OTC Minor Ailments 1 Flashcards
1
Q
What is the common cold primarily caused by?
A
A mixture of viral upper respiratory tract infections
The common cold is not caused by a single virus but rather a variety of viruses that infect the upper respiratory tract.
2
Q
What is the typical onset of symptoms for the common cold?
A
Generally gradual onset
Symptoms often develop slowly over a couple of days after exposure to the virus.
3
Q
How is the common cold transmitted?
A
Transferred via the inhalation of infected droplets through the mouth or nose
This transmission can occur when an infected person coughs or sneezes.
4
Q
What is the duration of symptoms for the common cold?
A
Last 2-14 days, usually resolve after 7 days
Symptoms typically begin to improve after about a week.
5
Q
How long after infection do symptoms of the common cold begin to appear?
A
2-3 days after infection
This incubation period can vary slightly between individuals.
6
Q
What are some common signs and symptoms of the common cold? List at least three.
A
- Runny/blocked nose
- Cough
- Sore throat
- Aches and pains
- Headache
Cough may persist for a few days after other symptoms have cleared.
7
Q
True or False: The common cold is a self-limiting condition.
A
True
This means that the condition typically resolves on its own without requiring medical treatment.
8
Q
What are referral symptoms of the common cold?
A
Wheezing / Shortness of breath, Pain on breathing or coughing, Earache, Blood stained mucus, Symptoms for 3 weeks or longer, Neck stiffness, Chest pain
9
Q
What is the nature of common cold treatment?
A
Self-limiting but patients often opt for symptomatic relief
10
Q
What are some over-the-counter (OTC) treatments for the common cold?
A
Decongestants, Demulcents
11
Q
What is a cough?
A
A reflex action of the body due to infection, inflammation, or irritation of the airway.
12
Q
What are the two categories of coughs?
A
- Productive/chesty: Phlegm is produced and the cough reflex expels the phlegm.
- Non-productive/dry: No phlegm production.
13
Q
What are the signs and symptoms of a cough?
A
Coughs are generally self-limiting, with symptoms improving within a few days with or without treatment.
14
Q
What are referral symptoms for coughs?
A
Referral symptoms include: longer than 3 weeks’ duration and not improving, regularly recurring cough, shortness of breath, chest pain/pain on breathing, coughing up blood, yellow, green, brown stained phlegm, offensive or foul smelling phlegm, and fever.
15
Q
What is the OTC treatment for coughs?
A
OTC treatment is self-limiting, but patients often opt for symptomatic relief. This includes expectorants, suppressants, and demulcents.
16
Q
What is a common cause of sore throats?
A
Usually a symptom of an acute upper respiratory tract infection.
17
Q
What other symptoms may accompany a sore throat?
A
May occur alone or be accompanied by other symptoms such as sinusitis, cough, and headache.
18
Q
What are the possible origins of a sore throat?
A
May be viral or bacterial in origin.
19
Q
Is there a significant difference in duration or severity between viral and bacterial sore throats?
A
No evidence that duration or severity is significantly different in either case.
20
Q
Can clinical examination differentiate between bacterial and viral sore throat?
A
Clinical examination is unlikely to differentiate between bacterial and viral sore throat.
21
Q
What are other possible causes of sore throat?
A
May be caused by GORD, physical or chemical irritation.
22
Q
What is the typical course of a sore throat?
A
Usually self-limiting.
23
Q
How long do symptoms of a sore throat generally improve?
A
Symptoms generally improve within 7 days.
24
Q
What is a common symptom of a sore throat?
A
Pain in the back of the throat.
25
What physical sign may be felt under the chin or neck with a sore throat?
Swollen lymph glands may be felt under the chin or neck.
26
What symptom may occur upon swallowing with a sore throat?
Pain upon swallowing.
27
What are referral symptoms for sore throats?
Referral symptoms include dysphagia, fever, duration longer than 14 days, hoarseness persisting for more than three weeks, sore throat with a skin rash, white spots or pus on the tonsils with high temperature and swollen glands, recurrent bouts of infection, failed treatment, and breathing difficulties.
28
What is the OTC treatment for sore throats?
OTC treatment is self-limiting, but patients often seek symptomatic relief using demulcents, analgesics, and local anaesthetics.
29
When are antibiotics necessary for sore throats?
Antibiotics are unnecessary in most cases where there is a bacterial infection, as they make little difference on outcome.
30
What is the general advice for Common Respiratory Minor Ailments?
- Smoking:
Consider referring the patient to a stop smoking service.
