Respiration

Question 1

What are the diagnostics for a common cold?

Answer 1

Runny nose, sore throat, eyes
may water.
Sometimes fever in children,
but not very common.
Sneezing, congestion, cough.

Question 2

What is the treatment for a common cold?

Answer 2

Paracetamol,
phenylephedrine, pseudoephedrine, xylometazoline, pholcodine, guaifenesin, Vicks/Olbas Oil (from 3 months), tixylix if under 6, saline nasal drops from birth.

Question 3

What non-pharmacological advice can be given for a common cold?

Answer 3

Will get better within 4-10 days.
Drink 1.5-2L of water a day.
Plenty of bed rest.
Hot baths can stop congestion.

Question 4

When should a common cold be referred?

Answer 4

Influenza diagnosed
(rapid onset, shivering,
headache, fever always, not many upper-respiratory tract symptoms like sneezing).

Question 5

What may a common cold be an exacerbation of?

Answer 5

May be due to an
exacerbation of COPD
or asthma - check adherence.

Question 6

What are the diagnostics for a sore throat?

Answer 6

Swollen glands with discharge
indicative of glandular fever.
White glands, some difficulty
swallowing indicative of
streptococcal A infection.
May be slightly inflamed with
some dysphagia.

Question 7

What is the treatment for sore throats?

Answer 7

Ultra Chloraseptic.
Tyrozets.
Difflam spray/oral rinse.

Question 8

What non-pharmacological advice can be given for sore throats?

Answer 8

Avoid hot drinks when using an
anaesthetic because it could burn
the mouth.

Question 9

When should a sore throat be referred?

Answer 9

Glandular fever or streptococcal A infection suspected.

Question 10

What are the diagnostics for allergic rhinitis?

Answer 10

Teary eyes which become very
itchy (scratch-itch-stratch issue),
runny nose, sneezing.

Question 11

What is the treatment for allergic rhinitis?

Answer 11

Chlorphenamine, loratadine,

cetirizine, acrivastine, sodium cromoglycate eye drops, beclometasone nasal spray.

Question 12

What non-pharmacological advice can be given for allergic rhinitis?

Answer 12

Avoid trigger (pollen for example).
Do not go outside between 5-7pm
as this is when the pollen count is
highest.
Wear sunglasses outside.
In the future, start taking the
anti-histamine before symptoms
start since it builds up some
extra protection.
Vacuum regularly.
Keep windows of house and car(s) shut.
Wash and clean hair immediately after having gone out.

Question 13

Which antihistamines are considered drowsy?

Answer 13

Chlorphenamine, hydroxyzine, promethazine.

Question 14

Which antihistamines are considered non-drowsy?

Answer 14

Cetirizine, loratadine, fexofenadine.

Question 15

When should allergic rhinitis be referred?

Answer 15

Anti-histamines have not worked and so fexofenadine or desloratadine should be prescribed.

Question 16

What is the concern with nighttime coughs?

Answer 16

They may be indicative of asthma.

Question 17

For how long should intranasal decongestants be used in adults?

Answer 17

One week.

Question 18

Are oral decongestants typically recommended for sinusitis?

Answer 18

No.

Question 19

How does a flu infection usually start?

Answer 19

Infection with the influenza virus usually starts abruptly with sweats and chills,
muscular aches and pains in the limbs, dry sore throat, cough, and high temperature.

Question 20

What symptoms may provide a warning that pneumonia is developing following a flu infection?

Answer 20

Warning
that pneumonia complications are developing may be given by a severe or
productive cough, persisting high fever, pleuritic-type chest pain or delirium.

Question 21

Should patients with a history of COPD be referred if they develop flu symptoms?

Answer 21

Yes.

Question 22

When dealing with a patient with a cold or flu, when would referral be appropriate?

Answer 22

Earache not settling with an analgesic.
In the very young.
In the frail and old.
In those with heart or lung disease, for example, COPD, kidney disease, diabetes,
compromised immune system.
With persisting fever and productive cough.
With delirium.
With pleuritic-type chest pain.
Asthma.

Question 23

Describe pleuritic-type chest pain.

Answer 23

Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling.

Question 24

What is the treatment timescale for colds and flu? (How long should one wait before seeking further medical advice?)

Answer 24

Once the pharmacist has recommended treatment, patients should be advised
to see their nurse or doctor in several weeks if the respiratory infection has not improved or earlier if there is a marked
deterioration in symptoms.

Question 25

Which cold and flu remedies should not be sold for their use in children under 6 years old?

Answer 25

Antitussives: Dextromethorphan and pholcodine Expectorants: Guaifenesin and ipecacuanha Nasal decongestants: Ephedrine, oxymetazoline, phenylephrine, pseudoephedrine and xylometazoline Antihistamines: Brompheniramine, chlorphenamine, diphenhydramine, doxylamine, promethazine and triprolidine

Question 26

In which patient groups should sympathomimetics be used in caution?

Answer 26

They should be used with caution in people with diabetes, those with heart disease or hypertension and those with hyperthyroidism.

Question 27

Oral and nasal sympathomimetics should be avoided in patients who are taking or have recently stopped taking which class of drugs?

Answer 27

MAOis.

Question 28

For how long can a cough persist after a bad cold?

Answer 28

3 weeks.

Question 29

How long should a cough persist for before one should seek further medical advice?

Answer 29

2-3 weeks with no signs of improvement. Accompanied by tiredness, malaise, or fever.

Question 30

What colour sputum is common in asthma?

Answer 30

Green.

Question 31

What colour is uninfected sputum?

Answer 31

Non-coloured (clear or whitish).

Question 32

What colour of sputum is a cause for a referral?

Answer 32

Red (blood in sputum).

Question 33

Is wheeziness a cause for a referral?

Answer 33

Yes, unless the patient is asthmatic and knows how to effectively manage this symptom when suffering from a cough.

Question 34

How can one identify croup in a child?

Answer 34

The cough has a harsh barking quality. It develops 1 day or so after the onset of cold-like symptoms. It is often associated with difficulty in breathing and an inspiratory stridor (noise in throat on breathing in).

Question 35

What symptoms/scenarios related to a cough would be conditions for a referral?

Answer 35

Wheezing, chest pains, shortness of breath, history of heart disease, failure of appropriate OTC remedies.

Question 36

How long after a pharmacist has recommended treatment should a patient seek further medical advice?

Answer 36

After 2-3 weeks if there is no improvement.

Question 37

If recommending pholcodine of codeine, what should a patient be made aware of?

Answer 37

Drowsiness.

Question 38

How long should hoarseness of voice persist for before referral is necessary?

Answer 38

3 weeks.

Question 39

What should one do if they suspect an oral thrush infection?

Answer 39

A referral is advised if thrush is suspected and the throat is sore and painful.