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PHA 116 - Professional Practice of Pharmacy > OTC Minor Ailments 1 > Flashcards

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.

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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.

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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.

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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.

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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.

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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.

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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.

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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

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9
Q

What is the nature of common cold treatment?

A

Self-limiting but patients often opt for symptomatic relief

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10
Q

What are some over-the-counter (OTC) treatments for the common cold?

A

Decongestants, Demulcents

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11
Q

What is a cough?

A

A reflex action of the body due to infection, inflammation, or irritation of the airway.

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12
Q

What are the two categories of coughs?

A
  1. Productive/chesty: Phlegm is produced and the cough reflex expels the phlegm.
  2. Non-productive/dry: No phlegm production.
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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.

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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.

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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.

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16
Q

What is a common cause of sore throats?

A

Usually a symptom of an acute upper respiratory tract infection.

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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.

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18
Q

What are the possible origins of a sore throat?

A

May be viral or bacterial in origin.

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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.

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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.

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21
Q

What are other possible causes of sore throat?

A

May be caused by GORD, physical or chemical irritation.

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22
Q

What is the typical course of a sore throat?

A

Usually self-limiting.

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23
Q

How long do symptoms of a sore throat generally improve?

A

Symptoms generally improve within 7 days.

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24
Q

What is a common symptom of a sore throat?

A

Pain in the back of the throat.

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25
Q

What physical sign may be felt under the chin or neck with a sore throat?

A

Swollen lymph glands may be felt under the chin or neck.

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26
Q

What symptom may occur upon swallowing with a sore throat?

A

Pain upon swallowing.

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27
Q

What are referral symptoms for sore throats?

A

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.

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28
Q

What is the OTC treatment for sore throats?

A

OTC treatment is self-limiting, but patients often seek symptomatic relief using demulcents, analgesics, and local anaesthetics.

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29
Q

When are antibiotics necessary for sore throats?

A

Antibiotics are unnecessary in most cases where there is a bacterial infection, as they make little difference on outcome.

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30
Q

What is the general advice for Common Respiratory Minor Ailments?

A
  • 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
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31
Q

What are decongestants used for?

A

Decongestants are used for nasal symptoms by constricting dilated blood vessels in the nasal mucosa.

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32
Q

How do decongestants relieve nasal stuffiness?

A

They shrink nasal membranes, improving drainage of mucus and circulation of air.

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33
Q

What is a potential side effect of decongestants if taken at night?

A

Stimulatory action may cause sleep disturbances.

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34
Q

How can decongestants be administered?

A

They can be given orally or applied topically.

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35
Q

What is the age licensing for decongestant tablets?

A

Tablets are licensed for individuals 12 years and older.

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36
Q

What is the age licensing for decongestant liquids?

A

Liquids are licensed for individuals 6 years and older.

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37
Q

What is the age licensing for nasal sprays/drops?

A

Nasal sprays/drops are licensed for individuals 12 years and older.

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38
Q

What is the maximum duration for using decongestants?

A

The maximum use is 7 days.

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39
Q

What are expectorants used for?

A

Expectorants are used for chesty coughs.

Examples include guaifenesin and squill extract.

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40
Q

What is the theoretical effect of expectorants?

A

They are theorized to produce expulsion of bronchial secretions.

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41
Q

What does the BNF state about expectorants?

A

The BNF states that expectorants are more likely to have a placebo effect.

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42
Q

Are expectorants generally expensive?

A

No, expectorants are generally inexpensive.

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43
Q

What is a potential benefit of offering expectorants to patients?

A

They may be useful to offer to some patients who feel the need to take something.

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44
Q

How are expectorants administered?

A

Expectorants are given orally.

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45
Q

What is the age licensing for expectorant liquids?

A

Expectorant liquids are licensed for use in individuals aged 6 years and older.

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46
Q

What are suppressants (anti-tussives) used for?

A

Suppressants are used for dry coughs.

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47
Q

What is an example of a suppressant?

A

Examples include codeine and dextromethorphan.

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48
Q

What do suppressants do?

A

They suppress the cough reflex.

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49
Q

When should suppressants not be used?

A

They should not be used if clearance of phlegm is needed.

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50
Q

Why are codeine and opioid derivatives not ideal?

A

They have a high incidence of side effects, such as constipation and dependence.

