Tutorial 3: Case 1

Question 1

Gerard, 45 years old, walks into the pharmacy with a dry cough you can hear as he approaches the counter.

A) Who is it for? (or say since it’s for yourself, what are your symptoms)

B) What are the symptoms?

C) How long have you had these symptoms?

D) Action taken

E) Medications being taken?

F) Medical conditions

G) Allergies

Answer 1

A) It is for myself

B) Dry cough that is annoying in the first day and sometimes waking him at night

C) A few days, seem to have followed the cold he experienced last week

D) Butter menthol lollies seem to soothe the throat at times and reduce cough though not enough

E) Butter menthols and sertraline 50mg daily

F) Depression, which is my GP prescribed me the sertraline tablets

G) None known

Question 2

Appropriate extended questions

1. Are they are any other symptoms
2. Have you had this before?
3. Have you had any mucus associated with your cough
4. Are you ever experiencing chest pain
5. Have you ever had asthma or another lung condition, smoker?
6. Do you prefer a drowsy or non-drowsy product?
7. Has anything changed recently? Any activities

Answer 2

1. No, my cold symptoms have resolved in the last couple of days, just this annoying cough
2. I often get this annoying dry cough after cold
3. Not at all, just dry irritating cough
4. Never
5. No
6. I prefer a non-drowsy option though I work from home and don’t have to drive so a little bit drowsy is ok I guess
7. No

Question 3

What is the diagnosis? Explain reasoning to patient

Answer 3

Based on the signs and symptoms you have told me, I believe you have a post-viral cough. It is completely normal after a cold. It can last 1-2 weeks

Question 4

What product would you recommend for this patient? Provide IDARL.

Answer 4

Pholcodine

• Indication: Safe to use with your depression medication, slight drowsy effect and will help your symptoms –> stop the dry cough.
• Dosage and directions: 5mL every 6-8 hours by measure
• Adverse effects: Drowsiness, diarrhea (due to sorbitol), constipation
• Duration of treatment, time to recovery, when to refer: can last 1-2 weeks so continue treatment for this period. If there is chest pain, fever, shortness of breath or last longer than 2 weeks –> refer.
• Lifestyle/self-care: Rest voice, consume plenty of fluids, avoid any irritants, use a humidifier

I will give you a self care-card for cough and a consumer medication information leaflet. Do you have any questions for me?