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I am so proud of myself today. I am happy. Im glad I did something good for my patient! Woohoo.

Ok, I know you want to know what it was. It wasn’t sucha biggie really. Just a prescription for locorten-vioform ear drops. Doctor prescribed four times a day, I knew it wasn’t meant to be used that frequently, as it was a steroid drops, normally its about twice a day, so I looked it up and according to the BNF, 2-3drops twice a day for 7-10days! I rang up the surgery, clarified it, and explained to the patient, and he was really thankful! I sent the prescription back to the surgery for ammendment. But I gave out the ear drop with the correct directions on there. So thats the highlight of my day! yay!

Other things I’v learnt today :-

1. Naproxen not prescribable under NHS by a dentist. Alternative would be Ibuprofen, but patient allergic to it, next best option was diclofenac, which can be used for dental pain.

2. A lady with mouth ulcers wanted to buy something OTC. I found out she was breast feeding, so I wouldnt sell bonjela, it contains salicylic acid – aspirin related stuff – worried about reye’s syndrome- so I sold Iglu instead, that contains lidocaine, which is ok for breast feeding, as minimal quantity gets into breast milk.

Thats it for the day, I had a very pleasant, and smooth day today! Off tomorrow.

Have you watched Despicable Me 2010 Movie?? I saw the advertisement of Despicable Me when I was at the cinema for Toy Story 3.. Seemed like a really fun to watch cartoon! I can’t believe I still have to wait till October to watch it.. Oh no.. Im going home in August, I can actually watch it at home!! Silly me..I heard it is out already in Malaysia!! woohoo.. You’d think the release of new movies will be earlier in England eh, but NO.. they are so slow.. I remember a friend was telling me about Toy Story 3 few weeks ago, but I just watched it yesterday..

Check out the Movie Trailer here

Basically you can find all these information online.. whilst I was doing my little research on them, I thought I’d summarize it, save you all the looking up.

What are horse flies?

They are also known as forest flies or deer flies, range from 30mm – 60mm in length. They are very noisy during flight. If you are bitten, it would be by a female horse fly, because they require a blood meal for reproduction. They have tiny, serrated mandibles which they use to rip and slice flesh apart, thus the bite can be very painful, and last over a few days. After the bite, the affected site will develop into a red lump within minutes, it can be itchy, hot, and painful.

How do they look?

                      
                                  No! this is not a horse fly                                 This looks more like it lol

How to treat the bite?

You can just leave it and let it run its course - the symptoms mentioned above can last for a few days.. then slowly settles over weeks.. or treat the symptoms with Antihistamine cream or tablets to relief the itch and reduce the swelling by suppressing histamine release. or low potency topical steroid i.e. hydrocortisone 1% to reduce the inflammation. Im not very keen on selling the steroid cream, especially if the wound looks nasty, and a definate no no if the wound is slightly opened or raw, it will make it worse.

I recommended the previous customer to get some non-drowsy antihistamine, cetirizine is my favourite one to sell. Piriton (chlorphenamine),the traditional, drowsy antihistamine are most effective, but of course it can be  a pest if they have to drive or work or even if they are on holiday.

When to refer?

When there are signs of infection – very painful, hot, red and produces pus. I would also refer if they have used the counter treatments and still no improvements after a couple of days.