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External Hordeolum
Bacitracin (UNG)
Erythromicin (UNG)

BID-QID
Internal Hordeulum
ALL 10 DAYS

Gentamicin (GTT QID)
Ofloxacin (GTT QID)
Erythromicin 250-500 mg QID
Dicloxacillin 250 mg QID
EES 400-880 mg QID

Tetracycline 250-500 mg QID
  • for use w/in first 2 days
Young Chalazion
(< 6 mo)
Triamcinolone (Kenalog)
5mg/mL

  • inject into lesion
  • decrease swelling/hardness
Preseptal Cellulitis

Tx for:

H. Flu
Amoxicillin 250 TID
Ampicillin 250 QID
Augmentin 250-500 TID

Cefaclor 250-300 TID
Ceftin 250-500 BID
Preseptal Cellulitis

Tx for:

Streptococci (no pus)
Penicillin G 125-250 QID
Cephalexin 250-500 QID
Cephradine 250-500 QID
Amoxicillin 250 QID
Ampicillin 250 QID
Preseptal Cellulitis

Tx for:

Staphylococci (pus forming)
Dicloxacillin 250 QID
Cephalexin 250-500 QID
Cephradine 250-500 QID
Erythromycin 250 QID
EES 800 QID
Augmentin 250-500 TID
Bactrim
Preseptal Cellulitis

Signs
-Diffuse, painful swelling of lid tissue
-No proptosis
-Pain/tenderness may radiate past orbital rim
-Tender pre-auricular nodes
-Unaffected VAs
-Normal EOMs
-Ache in sinuses may be present
Preseptal Cellulitis

Prophylaxis
Gentamicin QTT QID
Norfloxacin QTT QID
Polysporin UNG BID
Orbital Cellulitis

Signs
-Conj. hyperemia/chemosis
-Proptosis/diplopia
-Ophthalmoplegia
-ON ischemia/edema
-Decreased VAs
-EOM pain
-Lid edema/erythema
-General malaise - Fever/chills/Vomiting
Meibomitis
Tetracycline 250 POx3wk
Blepharitis

Steroid Tx
Blephamide
Sulfacetamide 10%
Corticosporin

Big Guns (UNG, BID-TID, <7days)
Pred-G
Tobradex
Maxitrol
Zylet
Blepharitis

Antibiotic UNG Tx
Neosporin
Erythromycin
Gentamycin

All at least BID, with QHS
Blepharitis

Antibiotic PO Tx
Dicloxacillin 250 QIDx10d
Tetracycline 250-500 QIDx10d
-No kids <12yo
-No pregnant/lactating women
Erythromycin 250-500 QIDx10d
EES 400-800 QID
-For kids <12yo
-For those with penicillin allergies
Angular Blepharitis
Polysporin UNG BID-QID
Visine AC BID-QID
Impetigo

Topical Tx
-Soak with Burow's solution 20 mins BID-QID
-Debride crust with wash cloth
-Chlorhexidene to cleanse area
-Polysporin/Erythromycin UNG

-Mupirocin (Bactroban) 2% UNG TID
Impetigo

PO Tx
For staph/strep:
-Cephalexin 250 QID
-Cefaclor 250 TID

For Staph:
-Dicloxacillin 125-250 QIDx10d

For Strep:
-Penicillin V 250 QIDx10d

For those allergic to penicillin:
-Erythromycin 250 QID
-EES 400 QID

Penicillin G Injection - 1.2 mil units
Facial Rosacea

Mild Variety Signs
Mild "Telangiectatic Stage"

Simple redness
Face blushes and flushes easily
Facial Rosacea

Moderate Variety Signs
Moderate "Papular-pustular Stage"

Single or multiple lesions, wax and wane
Papules perhaps more common
Facial Rosacea

Severe Variety Signs
Severe "Glandular Hyperplastic Stage"

Overgrowth of sebaceous and connective tissue of nose (rhinophyma)
W.C. Fields nose
Facial Rosacea

Tx
Tetracycline 250 QIDx8wk
-slowly taper down to 250 QD/QOD

Doxycycline 250 BIDx8wk
Metro-Gel
Ocular Rosacea

Tx
Artificial Tears QID PRN

0.12% Prednisolone acetate BID
Tetracycline 250 QID
Rosacea

Retinoid Tx
Tretinoin (Retin-A)  QHS
-stimulates cell mitosis/turnover
-dec. cohesiveness of epi. cells
-best for obstructive acne


Isotretinoin (Accutane)
-inhibits sebaceous gland fx
-inhibits keratinization
Isotretinoin (Accutane)

Side effects
Cheilitis (dry, chapped lips and skin)
Conjunctivitis
Musculoskeletal complaints
Dry mouth, skin, nose, eyes
Epistaxis (nose bleeds)
Corneal Opacities
Pseudotumor Cerebri
Lipid disorders
Elevated ESR
Varicella (Chicken Pox)

Calamine/Burows/Isopropyl

Chlorpheniramine Maleate 4mg QID
Diphenhydramine 25mg TID-QID

For Children:
Allerest Children's Chewable 1mg
Triaminic Chewable 0.5mg
Varicella (Chicken Pox)

Acyclovir Tx
Age 2-12 -> 20mg/KG QID

Age 13-18 -> 800mg QID
Zoster

Tx
Blephamide BID-TID
Hydrocortisone UNG
Oral antihistames TID-QID

Acyclovir (Zovirax) 800 PIDx10d
Famciclovir (Famvir) 500 TIDx7d
Valacyclovir (Valtrex) 1000mg TIDx7d
Zoster

Relief
Oral Steroids
Vicodin
Amitriptyline
Capsaicin (Zostrix)
Zostavax - vaccine for elderly
Type 1 Allergy
Diphenhydramine (Benadryl) 25-50 q4-q6h

Desloratadine (Clarinex) 5 QD
Cetirizine (Zyrtec) 5-20 QD
Fexofenadine (Allegra) 60/100/500 BID
Levocetirazine (Xyzal) 5 QD

Singulair (Monteleukast) 10 QHS
Accolate (Zafirlukast) 10-20 BID
Type 1 Allergy

Follow up
Severe - see next da
Moderate - see in 2-3 days
Mild - see in 3-5 days or PRN
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