Cold and Flu Flashcards
Name some considerations for patients when presenting with a cold
Patient age = young and old
Risk of complication, symptoms (and severity), other symptoms suggesting serious conditions (high fever, >39 degrees)
Recurrence of symptoms = allergy vs cold, immunocompromised
comorbidities = COPD, Asthma
Medications - interactions, contraindications, ADR
Smoking status
Immunisation status
What is a cold?
Acute viral infection which damages cilia cells in nasal/bronchial epithelia
Releases inflammatory mediators
Self-limiting, 4-10 days, any time of year
What are the symptoms of a viral cold?
sore throat, nasal congestion, sneezing
1-3 days after infection
What is an example of a complication of a cold?
Secondary bacterial infection = fever, chills, green mucous
What are the contributing factors to a cold?
spread via hand to hand combat, less frequently droplet transmission
Most contagious in 1-2 days after symptoms appear
TRUE or FALSE
Colds have a gradual onset
TRUE
Colds have a gradual onset, last 10-14 days
What are some signs and symptoms of a cold?
Sore throat (scratchy)/nose discomfort (first symptom)
Feeling unwell, nasal congestion, rhinorrhoea, sneezing
Nasal symptoms = initially water, clear, and profuse –> becomes mucoid and purulent (yellow-green)
Potential cough 4-5 days, mild but can last second week
Headache, malaise, fever uncommon. low-grade fever (38.9 deg)
Sore throat resolves quickly
What are some symptoms associated with the flu?
Sudden high fever, chills, sweating, severe headache, photosensitivity
generalised muscle and joint pains, weakness and fatigue
Initially mild resp symptoms, scratchy throat, runny nose, dry cough
Lower resp system affected –> persistent, raspy, productive cough
Acute symptoms subside after 2-3 days, fever may last up to 5 days
Cough, fatigue, sweating = may last over 10 days to even weeks
What are some alarm symptoms for cold and flu presentation?
Younger than 6 years old (to pharmacist), prolonged symptoms/getting worse, possible rhinosinusitis
Possible overuse of topical nasal decongestants, flu-like symptoms for selected medicines/conditions
Vulnerable patients = children, >65 y/o, chronic lung disease, asthma, aboriginal or torres strait islander
Possible middle ear involvement
When should cold and flu symptoms be referred?
Temperature >38.5/chills, neck stiffness, severe headache, photophobia
chest pain/SOB/difficulty breathing
Skin rash, pale or molted skin, vomiting, difficulty waking/unusual drowsiness, persistent cough
aching muscles, blood stained sputum
refer children younger than 6 to the pharmacist
When should a doctor be contacted with cold and flu symptom presentation?
Bulging fontanelle, high temp (<6 month old), excessive irritability, strange-high pitched cry
lack of energy, loss of appetite, not drinking, feeding poorly, earache
Key factors to consider when comparing cold and flu
Cold = gradual onset, any time of year, summer cold needs to be differentiated from seasonal allergic rhinitis
Flu = sudden onset, abrupt and severe, typically in winter, body aches, fatigue
What are some differential diagnoses for the common cold?
Allergic rhinitis = consistent runny nose, sneezing, itchy palate, itchy eyes, watery eyes (has trigger)
Acute rhinosinusitis = secondary inflam and bacterial infection of paranasal sinus, facial pain/pressure, loss of smell, congested nose, upper airways cough, initial mild localised pain that spreads and worsens
Otitis media = pain, pulling on ear, irritability, lethargy
Flu = severe and sudden symptoms, whole body, fever, chills more likely
Pneumonia = secondary complication, chest pain, difficulty breathing, fever, chills, nausea/vomiting, confusion
Tonsillitis = longer duration than typical, painful, difficulty swallowing, fever, bad breath, red and swollen tonsils
What are the goals for treating cold and flu?
manage symptoms and allow rest
prevent dehydration, spread of infection, recognise risk of complication, refer appropriately
What medicines are used to treat cold and flu?
Oral decongestants
Nasal decongestants
Sedating antihistamines
Cough mixtures
simple analgesics
What are the active ingredients in oral decongestants? (ADRs, indications)
Pseudoephedrine, phenylephrine
Best used for blocker/stuffy nose
ADRS = CNS stimulation, tremor, excitability
What are the active ingredients in nasal decongestants? (ADRs, indications)
oxymetazoline, xylometazoline, phenylephrine, tramazoline
Short term use only, cause rebound rhinitis (3-5 days)
ADRs = transient burning, stinging
What are the active ingredients in sedating antihistamines? (ADRs, indications)
Promethazine, chlorpheniramine
Relieves runny nose
ADRs= antichol effects, sedation/drowsiness
What are the active ingredients in simple analgesics? (ADRs, indications)
Paracetamol, Ibuprofen
Relieves headache, sore throat, body aches, fever
How are cold and flu treated in children
cough and cold medicines restricted in children, potential harm
Children <2 = prescription only
2-6 yrs = no meds
Children 6-11 years = use only on advice of doctor, pharmacist or nurse practitioner
Name some CAM medicines used to treat cold and flu
Vit C = prophylactic use, reduce severity of cold
Echinacea = some support for URTIs/strep, start with onset of symptoms, caution use in asthma and allergies
Zinc = evidence questionable
Probiotics = reduce cold duration, number of episodes, antibiotic use, school absence (low quality studies support)
What are some cold and flu referral points
Temp > 38.5°c, neck stiffness, severe headache, photophobia
Chest pain/SOB/difficulty breathing, skin rash, pale or mottled skin
Vomiting, difficulty waking up or unusual drowsiness, persistent cough, aching muscles
Blood stained sputum
Children <6 to pharmacist
Mention some referral (to doctor) points for children and babies
Bulging fontanelle, high temp (<6 months old), excessive irritability, strange high-pitched cry, lack of energy
Loss of appetite, not drinking, feeding poorly, earache
Mention some helpful information you can tell the patient and cold and flu
There is no cure, can only manage symptoms
Match symptoms to active ingredients in combination medicines
Avoid cigarette smoke - worsen symptoms
Check for duplicates of active ingredients in products
Eat healthy diet, limit high fat/sugar/salt food, limit alcohol
What are some tips on preventing the spread of cold and flu infection
Standard hygiene measures = wash hands, dont touch eyes/nose/mouth, sanitise/wash after cough/sneezing
Cover nose with tissue when sneezing, discard tissues immediately and wash hands
Sneeze/cough into bend of elbow, avoid sharing utensils
