QuestionSBA
QuestionChoice
This is an alternative oral antibiotic agent used to treat acne vulgaris where first line oral treatments are unsuitable
34062
c
Erythromycin 500mg PO BD
QuestionChoice
Tetracyclines are recommended as first line oral agents to treat acne vulgaris that has not responded to topical treatments. NICE recommends combination therapy (as opposed to antibiotic monotherapy), with topical azelaic acid.
34060
a
Topical azelaic acid and Doxycycline 100mg PO OD
QuestionChoice
This is an alternative oral antibiotic agent used to treat acne vulgaris where first line oral treatments are unsuitable
34064
e
Trimethoprim 300mg PO BD
QuestionChoice
Isotretinoin is a retinoid medication used to treat severe acne vulgaris. It should not be prescribed in the primary care setting without specialist assessment
34063
d
Isotretinoin 20mg PO BD
QuestionChoice
This is an alternative topical treatment for acne vulgaris which is less effective than the treatment that the patient is currently using
34061
b
Azelaic acid 20% cream (Skinoren) topical BD
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2756
Acne Vulgaris
Topic
92
General Practice
6823
Case Presentation: A 19 year old man attends a follow-up appointment at his GP. **PH** acne vulgaris. **DH** 3% benzoyl peroxide with 1% clindamycin gel (Duac). He has been using this for twelve weeks following failure to improve his condition with benzoyl peroxide gel alone.


**O/E**

He has a uniform distribution of open and closed comedones with occasional pustules on his face and upper back. No scarring or nodularity present.

Question: Select the most appropriate management at this stage.
a