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51
Q

What is a benefit of pholcodine compared to codeine?

A

Pholcodine has fewer side effects than codeine.

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52
Q

What is the administration method for suppressants?

A

They are given orally.

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53
Q

What is the age restriction for liquid suppressants?

A

Liquids are licensed for ages 6 years and older.

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54
Q

Are opioid derivatives recommended for adolescents with breathing problems?

A

No, they are not recommended for those aged 12-18 years with breathing problems.

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55
Q

What are demulcents used for?

A

Demulcents relieve irritation of the mucous membranes in the mouth by forming a protective film.

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56
Q

What are examples of demulcents?

A

Examples include glycerine, lemon & honey, and simple linctus.

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57
Q

Do demulcents contain active ingredients?

A

No, demulcents do not contain any active ingredient.

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58
Q

Are demulcents safe for children and pregnant women?

A

Yes, they are considered to be safe in children and pregnant women.

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59
Q

What is the current treatment recommendation for children under 6 years old?

A

Demulcents are now the recommended treatment for children under 6 years old.

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60
Q

How are demulcents administered?

A

Demulcents are given orally in liquid or lozenge form.

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61
Q

Are there different versions of liquid demulcents available?

A

Yes, both paediatric and adult versions are available.

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62
Q

Why should lozenges be avoided in young children?

A

Lozenges pose a choking hazard for young children.

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63
Q

What are Analgesics?

A

They are medicines used for general pain relief
e.g. paracetamol & Ibuprofen

64
Q

What kind of effects does paracetamol have?

A

They have analgesics and antipyretic effects

65
Q

What is the max dosage of paracetamol that can be given to an adult?

A

1000mg four times in a 24 hour period

66
Q

What kind of effect does Ibuprofen have?

A

It has analgesics, anti-inflammatory and antipyretic activites

67
Q

What is ibuprofen classed as?

A

Its classed as a non-steroidal anti-Inflammatory (NSAID)

68
Q

What ae some of the advantages ibuprofen has compared to aspirin?

A

It causes less irritation and damage to the stomach than aspirin

69
Q

What is the max dosage of an adult does of ibuprofen?

A
  • 200-400mg for analgesic activity
  • 300-600mg for anti-inflammatory action
70
Q

What are local anaesthetics used for?

A

Its used for Sore Throats
e.g. Benzocaine and Lidocaine

71
Q

When should local anaesthetics not be used

A
  • should not be used id sensitivity reactions are suspected
  • Should not be used for longer than five days
72
Q

How should local anaesthetics be given for sore throats?

A

Its given topically (applied to the body, i.e. skin)

73
Q

How old do you have to be to buy throat sprays?

A

+12 years

74
Q

How old do you have to be to buy Lozenges?

A

It is usually +6 years but it varies depending on the active ingredients

75
Q

What is dyspepsia?

A

Dyspepsia is a collection of symptoms that include upper abdominal discomfort, heartburn, acid reflux and nausea or vomiting related to eating

76
Q

Name two conditions that can be caused by dyspepsia

A
  • GORD (Gastro-Oesphageal Reflux Disease)
  • Peptic Ulcer Disease
77
Q

What is non-ulcer dyspepsia?

A

Its a type of dyspepsia diagnosed by endoscopy where no ulcer is found

78
Q

What is Hiatus hernia and how is it related dyspepsia?

A

A hiatus hernia is a condition where part of the stomach pushes through the diaphragm, which can contribute to dyspepsia symptoms

79
Q

Describe the pain experienced in dyspepsia

A

Burning discomfort or pain that is felt in the stomach and can pass upward behind the breastbone

80
Q

What is a common taste experienced by people with dyspepsia

A

An unpleasant acid taste in the mouth

81
Q

When are dyspepsia symptoms often triggered?

A

Symptoms are often related to eating

82
Q

What causes the Dyspepsia?

A

It is caused by the reflux of gastric contents, particularly acid, into the oesophagus, irritating the mucosal surface

83
Q

What are other symptoms might someone with dyspepsia experience?

A
  • Nausea
  • Fullness in the upper abdomen
  • Belching
84
Q

What are the referral symptoms for Dyspepsia?

A
  • 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
Q

What are the OTC treatments for dyspepsia?

