D&M Treatments

First line constipation

Bulk forming (fybogel) 72hrs see GP

Second line constipation

Osmotic lactulose, need to be taken with water

First line diarrhoea

Rehydrate ORT

Second line diarrhoea

Loperamide, increases transit time and reabsorption

First line haemorrhoids

Lidocaine, local anaesthetics, hydrocortisone anti-inflammatory

Second line haemorrhoids?

Suppositories internal only

First line IBS

Hyoscine anti-spasmodic, laxative bulk forming, loperamide

First line Dyspepsia

Antacids, rennies, Aliginates → first line heart burn

Second line Dyspepsia

PPI

First line NAV

Prochlorperazine buccal tablets for migraine associated, acupressure bands

First Line Mouth ulcers

Antibacterials Chlorhexidine mouthwash, analgesic bonjela, hydrocortisone buccal tablet

First line cystitis

Analgesics for pain, fluids

Second line

possible cymalon if patient really wants

First line thrush?

Cream, pessaries,

Second line thrush?

Fluconazole oral capsule

First line BV?

Canestest, Canesbalance

First line conjunctivitis bacterial

Chloramphenicol eye drops max 5 days

Second line conjunctivitis bacterial

Chloramphenicol eye ointment more at night

First line conjunctivitis allergic

Sodium cromoglycate eye drops, mast cell stabilisers used for prophylactically

Second line conjunctivitis allergic

Otrivine Antistin doesn’t treat underlying patholgy, antihistamines aim to reduce allergic response

First line styes

Warm compress for 5-10 minutes , 2-4 times a day

First line Blepharitis

Warm compress, baby shampoo twice a day, then reduce to one

First line dry eyes

Hypromellose

Second line dry eyes

Carbomer due to being more expensive better has better wetting characteristics

First line ear wax

Olive oil drops

Second line ear wax

Sodium bicarbonate, peroxide

First line otitis externa

Analgesics with a warm compress

Second line otitis externa

Acetic acid 2%

First line otitis media

Analgesics

First line eczema

Emollients and hydrocortisone 1%

Second line eczema

Clobetasone

First line Seborrheic dermatitis

Ketconazole shampoo, selenium sulphide shampoo

Second line Seborrheic dermatitis

keratolyic-tar combination

Acne first line

Benzoyl peroxide or freederm

Fungal skin infections first line

Clotrimazole cream

Athletes foot first line

Terbinafine cream (Lamisil)

Fungal nail infection first line

Amorolfine 5% nail lacquer

First line wart/verruca

Bazuka

First line cold sore

aciclovir 5%

First line psoriasis

Emollients for mild to moderate

Second line psoriasis

Tar preparations Dithranol