Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID'sFrom: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 maybe clindamycin,m not sureFrom: Marcela <marcesanchezf@...> Sent: Mon, February 21, 2011 7:36:41 PMSubject: Re: OSCE, prescription Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID'sFrom: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 Yes, Clindamycin is a option for penicillin allergic patients. For extra info about dose, indications and contraindications check the BNF website. You can register and have access to very helpful info related to medicaments.From: gurjot Rakhra <malki_nsr@...> Sent: Mon, 21 February, 2011 14:37:52Subject: Re: OSCE, prescription maybe clindamycin,m not sureFrom: Marcela <marcesanchezf@...> Sent: Mon, February 21, 2011 7:36:41 PMSubject: Re: OSCE, prescription Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID'sFrom: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 http://bnf.org/bnf/http://bnf.org/bnf/bnf/current/128215.htm?q=Clindamicina & t=search & ss=text & p=3#_128215From: gurjot Rakhra <malki_nsr@...> Sent: Mon, 21 February, 2011 14:37:52Subject: Re: OSCE, prescription maybe clindamycin,m not sureFrom: Marcela <marcesanchezf@...> Sent: Mon, February 21, 2011 7:36:41 PMSubject: Re: OSCE, prescription Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID'sFrom: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID'sFrom: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 clindamycin should be your choice in my view though antibiotics dont help with pus.U will get management just by incision and drainage of the abscess.From: Dr Avery <avery_dr@...> Sent: Mon, February 21, 2011 7:27:32 PMSubject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 I think erythromycin or metronidazole would be the antibiotic of choice in this case. From: [mailto: ] On Behalf Of Marcela Sent: 21 February 2011 19:51 Subject: Re: OSCE, prescription Yes, Clindamycin is a option for penicillin allergic patients. For extra info about dose, indications and contraindications check the BNF website. You can register and have access to very helpful info related to medicaments. From: gurjot Rakhra <malki_nsr@...> Sent: Mon, 21 February, 2011 14:37:52Subject: Re: OSCE, prescription maybe clindamycin,m not sureFrom: Marcela <marcesanchezf@...> Sent: Mon, February 21, 2011 7:36:41 PMSubject: Re: OSCE, prescription Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID's From: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter " A sore mouth " suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 21, 2011 Report Share Posted February 21, 2011 Yes erythromycim is the drug of choice in penicillin allergy, you would write the prescription erythromycin tablets 250mg qds 7 days 28 tablets2nd line drug:Metronidazole 200mg tds 5 days 15 tabletsClindamycin was the alternative as antibiotic prophylaxis in penicillin allergic patients but thats no longer recommended From: Manisha GuptaSent: 21 February 2011 22:40 Subject: RE: OSCE, prescription I think erythromycin or metronidazole would be the antibiotic of choice in this case. From: [mailto: ] On Behalf Of Marcela Sent: 21 February 2011 19:51 Subject: Re: OSCE, prescription Yes, Clindamycin is a option for penicillin allergic patients. For extra info about dose, indications and contraindications check the BNF website. You can register and have access to very helpful info related to medicaments. From: gurjot Rakhra <malki_nsr@...> Sent: Mon, 21 February, 2011 14:37:52Subject: Re: OSCE, prescription maybe clindamycin,m not sure From: Marcela <marcesanchezf@...> Sent: Mon, February 21, 2011 7:36:41 PMSubject: Re: OSCE, prescription Penicillin and aspirin allergies are quite common in asthmatic patients. Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID's From: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLee From: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby [The entire original message is not included.] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 22, 2011 Report Share Posted February 22, 2011 The alternative to penicillin in patients allergic to it would be Erythromicin or Azithromicin.This is form BNF: Oral infections Clarithromycin or erythromycin is an alternative for oral infections in penicillin-allergic patients or where a beta-lactamase producing organism is involved. However, many organisms are now resistant to macrolides or rapidly develop resistance; their use should therefore be limited to short courses. Metronidazole (section 5.1.11) may be preferred as an alternative to a penicillin. Gaby From: malki_nsr@...Date: Mon, 21 Feb 2011 11:37:52 -0800Subject: Re: OSCE, prescription maybe clindamycin,m not sureFrom: Marcela <marcesanchezf@...> Sent: Mon, February 21, 2011 7:36:41 PMSubject: Re: OSCE, prescription Penicillin and aspirin allergies are quite common in asthmatic patients.Prescribe AB therapy normally as you would do for any other penicillin allergic patient but remember not to prescribe NSAID'sFrom: Dr Avery <avery_dr@...> Sent: Mon, 21 February, 2011 14:27:32Subject: Re: OSCE, prescription hi guysCould anyone help me with this prescriptionAsthmatic Pt ,allergic to penicillin-write the prescription for a dental abscess.Please help me(SincerelyLeeFrom: Moreno <erikamorenorojas@...>Subject: Re: OSCE, liquen planus Date: Monday, 21 February, 2011, 12:06 Dear Gaby, When we come across to a lession, we explain to the patient -without scaring him/her that there is a withe/red patch present that would be worth to investigate in depth by an oral medicine specialist to discard any possible malignancy -you need to reasure the patient that this is the standard procedure to follow. If the patient is currently taking any medication that can contribute to the development of this lessions you can mention this to the patient to making him/her feeling less worried. With regards to timing I am not quite sure but can find out for you tomorow at work as my boss refers oral lesions quite frequently. We won't prescribe anything until we get a diagnosis made by an specialist (Oral medicine specialist) unless it is just a simple ulcer or burn that can be treated with corsodyl gel or gengigel. Hope this clarify some of your doubts, From: gabriela gomez <gabygomez82@...>ore mutual support < >; firas daoudi <firas@...>Sent: Sun, 13 February, 2011 19:03:46Subject: OSCE, liquen planus OSCE:LIQUEN PLANUS, LIQUENOID REACTION , LUPUS ERYTHEMATOSUSHi everyvody , I have some doubts related with this toppic and maybe someone can help me ,and I think is going to be useful for everybody as I can not find a book that make this clearer.When we have a patient, that we think because of the clinical findings, that could have either Liquen Planus or Liquenoid reaction or Lupus erythematosus, we know that biopsy needs to be done ino order to have the final diagnosis.How do we proceed in the exam?1) should we explain the patient what we think the lesion could be, the need for a biopsy to be done, explain what is biopsy andrefer patient to specialist? Which specialist here in Uk, pathologist, Oral maxillo facial surgeon or any of them?2)Should this referral be done urgent, I do not think so, but if it´s not urgent how long it would take for the patient to be seen by the specialist?3)Should we prescribe something to the patient meanwhile?Like, antimicrobial mouthwashes ( Chlorhexidine 0.2%)Analgesic mouthwashes ( Benzydamine 0.15%)I imagine we can not prescribe topical corticosteroids until we have the biopsy´s result as this lesions can be also infected with candida and corticosteroids could sread this infeciton easily.How would you poceed?4) another doubt, Odell in the chapter "A sore mouth" suggests that in those clincal cases, if ulcers are present, we should think about the possibility of candida infection so a smear cultive or saliva collected for candida count should be done, are we ( as general practitioners) sopposed to do that?Please if someone experienced in hospital in Uk I would really appreciate your suggestion.kind regardsGaby Quote Link to comment Share on other sites More sharing options...
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