SYMPTOMS IN PHARMACY Flashcards
Recognise symptoms related to common respiratory conditions
common cold - nasal stuffiness and discharge, sneezing, sore
throat, and cough.
cough - reflex response to airway irritation
seasonal influenza - coryza (inflammation), nasal
discharge, cough, fever, gastrointestinal (GI) symptoms,
headache, malaise, myalgia, arthralgia, ocular
symptoms, and sore throat.
croup - seal-like barking cough usually
accompanied by stridor (predominantly inspiratory), hoarse
voice, and respiratory distress due to upper-airway obstruction.
Symptoms are usually worse at night. There may be a fever.
whooping cough -
The catarrhal phase lasts ~ a week and is characterised by the development of a dry, unproductive cough.
The paroxysmal phase may last for a month or more and is characterised by coughing fits, whooping, and
post-tussive vomiting. The person may be relatively well between paroxysms.
The convalescent phase may last an additional 2 months or more, and is characterised by gradual
improvement in the frequency and severity of symptoms.
Recognise red flags and when to refer respiratory conditions
common cold -
cough - NOT respond to trials of treatment, if the diagnosis is
uncertain, or if systemically unwell.
seasonal influenza - A complication such as pneumonia occurs.
* The person has a concomitant disease that may be
affected by influenza (for example, type 1 diabetes).
* There is suspicion of a serious illness other than
influenza (for example, meningitis).
croup - A child should be immediately admitted when presenting
with moderate or severe croup, or impending respiratory
failure
whooping cough -
Recognise symptoms related to common skin conditions
atopic eczema -
Chronic, itchy skin condition – common
in children
- Often accompanies other “atopic” conditions
- Rash is dry, flaky and inflamed
contact dermatitis -
Commonly on the hands
- Consider patient history and occupation
- Nappy rash is a type of contact dermatitis
psoriasis -
Characterised by inflamed skin topped
with silver or white “plaques”
ringworm -
fungal infection that
presents as a circular rash
athletes foot -
fungal foot infection
usually spread by person-person
herpes -
usually around lips /
nose caused
warts - Small growths on the skin
verrucae - Small growths on the skin
acne - Hair follicles and sebaceous glands
become blocked
scabies -
Recognise symptoms related to common childhood conditions
Teething - pain, increased biting and drooling
Threadworms- itching around the anus, worms in stool and visible eggs
Colic - extreme crying
Head lice - itching, visible
Nappy Rash - redness around genital area
Oral thrush - white patches in mouth that can be wiped off
Recognise symptoms related to common pain conditions
sprain -
strains -
sciatica -
osteoarthritis -
tension headache -
sinus headache -
migraine -
meningitis-
dysmenorrhea -
Describe the signs and symptoms of cystitis, vaginal thrush, dysmenorrhoea, menorrhagia and the menopause.
Identify red flag signs and symptoms for these conditions and be able to refer appropriately
Suggest appropriate management options for cystitis, vaginal thrush, dysmenorrhoea, menorrhagia, contraception including in an emergency, and the menopause
common conditions related to the gastrointestinal tract encountered in the pharmacy
Ask pertinent questions related to specific conditions (GI TRACT)
Formulate a treatment plan (non-pharmacological or pharmacological) based on presenting symptoms (GI TRACT)
Respond appropriately to requests for named medicines (GI TRACT)
Identify any “red flag” issues and know when and how to refer (GI TRACT)
some of the common conditions related to the ears, nose and throat encountered in the pharmacy
Ask pertinent questions related to specific conditions (ENT)
Identify suitable options for management of the condition of respiratory conditions
common cold -
cough - Offer self care (e.g. paracetamol or ibuprofen for pain and inflammation,
if appropriate), and refer to smoking cessation if relevant
seasonal influenza - Drink adequate fluid
* Take paracetamol or ibuprofen to relieve symptoms, rest
* Stay off work or school until the worst symptoms have resolved
croup - All children with mild, moderate, or severe croup
should receive a single dose of oral dexamethasone (0.15 mg
per kg body weight).
