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Flashcards in RTS - Respiratory Conditions Deck (44)
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31

Outline the difference between day nurse and night nurse

Day capsules: paracetamol, pseudoephedrine, pholcodine.
Night capsules: paracetamol, promethazine, dextromethorphan

32

Outline the active ingredients in cough and cold products

pain relief- paracetamol
Nasal congestion - decongestant
Cough :
1) demulcents - soothes and moisturises throats e.g. Glycerol, simple linctus
2) expectorants- loosens phlegm e.g. Guaifenisen, ipecacuanha, squill, ammonium salts
3) opioids - depress the cough reflex, acts in brain e.g. Pholcodine, dextromethorphan, (codeine not for under 18 years)
4) antihistamines- anti-cholinergic action results in antitussive effects but can cause drowsiness e.g. Diphenyhydramine, triprolidine

33

Name two decongestants

1) pseudoephedrine - one box containing no more than 720mg at any one time without a prescription
2) ephedrine - no more than 180mg at any one time without a prescription
- unlawful to sell them together

34

Outline the management of coughs in children

1) OTC cough and cold medicines no longer recommended for children under 6
2) manufacturers still in the process of updating
3) only products for under 6 to be used in coughs and colds now are paracetamol and ibuprofen on their own , simple linctus and glycerol
3) for children over 6, products similar to adults are available but with clear advice (but not codeine for under 18 years)

35

What is allergic rhinitis?

1) inflammatory disorder of the nose which offers when membranes lining the nose become sensitised to allergens
2) an allergen is something that causes an allergic inflammatory response
3) pollen, dust mites, animal hair, latex, foods etc
4) a compound called histamine is released if a person is exposed to an allergen
5) histamines can act on the cells of the nasal membranes to intimate an inflammatory response
6) this results in symptoms of runny, itchy nose, sneezing, congestion

36

Explain the three main types of allergic rhinitis

1) seasonal allergic rhinitis - symptoms tend to occur at the same time each year e.g. Allergy to pollen
2) perennial allergic rhinitis- symptoms occur throughout the year e.g. Allergy to house dust mites or pets
3) occupational allergic rhinitis - symptoms are due to exposure to allergens at work e.g. Animal dander , wood dust
- allergic rhinitis is often associated with allergic conjunctivitis, eczema and asthma

37

Compare and contrast allergic rhinitis and the common cold?

Allergic rhinitis:
1) nasal discharge is clear, takes longer to become purulent
2) sneezing frequent
3) nasal itching
4) eye symptoms common
5) symptoms continue for as long as sufferer is in contact with allergen
6) sudden onset of symptoms
7) occurs same time each year
8) affects isolated individuals
Common cold
1) initially clear but may thicken and become purulent within a few days
2) sneezing less frequent
3) normally no nasal itching
4) normally no eye symptoms
5) symptoms last 4-7 days
6) gradual onset of symptoms
7) usually occurs in winter, but could be any time of the year
8) contagious

38

What is hay fever?

1) Hayfever describes seasonal allergic rhinitis and conjunctivitis caused by pollen
2) patients may be allergic to all types of pollen or just certain types e.g. Tree pollen, grass pollen , a particular type of plant or fungal spores
Tree pollen - symptoms from spring
Grass pollen- symptoms from late spring to early summer
Weed pollen- symptoms from early spring to early autumn
Fungal spores- symptoms in autumn

39

Describe the symptoms of allergic conjunctivitis

1) watery eyes - discharge is clear
2) redness
3) itching of eye and/or eye lids
4) eye area may puff up

40

Outline the symptomatic treatment of Hayfever

1) oral antihistamines- sedative
- chlorphenamine - adult dose 4mg every 4-6 hrs max 24mg in 24 hours
-loratadine & cetirizine- non drowsy -long acting so once daily dosing
- acrivastine - non drowsy only for ages 12-65 , dose 8mg TDS, max 24mg in 24 hours
2) topical antihistamines :
- (azelastine and levocabatine) rapid onset of action (15 mins) can cause temporary location irritation

41

Outline the side effects of anticholinergic antihistamines

Cl- narrow closed angle glaucoma, prostatism
1) dry mouth
2) blurred vision
3) urine retention
4) constipation
5) palpations
(Can't see, can't pee, can't spit , can't shit)

42

Describe the Non-pharmacological counselling advice given to patients suffering from cold and influenza

1) caused by virus so no paint going to GP!
2) rest, keep warm, plenty of fluids
3) eat plenty of fresh fruits and vegetables to help maintain body's vitamins and minerals and therefore immune system
4) should improve within 7-10 days
5) influenza vaccine advice to at risk groups
6) steam inhalation, inhalants etc.
7) sweets to ease throat

43

Describe the symptomatic treatment of Hayfever

May need to use a combination of products
1) corticosteroids nasal sprays- fluticasone (once daily) and beclometasone (twice daily) . From 18 years only, acts as a preventative so should use every day even if there are no symptoms. Takes up to 7-10 days to start taking effect
2) mast cell stabiliser - sodium cromoglicate, available as a nasal spray
3) sympathomimetic decongestants - systemic and locally as nasal sprays

44

Explain the non-pharmacological advice given to patients suffering from Hayfever

1) avoidance of pollen
- avoid goi no outdoors if possible , especially when pollen count is at its peak I.e. Morning and evening
- keep doors and windows shut
- if eyes affected close fitting, wrap round sunglasses can help
2) removal of pollen-
- damp dust surfaces in house , in particular bedroom
- shower and wash hair after being outdoors
3) barrier preparations- nasal sprays /balms coat nostrils to prevent pollen from making contact with mucosal membrane and initiating inflammatory response
4) nasal saline washouts - flushes out pollen