-Hand Hygiene:
Use of alcohol gels and effective hand washing to prevent transmission
-Flu Vaccination
31
What are decongestants used for?
Decongestants are used for nasal symptoms by constricting dilated blood vessels in the nasal mucosa.
32
How do decongestants relieve nasal stuffiness?
They shrink nasal membranes, improving drainage of mucus and circulation of air.
33
What is a potential side effect of decongestants if taken at night?
Stimulatory action may cause sleep disturbances.
34
How can decongestants be administered?
They can be given orally or applied topically.
35
What is the age licensing for decongestant tablets?
Tablets are licensed for individuals 12 years and older.
36
What is the age licensing for decongestant liquids?
Liquids are licensed for individuals 6 years and older.
37
What is the age licensing for nasal sprays/drops?
Nasal sprays/drops are licensed for individuals 12 years and older.
38
What is the maximum duration for using decongestants?
The maximum use is 7 days.
39
What are expectorants used for?
Expectorants are used for chesty coughs.
## Footnote
Examples include guaifenesin and squill extract.
40
What is the theoretical effect of expectorants?
They are theorized to produce expulsion of bronchial secretions.
41
What does the BNF state about expectorants?
The BNF states that expectorants are more likely to have a placebo effect.
42
Are expectorants generally expensive?
No, expectorants are generally inexpensive.
43
What is a potential benefit of offering expectorants to patients?
They may be useful to offer to some patients who feel the need to take something.
44
How are expectorants administered?
Expectorants are given orally.
45
What is the age licensing for expectorant liquids?
Expectorant liquids are licensed for use in individuals aged 6 years and older.
46
What are suppressants (anti-tussives) used for?
Suppressants are used for dry coughs.
47
What is an example of a suppressant?
Examples include codeine and dextromethorphan.
48
What do suppressants do?
They suppress the cough reflex.
49
When should suppressants not be used?
They should not be used if clearance of phlegm is needed.
50
Why are codeine and opioid derivatives not ideal?
They have a high incidence of side effects, such as constipation and dependence.
51
What is a benefit of pholcodine compared to codeine?
Pholcodine has fewer side effects than codeine.
52
What is the administration method for suppressants?
They are given orally.
53
What is the age restriction for liquid suppressants?
Liquids are licensed for ages 6 years and older.
54
Are opioid derivatives recommended for adolescents with breathing problems?
No, they are not recommended for those aged 12-18 years with breathing problems.
55
What are demulcents used for?
Demulcents relieve irritation of the mucous membranes in the mouth by forming a protective film.
56
What are examples of demulcents?
Examples include glycerine, lemon & honey, and simple linctus.
57
Do demulcents contain active ingredients?
No, demulcents do not contain any active ingredient.
58
Are demulcents safe for children and pregnant women?
Yes, they are considered to be safe in children and pregnant women.
59
What is the current treatment recommendation for children under 6 years old?
Demulcents are now the recommended treatment for children under 6 years old.
60
How are demulcents administered?
Demulcents are given orally in liquid or lozenge form.
61
Are there different versions of liquid demulcents available?
Yes, both paediatric and adult versions are available.
62
Why should lozenges be avoided in young children?
Lozenges pose a choking hazard for young children.
63
What are Analgesics?
They are medicines used for general pain relief
e.g. paracetamol & Ibuprofen
64
What kind of effects does paracetamol have?
They have analgesics and antipyretic effects
65
What is the max dosage of paracetamol that can be given to an adult?
1000mg four times in a 24 hour period
66
What kind of effect does Ibuprofen have?
It has analgesics, anti-inflammatory and antipyretic activites
67
What is ibuprofen classed as?
Its classed as a non-steroidal anti-Inflammatory (NSAID)
68
What ae some of the advantages ibuprofen has compared to aspirin?
It causes less irritation and damage to the stomach than aspirin
69
What is the max dosage of an adult does of ibuprofen?
- 200-400mg for analgesic activity
- 300-600mg for anti-inflammatory action
70
What are local anaesthetics used for?
Its used for Sore Throats
e.g. Benzocaine and Lidocaine
71
When should local anaesthetics not be used
- should not be used id sensitivity reactions are suspected
- Should not be used for longer than five days
72
How should local anaesthetics be given for sore throats?
Its given topically (applied to the body, i.e. skin)
73
How old do you have to be to buy throat sprays?
+12 years
74
How old do you have to be to buy Lozenges?
It is usually +6 years but it varies depending on the active ingredients
75
What is dyspepsia?
