Oral Thrush Flashcards Preview

OSCE Year 3 > Oral Thrush > Flashcards

Flashcards in Oral Thrush Deck (17)
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1
Q

What is oral thrush and its cause?

A

An infection caused by fungal Candida albicans
also causes nappy rash and vaginal thrush
Oral thrush: affects tongue surface and inside of cheeks

2
Q

Oral thrush presenting symptoms

A
  • sore mouth
  • white ‘milk’ flecks on the tongue/cheeks, can’t be wiped off. If scraped off, could lead to inflamed red patches and bleeding
  • cracks in the mouth
  • painful burning sensation`
3
Q

Danger elimination questions/red flag symptoms

A

-Failed medication
-Diabetics
-painless lesions
-recurrent oral thrush/thrush of other areas after neonatal period: possibly first signs of HIV infection
Other considerations:
-is patient on antibiotic? They might have wiped out normal flora
-asthmatic patient? May be caused by ICS inhaler
-breastfeeding mother?

4
Q

If a baby has oral thrush, what must you do as a pharmacist?

A

check if nappy rash is also present
Both should be treated at the same time
Antifungal cream containing miconazole or clotrimazole can be used for the nappy area

5
Q

Oral thrush age considerations

A

common in newborns (pick up infection in birth canal)

6
Q

How common is recurrent oral thrush?

A

Uncommon, unless baby is drinking from poorly sterilised bottles or if the infection comes from the mother’s nipples

7
Q

Lifestyle advice

A

-Inhaled steroids - rinse throat with water after using inhaler. Use spacer with inhaler
Switch to breath-actuated inhaler which will improve inhaler technique
-Breastfeeding mothers can apply small amounts of miconazole gel to the nipples - to eradicate any fungus present.
-for bottle-fed babies, sterilise bottles and teats effectively

8
Q

Treatment timescale of oral thrush

A

If no improvement of symptoms after 7 days of treatment, refer to GP

9
Q

Name 2 treatments for oral thrush

A

Miconazole gel 2% (Daktarin sugar free gel)

Antibacterial mouthwash - chlorhexidine

10
Q

Describe the directions for use of daktarin sugar free antifungal gel for oral thrush
(miconazole)

A

Adults and those over 2 years of age: apply 2.5mL of gel directly to affected area with a clean finger, QDS after meals
4-24 months: apply a small amount of gel (1.25mL) QDS after meals

Keep in contact with affected area for as long as possible
continue for 2 days until clear

11
Q

Side effects of miconazole gel 2% (for oral thrush)

A

sudden swelling of face, lips, tongue or throat due to allergy
skin rash: discontinue at first appearance of skin rash

12
Q

Warnings of miconazole gel 2% for oral thrush

A

Not recommended for patients taking anticoagulants
Caution in breastfeeding Do NOT apply to the nipple for administration to a child
Caution required: ensure gel does NOT obstruct the throat
Not for use in pregnancy
Caution in breastfeeding women

13
Q

Miconazole gel 2% for oral thrush

counselling

A
  • Apply gel after food
  • For babies, gel can be applied directly to the lesions using a cotton bud or the handle of a tea spoon
  • Gel should remain in the mouth for as long as possible.
14
Q

Antibacterial mouthwash for oral thrush

active ingredient and instructions

A

Chlorhexidine
Rinse mouth with 10mls BD
Use it until 2 days after the symptoms have gone

15
Q

Side effects of chlorhexidine mouth wash for oral thrush

A
dry mouth
mouth irritation
tooth or tongue staining (brown)
unusual or unpleasant taste in mouth
decreased taste or change in taste
16
Q

Chlorhexidine mouthwash for oral thrush - is it ok for pregnant women to take?

A

Yes

17
Q

Chlorhexidine mouthwash for oral thrush counselling

A

brush teeth beforehand to reduce the chance of brown staining of teeth
use after tooth brushing