Respiratory OTC - Sore Throat

Question 1

What is the first line treatment for a sore throat? (1)

Answer 1

Self care

Question 2

Which patients qualify to undergo the pharmacy first pathway for sore throat? (2)

Answer 2

Adults + children >= 5 yrs.

Question 3

What are the common symptoms of sore throat? (6)

Answer 3

4Ds (Dysphonia/dysphagia/drooling/distress.)
Swollen glands
Hoarseness

Question 4

What are the risk factors of sore throat? (2)

Answer 4

Prev. Hx = recurrent tonsillitis.
Smokers
Medications

Question 5

Explain the use of FeverPAIN. (7)

Answer 5

Identifies whether a sore throat is caused by streptococcal bacteria:

Score of 1 (max. Of 5):
Fever (38 degrees Celsius)
Purulence (pharyngeal/tonsillar exudate)
Attend rapidly (3 days or less)
Severely inflamed tonsils
No cough/coryza.

Question 6

What are the severity ranges for FeverPAIN? (3)

Answer 6

0-1 = No ABx
2-3 =3 days back up ABx.
4-5 =Immediate ABx. If severe or 48-hr short back up Rx.

Question 7

Explain the pharmacy first pathway for sore throat.

Answer 7

0-1: Self care + pain relief, ABx not needed + offer OTC + drink fluids. Ask px to return to community pharmacy after 1 week of no symptom improvement for reassessment.

2-3: Self care + pain relief, ABx make little difference to how long symptoms last + witholding ABx is unlikely to cause complications. Ask px to return to community pharmacy if no improvement within 3-5 days for reassessment. After pharmacist reassessment, patient is given ABx.

4-5: Shared decision making. Mild: pain relief + self care. Severe: ABx. Give phenoxymethylpenicillin (no allergy) for 5 days + self-care. Clarithromycin (penicillin allergy) for 5 days.+ self care. Erythromycin (pregnant only) for 5 days + self care.