Module 9 Live Lecture Notes PDF

Module 9 Live lecture Notes Bacterial skin infections: >Topical or systemic >Topical treats localized mild infections (consider pregnancy and lactation) >cellulitis: systemic abx because it’s more effective >MRSA: always follow the CDC (best guide) >incision and debridement >if pt shows systemic...

Module 9 Live lecture Notes Bacterial skin infections: >Topical or systemic >Topical treats localized mild infections (consider pregnancy and lactation) >cellulitis: systemic abx because it’s more effective >MRSA: always follow the CDC (best guide) >incision and debridement >if pt shows systemic s/s of an infection we treat with abx, but in general an I&D is curative of MRSA Types of Tinea: >pedis: feet, corporis: body, cruris: genital area, capitis: scalp, unguium: nail >fungus of the scalp and fungus of the nail are the most difficult to treat >more often require systemic antifungal (“azoles”) >fluconazole: prolonged QT interval Acne: >tx is based on severity >Mild: topical (differin, benzoyl peroxide) >moderate: topical and/or oral abx >severe: Accutane >safety: spironolactone, combined oral contraceptive >females have been proved to be effective, but not with males >only on studies in those at least 15 and have reached menarche >long-term therapy (6 months or more) >progesterone can sometimes make acne worse (estrogen component in OC helps with acne, but we don’t use only an estrogen OC because it increases risk of cancer >Accutane: >associated with teratogenic effects and multiple side effects; must be enrolled in ipledge (3 way stop if there is risk for pregnancy), must have 2 negative pregnancy test at onset of RX and 1 a month at refills and 2 reliable birth controls, 1 month washout period before attempting to conceive >Tretinoins: cannot be used during pregnancy or lactation >Retin-A is the most common >When should pts see a difference? >mild: 4-6 weeks of tx to see max effect >moderate: 6-12 weeks of tx to see max effect >Severe acne (COCs and Accutane): 6 months Lice: >insecticidal agents are neurotoxic to lice >Prometherin 1% is the best and most recommended >RID (OTC): avoid in those with specific allergies (chrysanthemums) >LindaNe: very caustic - contraindicated in those with skin issues; can also be neurotoxic – increases seizure risk (some deaths have been reported) Optic glucocorticosteroids: >APRNs should not prescribe these meds >this class of drug can cause blindness Sulfa Allergies: >do not give them any type of sulfa drug no matter the route >Silvadene: typically used for burns (contraindicated with sulfa allergies)