the year in both eyes, often on waking.
37
Contact dermatoconjunctivitis:
conjunctivitis with allergic dermatitis of the eyelids. Occurs in response to the use of eye drops.
38
Giant papillary conjunctivitis:
occurs in people using soft contact lenses- may occur with hard contact lenses and following eye surgery.
39
Chloramphenicol
drops 0.5%--> fridge ointment 1%--> fridge avoid unless essential risk of neonatal baby syndrome
40
blepharitis referral criteria
inward/outward turning of eyelid systemic painless nodular lesion
41
Medications causing dry eyes
``` diuretics HRT Isotretinoin TCAs Beta blockers ```
42
Treatment for dry eyes
hypromellose 1%, 0.3%, 0.5%- hourly or half-hourly dosing Polyvinyl alcohol Carbomer- TDS prn Lubricants- bedtime as blur vision
43
Alopecia referral
fungal infection of scalp patients under 18 sudden onset suspected iron deficiency
44
Alopecia treatment
Minoxidil 18-65 avoid in pregnancy and hypertension
45
Causes of dry mouth
sjogrens syndrome radiotherapy diabetes diuretics
46
Medicines inducing dyspepsia
``` Antibiotics ACE inhibitors bisphosphonates iron metformin metronidazole nitrates potassium supplements steroids theophylline NSAIDs ```
47
Antacids
constipation with calcium diarrhoea with magnesium do not take for longer than 2 weeks not for use under 12s
48
Alginates
can be used in pregnancy | First line in GORD
49
H2 antagonists
>16 years | side effects diarrhoea, constipation, headache and rash
50
PPI
e.g omeprazole 18+ side effects headache, diarrhoea, nausea and vomiting and flatulence Interactions: warfarin, digoxin, clopidogrel, phenytoin, antifungals
51
Dysphagia referral symptoms
``` Anaemia Loss of weight Persistent vomiting Pts over 55 years with unexplained recent onset Pain in arm ```
52
Cardiac or heartburn
Heartburn doesnt radiate to shoulders, neck or arm Usually comes after meals Usually respond to antacids Rarely accompanied by cold, sweat, lightheadedness or dizziness
53
Drugs that cause constipation
``` Aluminium Antidepressants Antiepileptics Antipsychotics Calcium supplements Opioids diuretics iron ```
54
IBS referral
``` Blood in stool children under 16 Fever nausea and vomiting over 45 with recent bowel habit change severe abdo pain steatorrhoea ```
55
Treatment for IBS
Hyoscine 12+, avoid in pregnancy, caution in glaucoma Mebeverine 10+, safe in pregnancy Peppermint oil- colpermin 15+, mintec 18+, alverine 12+ Avoid colpermin and mintec in breastfeeding
56
Risk factors for haemorrhoids
being overweight being over age 45 pregnant fh
57
Treatment of haemorrhoids
Anusol/anusol HC- no longer than 7 days
58
Ear wax symptoms
``` Ear pain decreased hearing dizziness ringing in ear itching or drainage in ear ```
59
Immediate referral ear wax
Dizziness and tinnitus Fever in children Foreign body in ear canal Pain in middle ear
60
Referral for ear wax
discharge of liquid or pus no improvement after 4 days pain on palpitation of mastoid bone fever
61
Treatment for otitis externa
choline salicylate 1+ | acetic acid 12+
62
Early signs of lymes
Bulls eye rash edges of rash may feel slightly raised rash usually about 15cm diameter
63
Late signs of lymes
pain around joints numbness and paralysis heart problems e.g. myocarditis meningitis
64
3 days 3 weeks 3 months
URTI Acute/chronic bronchitis Chronic bronchitis, TB, carcinoma
65
Chronic productive cough
more than 8 weeks
66
Colours of sputum
Yellow, Brown, Green = Infection present Thin, frothy, pink tingled = Left ventricular failure Rust coloured = Pneumonia Dark red = Carcinoma (occasional red sputum = force of coughing – not serious) Thick, mucoid to yellow = Asthma Offensive foul-smelling = Bronchiectasis or lung abscess

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