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Hay fever, Cough & Cold Flashcards

1
Q

What are the symptoms of hay fever? (4)

A
  1. Rhinorrhoea
  2. Nasal congestion
  3. Itching
  4. Allergic conjunctivitis
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2
Q

What are the referal criteria for hay fever? (5)

A
  1. Pregnancy
  2. Suspected infection
  3. Drug induced
  4. Structural or mechanical reasons
  5. Systemic conditions associated with mucus (e.g. CF)
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3
Q

Which drugs can induce symptoms of hay fever? (7)

A
  1. ACE inhibitors
  2. Beta blockers
  3. Chlopromazine
  4. Aspirin
  5. NSAIDs
  6. Cocaine
  7. Diverse effect of nasal decongestants
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4
Q

What is the first line treatment for someone presenting with general symptoms of hay fever?

A

Non-sedating antihistamine

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5
Q

At which age are Cetirizine and Loratadine both licensed from?

A

2 years

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6
Q

At which age is Acrivastine licensed?

A

Over 12

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7
Q

How often should a non-sedating antihistamine be taken?

A

Once daily

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8
Q

If a patient taking a non-sedating antihistamine experiences “breakthrough” symptoms, which drug can you recommended instead?

A

Sedating antihistamine taken at shorter intervals

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9
Q

At what age is chlorphenamine syrup licensed?

A

Over 1

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10
Q

At what age are chlorphenamine tablets licensed?

A

Over 6

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11
Q

At what age is promethazine licensed? (syrup and 10mg tablets)

A

Over 2

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12
Q

Can promethazine 25mg tablets be sold OTC for hay fever?

A

No, licensed for insominas in patients over 16

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13
Q

If patient is experiencing nasal congestion due to hay fever, what is the recommended OTC treatment?

A

Nasal corticosteroid

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14
Q

At what age are beconase and nasonex both licensed for?

A

Over 18

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15
Q

When should nasal corticosteroids be taken for maximal effect?

A

A week before hay fever begins

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16
Q

Is sudafed nasal decongestant spray recommended for hay fever?

A

Not recommended but can be used as an adjunct

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17
Q

What is the maximum recommended duration of use for sudafed nasal spray and why?

A

7 days - risk of rebound congestion

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18
Q

At what age is sudafed blocked nose spray?

A

Over 12

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19
Q

Which 2 drugs can be applied topically if the patient is experiencing allergic conjunctivitis?

A
  1. Mast cell stabilisers

2. Occular antihisatmines

20
Q

How long does it usually take for a common old to resolve?

21
Q

How long does it usually take for a common old to resolve in children?

22
Q

What is used for symptomatic relief of a cold?

A

Paracetamol and ibuprofen

23
Q

What advice do you give patients with colds?

A

Keep hydrated and rest

24
Q

As well as paracetamol and ibuprofen, what else can be used to treat symptoms of a cold?

A

Intranasal decongestants

25
Is there a place for oral decongestants when treating a cold?
They can be used in the short term but the benefit is small
26
As well as lifestyle measures, what must patients be counselled on when buying cough and cold medicines?
The risk of paracetamol overdose
27
Which cough and cold medicines should be avoided in those under 6? (4)
1. Anti-tussives 2. Expectorants 3. Topical and oral decongestants 4. Antihistamines
28
In patients under 6, what can be used for symptomatic relief of cough and cold?
1. Paracetamol and ibupofen | 2. Simple cough remedies
29
If a patient is over 1, what can be recommended for symptomatic relief of cough and cold?
Warm drink of honey and lemon
30
What are 5 self care measures for cough and cold that can be purchased OTC?
1. Steam inhalation 2. Vapour rubs 3. Gargling salt water 4. Menthol sweets 5. Nasal saline drops
31
What are the 2 types of cough?
1. Productive (chesty) | 2. Non-productive (dry)
32
How long does an acute cough last?
Less than 3 weeks
33
What should you do if a patient presents with a cough lasting longer than 3 weeks?
Refer for further investigation
34
How long must a cough last to become chronic?
Over 8 weeks
35
What is the most likely cause of a cough?
Viral upper respiratory tract infection
36
What is a trigger for croup?
Recent viral infection
37
At what age does croup normally occur?
Between 3 months and 6 years
38
How long does croup usually resolve?
48hours
39
When should you refer someone with croup for medical intervention? (2)
1. Over 48 hours | 2. Severe
40
A patient presenting with which symptoms is likely to have pneumonia? Requires urgent referral to GP (5)
1. High fever 2. Malaise 3. Headache 4. Breathlessness 5. Pleuritic pain
41
Give an active ingredient of expectorants
Guafenasin
42
Give 4 active ingredients of anti-tussives
1. Codeine 2. Pholcodeine 3. Dextromorphan 4. Antihistamines (diphenyldramine)
43
At which age is codeine linctus licensed for OTC?
Over 18
44
Does the MHRA advise the use of cough and cold medicines in children 6-12?
No, only supplementary to best principles of care
45
Who should not have codeine at all?
Under 18s with sleep apnoea who have had tonsil and adenoid surgery
46
In which patients should codeine be used with caution?
12-18 difficulty breathing

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