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PMP-103 > Symptoms in the Pharmacy - Respiratory Conditions > Flashcards

Symptoms in the Pharmacy - Respiratory Conditions Flashcards

1
Q

What is the Common Ailment Scheme (CAS)?

A
  • free NHS service
  • Patients can access for advice and treatment of 26 conditions through CAS.
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2
Q

What does the Common Ailment Scheme (CAS) involve?

A
  1. Patient registration with the pharmacy
  2. Private consultation with the pharmacist
  3. Advice on management and treatment where needed OR referral if necessary
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3
Q

Who can access the Common Ailment Scheme (CAS)

A

Any patient who LIVES in Wales or who is registered to a Welsh GP is eligible to access the Choose Pharmacy Service.

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4
Q

Exclusions from the CAS?

A
  • Temporary residents whose usual address is not in Wales
  • Care Home residents
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5
Q

Any exclusions for specific conditions?

A
  • Age
  • Pregnancy/breastfeeding
  • If they have had the condition multiple times
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6
Q

What are the 26 conditions that can be treated under the CAS?

A
  1. Acne
  2. Athletes Foot
  3. Backache (acute)
  4. Chickenpox
  5. Cold sores*
  6. Colic*
  7. Conjunctivitis (bacterial)
  8. Constipation
  9. Dermatitis (acute)
  10. Diarrhoea*
  11. Dry eyes
  12. Haemorrhoids
  13. Hayfever
  14. Head Lice
  15. Indigestion/reflux
  16. Ingrowing toenail*
  17. Intertrigo/ringworm
  18. Mouth Ulcers
  19. Nappy rash
  20. Oral thrush
  21. Scabies
  22. Sore throat/tonsillitis
  23. Teething
  24. Threadworm
  25. Vaginal thrush
  26. Verruca
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7
Q

What is Choose Pharmacy?

A

confidential NHS electronic records system, which community pharmacists use to record details of NHS services they provide to you

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8
Q

Cold v Flu Symptoms

A

Both;
Cough
Runny/stuffy nose
Sore throat
Headache

Cold;
Congestion
Itchy/watery eyes
Feeling tired

Flu;
Fever
Body aches
Extreme fatigue

Cold more MILD than Flu

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9
Q

What is the most common complications of common cold?

A
  • adults/older children = symptoms last about a week, cough can persist for up to 3w
  • younger children, symptoms typically last 10–14 days
  • Smokers tend to have more severe respiratory symptoms (including cough), and the infection is more prolonged.
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10
Q

Common cold info:

A
  • Mild, self-limiting, viral (rhinovirus), upper respiratory tract infection
  • General symptoms: nasal stuffiness and discharge, sneezing, sore throat, and cough. No known treatment improves the time course of infection
  • Transmitted by either direct contact or aerosol transmission
  • People can remain infectious for several weeks
  • The most common complications aresinusitis, lower respiratory tract infections (LRTI), andacute otitis media
  • Onset of symptoms after infection is sudden, reaching a peak at day 2–3, then decreasing in intensity
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11
Q

common symptoms for or signs for adults/older children;

A
  • Sore or irritated throat
  • Nasal irritation, congestion, nasal discharge (rhinorrhoea), and sneezing
  • Nasal discharge is often profuse and clear at first but becomes thicker and darker as the infection progresses
  • Cough, which typically develops after nasal symptoms clear
  • Hoarse voice caused by associated laryngitis.
    General malaise
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12
Q

Seasonal Influenza
what is it caused by?

A

Acute respiratory illness caused by RNA viruses of the family Orthomyxoviridae (influenza viruses

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13
Q

What are the most common complications of influenza in adults?

A

(they are respiratory in nature)
Acute bronchitis.

Pneumonia.

Exacerbations of asthma and chronic obstructive pulmonary disease (COPD).

Otitis media.

Sinusitis.

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14
Q

When do symptoms start to show with the seasonal Influenza?

A

2 days after exposure

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15
Q

Define Uncomplicated influenza:

A

coryza (inflammation), nasal discharge,cough, fever,gastrointestinal (GI) symptoms, headache, malaise, myalgia, arthralgia,ocular symptoms, and sore throat

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16
Q

Define Complicated influenza:

A

require hospital admission, involve thelower respiratory tract,central nervous system (CNS), or cause significant exacerbation of an underlying medical condition

17
Q

Who are the ‘At risk’ groups for influenza?