Dyspepsia is a collection of symptoms that include upper abdominal discomfort, heartburn, acid reflux and nausea or vomiting related to eating
76
Name two conditions that can be caused by dyspepsia
- GORD (Gastro-Oesphageal Reflux Disease)
- Peptic Ulcer Disease
77
What is non-ulcer dyspepsia?
Its a type of dyspepsia diagnosed by endoscopy where no ulcer is found
78
What is Hiatus hernia and how is it related dyspepsia?
A hiatus hernia is a condition where part of the stomach pushes through the diaphragm, which can contribute to dyspepsia symptoms
79
Describe the pain experienced in dyspepsia
Burning discomfort or pain that is felt in the stomach and can pass upward behind the breastbone
80
What is a common taste experienced by people with dyspepsia
An unpleasant acid taste in the mouth
81
When are dyspepsia symptoms often triggered?
Symptoms are often related to eating
82
What causes the Dyspepsia?
It is caused by the reflux of gastric contents, particularly acid, into the oesophagus, irritating the mucosal surface
83
What are other symptoms might someone with dyspepsia experience?
- Nausea
- Fullness in the upper abdomen
- Belching
84
What are the referral symptoms for Dyspepsia?
- Gastro-intestinal bleeding
e.g. Coffee grounds in the vomit, Black/tarry stools
- Dysphagia (difficulty swallowing)
- Progressive unintentional weight loss
- Persistent vomiting
- Severe pain
- Pain radiating to other areas of body e.g. arm
- Failed treatment
85
What are the OTC treatments for dyspepsia?
- Antacids
- Alginates
- Proton pump inhibitors
86
What is some general advice for gastro-intestinal minor ailments?
- Eating smaller and more frequent meals
- Raise the head end of your bed. so your head and chest is above the level of your waist, which can stop stomach acid travelling up towards your throat
- consider referring the patient into a stop smoking service
- Weight loss
- Avoid trigger foods
e.g. Chocolate, Alcohol, caffeine, rich/spicy/fatty foods
87
Give some examples of antacids
Calcium carbonate, magnesium and aluminium salts, Rennie
88
When should antacids be taken?
They should be given when symptoms occur or are expected
e.g. after meals and at bedtimes
89
When should antacids not be taken?
They should not be taken at the same time as other drugs as they may impair absorption
90
What combination of antacid products will treat gastro-intestinal upset
Magnesium and aluminium salts
- Magnesium salts alone may cause diarrhoea
- Aluminium salts alone may cause constipation
91
Give some examples of alginates
- Sodium alginate
- Potassium alginate
-Gaviscon
92
What do alginates do for the stomach
It creates a 'raft' on the stomach contents, providing symptomatic relief of reflux and protecting the oesophageal mucosa
93
What kind of alginate is used on patients with a restrictive sodium diet?
Potassium based alginates
94
Give some examples of proton pump inhibitors?
e.g. omeprazole, esomeprazole
95
How long can it take for proton pump inhibitors to take into effect
24 hours
96
What do proton pump inhibitors do?
Inhibit gastric acid secretion by blocking the hydrogen potassium adenosine triphosphate enzyme system (the proton pump) of the gastric parietal cell
97
How old do you have to be to buy Omeprazole and how long can it be used for?
+18 years old
- its short term relief for a maximum of four weeks
98
How old do you have to be to buy esomprazole and how long can it be used for?
+18 years old
- A maximum of 14 day treatment
99
What is constipation caused by?
- Poor fibre intake
- Poor fluid intake
- Sedentary Lifestyle
- Other medication
100
What are the signs and symptoms of constipation?
- Reduced frequency of defection compared to what is normal for that person
- Straining and passage of small, hard stools
- Abdominal discomfort
- Abdominal cramps
- Feeling of incomplete emptying of bowel after going to the toilet
101
What are the referral symptoms for constipation?
- Blood in the stools
- Pain on defection
- With abdominal pain, vomiting or bloating
- Unexplained weight loss
- Failed treatment
- Change in bowel habit of more than 2 weeks
- Adults with new or worsening constipation without adequate explanation
102
What are the OTC treatments for Constipation?
- Laxatives: Bulk forming, Osmotic, Stimulant
- Stool softener
103
What are treatments for children with constipation?
- Normally resolves on its own without treatment
- Fruit juice can help
- Referral to a GP is not needed unless there is a danger symptom
- If constipation becomes regular then a prescribed treatment may be appropriate
- 'Toilet phobia' needs to be avoided
104
What are the treatments of constipation for patients that are pregnant and breastfeeding?
- Bulk forming and osmotic laxatives are the safest options as they are not absorbed
- Senna enters the breast milk so it may cause colic and diarrhoea in the infant
105
what is the general advice given to those that have Constipation?
