cold and flu

Question 1

symptoms of cold and flu?

Answer 1

○ Nasal symptoms: Sneezing, runny/blocked nose
○ Sore throat
○ Coughing
○ Lethargy (more severe in flu)
○ Fever
■ Body temperature > 38°C in adults or
>37.5°C in the elderly
○ Headache
○ Aches and pains (more common in flu)
○ Irritated or watery eyes
○ Earache and acute otitis media
○ Hoarseness
○ Loss of taste or smell
○ Infants may become more irritable or have
difficulty feeding

Question 2

red flag symptoms of cold and flu?

Answer 2

● Children with severe symptoms such as fever, tachypnoea (abnormally rapid breathing), nasal flaring, shortness of breath, anxiety, cyanosis (blue skin) etc.
● Earache that does not improve despite analgesic use
○ Most earaches are self-limiting and resolve themselves within a few days
● In the very young and very old
● Co-existing health conditions e.g.
○ Diabetes
○ COPD (Chronic Obstructive Pulmonary Disease)
○ Asthma
○ A compromised immune system or a patient taking immunosuppressive therapy
○ Kidney disease

Question 3

lifestyle advice for cold and flu?

Answer 3

● Adequate fluid intake and rest is important when experiencing cold or flu symptoms
● Reassure patients that colds and flus are self-limiting conditions
● Smokers are more likely to experience worse symptoms and a longer amount of time being
unwell from colds and flu than non-smokers
● Flu vaccines are available and certain patients are eligible to get it for free
● There is some practice stating that Echinacea and vitamin C may be of use to prevent and
alleviate cold symptoms, but evidence is lacking. Echinacea has also shown a possible
risk of hepatotoxicity
● Hand washing and basic hygiene advice is important in preventing the spread of flu. It is
important that patients know to cover their coughs and sneezes to prevent others catching
their cold or flu
● Inhalants such as menthol crystals and Olbas oil can be used to clear nasal passages.
They are useful for symptomatic relief in patients who cannot take decongestants
● 0.9% saline nasal drops may provide some symptomatic relief to infants if given prior to
feeds, but evidence around this is lacking

Question 4

what are the drug treatments for cold/flu?

Answer 4

there is NO cure

- anaglesics (paracetamol, ibuprofen and aspirin)

Question 5

which anagelsic should be used first line for colds?

Answer 5

Paracetamol is first-line due to its antipyretic properties and ability to help symptoms, but it is important to take care that the maximum daily dose of paracetamol is not exceeded via the use of multiple preparations containing paracetamol.

Question 6

what do topical decongestants do?

Answer 6

Provide rapid relief of nasal stuffiness

● Should not be used for longer than 1 week due to the risk of rebound decongestion

Question 7

what are oral decongestants?

Answer 7

● These act by vasoconstriction of the dilated blood vessels in the nose, providing symptomatic relief of oedema in the nasal mucosa
● Unlike topical decongestants, they do not cause rebound decongestion

Question 8

who should NOT use oral decongestants?

Answer 8

○ Children under 6 years of age
○ Hypertensive patients, because sympathomimetics have stimulant effects of
raising blood pressure
○ Hyperthyroidism patients – as the stimulant effect can cause heart irregularities
○ Diabetic patients – due to adverse effects that reduce control of diabetes
○ Patients taking beta blockers – as a contradictory effect can occur
○ Patients taking monoamine oxidase inhibitors – as this would put them at risk of
hypertensive crisis, which is life-threatening
○ Patients with raised intraocular pressure, prostatic hypertrophy, hepatic
impairment, renal impairment or ischaemic heart disease