Antihistamines

Question 1

Hay fever symptoms

Answer 1

Rhinorrhoea - runny nose - clear watery 
Nasal congestion inflammatory response 
Nasal itching 
Eye changes
Sneezing

Question 2

Referral and treatment for hay fever

Answer 2

Wheezing earache / facial pain
Purulent conjunctivitis

Treatment
Antihistamines -piriton - 1 tan every 4-6 hours max 6

Loratadine - 1 daily

Sodium cromoglicate - tilt head back 1-2 drops into the affected lower lid then close eye and wipe XS (4 times )

Steroid nasal spray - beconase 2 sprays into each nose 2 times a day

Wear wraparound sunglasses 
Shower / change after being out 
Stay in when pollen count is high (50g pcm) 
Vaseline on nose
Vacuum 
Car windows closed 
Damp dust 
Don’t keep fresh flowers in House

Question 3

Motion sickness

Answer 3

Nausea vomiting dizziness pallor
Cold sweats hypersalivation

Refer in below 2 or otc fails

Treatment includes
Hyoscine - (3y) acts up to 4 hours - 2 tabs 20 mind before journey

Cinnarizine - (5y) 8 hours

Promethazine (2y) 8+ hours
Acupressure bands and ginger

Question 4

Insomnia

Answer 4

Difficulty getting to sleep or staying asleep for long enough to feel refreshed in the morning
1 in 3 people in the Uk

Question 5

Causes of insomnia

Answer 5

Underlying medical condition
Envinroment - noise 
Altered patterns - shifts 
Stress
Mental health - depression 
Sleep hygiene 
Behavioural - children 
Biological - age or pregnant 
Medicines - decongestants steroids caffeine alcohol

Question 6

Treatment for insomnia

Answer 6

Sedating antihistamines

Nytol- diphenhydramine - 16+
Swallow 1 tab with water 20 mins before bed no more than 2 weeks

Sominex- 16+- one tablet at bed up to 1H after failing to sleep - 7 days

Routine - regular waking / sleeping times 
Alcohol and caffeine avoided 
Avoid warm rooms 
Daytime exercise  
Avoid lie ins and naps 

Refer if under 12, more than 3 weeks, no cause and symptoms suggestive of anxiety and stress