Hay fever, Cough & Cold Flashcards
What are the symptoms of hay fever? (4)
- Rhinorrhoea
- Nasal congestion
- Itching
- Allergic conjunctivitis
What are the referal criteria for hay fever? (5)
- Pregnancy
- Suspected infection
- Drug induced
- Structural or mechanical reasons
- Systemic conditions associated with mucus (e.g. CF)
Which drugs can induce symptoms of hay fever? (7)
- ACE inhibitors
- Beta blockers
- Chlopromazine
- Aspirin
- NSAIDs
- Cocaine
- Diverse effect of nasal decongestants
What is the first line treatment for someone presenting with general symptoms of hay fever?
Non-sedating antihistamine
At which age are Cetirizine and Loratadine both licensed from?
2 years
At which age is Acrivastine licensed?
Over 12
How often should a non-sedating antihistamine be taken?
Once daily
If a patient taking a non-sedating antihistamine experiences “breakthrough” symptoms, which drug can you recommended instead?
Sedating antihistamine taken at shorter intervals
At what age is chlorphenamine syrup licensed?
Over 1
At what age are chlorphenamine tablets licensed?
Over 6
At what age is promethazine licensed? (syrup and 10mg tablets)
Over 2
Can promethazine 25mg tablets be sold OTC for hay fever?
No, licensed for insominas in patients over 16
If patient is experiencing nasal congestion due to hay fever, what is the recommended OTC treatment?
Nasal corticosteroid
At what age are beconase and nasonex both licensed for?
Over 18
When should nasal corticosteroids be taken for maximal effect?
A week before hay fever begins
Is sudafed nasal decongestant spray recommended for hay fever?
Not recommended but can be used as an adjunct
What is the maximum recommended duration of use for sudafed nasal spray and why?
7 days - risk of rebound congestion
At what age is sudafed blocked nose spray?
Over 12
Which 2 drugs can be applied topically if the patient is experiencing allergic conjunctivitis?
- Mast cell stabilisers
2. Occular antihisatmines
How long does it usually take for a common old to resolve?
7 days
How long does it usually take for a common old to resolve in children?
14 days
What is used for symptomatic relief of a cold?
Paracetamol and ibuprofen
What advice do you give patients with colds?
Keep hydrated and rest
As well as paracetamol and ibuprofen, what else can be used to treat symptoms of a cold?
Intranasal decongestants
Is there a place for oral decongestants when treating a cold?
They can be used in the short term but the benefit is small
As well as lifestyle measures, what must patients be counselled on when buying cough and cold medicines?
The risk of paracetamol overdose
Which cough and cold medicines should be avoided in those under 6? (4)
- Anti-tussives
- Expectorants
- Topical and oral decongestants
- Antihistamines
In patients under 6, what can be used for symptomatic relief of cough and cold?
- Paracetamol and ibupofen
2. Simple cough remedies
If a patient is over 1, what can be recommended for symptomatic relief of cough and cold?
Warm drink of honey and lemon
What are 5 self care measures for cough and cold that can be purchased OTC?
- Steam inhalation
- Vapour rubs
- Gargling salt water
- Menthol sweets
- Nasal saline drops
What are the 2 types of cough?
- Productive (chesty)
2. Non-productive (dry)
How long does an acute cough last?
Less than 3 weeks
What should you do if a patient presents with a cough lasting longer than 3 weeks?
Refer for further investigation
How long must a cough last to become chronic?
Over 8 weeks
What is the most likely cause of a cough?
Viral upper respiratory tract infection
What is a trigger for croup?
Recent viral infection
At what age does croup normally occur?
Between 3 months and 6 years
How long does croup usually resolve?
48hours
When should you refer someone with croup for medical intervention? (2)
- Over 48 hours
2. Severe
A patient presenting with which symptoms is likely to have pneumonia? Requires urgent referral to GP (5)
- High fever
- Malaise
- Headache
- Breathlessness
- Pleuritic pain
Give an active ingredient of expectorants
Guafenasin
Give 4 active ingredients of anti-tussives
- Codeine
- Pholcodeine
- Dextromorphan
- Antihistamines (diphenyldramine)
At which age is codeine linctus licensed for OTC?
Over 18
Does the MHRA advise the use of cough and cold medicines in children 6-12?
No, only supplementary to best principles of care
Who should not have codeine at all?
Under 18s with sleep apnoea who have had tonsil and adenoid surgery
In which patients should codeine be used with caution?
12-18 difficulty breathing