Symptoms In The Pharmacy - Respiratory Conditions

• What is the common cold + how its spread?

  • Mild, self-limiting, viral (rhinovirus), upper respiratory tract infection
  • General symptoms: nasal stuffiness and discharge, sneezing, sorethroat, and cough. No known treatment improves the time course ofinfection.
  • Transmitted by either direct contact or aerosol transmission.
  • People can remain infectious for several weeks.
  • The most common complications are sinusitis, lower respiratory tractinfections (LRTI), and acute otitis media.
  • Onset of symptoms after infection is sudden, reaching a peak atday 2–3, then decreasing in intensity
• What is the duration of the common cold across different age groups? + smokers?

  • In adults and older children, symptoms tend to lastabout a week, although cough can persist for up to 3weeks.
  • In younger children, symptoms typically last 10–14days.
  • Smokers tend to have more severe respiratorysymptoms (including cough), and the infection is moreprolonged.
• What are the symptoms of the common cold?

  • Sore or irritated throat.
  • Nasal irritation, congestion, nasal discharge (rhinorrhoea),and sneezing.
  • Nasal discharge is often profuse and clear at first butbecomes thicker and darker as the infection progresses.
  • Cough, which typically develops after nasal symptoms clear.
  • Hoarse voice caused by associated laryngitis.
  • General malaise
• What is seasonal influenza + what other respiratory complications?

  • Acute respiratory illness caused by RNA viruses of thefamily Orthomyxoviridae (influenza viruses).
  • Most complications of influenza in adults arerespiratory in nature and include:
  • Acute bronchitis.
  • Pneumonia.
  • Exacerbations of asthma and chronic obstructivepulmonary disease (COPD).
  • Otitis media.
  • Sinusitis
• What are the two different types of influenza?

  • uncomplicated influenza
  • complicated influenza
• What does uncomplicated influenza entail?

  • Uncomplicated influenza: coryza (inflammation), nasaldischarge, cough, fever, gastrointestinal (GI) symptoms,headache, malaise, myalgia, arthralgia, ocularsymptoms, and sore throat.
• What does complicated influenza entail?

  Complicated influenza: require hospital admission,involve the lower respiratory tract, central nervoussystem (CNS), or cause significant exacerbation of anunderlying medical condition
• Who is at risk of seasonal influenza?

  • Those with chronic respiratory, heart, kidney, liver, or neurologicaldisease; diabetes mellitus (DM); or those who are obeseor immunosuppressed.
  • Those > 65 years.
  • Women who are pregnant (or women up to two weeks post partum).
  • Children aged < 6 months
• What is suggested for the management of seasonal influenza?

  • 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)
• When should urgent admission to hospital for seasonal influenza be considered?

  • A complication such as pneumonia occurs.
  • The person has a concomitant disease that may beaffected by influenza (for example, type 1 diabetes).
  • There is suspicion of a serious illness other thaninfluenza (for example, meningitis).
• What is a cough + causes?

  • It is a reflex response to airway irritation.
  • It is triggered by stimulation of airway cough receptors, either by irritantsor by conditions that cause airway distortion.
  • Commonly caused by a viral upper respiratory tract infection (URTI).
  • Other causes include:
  • Acute bronchitis.
  • Pneumonia.
  • Acute exacerbations of asthma
  • Environmental or occupational causes.
  • Foreign body aspiration.
• What are the types of cough + lengths?

  Cough can be acute (lasting < 3 weeks), sub-acute (lasting 3–8 weeks),or chronic (lasting > 8 weeks)
• What to do for a patient with a cough?

  Offer self care (e.g. paracetamol or ibuprofen for pain and inflammation,if appropriate), and refer to smoking cessation if relevant
• When to refer a patient with a cough?

  • Referral to a respiratory physician should be arranged for people with acough that does NOT respond to trials of treatment, if the diagnosis isuncertain, or if systemically unwell.
  • Emergency referral should be arranged for people with:
  • Clinical features of foreign body aspiration
• What is croup?

  • Croup (laryngotracheobronchitis) is a common childhooddisease
  • Usually caused by a virus
• What are the symptoms of croup?

  • Symptoms: sudden onset of a seal-like barking cough usuallyaccompanied by stridor (predominantly inspiratory), hoarsevoice, and respiratory distress due to upper-airway obstruction.Symptoms are usually worse at night. There may be a fever.
  • There is often a preceding 12–48 hour history of a non-specificcough, rhinorrhoea, and fever.
• Who does croup mostly affect?

  • Croup most commonly affects children between 6 months and6 years of age, with a peak incidence during the second year oflife.
• What are some examples of mild croup symptoms?

  • Mild croup symptoms include seal-like barking coughbut no stridor or sternal/intercostal recession at rest.
• What are some examples of moderate croup symptoms?

  • Moderate croup symptoms include seal-likebarking cough with stridor and sternal recession at rest;no agitation or lethargy.
• What are some examples of severe croup symptoms?

  • Severe croup symptoms include seal-likebarking cough with stridor and sternal/intercostalrecession associated with agitation or lethargy.
  • A child should be immediately admitted when presentingwith moderate or severe croup, or impending respiratoryfailure.
• How to manage croup?

  • Management: All children with mild, moderate, or severe croupshould receive a single dose of oral dexamethasone (0.15 mgper kg body weight).
  • If the child is too unwell to receive medication, inhaledbudesonide (2 mg nebulised as a single dose) or intramuscular(IM) dexamethasome (0.6 mg/kg as a single dose) are possiblealternatives.
  • Mild croup can usually be managed at home.
  • Croup is usually self-limiting and symptoms usually resolvewithin 48 hours.
  • If the child is being managed at home, the use of paracetamol oribuprofen to control fever and pain should be advised, andparents should be advised to seek urgent medical advice if thereis any deterioration
• What is whooping cough?

  • Also known as pertussis
  • It is a highly infectious disease caused by the bacterium Bordetella pertussis.
  • It is spread by aerosol droplets released during coughing, anddisproportionately affects infants and young children.
  • The incubation period is usually about 7 days, and the person is infectious for3 weeks after the onset of symptoms.
• What are the three phases of the 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, andpost-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 gradualimprovement in the frequency and severity of symptoms.
• What is the management of whooping cough?

  • People who are seriously unwell should be admitted to hospital (a lowthreshold 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 whoopingcough with onset of cough within the previous 21 days.
  • Advice should be given on rest, adequate fluid intake, and the use ofparacetamol 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 beencompleted, or 21 days after onset of symptoms if not treated.
  • Close contacts may require antibiotic prophylaxis.
• What are the 9 types of cough in kids?

  *barking cough *cough with phlegm *dry night time cough*miserable cough* whooping cough* gross sounding cough*rattling cough*reflux cough*allergic cough