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MO1 > Respiratory OTC > Flashcards

Respiratory OTC Flashcards

1
Q

define the common cold

A

A mild, self-limiting
upper respiratory tract infection
characterised by nasal stuffiness
and discharge, sneezing sore
throat and cough.

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2
Q

what are the causes of the common cold?

A

viral cause

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3
Q

how does a cold spread?

A
  • Inhale drops of mucus containing cold virus
  • Touch something carrying the virus and then rub
    eyes/nose.
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4
Q

when is a cold most contageous?

A

Symptoms within 2-3 days - most contagious in
early stages

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5
Q

what are the symptoms of a cold?

A

Runny/blocked nose
* Sneezing/coughing
* Headache/aches and pains
* Temperature –unlikely to be raised much in a
common cold
* Sore throat
* Earache –blocked and uncomfortable = normal
* - Acutely painful = referral

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6
Q

what is the flu?

A

Acute respiratory illness caused by RNA viruses of the family Orthomyxoviridae (influenza viruses).

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7
Q

what are the different types of viruses?

A

Influenza A - occurs more frequently and is more
virulent. It is responsible for most major epidemics and
pandemics.
* Influenza B - often co-circulates with influenza A during
the yearly outbreaks.
* Influenza C - usually causes a mild or asymptomatic
infection similar to the common cold.

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8
Q

what are the symptoms of flu?

A
  • As per the common cold –PLUS…
  • Onset - very rapid
  • Weakness and fatigue –Many patients bed bound
  • Fever (if present) tends to be more severe in children.
  • Resistance is reduced during long term illness, stress, fatigue, depression
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9
Q

what are the complications of flu?

A
  • Acute bronchitis.
  • Pneumonia….may require admission to hospital
  • Exacerbations of asthma and COPD
  • Otitis media.
  • Sinusitis.
  • Non-respiratory complications –rare
  • In pregnancy, complications include perinatal
    mortality, prematurity, smaller neonatal size, and
    lower birth weight (DoH, 2013)
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10
Q

how do you treat cold/ flu?

A

paracteamol- fever/ chills/pains
sore throat-local anesthetics- benzocaine sprays
congestion- decongestants- sudafed
inability to sleep- antihistamines- promethazine/ diphenydramine

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11
Q

how do decongestants work?

A

Constrict blood vessels in nasal mucosa
* Relieve nasal stuffiness
* Ingredient in oral cold remedies, nasal sprays & drops

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12
Q

what are the ingredients in oral/ topical decongestants?

A

Oral Decongestants
1. Ephedrine
2. pseudoephedrine
3. phenylephrine
Topical Decongestants
1. ephedrine
2. oxymetazoline
3. xylometazoline

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13
Q

what are the side effects of decongestants?

A
  • Rebound congestion (topical)
  • CNS Stimulants –do not take at night (orally)
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14
Q

who are decongestants contraindicaed in?

A
  • Hypertension/Heart disease - stimulation of heart and
    increase in BP
  • Diabetes –can increase blood glucose levels
  • Hyperthyroidism
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15
Q

what do decongestants interact with?

A
  • MAOIs
  • beta blockers
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16
Q

what is the legal amount of psudeoephedrine/ ephedrine you can sell to a patient?

A
  • Misused to produce
    methylamphetamine (crystal meth)
  • Max sale of 720mg packs (12x60mg tabs)
  • Limit of 1 pack per person
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17
Q

what are the side effects of antihistamines?

A
  • Drowsiness…counsel re driving etc
  • anticholinergic
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18
Q

who are antihistamines contraindicated in?

A
  • Severe respiratory disease
  • closed angle glaucoma
  • prostatic hypertrophy
  • epilepsy
  • liver disease
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19
Q

what do antihistamines interact with?

A

Alcohol…increased sedative effects

20
Q

what is used to treat cold/ flu in children?

A

Antitussives - Dextromethorphan,Pholcodine
Expectorants - Guaifenasin,Ipecacuanha
Nasal decongestants - Ephedrine,Oxymetazoline,Phenylephrine, Pseudoephedrine,Xylometazoline
Antihistamines Brompheniramine,Diphenhydramine,Doxylamine,Promethazine,Triprolidine.

21
Q

who can codeine be used in?

A

not u12
12-18 P
18+ OTC

22
Q

what counselling should you give for a child with cold/ flu?

A
  • Can only recommend analgesic/anti-pyretic
    (check if appropriate)
  • Fluids
  • Rest
  • Child sleep on side
  • Vapour rubs/ inhalants/saline nasal drops
23
Q

when should you refer child for cold/flu?

A
  • noisy breathing/wheezing
  • croup or whooping cough
  • ear tugging
  • persistent / extremely high temperature
  • persistent nocturnal cough
24
Q

when should you refer adults for cold/flu?

A

asthmatics
coloured mucus- consider as a whole
blood
infant/elderly
cardiac/ lung disease

25
Q

when can antivirals be prescribed?

