L11 - Minor ailments of Respiratory System

Question 1

What are the symptoms of common cold?

Answer 1

• 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

Question 2

What are the symptoms of influenza?

Answer 2

• 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

Question 3

Who fits under high-risk groups for flu?

Answer 3

• 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)

Question 4

When should a pharmacist refer to GP for colds/flu?

Answer 4

• Prolonged severe symptoms relating to cough, sputum volume/colour, breathlessness, fever, general malaise
• Worsening of asthma / COPD
• Earache (Utilities media) - common in children

Question 5

OTC for common cold - aches, pains, fever, shivers

Answer 5

• 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)

Question 6

OTC for common cold - runny nose or sneezing

Answer 6

Antihistamines:
- Cetirizine
- Fexofenadine
- Loratadine

• Care should be exercised in patients with:
• Glaucoma
• Men with enlarged prostrate

Question 7

OTC for common cold - nasal congestion

Answer 7

Systemic sympathomimetics:
- Otrivine Adult Nasal Spray (Xylometazoline hydrochloride)

• Care should be exercised in patients with:
• Hypertension
• Heart disease
• Hyperthyroidism

Question 8

OTC for common cold - coughcough

Answer 8

• 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)

Question 9

What are the danger symptoms for sore/inflamed throat?

Answer 9

• Difficulty swallowing food + liquid (sharp feeling)
• Large tender lymph nodes in neck
• Ulceration in mouth area

Question 10

OTC for common cold - sore/inflamed throat

Answer 10

• Analgesic: ibuprofen, aspirin (adults or children)
• Antibacterial agent: chlorhexidine, tyrothicrin
• Anaesthetic agent: benzocaine, lidocaine
• Anti-inflammatory agent: benzydamine (Difflam)
• Demulcents: Glycerol

Question 11

What are the symptoms of hay fever?

Answer 11

• 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

Question 12

OTC for hay fever

Answer 12

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)

Question 13

What non-drug advice can be given for hay fever?

Answer 13

• 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)