- Drink eight glasses of fluid a day (about 2 litres)
- Too much caffeine can worsen constipation
- Eat foods high in fibre
- Remain physically active
106
How do Laxatives in bulk forming work?
- Act by retaining water in the gut and increase faecal mass, stimulating peristalsis
- Have a delayed onset, therefor not suitable for acute occasional relief
107
What should Laxatives (bulk forming) be taken with?
Must be taken with adequate water fluids to avoid intestinal obstruction.
108
What are the side effects of Laxatives (bulk forming) ?
- Bloating
- Distension and Flatulence
- Should settle with regular use
109
How are laxatives (bulk forming) taken?
Dissolve sachet in water ad drink
110
How old do you have to be to buy laxatives (bulk forming)?
+ 6 Years oold
111
Give some examples of Osmotic laxatives
- Lactulose
- Macrogol
112
How do osmotic Laxatives work?
- Act by increasing the absorption of water into the large bowel
- Can take up 48 hours to be effective
113
What form does Lactulose come in and what is the licensed age?
- Liquid
- Licensed for use in babies
114
What form does macrogol come in?
- Sachets, Paediatric sachets and liquid (All require dilution)
- + 2 Yrs depending on the formula
115
Give some examples of stimulant Laxatives
- Senna
- Bisacodyl
116
How do stimulant Laxatives work?
- Act by stimulating colonic nerves to increase intestinal motility
- They take effect within 8-12 Hrs so the dose is usually taken at night
117
What can frequent use of stimulant Laxatives?
- Frequent use can lead to fluid and electrolyte imbalance
118
How are stimulant laxatives given?
Its given orally
119
What is the licensed age to use senna?
+ 18 Yrs
120
What is the licensed age to use bisacodyl?
+ 12 Yrs
121
Give some examples of Stool softener?
- Docusate
- Glycerol
Both are stimulant Laxatives
122
How do Stool softeners work?
Act by reducing the surface tension and increasing penetration of intestinal fluids into faeces
123
What form does Docusate come in and what is the licensed age?
- Given orally as liquids or capsules
- Licensing depends on the formulation
124
What form does Glycerol come in and what is the licensed age?
- Given Rectally
- Licensed for use in children
- Size of suppository used depends on age
- Useful for Rapid relief (Works within 30 Mins)
125
What are the cause of Diarrhoea?
- Viral or bacterial infections
e.g E.coli, Salmonella, Cryptosporidium
- Diseases of the GI tract
e.g IBS
126
What are the signs and symptoms of Diarrhoea?
- Increased frequency of bowel evacuation, with the passage of abnormally soft or watery Faeces
- Usually acute and self limiting
- Abdominal Cramps
- Flactulence
- Weakness/malaise may also occur
127
What are the referral symptoms for Diarrhoea
- Drowsiness or Confusion
- Sign of dehydration e.g passing little urine, dry mouth and tongue
- Cool hands or feet
- Sunken fontanelle in babies/young infants
- Blood or mucus in the stools
- Persistent vomitting
- Lasting longer than 3 days in adults
- Recent travel abroad
128
What are the OTC treatments for Diarrhoea?
- Basis of treatment is electrolyte and fluid replacement
- Anti-diarrhoeals (Aka anti-motility drugs) may be useful in some adults and older children
129
What is the general advice for people with Diarrhoea
- Drink plenty of normal drinks if possible
- Eat as normally as possible
* Ideally include fruit juices and soups, which will provide sugar
and salt, and also foods that are high in carbohydrate
* Little evidence supporting the need to avoid solid food for 24 hrs
- Always wash your hands after going to the toilet
- Regular cleaning of the toilet, including flush handle and toilet seat is advisable
- Specialist advice is required or those whose job involves handling food
130
Give an example of Oral Rehydration Sachets used for Diarrhoea
- Dioraltye
131
What do Oral Rehydration Sachets do?
They are standard treatment for acute diarrhoea in babies and young children
132
How are the oral rehydration sachets taken?
They are dissolved in water and should be taken with each loose stool, in addition to taking fluids throughout the day
133
What is the licensed age for Oral Rehydration Sachets
- Licensing varies based on preparation
134
Give some examples of Anti-Motility ( Anti-Diarrhoeals) drugs
- Ioperamide
- Imodium
135
What do Anti-Motility drugs do?
- Help reduce the duration of diarrhoea and improves the symptoms
* Increases Stool consistency*
- Should only be used when symptom control is necessary
* Should not be used routinely to treat diarrhoea*
136
What causes Allergic Rhinitis?
