Cold + flu

Question 1

Referral

Answer 1

• 2 weeks + no improvement
• Middle ear pain not improving

Persistent chesty cough + high fever
- 24H+ 3-6M
- 72H 6M
- >38 degrees <3M
- >39 degrees 3-6M

Question 2

Treatment: oral analgesics

Answer 2

• Paracetamol 2x 500mg QDS
• Ibuprofen 200 - 400mg TDS
• Aspirin 1-3 x 300mg QDS

Question 3

Treatment: nasal decongestants

Answer 3

• Xylometazoline, oxymetazoline max 7 days
• Phenylephrine, pseudoephedrine (max 720mg)
• Avoid: HPT, diabetes, CVD, hyperthyroidism, glaucome, BPH
• Interacts: bblocker, MAOI + TCA

Question 4

MHRA: pseudoephedrine

Answer 4

Posterior reversible encephalopathy syndrome + reversible cerebral vasoconstriction syndrome

• CI: uncontrolled/severe HT, severe kidney disease, RF
• Report: sudden severe headache, nausea + vom

Question 5

Treatment: antihistamines

Answer 5

• Chlorphenamine
• Promethazine
• MHRA: don’t give children under 6 for cough + cold
• 6-12 for 5 days: only 1 cough + cold remedy

Question 6

Advice

Answer 6

• Under 12: steam inhalation + saline nasal spray (3m+)
• Vit C
• Wash hands
• Annual flu jab