Measles symptoms?
Rash which starts behind the ears, then spreads to the face, limb and trunk
Redbrown confluent blotchy rash
May also develop grey-white spots in the mouth
Red, confluent blotchy rash
Colf like symptoms with a fever
Mumps
Fever
Swelling on 1 or both sides of the face(Inflammation of the paratid gland)
Rubella
Rash starts on the face then spreads to trunk and limbs
Pink-red non confluent rash
Stay away from pregnant people
Oral thrush
Symptoms-
White patches on the tongue- when scrapped can bleed
Treatment: Miconazole gel (4 months +)
or Nystatin(POM)
Scarlet fever
- Fever + flu like symptoms
- Pink sand-paper rash (first on the chest and stomach before spreading)
- Rash turns white when you press a glass on it
- Red-swollen strawberry tounge
Refer !!!Abx
- Phenoxy
- Amox
- Azithro
*
Slapped cheek
Initially cold-flu like symptoms
Bright red rash on the cheek
Para/ibuprofen
Whooping cough/peritusis
Runny nose, watery eyes, soar throat fever
Intense coughing bouts (Thick mucus + vomiting)
between coughing bouts “whoop” when gasping for air.
Para/ibu
If coughing is within the previous 21 days
- Clarithromycin if infant is less than 1month of age
- Azithromycin if child >1month and non-pregnant adults
- Erythromycin for preg
- Stay away from school/work 48 hours after finishing abx
Warts
When to refer?
Salicylic Acid(15-50%)(Bazuka)
Cryotherapy with liquid nitrogen
Refer:
Facial warts
Immunocompromised
Acne
Benzyl peroxide (12+)
Start at low strength 2.5% or 5% then increase gradually from OD to BD
Isotretanoin
MHRA:
Blood donations?
When to discontinue?
Contraception?
PPP Conditions?
Teratogenic
MHRA: Repots of ED and decreased Libido, Neuropsychiatric reactions
Blood Donations
-Avoid for atleast 1 month after treatment
Other s/e:
Risk of pancreatitis if TGL>9mmol/L. Discountinue if uncontrolled hypertriglyceridaemia or pancreatitis
Discontinue if skin peeling
Avoid UV light(Photosensitivity)
Visual disturbance-withdraw and refer
Contraception
- Teratogenic
- PPP
- Exclude pregnancy , every month during treatment, 4 weeks after stopping
- Progestogen OC not effective
- Use 2 forms of contraceptive 1 month before, throughout and 1 month after
Under the PPP
- Prescription is only valid for 7 days and should be dispensed on the date the Rx Is written
- Quantity - max 30 days supply
- More than 30 days can be supplied if prescriber confirms pt is not under PPP
- No repeats
- Emergency supply only at the request of a specialist prescriber with a confirmed negative test result
Monitoring
Monitor hepatic function, and serum lipids before treatment and then every 3 months. Discontinue/reduce dose if lipids or transaminase persistently raised
Cold sore
Symptoms ?
Treatment
Tingling (6-24 hours before)
Blister on top of mouth
Highly contagious(until crusts form)
Treatment: Aciclovir (Zovirax cold sore cream) ay 5x a day for 5 days 4 hourly interval . Not recommended for immunocompromised
Refer if longer than 2 weeks from prodromal symptoms and inside mouth, and painless
Atopic dermatitis(Eczema)
Treatment ?
Steroid
itchy, dry , cracked and sore
commonly affects the flextures
Tretment:
Emollients eg dermol 500 - apply before steroid and wait 30 mins
Steroids:
If inflamed
HCN 1%(10+)
Clobetasone 0.05% (12+)(Eumovate
Max:15g
Max 7 days
not for broken skin /or the face
and not for pregnancy
Steroid potency
Very potent
potent
Moderate
Mild
Very Potent-
Clobetasol (Dermovate)
Potent
Bethamethasone 0.1% (Betnovate)
Hydrocortisone Butyrate
Mometasone
Moderate
Clobetasone(Eumovate)
Betamethasone 0.025%(Betnovate R-D)
Mild
Hydrocortisone <2.5%
Psoriasis
Red plaques
Silvery scales
Well-defined edges
usually on elbows knees and scalp
Use emollients
Coal tar solution (12+)(Exorex)(T/gel shampoo)
Calcipot
Fungal Nail infection
Age limit?
Amorlifine (Curanail 5% nail lacquer)
18+
No more than 2 nails affected
Only beneath the tips or side of the nails affected
CI in preg/bf
Athletes foot, (Tinea pedis) Symptoms?
Body ring worm (Tinea corporis) Symptoms?
Scalp Ring worm(Tinea Captis ) Symptoms?
Jock itch (Tinea Cruris) Symptoms?
AF:White, itchy, flaky skin inbetween toes
BRW: Flat , slightly raised circular rings, red scaly border with central clearing
Scalp ring worm: Distinct ring shape w/hair loss. REFER!
Jock itch:Red-brown rash with well defined edges on inner thigh and buttocks
Treatment:
- Canesten 1%(all ages)
- Daktacort HCN/Miconazole cream( 10 and over) max 7 day
- Terbinafine (Lamisil AT 1% 16+) Lamisil once(18+)
Continue for 7 days after symptoms dissapear
Pregnancy (Constipation)
Bulk-forming or Lactulose
Opiod induced
Stimulant + Lactulose
Haemorrhoids
Swollen veins inside or outside anal canal
1) Bulk forming laxative
2) Analgesics
3) Local anaesthetic (lidocaine) Germaloids 12+
4) Products with HCN (Anusol plus HCN) 18+
Children constipation
1) Macrogol 12+
2) Stimulant e.g.Senna otc 12+, Bisocodyl 10+
Diarrhoea
1) ORT- DISSOLVE IN 200ml water . Must use boiled/cooled waterif baby <1
2) Loperamide(QT Prolongation) 12+/ Initially 4mg (2 caps), followed by 2mg after each loose stool for up to 5 days max 16mg/day. Not in Preg/BF
IBS
Constipation?
Diarrhoea?
1) Antispasmodics
- Mebeverine (18+)
- Alverine 12+
2) Antimuscarinics
- Hyoscine 12+
Constipation
- Bulk Forming laxative
Diarrhoea
- Loperamide (Imodium IBS Relief) 18+! Can use for up to 2 weeks for repeated attacks If 1 attack lasts longer than 48 hours spk to Dr
Orlistat Licensing
how to take?
- BMI 28> in the presence of other RF such as diabetes, hypertension, hypercholesterolaemia
- or BMI>30
- for 6 months In conjunction with a mildly hypocalorific diet
Take one capsule TDS with 3 Main Meals
Can continue for more than 3 months if loose 5% of body weight
Not for use in preg/BF
Orlistat interactions
Ciclosporin
Vitamin K antagonist anticoagulants
Hormonal contraceptives
Levothyroxine
Antiepileptic drugs
Fat soluble vitamins
Amiodarone
Tacrolimus
Acarbose
