Phar 1821 (2022) week 7 lecture note
Week 7 – Coughs & Colds
LO - Background
- Case study
- S3/S3 protocols
- Rhinitis/congestion
- Sore throat
- Coughs
- When to refer
- Other remedies
The principles - First do no harm
o Not giving out meds that are contraindicated, etc
- Met consumer needs
- Consider self interest
- Refer when necessary
Managing the - An opportunity to develop long-term loyalty
common cold
How common - Children 2-6 years: 5-10 colds a year
is the o Children hanging out in very close proximity/close contact
common ▪ Poor hygiene
cold? o Childcare in school
o Immature immune system
- Adults: 2-4 colds a year
- Symptoms: last 4-14 days
- Generally resolve spontaneously
- Cough may persist for 14 days or more
o Sometimes it might not be common cold; it might be the SE of
blood pressure meds
Signs & - Dry/sore throat (often the first sign)
symptoms - Runny nose (clear & watery to begin)
- Blocked nose (babies have trouble feeding)
- Sneezing (to clear nasal passages)
- Cough (may be dry/productive)
- Hoarseness (from swollen vocal cord)
- Headache (head, eyes, nose)
S2/S3 What Stop Go Protocol
Procedures
W – Who is the patient
H – How long they have the symptoms
A – Actual symptoms
- Congested nose/how do you feel/tell me about it/is there any
mucus/is there headache associated with it?
, - e.g., Could you describe your symptoms for me? (open-ended
questions)
T – Treatment for this? Or any other medical conditions?
- Are you on any other meds?
- Do you have any other medical conditions?
- What have you tried so far to treat this?
S – Symptoms?
- Do the symptoms they provided make sense along with the
medication they want?
- Check whether they match
T – Totally sure?
- Double-check does all of this make sense
- Do I feel comfortable handing it out
O – Overuse/Abuse
- e.g., if a patient asked for a nasal spray and has been used it
for more than 4-5 days in a row => they can get rebound
congestion (overuse issue)
P – Pharmacist only products
- S3 meds that are kept behind the counter where pharmacists
have to hand out
- Maybe S4 Prescription meds? (if I assume that the symptoms
might not be able to treated by S3 meds)
=> GO
, (symptom based request)
Neglected Pharmacists often neglect...
areas - Who the medicine is for?
- What other medicines are being used?
- Are there any pre-existing medical conditions?
- The supply of printed info?
o Back our explanation with any written info, etc
Differential - Could he have a viral cold?
Diagnosis - Could it be bacterial sinusitis?
- Could he have flu? (Influenza; ppl w/ flu are usually extremely
unwell; feeling v sick; they could hardly come to pharmacy)
- Could it be hay fever?
- Could it be medication induced?
o Some meds can cause congestion in the nose
o Some blood pressure meds open up the blood vessels
o => nose feel more congested
The myth ab - Yellow/green discharge from either your nose/mouth
coloured o Is due to the release of peroxidases by leukocytes (WBCs)
mucus - This can indicate either a viral/bacterial infection
Week 7 – Coughs & Colds
LO - Background
- Case study
- S3/S3 protocols
- Rhinitis/congestion
- Sore throat
- Coughs
- When to refer
- Other remedies
The principles - First do no harm
o Not giving out meds that are contraindicated, etc
- Met consumer needs
- Consider self interest
- Refer when necessary
Managing the - An opportunity to develop long-term loyalty
common cold
How common - Children 2-6 years: 5-10 colds a year
is the o Children hanging out in very close proximity/close contact
common ▪ Poor hygiene
cold? o Childcare in school
o Immature immune system
- Adults: 2-4 colds a year
- Symptoms: last 4-14 days
- Generally resolve spontaneously
- Cough may persist for 14 days or more
o Sometimes it might not be common cold; it might be the SE of
blood pressure meds
Signs & - Dry/sore throat (often the first sign)
symptoms - Runny nose (clear & watery to begin)
- Blocked nose (babies have trouble feeding)
- Sneezing (to clear nasal passages)
- Cough (may be dry/productive)
- Hoarseness (from swollen vocal cord)
- Headache (head, eyes, nose)
S2/S3 What Stop Go Protocol
Procedures
W – Who is the patient
H – How long they have the symptoms
A – Actual symptoms
- Congested nose/how do you feel/tell me about it/is there any
mucus/is there headache associated with it?
, - e.g., Could you describe your symptoms for me? (open-ended
questions)
T – Treatment for this? Or any other medical conditions?
- Are you on any other meds?
- Do you have any other medical conditions?
- What have you tried so far to treat this?
S – Symptoms?
- Do the symptoms they provided make sense along with the
medication they want?
- Check whether they match
T – Totally sure?
- Double-check does all of this make sense
- Do I feel comfortable handing it out
O – Overuse/Abuse
- e.g., if a patient asked for a nasal spray and has been used it
for more than 4-5 days in a row => they can get rebound
congestion (overuse issue)
P – Pharmacist only products
- S3 meds that are kept behind the counter where pharmacists
have to hand out
- Maybe S4 Prescription meds? (if I assume that the symptoms
might not be able to treated by S3 meds)
=> GO
, (symptom based request)
Neglected Pharmacists often neglect...
areas - Who the medicine is for?
- What other medicines are being used?
- Are there any pre-existing medical conditions?
- The supply of printed info?
o Back our explanation with any written info, etc
Differential - Could he have a viral cold?
Diagnosis - Could it be bacterial sinusitis?
- Could he have flu? (Influenza; ppl w/ flu are usually extremely
unwell; feeling v sick; they could hardly come to pharmacy)
- Could it be hay fever?
- Could it be medication induced?
o Some meds can cause congestion in the nose
o Some blood pressure meds open up the blood vessels
o => nose feel more congested
The myth ab - Yellow/green discharge from either your nose/mouth
coloured o Is due to the release of peroxidases by leukocytes (WBCs)
mucus - This can indicate either a viral/bacterial infection
