OTC Respiratory Flashcards
What are the symptoms of cold and flu?
Blocked/runny nose
Sneezing
Cough
Sore throat
Fever Aches and pains Headache, sinus pain Earache Irritated, watery eyes
Flu is more sudden and severe. Includes headache, marked myalgia, chills, malaise or high grade fever
When do you refer cold and flu?
No improvement after 2 weeks
Middle ear pain not improving with analgesics
Persisting productive cough and high grade fever
Vulnerable patients
What is used for fever, aches and pains OTC?
Paracetamol
Ibuprofen
Aspirin
What do you use for nasal congestion OTC?
Pseudoephedrine, phenylephrine
Xylometazoline, oxymetazoline
No more than 7 days
When should nasal decongestants be avoided?
Hypertension Hyperthyroidism Diabetes CVD Glaucoma Prostatic enlargement
MAOIs
TCAs
Beta blockers
Why is diphenhydramine used in cold/flu products?
Dries up nasal secretions
What is the advice for cold and flu?
Vitamin C and Echinacea
Wash hands
Cough or sneeze into tissue
Annual flu jab if at risk group
What are the symptoms of a non-productive cough?
Dry
Thickly
What are the symptoms of productive cough?
Chesty
Sputum
What are the referral criteria for coughs?
> 3 weeks Chest pain Wheezing Shortness of breath Pain on inspiration Recurrent night time cough Whooping cough Croup Coloured sputum Blood in sputum
What does pink tinged sputum indicate?
Heart failure
What does rust coloured sputum indicate?
CAP
What are the OTC products for dry cough?
6+
Pholcodeine
Dextromethorpan
Codeine linctus 18+
Sedation and constipation
What are the OTC products for chesty cough?
Expectorants 6+ Guaifenesin Ipecacuanha - covonia Ammonium chloride - unicough Squill - buttercups
Antihistamines 6+ Diphenhydramine - benylin Promethazine - night nurse Brompheniramime Triprolidine - actifed
What OTC products can be used for any cough?
Demulcente
Glycerol - 3+
Simple linctus - 1+
Safe for pregnant and children under 6
What is the advice for coughs?
Dry, tickly coughs are self limiting
Do not treat chesty coughs with an antitussive
Sugar free products in diabetics
What are the symptoms of hayfever?
Itchy, watery eyes
Nasal symptoms
What are the referral criteria for hay fever?
Chest tightness
Wheezing
Shortness of breath
Cough
Purulent conjunctivitis
Painful ear/sinuses
What are the OTC non-sedating antihistamines?
Acrivastine TDS 12-65
Cetirizine OD 6+, 2+ liquid
Loratadine OD 2+
What are the sedating OTC antihistamines?
Chlorphenamine 6+, 1+ liquid
Promethazine 5+, 2+ liquid
What are the cautions with antihistamines?
BPH
Glaucoma
Epilepsy
MAOIs contraindicated
What are the OTC products for hay fever?
Steroid nasal sprays 18+, 3 months
Sodium cromoglicate
Xylometazoline
What is the advice for hay fever?
Close windows, stay indoors when pollen high
Avoid grass
Exclude pets from areas of house
What are the symptoms of sore throat?
Pain from back of throat
Pain on swallowing
Swollen lymph glands
When is a sore throat referred?
> 1 week
Dysphagia
Hoarse voice > 3 weeks
Extremely painful and no improvement within 24-48 hours
Medication ADR - bone marrow suppression, ICS
Red, swollen tonsils, swollen lymph nodes
What are the OTC products for sore throat?
Ibuprofen 400mg TDS
Paracetamol 1g QDS
Glycerin, honey
Benzydamine 12+ difflam rinse, 6+ spray
Flurbiprofen 12+ max 3 days, every 3-6 hours, max 5 lozenges in 24 hours
Gargle aspirin 16+
Lidocaine - covonia spray 12+
Benzocaine - tyrozet 3+, ultra 6+
Hexylresorcinol - strepsils extra 6+
What is the advice for sore throats?
Drink fluids Avoid hot drinks Eat cool, soft foods Suck lozenges, sweets, ice cubes Salty water Avoid smoking Diabetics use sugar free
