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Applied Pharmacy Practice > Minor ailments > Flashcards

Minor ailments Flashcards

1
Q

L15

What is an allergy and What is an allergen?

A

An allergy is an immune system reaction to a harmless substance, classified as a hypersensitivity disorder.
An allergen is a substance that triggers an allergic reaction.

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2
Q

L15 Allergies

Name risk factors for allergies.

A

Heredity, gender, race, age, environmental factors (pollution, allergen levels, dietary changes).

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3
Q

L15 Allergies

Define atopy.

A

A genetic predisposition to produce IgE antibodies in response to allergens, affecting the nose, eyes, skin, and lungs.

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4
Q

L15 Allergies

List common allergens and examples.

A

Proteins (e.g., foreign serum, vaccines)

Plant pollens (e.g., rye grass, ragweed)

Foods (e.g., nuts, seafood)

Drugs (e.g., penicillin)

Insect products (e.g., bee venom)

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5
Q

L15 Allergies

What are the actions of histamine on H1 receptors?

A

Vasodilation (erythema)

Increased capillary permeability (oedema)

Smooth muscle contraction (bronchoconstriction, GI motility)

Stimulation of sensory nerves (itch)

Increased gland secretions (nasal, salivary)

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6
Q

L15 Allergies

What is allergic rhinitis?

A

Inflammation of the nasal lining causing sneezing, nasal discharge, and blockage, affecting 1 in 5 people in the UK

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7
Q

L15 Allergies

Differentiate between types of allergic rhinitis.

A

Seasonal (e.g., hay fever): Symptoms occur with outdoor allergens (e.g., pollen).

Perennial: Year-round symptoms caused by indoor allergens (e.g., dust mites).

Occupational: Work-related allergens (e.g., wood dust).

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8
Q

L15 Allergies

Name non-pharmacological strategies for managing allergic rhinitis.

A

Allergen avoidance (e.g., keeping windows closed)

Using wrap-around sunglasses

Regular cleaning to minimize allergens

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9
Q

L15 Allergies

What are pharmacological treatments for allergic rhinitis?

A

H1 receptor antagonists (antihistamines)

Mast cell stabilisers

Intranasal corticosteroids

Local vasoconstrictors

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10
Q

L15 Allergies

Differentiate between 1st and 2nd generation antihistamines.

A

1st Generation: Cross blood-brain barrier, cause sedation (e.g., chlorphenamine).

2nd Generation: More selective, less sedation (e.g., loratadine).

Q: What is the preferred generation for allergic rhinitis treatment?
A: 2nd generation due to reduced side effects and dosing frequency.

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11
Q

L15 Allergies

What are the roles of mast cell stabilisers in eye drops?

A

Prevent histamine release, used for itchy and runny eyes.

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12
Q

L15 Allergies

List examples of intranasal corticosteroids.

A

Beclometasone, budesonide, fluticasone, mometasone.

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13
Q

L15 Allergies

When should allergic rhinitis patients be referred?

A

Symptoms persist despite treatment

Sleep disruption

Nasal obstruction that doesn’t clear

Red flags (e.g., orbital cellulitis, recurrent nosebleeds)

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14
Q

L16: Coughs and Colds

What are the classifications of cough by duration?

A
  1. Acute (<3 weeks): Commonly due to cold/flu or asthma.
  2. Subacute (3–8 weeks): Often post-infection or due to airway inflammation.
  3. Chronic (>8 weeks): Caused by allergies, reflux, infection, or serious conditions like lung cancer.
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15
Q

L16: Coughs and Colds

What is the difference between a dry and a chesty cough?

A
  • Dry Cough: Non-productive, with no mucus.
  • Chesty Cough: Productive, with mucus (clear, yellow, or green).

For chesty if you see this, refer to GP

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16
Q

L16: Coughs and Colds

How are coughs treated?

A

*Dry Cough: Suppressants (e.g., codeine, dextromethorphan).
* Chesty Cough: Expectorants (e.g., guaifenesin).
* Soothing agents: Demulcents like honey or glycerol.

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17
Q

L16: Coughs and Colds

What is rhinitis medicamentosa?

A

Rebound congestion caused by prolonged use of topical decongestants (>7 days). Recovery can take months for severe cases.

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18
Q

L16: Coughs and Colds

What are the treatment options for a cold?

A
  1. Symptomatic remedies:
    - Painkillers (e.g., paracetamol).
    - Antihistamines for decongestion or sedation.
    - Steam inhalation (menthol, eucalyptus).
  2. Decongestants: Pseudoephedrine, phenylephrine (available as nasal sprays, drops, or tablets).
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19
Q

L16: Coughs and Colds

What are the legal restrictions for pseudoephedrine in the UK?

A

Cannot sell more than 720 mg of pseudoephedrine or 180 mg of ephedrine without a prescription.

