Cold And Flu Flashcards
Self limiting? True or false
Spread by infected person coughing, sneezing and touching infected surfaces? True or false
True
True
Common Symptoms
Blocked/ runny nose
Cough
Sore throat
Less common symptoms of a cold
Fever, aches and pain Headache Sinus pain Earache Irritated, watery eyes (conjunctivitis)
How does the flu differ from the common cold??
Flu is More sudden and severe.
Includes headache, marked myalgia, chills, Malaise or high grade fever
What causes the headaches and sinus pain??
Inflammation of sinus (air filled cavities just under the eyes and cheek bone areas)
Sinuses produce mucus which drains in to the nose but the nasal passages become blocked due to inflamed sinus lining
What can help with sinus pain??
Decongestant
Referral criteria
No improvement - 2 weeks
Middle ear pain not improving with analgesics (acute otitis media)
Persistent productive cough and high grade fever(flu can be complicated by pneumonia??
Vulnerable patients: COPD, asthma, kidney disease, diabetes, or immune improvised. Very young <3 months, very old
During a cold, what complication is more common in children?
And what to do in when it occurs?
Middle ear infection (acute otitis media)
Suggest using some analgesics
Normally resolves in 3 days without Abx, but if pain persists despite analgesics: REFER to GP!!
Pneumonia is common in which age group?
And what are it’s symptoms
Age: children and elderly
Persistent productive cough and high grade fever
What is the referral duration for pneumonia symptoms in children
> 24 hrs: 3-6 months
>72 hrs: 6 months
Referral temperature for pneumonia symptoms in children?
>= 38c in <3 months >= 39c in 3-6 months
OTC products for fever aches and pains and the doses
Analgesics
Paracetamol - 2 x 500mg QDS
Ibuprofen - 200-400mg TDS
Aspirin - 1-3 x 300mg QDS
OTC products for nasal congestion?
Nasal decongestants - sympathomimetics (construct dilated blood vessels in the nasal mucosa)
Oral decongestants available OTC
Psuodoephidrine(Sudafed)
Phenylephrine (sudafed PE)
What is the legal restriction for pseudoephedrine??
Maximum 720mg = 60mg x 12 tablets
Nasal spray decongestants available OTC
Xylometazoline (otrivine)
Oxymetazoline (sinex)
How long should nasal decongestants be used for? And why??
Do not use for more than 7 days
Because of rebound nasal congestion
What conditions should you avoid nasal decongestants in?? And why??
Tip: nasal sprays are sympathomimetics(stimulate sympathetic nervous system)
Hypertension: raises bp Hyperthyroidism: vulnerable to heart irregularities Diabetes: hyperglycaemia CVD: stimulant effect Glaucoma: raised intraocular pressure Prostatic enlargement: urinary retention
What medications should you avoid nasal decongestants in? And why??
MAOIs (hypertensive crisis if <14 days after stopping)
TCAs (theoretical risk of hypertensive crises)
Beta blockers (antagonised effect)
How to treat runny nose and sneezing??
Antihistamines: Diphenhydramine and promethazine in cold/flu combination products
Dries up nasal secretions to relieve runny nose and sneezing via anticholinergic action
What are the legal considerations for cough and cold remedies for children < 6 YRS??
Certain ingredients in cough and cold remedies should nit be given to children under 6
Give second line in 6-12 yrs as second line to best practice for 5 DAYS only
Best practice for nasal congestion
Steam inhalation e.g with olbas oil (3 months +)
Saline sprays/drops in < 3 months
List of ingredients in cold and cough that can’t be given to children
Decongestants: xylometazoline, oxymetazoline, pseudophederine, phenylephrine
Antihistamines: chlorphenamine, diphenhydramine, doxylamine, brompheniramine, promethazine, tripolidone
Anti-tussives: pholcodine, dexteomethorpan
Expectorants: guafenesin, ipacacuanha, ammonium chloride, squill
Advice for cold and flu?
Vitamin c and echinacea: helps prevent and alleviate cold symptoms
Wash hands regularly: avoid directs transmission
Cough or sneeze into a tissue: avoids air droplets transmission
Annual flu jab if at risk group e.g diabetes
