OTC - sore throat

Question 1

Symptoms?

Answer 1

• pain from back of throat (pharynx)
• pain on swallowing
• swollen lymph glands

Question 2

Referral criteria?

Answer 2

• > 1 week
• dysphagia (difficulty swallowing)
• hoarse voice > 3 weeks (laryngeal cancer?)
• extremely painful and no improvement within 24-48 hours
• medication ADR: bone marrow suppression: carbimazole, methotrexate, clozapine, sulfasalazine etc)
• oral thrush= steroid inhalers; can treat OTC with oral miconazole and checking inhaler technique but may require review by doctor e.g. change to a different inhaler
• red swollen tonsils with marked exudate swollen lymph glands and high fevere (strep infection? tonsilitis? glandular fever?)

Question 3

OTC products?

Answer 3

ORAL ANALGESICS

• ibuprofen 400mg TDS
• paracetamol 1g QDS (if intolerant to nsaids)

DEMULCENTS LOZENGES - soothes throat
- glycerin, honey

ANTI-INFLAMMATORY (NSAID)

• benzydamine (difflam rinse 12+/spray 6+)
• flurbiprofen (strefen lozenges 12+) - max 3 days use, every 3-6 hours, max 5 lozenges in 24 hours
• gargling disp aspirin 16+

LOCAL ANAESTHETICS - numb pain

• lidocaine (covonia throat spray) 12+
• benzocaine (tyrozet lozenges) 3+
• ultra chloroseptic anaesthetic throat sprays 6+
• hexylresorcinol (strepsils extra triple action)

ANTIBAC AND ANTIFUNGAL LOZENGES 
- chlorhexidine 
- tyrothricin 
- benzalkonium chloride 
- cetylpyridinium chloride 
(antibac)
- dequalinium chloride (antifungal)
- amylmetacresol
- 2,4-dichlorobenzyl alcohol
(antiseptic and anaesthetic)

Question 4

Advice?

Answer 4

• drink plenty of fluids
• avoid very hot drinks
• eat cool, soft foods
• sucking lozenges, hard boiled sweets, ice cubes
• gargle with a homemade mouthwash of warm, salty water
• avoid smoking
• diabetics: sugar free recommended