A

Those with chronic respiratory, heart, kidney, liver, or neurological disease; diabetes mellitus (DM); or those who are obese orimmunosuppressed

Those > 65 years
Women who are pregnant (or women up to two weeks post partum)

Children aged < 6 months

18
Q

Chronic respiratory diseases;

A

cannot be healed from it

e.g. asthma

19
Q

Infections cause blood sugars to increase a lot;

A

if diabetic patient does not take insulin because they are not eating. Can be hospitalised bc sugar is not broken down by insulin

20
Q

Children aged < 6 months
Why are they at risk for influenza

A

they’re kidneys are not fully developed

not a lot of medicines for their age available

more at risk for kidney injury

21
Q

Management for seasonal influenza:

A

Drink adequate fluid

Take paracetamol or ibuprofen to relieve symptoms, rest

Stay off work or school until the worst symptoms have resolved (usually ~1 week)

22
Q

Urgent admission to hospital should be considered for influenza if:

A

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)

Purple rash

stiff neck

23
Q

Cough - irritation in airways

A

reflex response to airway irritation

It is triggered by stimulation of airway cough receptors, either by irritants or by conditions that cause airway distortion

Cough can be acute (lasting < 3 weeks), sub-acute (lasting 3–8 weeks), or chronic (lasting > 8 weeks)

Commonly caused by a viral upper respiratory tract infection (URTI).

24
Q

What are OTHER causes of cough?

A

Acute bronchitis

Pneumonia

Acute exacerbations of asthma

Environmental or occupational causes

Foreign body aspiration

25
Q

How long does cough last if patient has LUNG cancer?

A

more than 3 weeks

hard to diagnose

26
Q

Management of cough:

A

based on treating the underlying cause where it has been identified, or sequential trials of treatment to confirm or refute common causes

Offer self care; e.g. paracetamol or ibuprofen for pain and inflammation, if appropriate), and refer to smoking cessation if relevant

Referral to a respiratory physician should be arranged for people with a cough that does NOT respond to trials of treatment, if the diagnosis is uncertain/systemically unwell

Emergency referral

27
Q

What is emergency referral for cough appropriate?

A

fro people with clinical features of foreign body aspiration.

28
Q

What is Croup?

A

(laryngotracheobronchitis) is a common childhood disease

Usually caused by a virus (can’t be treated)

29
Q

What are the symptoms of Croup?

A

sudden onset of a seal-like barking cough usually accompanied by stridor (predominantly inspiratory)

hoarse voice

respiratory distress due to upper-airwayobstruction

Symptoms usually worse at night

preceding 12–48 hour history of a non-specific cough, rhinorrhoea, and fever

30
Q

What groups does Croup normally affect?

A

children between 6 months and 6years of age, with a peak incidence during the second year of life

31
Q

What are the mild, moderate and sever symptoms of CROUP?

A

Mild = seal-like barkingcough but no stridor or sternal/intercostal recession at rest

Moderate = includeseal-like barkingcough with stridor and sternal recession at rest; no agitation or lethargy

Severe = includeseal-like barkingcough with stridor and sternal/intercostal recession associated with agitation or lethargy

A child should be immediately admitted when presenting with moderate or severe croup, or impending respiratory failure

32
Q

How to manage croups?

A
  • all kids, mild/mod/sev symptoms = receive SINGLE dose of oral dexamethasone (0.15mg per kg body weight)
  • Mild croup can usually be managed at home
  • self-limiting, symptoms resolve within 48hrs
  • IF managed at home - paracetamol/ibuprofen can be used to control fever and pain
33
Q

croups symptoms; when do they appear?

A

12- 14 hrs after exposure

34
Q

If child is TOO unwell with CROUP to receive medication, inhaled budesonide (2mg mg nebulised as a single dose) or intramuscular (IM)
What is an alternative?

A

dexamethasome (0.6 mg/kg as a single dose) are possible alternatives

(lower dose)

35
Q

what is Whooping cough?

A

Also known as pertussis

It is a highly infectious disease caused by the bacteriumBordetella pertussis

It is spread by aerosol droplets released during coughing, and disproportionately affects infants and young children

36
Q

how long does the incubation period last for

A

usually about 7 days, and the person is infectious for 3weeks after the onset of symptoms

37
Q

usually about 7 days, and the person is infectious for 3weeks after the onset of symptoms

A

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

38
Q

Whopping Cough is a _______ disease

A

notifiable

39
Q

In the management of whooping cough:

A

People who are seriously unwell should be admitted to hospital (a low threshold is required for children aged 6 months or less)

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.

Advise = should be given on rest, adequate fluid intake, and the use of paracetamol or ibuprofen for symptomatic relief

Children and healthcare workers should be advised to stay off nursery, school, or work until 48 hours of appropriate antibiotic treatment has been completed, or 21 days after onset of symptoms if not treated

Close contacts may require antibiotic prophylaxis

PMP-103 (33 decks)

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