Acute Sinusitis Flashcards
What is sinusitis?
Inflammation of the paranasal sinuses
What is sinusitis triggered by?
Viral Upper Respiratory Tract Infection(URTI)
How does sinusitis spread within the nose?
It spreads from the nasal cavity into the sinuses
Which part of the nose becomes inflamed during sinusitis?
Lining of the nasal cavity
If the lining of the nasal cavity is inflamed, what happens to the mucous?
What would normally happen
The mucous which would normally flow through the narrow channels to drain into the nose would be blocked
What effect does a blockage of mucous (lack of drainage) have on the sinuses?
Creates pressure and pain
What is followed by the primary infection of sinusitis?
Bacterial Secondary infection
How common is a secondary bacterial infection following sinusitis?
2 in 100 cases
What symptoms are presented during sinusitis?
-Pain and tenderness affecting sinuses
-Throbbing pain which often gets worse when bending forwards
-Green/yellow discharge from the nose
-Headache
-Blocked nose
-Loss of smell
-Fever
How long does it take for symptoms of sinusitis to improve?
7-10 days
How long does it take for symptoms of sinusitis to resolve?
2-3 weeks, but may take as long as 12 weeks
What age group is sinusitis more prevalent in?
Can occur in any age group but is more common in children
Why is sinusitis more common in children?
Their sinuses have not yet fully developed
What advice should you give patients with symptoms of sinusitis for 10 days or less?
Antibiotics unlikely to be appropriate
Why are antibiotics inappropriate for sinusitis?
The are inappropriate because of the likely cause of infection and the expected timeframe
Is sinusitis more likely to be viral or bacterial?
Viral
Is sinusitis self-limiting
Yes, both viral and bacterial are
Should analgesia be provided for sinusitis?
Yes
What is analgesia?
Used to manage pain and fever
Which analgesia should be provided?
Paracetamol or Ibuprofen
What can be done about the congestion associated with sinusitis?
-Saline nasal drops
-Xylometazoline
-Pseudoephedrine
-Steam inhalation
What is Xylometazoline?
A decongestant nasal spray
How long can xylometazoline be used for in the treatment of sinusitis?
7 days
Why shouldn’t xylometazoline be used for more than 7 days?
Rebound congestion
What is Pseudoephedrine?
A decongestant tablet or component in other formulations
Caution should be taken when dispensing pseudoephedrine to patients with which underlying conditions?
Glaucoma and hypertension
What is the legal maximum pseudoephedrine that can be dispensed in one transaction?
720mg per transaction
What should be prescribed if the patient has had sinusitis for more than 10 days?
Consider prescribing a high dose nasal corticosteroid spray
How long should the high-dose nasal corticosteroid spray for treating chronic sinusitis be prescribed for?
14 days
What should be considered if sinusitis symptoms persist for more than 10 days?
Dental Infection
Should a backup antibiotic prescription be dispensed for chronic sinusitis?
Yes, it is to be used if symptoms do not improve within 7 days or worsen suddenly or significantly
What safety netting advice should you give a patient with sinusitis?
The patient should return to seek medical advice if:
-Symptoms worsen suddenly or significantly
-Symptoms do not improve within 3-5 days of initial treatment
-They cannot tolerate the antibiotic (if prescribed)
-Becomes systemically unwell
Red flag management of sinusitis
-Chronic or recurring sinusitis
-Medical conditions such as nasal polyps, which could complicate treatment
-Experience repeated treatment failures
