Community Pharmacy Flashcards
What is guaifenesin?
What is the dose?
Expectorant.
6-12yrs (discourage use): 100mg qid
Adults: 200mg qid
What is bromhexine?
Dose? Side effects?
Mucolytic.
8mg tds (up to 16mg tds first week).
SE: N/V/D
How to treat cough in children under 12?
Increase fluid. Potentially try non-pharmacological cough mixture such as a demulcent, eg. simple linctus
Egs of cough suppressants? Side effects?
Dihydrocodeine [Rikodeine - S3] (most abuse potential), pholcodine, dextromethorphan.
Opiate derivatives - caution sedation and respiratory depression, constipation.
Dextromethorphan - serotonin syndrome
5 most common viruses that produce symptoms of the common cold?
Rhinoviruses (30-50%), coronaviruses, parainfluenza virus, respiratory syncytial virus, adenovirus
Incubation period of the common cold?
Usually 1-3 days (can be short as 10-12 hours)
Normal body temp? Fever severity?
Normal 37*
Fever if oral/axillary >37.6* or rectal/ear >38.1*
Mild-mod less than 39*
(listening to farts is hotter than licking armpits)
What are the four pairs of sinuses called?
Frontal,
Ethmoid,
Maxillary,
Sphenoidal
When to prescribe antibiotics for rhinosinusitis?
- > 3 days & severe sx, high fever (>39*C)
- > 7 days with unilateral maxillary tenderness & purulent discharge
- worsening sx after initial improvement
Role of intranasal ipratropium in the common cold? What age suitable for?
Good for rhinorrhoea, no evidence for use in nasal congestion.
(For >12yo)
Types of influenza?
A - affect humans & animals. Cause seasonal epidemics.
Only type to cause pandemics (e.g. bird & swine flu).
Two surface proteins: hemagglutinin and neuraminidase.
B - affect humans only. Mutate more slowly than A.
Cause seasonal epidemics. Can be severe.
Two lineages: Victoria and Yamagata.
C - mild
D - affect cattle, do not appear to affect humans.
How to treat stuffy noses in babies?
Saline nose drops can be used from birth to help with congestion.
Phenylephrine/pseudoephedrine considerations?
- Age
- 3 SEs
- Drug interactions
- P&B
Not recommended <12yo
3 likely SEs: insomnia, may cause tachycardia. Can increase BP, but likely ok if short course.
Risk of hypertensive crisis with with MAOIs & moclobemide.
Caution in patients taking beta-blockers & TCAs. Consider topical.
Avoid in pregnancy & breastfeeding.
Topical sympathomimetics ok in breastfeeding & could use after first semester.
Differentiating viral sore throat from bacterial (usu. Strep).
Very difficult, but usually:
- Strep/bact: swollen glands, exudate, high-grade fever, no cough
- Viral: no swollen glands or exudate, low-grade fever, cough & headache
- Strep unlikely if <3yo
- Strep most prevalent in 5-15yo.
- EBV / glandular fever peak incidence teens & young adults.
- Viral more likely in adults.
What are the Centor criteria? What do you do if someone has 3 or all symptoms?
Used to determine likelihood of strep.
- Cough absent
- Exudate (pharyngeal/tonsillar)
- Nodes (swollen cervical glands)
- Temperature - high grade fever (>38*C)
Refer as more likely to be bacterial & require antibiotics, esp. if <15yo
Medications known to cause agranulocytosis?
Think “gran” for the mnemonic
The triple C had a PASS at gran(ulocytosis)
Cytotoxics, Captopril, Carbimazole Penicillamine Antipsychotics Sulfasalazine Sulfonamides
When to refer sore throat?
think of a painful plaited noose for the mnemonic
BRAIDD
Bacterial sx Rash ADR Indigenous 2-25yo remote/rural Dysphagia/phonia Duration >2 weeks