Illegal to sell products containing both pseudoephedrine and ephedrine in one transaction.

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20
Q

L16: Coughs and Colds

What are some non-pharmacological treatments for children with a cough or cold?

A
  • Rest and fluids.
  • Saline nasal drops for congestion.
  • Lemon and honey drinks (not for infants <1 year).
  • Vapour rubs and steam inhalation.
    *
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21
Q

L16: Coughs and Colds

What are the red flags for lung cancer linked to coughing?

A
  • Cough >3 weeks.
  • Blood in phlegm (haemoptysis).
  • Persistent chest/shoulder pain.
  • Unexplained weight loss or fatigue
  • Persistent breathlessness or hoarseness.
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22
Q

L16: Coughs and Colds

How can influenza be differentiated from the common cold?

A
  • Cold: Gradual onset, mild symptoms, nasal congestion.
  • Flu: Sudden onset, fever, severe malaise, aches, and potential complications in vulnerable populations.
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23
Q

L16: Coughs and Colds

What are the best practices for treating cough in children?

A
  • Avoid antitussives, expectorants, and decongestants in children under 6.
  • Use glycerol, simple linctus, or warm clear fluids.
  • Refer to GP if symptoms persist or worsen.
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24
Q

L16: Coughs and Colds

What is the role of hydration in managing a chesty cough?

A

Hydration reduces mucus viscosity, making it easier to clear. Water acts as a natural expectorant.

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25
Q

L16: Coughs and Colds

Why is codeine not recommended for children under 18?

A

Due to safety concerns, including risks of respiratory depression.

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26
Q

L16: Coughs and Colds

What should be determined during OTC supply for coughs?

A
  • Who: Patient’s age and underlying conditions.
  • What: Nature and history of symptoms.
  • How long: Exclude chronic conditions.
  • Any other symptoms?
  • Medication: Current or past treatments.
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27
Q

L16: Coughs and Colds

What are the limitations of OTC cough medicines?

A

Cochrane reviews show no strong evidence for their efficacy in acute cough.

28
Q

L16: Coughs and Colds

What are some common side effects of decongestants?

A
  • Increased blood pressure.
  • Avoid in diabetes, hypertension, heart disease, and pregnancy.
29
Q

L16: Coughs and Colds

What is the main difference between a cold and flu in terms of contagion?

A
  • Cold: Less contagious, mostly mild symptoms.
  • Flu: Highly contagious, especially in the first 3 days, spread via nasal secretions and airborne droplets.
30
Q

L17: Pain

What are the factors influencing pain?

A

Biological, psychological, and social factors.

31
Q

L17: Pain

What is nociception?

A

It refers to the activation of pain receptors (nociceptors) by noxious stimuli, such as tissue injury or extreme temperatures

32
Q

L17: Pain

What are the classifications of pain?

A
  1. By Type: Nociceptive, Neuropathic, and Pain with no apparent cause.
  2. By Duration: Acute, Chronic (Persistent), Recurrent/Intermittent.
33
Q

L17: Pain

What is the WHO three-step analgesic ladder?

A
  1. Mild pain: Non-opioid ± adjuvant.
  2. Moderate pain: Weak opioid ± non-opioid ± adjuvant.
  3. Severe pain: Strong opioid ± non-opioid ± adjuvant.
34
Q

L17: Pain

What are the key characteristics of paracetamol?
A:

A

Non-opioid, CNS-acting analgesic.

Antipyretic, but no anti-inflammatory effects.

Side effects are few and rare.

Adult dose: 500-1000 mg every 4-6 hours (max 4 g/day).

35
Q

L17: Pain

What are some examples of compound analgesics?

A

What are some examples of compound analgesics?

36
Q

L17: Pain

What is paracetamol hepatotoxicity?

A

Overdose leads to the accumulation of toxic metabolite NAPQI, causing liver damage. Risk factors include chronic alcohol use and malnutrition.

37
Q

L17: Pain

What are the limitations on OTC paracetamol sales in pharmacies?

A

Max 100 non-effervescent tablets/capsules.

Usually supplied in packs of 16 or 32 dose units.

Professional judgment required for larger quantities.

38
Q

L17: Pain

Name the common NSAIDs available OTC

A

Aspirin, ibuprofen, diclofenac, and naproxen.

39
Q

L17: Pain

What are the contraindications for aspirin use?

A

Children under 16 (Reye’s syndrome risk).

Hypersensitivity, especially in asthma patients.

Avoid in bleeding disorders.

40
Q

L17: Pain

What are the potential side effects of NSAIDs?

A

GI issues: Gastritis, ulcers, bleeding.

Renal effects: Reduced renal blood flow.

Cardiovascular risks: Increased thrombotic events.

41
Q

L17: Pain

What are the red flags for referral in pain management?

A

Severe headache onset.

Neck stiffness and photophobia.

