The Nose ( Acute Sinusitis ) Flashcards
What is acute sinusitis ?
Sinusitis is inflammation of the paranasal sinuses.
Acute sinusitis is triggered by viral upper respiratory tract infection which spreads into the sinuses from the nasal cavity.
The lining of the sinuses becomes inflamed blocking the mucus which would normally flow through narrow channels to drain into the nose. This creates pressure and pain within the sinus.
What are the symptoms of acute sinusitis ?
Pain and tenderness in the area of affected sinuses such as cheeks eyes and forehead
Throbbing pain which gets worse when bending forwards
Green/yellow discharge from nose
Headache
Blocked Nose , loss of smell
Fever
Symptoms often start to improve 7-10 days and resolve in 2-3 weeks but may take as long as 12 weeks.
Management
Paracetamol or ibuprofen where appropriate to manage pain and fever
To help with congestion if the patient expresses interest :
Saline nasal drops - OTC
Xylometazoline ( a decongestant nasal spray for a max of 7 days ) - OTC
Pseudoephedrine ( a decongestant tablet and can be used for other conditions) - P Med - It is unlawful to supply a product or combination of products which contain more than 720mg of pseudoephedrine OR 180mg of ephedrine in a single transaction, without a prescription
Could advise pt to to steam inhalation.
Management for patients with symptoms of around 10 days or more
Consider prescribing a high dose nasal corticosteroid spray for 14 days
Consider a back up antibiotic rx if symptoms worsen rapidly or do not improve in 7 days
Consider possibility of dental infection
Safety Netting
Pt should seek medical advice if :
Symptoms worsen rapidly or significantly
Symptoms do not improve within 3-5 days of initial treatment
Cannot tolerate the antibiotic
The pt becomes systemically unwell
RED FLAGS
Are experiencing chronic or recurring sinusitis
Have medical conditions such as nasal polyps which could complicate treatment
Experience repeated treatment failure
