L11 - Minor ailments of Respiratory System Flashcards
What are the symptoms of common cold?
- Gradual onset of symptoms - tingling in nose/throat/eyes
-Rhinorrhoea (runny nose) - maybe sneezing
- Nasal congestion
- Low-grade fever if present (children)
- Body aches + fatigue
- Cough may develop
- Sore/inflamed throat
- Can lead to mild inner ear infections
- Runs its course in approx. 1 week
What are the symptoms of influenza?
- Faster onset of symptoms
- Higher + sustained fever
- Body aches + fatigue + sore throat + cough – more severe than common cold
- Symptoms persist for 2 weeks or more
- Can lead to pneumonia, bronchitis + secondary infections
Who fits under high-risk groups for flu?
- Under 5 yrs
- Over 65 yrs
- Asthma
- COPD
- Immunocompromised
- Diabetes – make sure sugar-free meds)
- Cardiovascular disease
- Renal failure
- They should be referred to GPif worsening of their conditions
- Hypertension / CV / Diabetes – avoid sympathomimetics (oral or nasal decongestants)
When should a pharmacist refer to GP for colds/flu?
- Prolonged severe symptoms relating to cough, sputum volume/colour, breathlessness, fever, general malaise
- Worsening of asthma / COPD
- Earache (Utilities media) - common in children
OTC for common cold - aches, pains, fever, shivers
- Paracetamol – dose regulations for children (+2 months)
- Ibuprofen (NSAID) – dose regulations for children (+3 months)
- Aspirin (NSAID) – for 16+ yrs in adults only (not for children)
OTC for common cold - runny nose or sneezing
Antihistamines:
- Cetirizine
- Fexofenadine
- Loratadine
- Care should be exercised in patients with:
- Glaucoma
- Men with enlarged prostrate
OTC for common cold - nasal congestion
Systemic sympathomimetics:
- Otrivine Adult Nasal Spray (Xylometazoline hydrochloride)
- Care should be exercised in patients with:
- Hypertension
- Heart disease
- Hyperthyroidism
OTC for common cold - coughcough
- All are largely placebo effects!
Expectorant — to loosen phlegm/catarrh:
- Guaifenesin - BENELYN
- Ipecacuanha -Bell’s Chesty Cough Oral Solution
Suppressant — to surpress cough:
- Pholcodine - Codeine linctus
- Dextromethorphan - Robitussin Dry Cough Medicine
Demulcents — soothing inflamed throat:
- Simple linctus
- Simple linctus Paediatric
- Lozenges
- Gargle with soluble aspirin (if appropriate)
Inhalants: menthol, eucalyptus, pine oil, camphor
Vitamin C (stimulation of immune system)
Echinacea (supports body’s immune system)
What are the danger symptoms for sore/inflamed throat?
- Difficulty swallowing food + liquid (sharp feeling)
- Large tender lymph nodes in neck
- Ulceration in mouth area
OTC for common cold - sore/inflamed throat
- Analgesic: ibuprofen, aspirin (adults or children)
- Antibacterial agent: chlorhexidine, tyrothicrin
- Anaesthetic agent: benzocaine, lidocaine
- Anti-inflammatory agent: benzydamine (Difflam)
- Demulcents: Glycerol
What are the symptoms of hay fever?
- Red, itchy, watery eyes
- Congestion, sneezing, runny nose
- Itchy or sore throat, post-nasal drip, coughing
- If severe - throat or palate or ears may be affected
- Symptoms worse - late morning and early evening — lasts whole season (March-Oct)
- REFER - if breathing affected or wheezing
OTC for hay fever
Oral anti-histamines:
- Sedating –> chlorphenamine
- Less-sedating –> cetirizine, loratadine, acrivastine
(more effective if started before symptoms appear - advised to take one daily in morning throughout season)
Antihistamine eyes drops:
- Antazoline sulphate - Vasocon-A
- Xylometazoline - Otrivin (vasoconstrictor)
(combination often used for intermittent symptoms)
Topical corticosteroid (nasal spray):
- Beclometasone, fluticasone, triamcinolone
(For only +18 yrs, use regularly as takes few days for effect)
Mast cell stabiliser:
- Sodium cromoglicate - as nasal spray or eye drops
(use regularly as takes few days for effect)
What non-drug advice can be given for hay fever?
- Keep windows + doors closed, especially early evening
- Check pollen count - stay inside when very high
- Avoid cutting grass
- Wear wrap around sun glasses
- Avoid hanging washing out on high pollen count days
- Smear vaseline around the inside edges of nostrils - stop pollen going through
- Prepare in advance of the season (if you know your pattern)