Persistent weight loss.

Visual disturbances.

Neurological symptoms (seizures, numbness).

42
Q

L17: Pain

What does the acronym “SOCRATES” in pain assessment stand for?

A

S: Site

O: Onset

C: Characteristics

R: Radiates

A: Associated symptoms

T: Time course

E: Exacerbating/relieving factors

S: Severity

43
Q

L17: Pain

What is temporal arteritis (giant cell arteritis), and why is it serious?

A

Cause: Inflammation of arteries in the temples.

Symptoms: Severe continuous headaches (one or both sides), scalp tenderness, jaw pain, vision problems.

Complication: If untreated, it can lead to blindness.

Demographics: Affects individuals >50 years, incidence of 1 in 5000.

Referral: Requires immediate medical attention.

44
Q

L17: Pain

What are the characteristics of sinusitis-related headaches?

A

Cause: Inflammation of sinus mucosal lining due to allergies or viral/bacterial infection.

Pain: Severe, with tenderness, worsens when bending forward or lying down.

Referral: Necessary for treating secondary bacterial infections.

45
Q

L17: Pain

What are the key features of migraines?

A

Pain: Unilateral, pulsing or throbbing, onset over minutes to hours.

Aura: Visual disturbances (flashing lights, zigzag lines, or partial visual field loss) lasting up to 60 minutes.

Associated symptoms: Nausea, vomiting, sensitivity to light, impaired daily activities.

Duration: Up to 72 hours.

Demographics: More common in women.

46
Q

L17: Pain

What are the characteristics of cluster headaches?

A

Pain: Severe, unilateral (one side of the head), often around the eye and temporal area.

Frequency: Occurs in clusters, can recur daily for months or years.

Duration: Lasts 15 minutes to 3 hours.

Associated symptoms: Lacrimation (tearing), rhinitis (nasal congestion).

Trigger patterns: Often occur at similar times of the day.

Note: Requires referral if frequent.

47
Q

L17: Pain

What are the characteristics of tension-type headaches?

A

Pain: Mild to moderate, described as a tight band around the head.

Features: Dull ache, constant pressure, bilateral, non-pulsating, no aura, no light sensitivity.

Cause: Muscle spasms in the neck and scalp.

Triggers: Stress, lack of sleep, alcohol, dehydration.

Activity Impact: Not aggravated by physical activity.

48
Q

L17: Pain

How are headaches classified?

A
  1. Primary headaches: Standalone conditions (e.g., migraine, tension-type, cluster headaches).
  2. Secondary headaches: Symptomatic of underlying issues (e.g., infections, neoplasms, vascular problems, intracranial bleeds, or drug-induced).
49
Q

L17A: Eye and ear health

Describe the anatomy of the eye.

A

Sclera: White part, protects the eye and maintains shape.

Cornea: Transparent dome, refracts light onto the lens.

Lens: Focuses light onto the retina.

Retina: Contains light-sensitive cells that convert light to electrical signals sent to the brain.

Iris: Colored part; controls light entering the pupil.

Pupil: Central circular opening for light passage.

Macula: Provides vision for fine work and reading.

50
Q

L17A: Eye and ear health

What are the key symptoms of ophthalmic health issues?

A

Affected eyes.

Discharge.

Pain, discomfort, itchiness.

Photophobia.

Visual changes.

Associated systemic symptoms.

Duration and previous treatments tried.

51
Q

L17A: Eye and ear health

What are the common causes and management of red eye?

A

Causes: Inflammation of the conjunctiva due to bacterial, viral, or allergic reactions.

Symptoms: Pain, discharge, altered vision.

Management:

Take a detailed history for diagnosis.

Treat based on the cause (e.g., bacterial or allergic conjunctivitis).

52
Q

L17A: Eye and ear health

What are the symptoms and treatment of bacterial conjunctivitis?

A

Symptoms:

Redness, purulent discharge.

Gritty or burning feeling.

Eyelids stuck together in the morning.

Management:

Self-limiting (5-10 days).

Clean discharge with boiled water and cotton wool.

Severe cases: Chloramphenicol drops (2-hourly for 2 days, then 4-hourly) or ointment (4 times daily).

53
Q

L17A: Eye and ear health

How do you manage allergic conjunctivitis?

A

Avoid triggers: Pollen, animal fur, etc.

Medications:

Sodium cromoglicate drops (mast cell stabilizers).

Oral antihistamines (e.g., loratadine, cetirizine).

Self-care: Avoid allergens, do not rub eyes.

54
Q

L17A: Eye and ear health

What are the causes, symptoms, and management of dry eyes?

A

Causes: Aging, medications (antihistamines, diuretics), increased tear evaporation.

Symptoms: Gritty, burning sensation; vision unaffected.

Management:

Use artificial tears (e.g., Hypromellose).

Avoid prolonged screen use.

