colds cough hayfever

Question 1

flu is likely during the winter months - which months?

Answer 1

October to May

Question 2

Patient has had sudden onset of fever >38C and has a runny nose and headache. Cold or flu?

Answer 2

Flu - sudden onset of symptoms.

Question 3

Decongestants are not suitable for people with the following conditions (5)

Answer 3

heart disease
high BP
diabetes
hyperthyroidism
prostatic enlargement

Question 4

Topical decongestants e.g. xylometazoline, oxymetazoline, ephedrine can only be used for ….

Answer 4

max 7 days because continued use can cause rebound congestion

Question 5

true or false you can buy ipratropium (SAMA) OTC

Answer 5

true
OTC nasal spray for relief of cold symptoms that contains both xylometazoline (topical decongestant, max 7 days) and ipratropium bromide (which acts to reduce nasal secretions)

Question 6

pseudoephedrine and ephedrine are degonestants that are found in OTC products for coughs, cold and flu. they can be used in the manufacture of this …

Answer 6

illegal class A CD called methamphetamine, aka crystal meth

Question 7

restrictions to pseudoephedrine OTC

Answer 7

pack size limited to 720mg (e.g. 12x60mg tabs)

MAX you can sell is 720mg

Question 8

restrictions to ephedrine OTC

Answer 8

max you can sell is 180mg

Question 9

can you sell epehedrine and pseudoephedrine at the same time if they are buying less than the max (720mg P, 180mg E)

Answer 9

never sell P + E at the same time to one person regardless of pack size

Question 10

A patient comes in to buy nurofen day and night cold and flu tabs (ibuprofen, phenylephrine). He wants to buy 2 packs , one for him and one for his wife. Can you sell this?

Answer 10

Yes

restrictions only apply to pseudoephedrine (max 720mg) and epehedrine (max 180mg)

Question 11

refer if cough longer than

Answer 11

3 weeks

Question 12

a mother comes in with her 4 yr old son who has a barking cough , hoarse voice and stidor (high pitched sound when breathing in). What do you suggest?

Answer 12

Croup - refer to GP
usually self limiting, but speak to GP
can recommend paracetamol in the mean time to help with pain/fever

Question 13

a mother comes in with her young child. he has been unwell. he has coughing bouts which are worse at night and she says that he takes deep gasps between each cough. what do you suggest

Answer 13

refer to GP - whooping cough
if within 3 weeks of onset of cough, GP can provide abx which will reduce the length of time the pt is coughing for

can recommend paracetamol/ibuprofen in the mean time

Question 14

mother comes in asking to buy something to help her daughter sleep better at night because she has had a persistent night time cough. what do you suggets

Answer 14

refer to GP - night time cough classic sign of asthma in children

Question 15

name 2 cough suppressants for dry cough

Answer 15

dextromethorphan
codeine (codeine linctus now a POM!! do not use in under 18s)

Question 16

name 3 soothing agents for cough and how do they work

Answer 16

glycerin
honey
simple linctus

soothe irritation in throat
most useful for dry tickly cough, but can provide short term relief for chesty coughs too

Question 17

What type of cough medicine would you give for a productive cough

Answer 17

expectorant

Question 18

Name some expectorants for productive cough (3)

Answer 18

guaifenesin
sodium citrate
ammonium chloride

Question 19

how do expectorants work for chesty cough

Answer 19

help break down phlegm in airways
doubt whether they actually do help although some evidence shows that guafinesin may be helpful

Question 20

in march 2023, pholcoine containing cough and cold meds were withdrawn from UK market and are not sold or dispensed. why?

Answer 20

Due to a rare anaphylaxis reaction that can occur under certain types of general anaesthesia, so customers who are due to have surgery and have taken pholcodine in the last 12 months should inform their anaesthetist

Question 21

can you give a cough or cold remedy that contains an antitussive (dextromethorphan) to children under 6

Answer 21

NO

Question 22

can you give a cough or cold remedy that contains expectorants (guaifenesin) to children under 6

Answer 22

NO

Question 23

can you give a cough or cold remedy that contains nasal congestants to children under 6

e.g. pseudoephedrine, ephedrine, oxymetazoline, phenylephedrine, xylometazoline

Answer 23

no

Question 24

can you give a cough or cold remedy that contains antihitamines (e.g. chlorphenamine, diphenhydrarmine, promethazine etc) to child under 6

Answer 24

no

Question 25

This can be recommeended to children >1year for dry cough but doctor should be consulted if symptoms last longer than 5 days

Answer 25

paediatric simple linctus or hot lemon and honey

Question 26

child under 6 has blocked nose. what can you suggest

Answer 26

saline drops or nasal spray

Question 27

patient has had sore throat lasting >7 days and no other associated cold and fly symptoms. what do you do

Answer 27

refer

Question 28

which antihistamine OTC is combined with a decongestant e.g. pseudoephedrine to clear a blcoked nose

Answer 28

acrivastine

Question 29

name a topical antihitamine that is available as OTC eye drops for itchy, red, watery eyes

hint antihistamine not mast cell stabiliser

Answer 29

antazoline

Question 30

true or false - beconase can be used on regular basis during peak pollen season to prevent hay fever symptoms

Answer 30

true

Question 31

what age for OTC beconase

Answer 31

18 and over

Question 32

what is OTC beconase licensed for

Answer 32

Question 33

steroid nasal sprays OTC - how do they work and when do they need to be taken

Answer 33

reduce inflammation in nose
need to be used continuously to stop nasal congestion and sneezing
can be used prn or long term
hay fever: best to use 1-2 weeks before symptoms are suspected to start

Question 34

steroid nasal sprays should not be sold for use for <18s. name the ones available OTC

Answer 34

beclometasone
mometasone
triamcinolone
fluticasone