A
  • Antiviral drugs can be prescribed (oral oseltamivir or inhaled
    zanamivir) for influenza in at risk groups.
26
Q

what counselling should you give for a patient with cold/ flu symptoms?

A
  • Steam inhalations v salt water nasal
    cleaning
  • Avoid over treatment
  • Care with analgesic dose
  • Caution with sedative antihistamines
  • Expect improvement after 1 week
  • Diabetics
27
Q

what is a cough?

A
  • Part of body’s natural defense mechanism
  • Not a condition but a symptom
    reflex response to airway irritation
28
Q

what are the causes of a cough?

A

Upper respiratory tract viral infections
* Cold/dry atmosphere
* Smoking
* Other conditions: asthma/COPD/Heart
failure/allergies
* Medication: ACEI

29
Q

what are the different types of coughs?

A

Non-productive cough
* dry, tickly irritation of throat and chest
* no sputum
Productive cough
* excess sputum
* thin & clear removed by cough (Mucoid)
* thick and difficult to clear chest
* coloured sputum

30
Q

what are the available cough suppressants? antitussives

A

Codeine Linctus –(> 18yrs)
* constipation
* abuse
Pholcodine Linctus
* fewer side effects
Dextromethorphan
* less potent
* few side effects

31
Q

why would you give antihistamiens for a cough?

A
  • Eg. Diphenhydramine, promethazine,
    triprolidine
  • Dry secretions
  • Reduce cough frequency
  • Cause drowsiness –useful if cough is
    disturbing sleep
  • Anticholinergic side effects
32
Q

what is the purpose of demucents?

A
  • Soothe throat/cough
  • Sugar or syrup base - pleasant to take
  • Glycerin, honey & lemon
33
Q

what is the two possible MOA of expectorants?

A
  1. stimulate bronchial mucus secretion –liquefying
    sputum
  2. emetic reflex response
34
Q

what counselling should be given for a cough?

A
  • Increase fluid intake –liquefy
    secretions/soothe throat
  • Steam inhalation?? –add
    inhalant??
  • Sugar free remedies - diabetics
35
Q

when should you refer a cough?

A
  • Lasting longer than 3 weeks (nhs.uk 2019)
  • Coloured sputum associated with other
    systemic symptoms
  • Chest pain (PE/Pleurisy)
  • Shortness of breath and / or wheeze
  • Recurrent nocturnal cough (particularly
    children)
  • Whooping cough or croup
  • ADRs
  • Smokers with recurrent cough
36
Q

what should you consider for someone who presents with a sore throat?

A
  • Duration
  • Other symptoms…dysphagia/ swollen glands
    Glandular fever??
  • Persistent hoarseness –refer if >3 weeks
  • Previous history –recurrent tonsilitis
  • Smoker?
  • Current meds??
37
Q

what are the different types of allergic rhinitis?

A

Seasonal - symptoms occur at the same time each year
❖response to grass and tree pollens (also known as
hayfever)
Perennial - symptoms occur throughout the year
❖house dust mite/animal fur/feathers/fungal
spores/dust

38
Q

what are the symptoms of allergic rhinitis?

A
  • sneezing
  • rhinorrhoea
  • nasal congestion
  • nasal itch
  • irritation of mouth & palate
  • itching eyes with lacrimation &
    conjunctivitis
39
Q

what is the first line treatment for allergic rhinitis?

A

oral antihistamines

40
Q

what nasal preparations are available for hayfever?

A

beclometasone and fluticasone
* For 18 years +
* anti-inflammatory
* start 2 weeks before symptoms expected
* regular use throughout season –ensure compliance

41
Q

what are the side effects of corticosteroid nasal prep?

A
  • dryness & irritation of nose
  • nose bleeds
42
Q

how do mast cell stabilisers work?

A

Stabilises mast cells to prevent histamine release - used
prophylactically
* Intra-nasal & intra-ocular
* Prophylactic treatment
* QDS dose
* Children from 6 years
* No specific cautions

43
Q

what is a POM version of a mast cell stabiliser?

A

Lodoxamide

44
Q

how does Lodoxamide work?

A

Alomide for allergic conjunctivitis –prevents
histamine release
* intra-ocular
* not for children under 4 years
no longer than 4 weeks

45
Q

what are the combination topical antihistamines?

A

Otrivine-Antistin eye drops
* antazoline with xylometazoline
* antihistamine with vasoconstrictor
* short term use
* 2 or 3 times daily no more than 7 days
* not for children

46
Q

who are topical antihistamines contra indicated in?

A
  • children under 12 years
  • pregnancy & breast feeding
47
Q

what are the red flag symptoms for hayfever?

A
  • Wheezing or shortness of breath (asthma?)
  • Prolonged or severe earache (otitis media?)
  • Facial pain (sinusitis?)
  • Coloured nasal discharge
  • Purulent conjunctivitis
  • No improvement after 5-7 days

MO1 (50 decks)

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