A
  • Antacids
  • Alginates
  • Proton pump inhibitors
86
Q

What is some general advice for gastro-intestinal minor ailments?

A
  • 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
Q

Give some examples of antacids

A

Calcium carbonate, magnesium and aluminium salts, Rennie

88
Q

When should antacids be taken?

A

They should be given when symptoms occur or are expected
e.g. after meals and at bedtimes

89
Q

When should antacids not be taken?

A

They should not be taken at the same time as other drugs as they may impair absorption

90
Q

What combination of antacid products will treat gastro-intestinal upset

A

Magnesium and aluminium salts
- Magnesium salts alone may cause diarrhoea
- Aluminium salts alone may cause constipation

91
Q

Give some examples of alginates

A
  • Sodium alginate
  • Potassium alginate
    -Gaviscon
92
Q

What do alginates do for the stomach

A

It creates a ‘raft’ on the stomach contents, providing symptomatic relief of reflux and protecting the oesophageal mucosa

93
Q

What kind of alginate is used on patients with a restrictive sodium diet?

A

Potassium based alginates

94
Q

Give some examples of proton pump inhibitors?

A

e.g. omeprazole, esomeprazole

95
Q

How long can it take for proton pump inhibitors to take into effect

A

24 hours

96
Q

What do proton pump inhibitors do?

A

Inhibit gastric acid secretion by blocking the hydrogen potassium adenosine triphosphate enzyme system (the proton pump) of the gastric parietal cell

97
Q

How old do you have to be to buy Omeprazole and how long can it be used for?

A

+18 years old
- its short term relief for a maximum of four weeks

98
Q

How old do you have to be to buy esomprazole and how long can it be used for?

A

+18 years old
- A maximum of 14 day treatment

99
Q

What is constipation caused by?

A
  • Poor fibre intake
  • Poor fluid intake
  • Sedentary Lifestyle
  • Other medication
100
Q

What are the signs and symptoms of constipation?

A
  • 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
Q

What are the referral symptoms for constipation?

A
  • 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
Q

What are the OTC treatments for Constipation?

A
  • Laxatives: Bulk forming, Osmotic, Stimulant
  • Stool softener
103
Q

What are treatments for children with constipation?

A
  • 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
Q

What are the treatments of constipation for patients that are pregnant and breastfeeding?

A
  • 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
Q

what is the general advice given to those that have Constipation?

A
  • 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
Q

How do Laxatives in bulk forming work?

A
  • 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
Q

What should Laxatives (bulk forming) be taken with?

A

Must be taken with adequate water fluids to avoid intestinal obstruction.

108
Q

What are the side effects of Laxatives (bulk forming) ?

A
  • Bloating
  • Distension and Flatulence
  • Should settle with regular use
109
Q

How are laxatives (bulk forming) taken?

A

Dissolve sachet in water ad drink

110
Q

How old do you have to be to buy laxatives (bulk forming)?

A

+ 6 Years oold

111
Q

Give some examples of Osmotic laxatives

A
  • Lactulose
  • Macrogol
112
Q

How do osmotic Laxatives work?

A
  • Act by increasing the absorption of water into the large bowel
  • Can take up 48 hours to be effective
113
Q

What form does Lactulose come in and what is the licensed age?

A
  • Liquid
  • Licensed for use in babies
114
Q

What form does macrogol come in?

A
  • Sachets, Paediatric sachets and liquid (All require dilution)
    • 2 Yrs depending on the formula
115
Q

Give some examples of stimulant Laxatives

A
  • Senna
  • Bisacodyl
116
Q

How do stimulant Laxatives work?

A
  • 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
Q

What can frequent use of stimulant Laxatives?

A
  • Frequent use can lead to fluid and electrolyte imbalance
118
Q

How are stimulant laxatives given?

A

Its given orally

119
Q

What is the licensed age to use senna?

A

+ 18 Yrs

120
Q

What is the licensed age to use bisacodyl?

A

+ 12 Yrs

121
Q

Give some examples of Stool softener?

A
  • Docusate
  • Glycerol
    Both are stimulant Laxatives
122
Q

How do Stool softeners work?

A

Act by reducing the surface tension and increasing penetration of intestinal fluids into faeces

123
Q

What form does Docusate come in and what is the licensed age?