Croup is usually self-limiting and symptoms usually resolve
within 48 hours
whooping cough - An antibiotic (usually a macrolide, such as erythromycin or clarithromycin)
should be prescribed to all people with suspected or confirmed whooping
cough with onset of cough within the previous 21 days.
Recognise red flags and when to refer skin conditions
atopic eczema and contact dermatitis -
Infected rashes, e.g. weeping from the rash
- Suspected ADR or unidentifiable cause
- Failed medication, e.g. >1 week of topical corticosteroid use
- Always consider meningitis / septicaemia
psoriasis - failed treatment
ringworm and athletes foot - Treatment failure (>2 weeks)
- Bacterial infection
- Diabetic patients
- Involvement of the nail
herpes -
Eyes / genital regions affected
- Age of patient? (Zovirax® cream has no age restrictions)
- Painless, in the mouth or lasting >2 weeks
- Immunocompromised
Skin infections (Herpes)
Herpes simplex labialis (cold sores)
warts and verrucae -
Suspicious changes in shape or colour +/- bleeding and itching
- (A) Asymmetrical – melanomas usually irregular shape
- (B) Border – melanoma border often “ragged”
- (C) Colours – at least 2 colours
- (D) Diameter – most melanomas >6mm in diameter
- (E) Evolving – moles that change in size may be a melanoma
- Diabetic and immunocompromised patients
- Anogenital warts in children
- Failed treatment
acne -
Severe acne
- Treatment failure
- Suspected ADR
- ABCDE concerns
- Causing mental health issues
scabies -
Age: young children and elderly
- Outbreaks suspected, e.g. in a school
- Crusted scabies (hyper-infection with mites)
- Infected rash
- Treatment failure
- Acquired through sexual activity?
Identify suitable options for OTC supply skin conditions
atopic eczema and contact dermatitis -
Emollients are the mainstay of treatment – they soothe
the skin and can form a waterproof barrier to prevent drying
- May be applied to soothe the skin or used as soaps or bath
additives
- Topical corticosteroids, e.g. hydrocortisone 1%
w/v, are available as P medicines.
More potent corticosteroids are also available
- Antipruritics to prevent itching are also available but generally not
recommended
psoriasis -
Emollients
- Coal tar preparations
- Dithranol and salicylic acid
- Topical corticosteroids
ringworm and athletes foot - Imidazoles, e.g. miconazole cream (Daktarin®)
herpes - aciclovir 5% cream (apply 5 × 5 + 5)
warts and verrucae - Salicylic acid based products are commonly used.
acne - Benzoyl peroxide is usually the first line treatment
scabies - Two applications of a topical acaricide required 7 days
apart
Identify suitable options for management of the condition (childhood conditions)
Teething - teething ring
Threadworms- mebenzadole/vermox and hygiene management
Colic - self limiting
Head lice - comb or hedrin
Nappy Rash -
mild - zinc and castor oil cream
discomfort - hydrocortisone cream 0.5% + barrier prep
candida infection suspected - clotrimazole 1% cream then barrier prep
Oral thrush - miconazole oral gel or nystatin oral suspension if interactions with miconazole
Recognise red flags and when to refer (childhood conditions)
Teething - change in stool or systemically unwell
Threadworms- pregnant, breastfeeding or unwilling to take hygiene measures
Colic - systemically unwell
Head lice - people with scalp inflammation
Nappy Rash - bacterial infection, severe inflammation or systemically unwell
Oral thrush - not resolved after7 days, pain swallowing, immunocompromised
Identify suitable options for management of the condition (pain conditions)
sprain -
strains -
sciatica -
osteoarthritis -
tension headache -
sinus headache -
migraine -
meningitis-
dysmenorrhea -
Recognise red flags and when to refer (pain conditions)
