L2 Sore Throat Flashcards
What are the most common causes of viral, bacterial or fungal throat infections?
70-90% of sore throats are of viral origin. Most common cause is Rhinovirus, but may also be Epstein-Barr virus. Streptococcus bacteria (strep throat) Candida fungus (thrush)
What are the symptoms to look for when making a differential diagnosis of Strep throat?
History of fever over 38 degrees. Absence of cough. Tender glands tonsillar swelling or exudate age less than 15 years. In patients with these symptoms, there is a 51% chance they have strep throat.
Describe Strep throat.
Caused by Strep pyrogenes. Children between the ages of 5 and 14 years are most susceptible.
May lead to rheumatic heart disease in patients 30-40 years of age. Characterised by heart failure and arrhythmia.
Indigenous population is at higher risk of strep throat.
Penicillin antibiotics can be used to treat strep.
What is the major symptom of an oral candida infection?
White plaques on tongue or roof of mouth and throat.
What are the symptoms of a drug-induced sore throat, and give examples of drugs that may cause this.
Agranulocytosis (decrease in white blood cells) causing fever, chills and ulcers. May be caused by: Antithyroid drugs chloramphenicol sulfonamides cytotoxic drugs clomipramine penicillamine catopril clozapine
When should you refer a patient to a doctor for their sore throat?
Duration of 14 days or more, especially if patient has already tried treatment.
Dysphagia
Tonsillar exudate, swollen lymph glands, fever over 38 degrees and absence of cough, (strep throat likely_
Indigenous patient (high incidence of rheumatic fever)
Development of rash, especially if on amoxycillin (may have mono)
What are the aims of sore throat treatment?
To reduce symptoms and relieve pain.
What are 2 non-pharmacological treatments of sore throat, and what are their mechanism of action?
Ice and suck lozenges.
Both keep the throat moist, and lozenges act as a demulcent.
List 4 pharmacological treatments of sore throat.
Systemic analgesics or anti-inflammatories
Local anti-inflammatories
Local anaesthetics
antibacterials/antivirals
What are 3 simple analgesics that can be used for sore throat? What are their maximum daily doses?
Paracetamol: 500mg tablets. take 1 or 2 every 4 hours. Maximum of 8 tablets per day (4g).
Aspirin: can take 300-1000mg every 4 hours. maximum of 3.6g in one day (12 tablets 300mg).
Ibuprofen: 200-400mg every 6 to 8 hours (1-2 200mg tablets). Maximum of 6 200mg tablets daily.
Why can’t aspirin be used in children?
Risk of development of Reye’s syndrome.
Describe one local anti-inflammatory, and it’s dosage forms.
Benzydamine. Absorbed into local tissues. May cause local numbness, burning/stinging and is not recommended for use in pregnancy.
Present in difflam lozenges, solution or throat gargle, throat spray.
What are the instructions for use of benzydamine?
Use every 1-3 hours. Gargle and do not swallow.
What are two local anaesthetics used for sore throat? Describe their pharmacokinetics, adverse effects and dosing instructions.
lignocaine and benzocaine. Locally acting, with low bioavailability. cause extensive anaesthesia, so must use caution when drinking hot drinks or eating hot foods. May cause taste perversion.
Suck 1 lozenge every 2-3 hours as needed.
Ok in pregnancy.
Describe the use of antibacterials in lozenges.
Usually cetylpyridinium chloride, but may also be amylmetacresol, hexylresorcinol or chlorhexidine.
Not indicated for use in sore throat because it is 90% likely to be of viral origin.
Usually used in combination with local anaesthetic or anti-inflammatory.
