Cold and Flu

Question 1

Cold symptoms

Answer 1

• blocked/runny nose
• sneezing
• cough
• sore throat
• fever, aches, pains
• headache
• sinus pain
• earache
• watery eyes

Question 2

Flu symptoms

Answer 2

• same as cold just more sudden and severe

In Addition:
- Malaise (illness/discomfort feeling)

Question 3

Referral for cold and flu

Answer 3

• > = 2 weeks no improvement
• middle ear pain not improving with analgesics
• persistant cough (3 weeks or more)
• high grade temperature

Question 4

Vulnerable patients referral

Answer 4

• COPD
• Asthma
• Kidney disease
• diabetes
• immuno- compromised
• under 3 months
• very old

Question 5

OTC treatment for fever, aches and pains

Answer 5

Oral analgesics

• paracetamol 500mg x 2 QDS
• ibuprofen 200-400mg TDS
• Aspirin 300mg 3 x QDS

Question 6

Adult Max dose Aspirin

Answer 6

300mg 3 x QDS

Question 7

Adult Max dose Ibuprofen

Answer 7

200-400mg TDS

Question 8

Adult Max dose Paracetamol

Answer 8

500mg x 2 QDS

Question 9

OTC treatment for nasal congestion

Answer 9

Decongestants

Oral
- Pseudoephedrine
- Phenylephrine (sudafed)

Nasal
- Xylometazoline (Otrivine)
- Oxymetazoline

Question 10

Legal restrictions for Pseudoephedrine

Answer 10

can only sell 12 60mg tablets OTC

Question 11

Warning for Oxymetazoline and Xylometazoline (Otrivine)

Answer 11

do not use for more than 7 days, can cause rebound nasal congestion

Question 12

Avoid Nasal decongestants in these conditions

Answer 12

• hypertension
• hyperthyroidism
• diabetes
• CVD
• glaucoma
• prostatic enlargment

Question 13

Avoid nasal decongestants when taking these medications

Answer 13

• MAOIs
• TCA
• Beta blockers

Question 14

What does a nasal decongestant and MAOIs interaction cause

Answer 14

hypertensive crisis if taken less than 2 weeks after stopping

Question 15

What does a nasal decongestant and TCAs interaction cause

Answer 15

hypertensive crisis

Question 16

What does a nasal decongestant and Beta Blockers interaction cause

Answer 16

antagonised effect

Question 17

OTC treatments: Antihistamines

Answer 17

Diphenhydramine

dries up nasal secretions via anticholinergic action

Question 18

Legal considerations for children under 6 using cough and cold remedies

Answer 18

• some ingredients in cough remedies should not be given to children under 6
• ages 6 to 12, remedies should be given second line only

Question 19

Best practice for nasal decongestion in under 6 years

Answer 19

• Steam inhalation (olbas oil 3 months +)
• Saline sprays/drops for under 3 months

Question 20

Advice for cold and flu

Answer 20

• vitamin c and echinaea
  (helps to prevent cold symptoms)
• wash hands regularly, sneeze into tissue
• annual flu jab if at risk group