- An inflammatory response involving the release of histamine, initiated by allergens being deposited on the nasal and respiratory tract mucosa
*may also affect the eyes*
- Allergens responsible for seasonal allergic rhinitis e.g grass/tree pollens
- Perennial allergic rhinitis occurs when symptoms are present all year
*- Commonly caused by dust mites, animal dander and feather*
- Allergic rhinitis associated with asthma and eczema
137
What are the signs and symptoms of Allergic rhinitis?
- Rhinorrhoea (runny nose)
- Nasal Congestion
- Nasal itching
- Watery eyes
- Irritated eyes
- Discharge from the eyes
- Sneezing
138
What are the referral symptoms of Allergic Rhinitis?
- Tightness of the chest
- Wheezing
- Shortness of breath
- Painful ear
- Painful sinuses
- Purulent Conjunctivitis
- Severe symptoms only partially relieved by OTC preparations
139
What are OTC treatments used to treat Allergic Rhinitis?
- Antihistamines
- Nasal Corticosteroids
- Sodium Cromoglicate
- Decongestants (Short Term)
140
What is the general advice given for Allergic Rhinitis?
- Allergen avoidance is recommended but not always possible
- For seasonal Allergic Rhinitis (hay-fever)
*- Car windows and air vents should be kept closed while driving
reducing the amount of pollen/allergens entering*
*- House windows should be kept closed when pollen count is
high*
- For perennial allergic rhinitis:
*Regular cleaning of the house to keep dust levels at minimum*
141
Give some examples of Non-seating Antihistamines
- Acrivastine
- Cetirizine
- Loratdine
- Fexofenadine
142
Give some examples of sedating Antihistamines
- Chlorphenamine
143
What do Antihistamines do?
- First line treatment for mild-to-moderate
- Effective in reducing sneezing and rhinorrhoea
144
How are antihistamines given?
- Usually given Orally
*- Azelastine is available as a nasal spray on prescription*
145
Give some examples of Intranasal Corticosteroids?
- Beclometasone
- Fluticasone
- Mometasone
146
How do Intranasal Corticosteroids work?
- Reduce the inflammation that has occurred as a result of the allergens action
- Regular use is essential for full benefit to be obtained
- Treatment should be used throughout the hay fever season
147
How long does it take Intranasal Corticosteroids to take effect?
- Can take several days to be effective
- side effects are rare
148
What is the licensed age for Intranasal Corticosteroids
- Licensing varies per product
149
What do Sodium Cromoglicate eye drops do?
- Highly effective treatment of eye symptoms
150
How long does it take for Sodium Cromoglicate eye drops take effect?
- Work within an hour
- Should be used continuously to obain full benefit
151
What do Decongestants do?
- May be used short term to reduce nasal congestion alone or in combination with antihistamine
152
What are the causes of Headaches?
- Stress/Tension
- Migraine triggers
*- Bright lights*
*- Eating certain foods or missing meals*
*- Extremes of weather*
*- Long-distance travel*
*- Loud noises*
*- Altered sleep pattern*
- Increased pressure in sinuses
153
What are the signs an symptoms of Headaches?
- Tension headaches
*- Bilateral, dull ache with a pressing or tightening sensation across
the forehead and/or base of skull*
- Migraine
*- Pulsating/throbbing headache*
*- With or without aura/visual disturbances*
- Sinusitis
*- Usually unilateral behind and around the eye and is typically
worse on bending forwards and sensitive to touch*
154
What are the referral symptoms of headaches?
- Headaches associated with injury/trauma
- Headache associated with fever or rash
- Severe headache for more than 4 Hrs
- Headache in children under 12 Yrs
- Associated drowsiness, unsteadiness, visual disturbances, vomiting
or altered level of consciousness
- Neck stiffness
- Frequent and persistent headaches
- Sudden onset
- Different or more severe than previous headaches
155
What are the OTC treatments for Headaches?
- Analgesics
*- Simple*
*- Opioid containing*
- Sumatriptan
- Doxylamine
156
What is some general advice for Headaches?
- Has the patient had a recent eye test?
*- Eye strain can be cause of headaches*
- Tension headaches:
*- Reassurance and stress-relieving techniques are often useful in
sufferers*
*- Physical exercise can also help to alleviate symptoms, particularly
as it is more common in sedentary lifestyles.*
- Migraines:
*- Avoidance of trigger factors*
*- Keep diary to help identify triggers*
- Meningitis should always be considered and ruled out when asked for advice on headaches. Symptoms to watch out are the referral symptoms for headaches