Reduce contact lens wear.

55
Q

L17A: Eye and ear health

What is a subconjunctival hemorrhage, and how is it managed?

A

Definition: Ruptured blood vessel under the conjunctiva, causing redness.

Symptoms: Bright red patch on the sclera, no pain or vision issues.

Management:

Reassure patient.

Resolves in 10-14 days.

Check blood pressure.

56
Q

L17A: Eye and ear health

Describe otic health anatomy and common issues.

A

Ear Anatomy:

Outer ear: Pinna, ear canal, tympanic membrane.

Middle ear: Eustachian tube, ossicles (malleus, incus, stapes).

Inner ear: Cochlea.

Symptoms of Issues: Discharge, hearing changes, pain, and duration of symptoms.

57
Q

L17A: Eye and ear health

What are the causes, symptoms, and management of impacted ear wax?

A

Causes: Use of cotton buds, hearing aids.

Symptoms: Gradual hearing loss, blocked feeling.

Management:

Use cerumenolytic agents (e.g., olive oil).

Avoid cotton buds or ear candles.

In severe cases, microsuction or syringing by a professional.

58
Q

L17A: Eye and ear health

How is otitis externa treated?

A

Definition: Inflammation of the external ear canal.

Causes: Bacteria (e.g., Pseudomonas aeruginosa), swimming, trauma.

Symptoms: Pain, itch, discharge, worsened by moving the pinna.

Management:

Mild: Acetic acid ear drops (EarCalm).

Moderate/severe: Topical antibiotics with/without corticosteroids (e.g., Gentisone HC).

59
Q

L17A: Eye and ear health

What are the steps for administering ear drops?

A
  1. Wash hands.
  2. Warm drops by holding the bottle in your hand.
  3. Lie on your side with the affected ear facing upward.
  4. Pull the ear upward and back to straighten the canal.
  5. Insert the required drops.
  6. Remain in position for 5-10 minutes.
  7. Replace the lid and discard after 4 weeks of opening.
60
Q

L17A: Eye and ear health

What is a stye, and how is it managed?

A

Definition: Infection of an eyelash root (Staphylococcus bacteria).

Symptoms:

Painful, red lump on the eyelid.

Sensitive to touch.

Management:

Self-limiting (resolves in a few days to weeks).

Warm compresses 3-4 times daily to release pus.

Avoid puncturing the stye.

Refrain from using makeup or contact lenses.

61
Q

L17A: Eye and ear health

What is blepharitis, and how is it managed?

A

Definition: Chronic inflammation of the eyelid margins.

Causes: Staphylococcus bacteria, seborrhoeic dermatitis, rosacea.

Symptoms:

Stickiness, yellow scales on eyelashes.

Worse in the morning.

Associated with dry eyes.

Management:

Long-term lid hygiene (Blephaclean, Blephasol).

Warm compresses daily.

Chloramphenicol ointment if hygiene is insufficient.

62
Q

L17A: Eye and ear health

When should eye-related symptoms be referred to a specialist?

A

Visual disturbances.

Photophobia.

True eye pain.

Trauma or foreign body in the eye.

Red eye in infants under 4 weeks.

Irregular/non-reactive pupils.

Previous serious eye diseases.

63
Q

L17A: Eye and ear health

What are the steps for administering eye ointment?

A
  1. Wash hands thoroughly.
  2. Tilt the head backward and look upward.
  3. Pull down the lower eyelid to form a pocket.
  4. Apply a 1 cm strip of ointment along the lower eyelid, from the nose outward.
  5. Close the eye and blink to spread the ointment.
  6. Wipe away any excess ointment.
  7. Vision may be blurry temporarily but clears upon blinking.
64
Q

L17A: Eye and ear health

What is mastoiditis, and why is it a red flag in otic health?

A

Definition: Infection of the mastoid bone, typically a complication of untreated middle ear infections.

Symptoms:

Redness, tenderness, and pain behind the ear.

Swelling or ear displacement.

Referral: Requires urgent medical attention to prevent complications such as hearing loss or systemic infections.

65
Q

L17A: Eye and ear health

What are the common symptoms and management of subconjunctival hemorrhage?

A

Symptoms:

Bright red patch on the sclera due to ruptured blood vessel.

No pain, no vision loss.

Management:

Reassure the patient.

Typically resolves without treatment in 10-14 days.

Measure blood pressure if recurrent.

66
Q

L17A: Eye and ear health

What are the contraindications for using certain ophthalmic and otic treatments

A

Chloramphenicol: Not licensed OTC for children under 2 years.

Ear syringing: No longer provided by GP surgeries, must be performed by trained professionals.

Cotton buds: Should not be used to remove earwax, as they can worsen impaction.

Ear candles: Lack scientific evidence and may pose risks.

67
Q
A

Applied Pharmacy Practice (5 decks)

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