A
  • Given orally as liquids or capsules
  • Licensing depends on the formulation
124
Q

What form does Glycerol come in and what is the licensed age?

A
  • Given Rectally
  • Licensed for use in children
  • Size of suppository used depends on age
  • Useful for Rapid relief (Works within 30 Mins)
125
Q

What are the cause of Diarrhoea?

A
  • Viral or bacterial infections
    e.g E.coli, Salmonella, Cryptosporidium
  • Diseases of the GI tract
    e.g IBS
126
Q

What are the signs and symptoms of Diarrhoea?

A
  • 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
Q

What are the referral symptoms for Diarrhoea

A
  • 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
Q

What are the OTC treatments for Diarrhoea?

A
  • Basis of treatment is electrolyte and fluid replacement
  • Anti-diarrhoeals (Aka anti-motility drugs) may be useful in some adults and older children
129
Q

What is the general advice for people with Diarrhoea

A
  • 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
Q

Give an example of Oral Rehydration Sachets used for Diarrhoea

A
  • Dioraltye
131
Q

What do Oral Rehydration Sachets do?

A

They are standard treatment for acute diarrhoea in babies and young children

132
Q

How are the oral rehydration sachets taken?

A

They are dissolved in water and should be taken with each loose stool, in addition to taking fluids throughout the day

133
Q

What is the licensed age for Oral Rehydration Sachets

A
  • Licensing varies based on preparation
134
Q

Give some examples of Anti-Motility ( Anti-Diarrhoeals) drugs

A
  • Ioperamide
  • Imodium
135
Q

What do Anti-Motility drugs do?

A
  • 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
Q

What causes Allergic Rhinitis?

A
  • 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
Q

What are the signs and symptoms of Allergic rhinitis?

A
  • Rhinorrhoea (runny nose)
  • Nasal Congestion
  • Nasal itching
  • Watery eyes
  • Irritated eyes
  • Discharge from the eyes
  • Sneezing
138
Q

What are the referral symptoms of Allergic Rhinitis?

A
  • Tightness of the chest
  • Wheezing
  • Shortness of breath
  • Painful ear
  • Painful sinuses
  • Purulent Conjunctivitis
  • Severe symptoms only partially relieved by OTC preparations
139
Q

What are OTC treatments used to treat Allergic Rhinitis?

A
  • Antihistamines
  • Nasal Corticosteroids
  • Sodium Cromoglicate
  • Decongestants (Short Term)
140
Q

What is the general advice given for Allergic Rhinitis?

A
  • 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
Q

Give some examples of Non-seating Antihistamines

A
  • Acrivastine
  • Cetirizine
  • Loratdine
  • Fexofenadine
142
Q

Give some examples of sedating Antihistamines

A
  • Chlorphenamine
143
Q

What do Antihistamines do?

A
  • First line treatment for mild-to-moderate
  • Effective in reducing sneezing and rhinorrhoea
144
Q

How are antihistamines given?

A
  • Usually given Orally
    - Azelastine is available as a nasal spray on prescription
145
Q

Give some examples of Intranasal Corticosteroids?

A
  • Beclometasone
  • Fluticasone
  • Mometasone
146
Q

How do Intranasal Corticosteroids work?

A
  • 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
Q

How long does it take Intranasal Corticosteroids to take effect?

A
  • Can take several days to be effective
  • side effects are rare
148
Q

What is the licensed age for Intranasal Corticosteroids

A
  • Licensing varies per product
149
Q

What do Sodium Cromoglicate eye drops do?

A
  • Highly effective treatment of eye symptoms
150
Q

How long does it take for Sodium Cromoglicate eye drops take effect?

A
  • Work within an hour
  • Should be used continuously to obain full benefit
151
Q

What do Decongestants do?

A
  • May be used short term to reduce nasal congestion alone or in combination with antihistamine
152
Q

What are the causes of Headaches?

A
  • 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
Q

What are the signs an symptoms of Headaches?

A
  • 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
Q

What are the referral symptoms of headaches?

A
  • 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
Q

What are the OTC treatments for Headaches?

A
  • Analgesics
    - Simple
    - Opioid containing
  • Sumatriptan
  • Doxylamine
156
Q

What is some general advice for Headaches?

A
  • 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

PHA 116 - Professional Practice of Pharmacy (9 decks)

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