Responding to symptoms

presented by

Sahar Hyder Ibnouf

B. Pharm., MSc clinical pharmacy
saharhaider90@gmail.com
Department of Pharmacy Practice
2020
Sore throat
Most people with a sore throat do not consult the doctor – only about
5% do so and many will consult their pharmacist. Most sore throats
that present in the pharmacy will be caused by viral infection (90%),
with only one in ten being due to bacterial infection, so that treatment
with antibiotics is unnecessary in most cases. Clinically it is almost
impossible to differentiate between the two
. The majority of infections
are self-limiting. Sore throats are often associated with other symptoms
of a cold.

Once the pharmacist has excluded more serious conditions, an

appropriate OTC medicine can be recommended.
What you need to know

Age (approximate)
Baby, child, adult
Duration
Severity
Associated symptoms
Cold, congested nose, cough
Difficulty in swallowing
Hoarseness
Fever
Previous history
Smoking habit
Present medication
Symptoms for direct referral
Hoarseness.
Dysphagia.
Appearance of throat.
Thrush.
Glandular fever.
Treatment timescale:
Patients should see their doctor in 1 week if the sore throat has not
improved.
Management
Oral analgesics
Mouthwashes and sprays
Local anaesthetic
Lozenges and pastilles
Caution. Iodised throat lozenges should be avoided in pregnancy
because they have the potential to affect the thyroid gland of the fetus.
Sore throats in practice
Case 1
A woman asks your advice about her son’s very sore throat. He is 15
years old and is at home in bed. She says he has a temperature and that
she can see creamy white matter at the back of his throat. He seems
lethargic and hasn’t been eating very well because his throat has been
so painful. The sore throat started about 5 days ago and he has been in
bed since yesterday. The glands on his neck are swollen.
Case 2

A teenage girl comes into your shop with her mother. The girl has a
sore throat which started yesterday. There is slight reddening of the
throat. Her mother tells you she had a slight temperature during the
night. She also has a blocked nose and has been feeling general aching.
She has no difficulty in swallowing and is not taking any medicines,
either prescribed or OTC.
Case 3

A middle-aged woman comes to ask your advice about her husband’s

bad throat. He has had a hoarse gruff voice for about 1 month and has
tried various lozenges and pastilles without success. He has been a
heavy smoker (at least a pack a day) for over 20 years and works as
a bus driver.