OTC

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Author:
kvan4741
ID:
105689
Filename:
OTC
Updated:
2011-10-03 01:02:39
Tags:
OTC over counter practice points pharmacy
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Description:
Practice points for some common OTC products/requests/conditions
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  1. scabicides
    • treat affected person, all household/family members and close contacts at the same time
    • apply to clean, dry skin
    • apply to the scalp, neck, face and ears in children < 2 yrs, elderly and immunocompromised, ppl with tx failure or crusted scabies
    • remember to apply between fingers, toes, under nails, skin folds, bellyi butoon, between buttocks and groin area
    • soft toys, bed linen and clothing in contact with the person in the last 48-72 hrs should be washed and dried in a hot machine the morning after treatment or stored in tightly sealed plastic bags for 3 days
    • improvement usually occurs w/in 1-2 days, but itch may last 2-3 weeks - manage with moisturiser, topical corticosteroids, crotamiton or antihistamine
    • reinvestigate if itch still present after 4 weeks
  2. Head lice
    • treat only if live louse is found - confirm using wet combing (itching, nits/eggs not necessarily indicator of active infection)
    • examine family members and close contacts
    • insecticides - 2 applications 7 days apart, avoid hair dryer (inactivates), do not overuse (e.g. for prevention) --> resistance and irritation
    • children back to school after 1st tx, advice against sharing hats and brushes
    • soak combs/brushes in hot water (>60oC) for 30 secs, wash pillowcases in hot water/dryer for 15 mins
  3. Permethrin 1% for head lice
    • Quellada Head Lice treatment
    • apply to damp hair after washing with usual shampoo
    • leave in for 10 mins
    • rinse with warm water
    • rpt after 7/7
    • Use fine tooth comb to remove dead lice/nits.
  4. Permethrin 5% for scabies
    • Quellada Scabies Treatment 5% Lotion, Lyclear 5% Cream
    • Apply chin-down and wash off with warm soapy water 8-14 hours later
    • rinse thoroughly
    • rpt after 7 days
    • Also apply to neck, face, scalp and ears in children <2 yrs, elderly or immunocompromised ppl, tx failure
  5. Maldison 0.5% lotion, 1% shampoo
    • KP24
    • avoid contact in eyes/mouth/ears/inside nose
    • wear gloves
    • avoid excessive tx - irritation
    • allow skin/hair to dry naturally without head - contains ethanol
    • lotion preferred - longer contact time, shampoo may be diluted during use - reduced efficacy
    • shampoo - preferred in asthma - no ethanol vapour
  6. xenical
    • orlistat 120mg
    • 1 TDS with main meals
    • do not take if missing meal/no fat in meal
    • eat low-calorie diet high in fruit and veges
    • fatty/oily stools likely if meals too high in fat
    • efficacy for up to 4 yrs - mean wt loss of 2-4kg in first yr
    • may reduce absorption of fat-soluble vitamins - ADEK - supplement if necessary, take at least 2 hrs from orlistat BMI > 30 or >27 with other risk factors
    • not recommended for children adolscents unless by specialist input - limited role and associated with comorbidity, lifestyle more imp
  7. Haemorrhoids
    • confirm diagnosis - pts often misdiagnose
    • avoid prolonged straining
    • increase fibre (dietary, bulking agentst) and fluid intake
    • topical corticosteroids - reduce inflammation, limit use to < 7/7 (local infection, skin atrophy)
    • local anaesthetics - relieve pain, burning and itching (limit use to <7/7 - sensitise skin)
    • GTN - relieve pain post haemorroidectomy, commonly causes headache
    • stool softeners may be helpful
  8. proctosedyl
    hydrocortisone, cinchocaine
  9. anusol
    zinc oxide
  10. scheriproct
    prednisolone, cinchocaine
  11. hemocane
    lignocaine, allantoin, zinc oxide
  12. rectinol
    cinchocaine, hydrocortisone
  13. rectogesic
    • GTN
    • NB: pain relief often occurs before anal fissure healing - ensure adequate tx course

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