Flashcards in SKIN Deck (29)
How should Oral thrush be treated?
1) Daktarin (Miconazole) oral gel
2) Nystatin solution
3) Oral fluconazole
Urea is often present in many topical agents. What is its action?
How is Nappy Rash managed?
1) Change Nappy more frequently
2) Irritant case: Barrier cream e.g. Sudocreme, Drapolene, Zinc oxide
3) Fungal cases: Clotrimazole cream BD- do not use barrier cream till infection settled
How are insect bites and stings usually managed?
Antihistamine cream or short course of steroid cream if inflamed.
DO NOT use calamine lotion- leaves itchy residues
Topical local anaesthetics may be used for burns, wasp stings etc. These should be avoided in young children, and used for max __ days?
max 3 days
Creams containing Benzocaine
Hydrocortisone is a ___ steroid
Hydrocortisone + urea is a ____ steroid
Hydrocortisone Butyrate is a _____ steroid
One of the treatments of seborrhoeic dermatitis of the scalp is Coal Tar (nizoral) shampoo.
It is an SLS item but this does not apply for use in seborrhoeic dermatitis
First line treatment for seborrhoeic dermatitis?
Ketoconazole 2% shampoo
What drugs can exacerbate psoriasis?
A lot of emollients used in Eczema management are marked ACBS. What does this mean?
Advisory Committee of Borderline Substances:
In certain conditions, some foods and toiletry preparations have the characteristics of drugs. A board known as the Advisory Committee on Borderline Substances (ACBS) advises on the circumstances in which these products may be regarded as drugs, and if prescribed in accordance with their advise, prescriptions need to be marked ACBS.
A lot of emollients are 'leave-on' preparations like moisturisers: Just rub these in the direction of the hairs and leave on. Aqueous cream should be used as a soap substitute and is rinsed off after application. Why is it not used as a leave-on prep?
Aqueous cream may increase the risk of skin reactions if left on particularly in eczema, often within 20 mins of application.
It is Sodium Lauryl sulphate in the cream that can cause this!
NB: emulsifying ointment is also used as a soap substitute in the bath
Urea is occasionally used with other topical agents, like corticosteroids, in order to do what?
Enhance penetration of the skin- makes them more potent
Eg. Hydrocortisone cream= mild steroid, hydrocortisone + urea= moderate
What drugs, used for psoriasis and acne, are teratogenic?
These are similar to VITAMIN A/ RETINOL and this is also contra-indicated in pregnancy!
Acetretin is especially teratogenic. When should pregnancy be avoided?
3 days before, every month whilst on it and at least 3 years after
When should contraception be used with Isotretinoin?
1 month before and 1 month after (even with topical). Exclude pregnany 3 days before every month during treatment and 5 weeks after
Is sunlight exposure advised for those receiving acne treatments ?
No- the retinoids used to treat acne and benzoyl peroxide may make the skin more sensitive to sunlight.
Sunlight in acne anyway has little evidence of being helpful
Which drugs used for acne may cause Benign Intercranial Hypertension?
Discontinue if severe headache, nausea, vomiting or visual disturbance occur
Which Oral retinoid can cause psychiatric reactions like Psychosis, suicidal ideation? How should this be managed? What about Visual disturbance?
refer to an expert for both psychiatric and visual problems
What should a patient do if they experience bloody diarrhoea or severe skin peeling with isotretinoin?
Rosacea, commonly presenting as particularly reddened facial skin/ flushing, butterfly (but don't mistake for lupus) and pustules and papules, must always be referred. What does it require treatment with?
Oral tetracycline/ doxycycline
Brimonidine tartrate is also licensed for rosacea
Women may take Co-cyrindol with ethinyestradiol (Dianette) for acne. What must they be warned about?
Risk of VTE (its a contraceptive)
Topical antibiotics , e.g. erythromycin or tetracycline, can be used for acne, for a least __ months
Oral tetracyclines commonly used also
How should cradle cap in infants be treated?
Olive oil or Arachic oil (nut oil) or coconut oil
Preparations for Male pattern baldness include Finasteride and Minoxidil. Can these be prescribed on NHS Rx's?
NO- all preps for male baldness not available on prescription
What is used to treat impetigo?
Topical antibiotics e.g. Fusidic acid or MUPIROCIN OINTMENT. Use for No longer than 10 days
Oral Flucloxacillin / clindamycin also indicated
How is ring worm (Tinea corporis and Capitis) treated?
If its NOT on the scalp: Use topical anti fungal e.g. miconazole, clortimazole
If its on the scalp (TINEA CAPITIS)- requires oral antifungal- griseofulvin or terbinafine, possibly ketoconazole shampoo (Nizoral) but would need to be SLS.
How should Nicotinamide (freederm) gel be applied?
Apply after washing face with warm water and soap, twice daily
Permethrin and Malathion can be used in Scabies treatment. What is the directions??
Permethrin: Apply to entire body, leave on for 8-12 hours
Malathion: Apply to entire body, leave on for 24 hours
Repeat treatment again after 7 days
Itching may continue for 2-3 weeks after treatment due to allergens- will eventually fade
Treat whole house