Learning scenario
Learning scenario
Matching product to need
Elliot comes into the pharmacy and asks to speak to the pharmacist, but the support team ask if there is anything they can help with first. Elliot explains that it is a busy time of year at work, balancing meetings, presentations and events over a short time period. For the last few days he has had a really sore throat that has made it too painful to eat. He takes no other medication, but in the past has used Difflam™ Throat Spray. He wants something that works just as well but is more discrete, so he can use it between meetings at work.
What would you recommend?
Refer him to the GP - incorrect.
Elliot is not showing any sign of concerns to refer to the GP. Sore throats are often self-limiting and should improve within one week. You can offer appropriate self-care advice and Difflam™ to provide pain relief
Recommend Difflam™ Throat Spray - incorrect.
There is a more suitable answer. Although Difflam™ Throat Spray is portable and will offer effective pain relief, Difflam™ Lozenges are a better option as they are equally as effective as the spray and he will be able to use them more discretely at work
Explain that it will improve on its own - incorrect.
Even though sore throats are often self-limiting and should improve within one week, you can still offer self-care advice to help relieve symptoms and pain relief using Difflam™ products
Recommend Difflam™ Lozenges - correct.
Difflam™ Lozenges are as effective as Difflam™ Throat Spray to provide relief, but are more convenient to use around Elliot's lifestyle at work
Counselling on sore throats and antibiotics
A woman comes into the pharmacy and explains that her partner, 3 children and herself have been suffering with a sore throat over the last 4 days. You check how old her children are, and they are between the ages of 4 and 12. She is worried they all have a throat infection, and wants to see her doctor to get some antibiotics. She is looking for pain relief in the meantime. Using your WWHAM questioning, you confirm that they are not taking any other medicines, and she is not pregnant.
What would you advise for this family?
Recommend Difflam™ Throat Spray - correct.
Explain that she doesn't need to see a GP as their sore throats should improve within a week. Difflam™ Throat Spray is suitable for the whole family and will provide quick relief
Refer to the GP - incorrect.
You can explain that sore throats typically improve within a week. You can also use this opportunity to educate about antibiotic resistance, and why they should not be used on this occasion. Offer self-care advice such as maintaining an adequate fluid intake, and recommend Difflam™ Throat Spray for pain relief
Recommend paracetamol for pain relief - incorrect.
Although this is suitable self-care advice, Difflam™ Throat Spray is a better option as it targets the site of pain directly and works with a triple action mechanism to provide relief. Difflam™ Throat Spray is also suitable for the whole family
Explain that the family needs antibiotics - incorrect.
Sore throats are not recommended to be treated with antibiotics first-line. This is a good opportunity to educate the customer about antibiotic resistance, and why they shouldn't be used on this occasion. Offer self-care advice and Difflam™ Throat Spray to provide quick pain relief for the family
Now you have completed this module, proceed to the next screen to test your knowledge and record your learning.
References
1. Bacteria in the human body, Antibiotic Research UK. Available at: https://www.antibioticresearch.org.uk/about-antibiotic-resistance/bacterial-infections/bacteria-in-the-human-body/
2. Health matters: antimicrobial resistance, Public Health England. Available at: https://www.gov.uk/government/publications/health-matters-antimicrobial-resistance/health-matters-antimicrobial-resistance
3. Tackling antimicrobial resistance 2019-2024, HM Government. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/784894/UK_AMR_5_year_national_action_plan.pdf
4. What can I do about antibiotic resistance, Antibiotic Research UK. Available at: https://www.antibioticresearch.org.uk/about-antibiotic-resistance/what-can-i-do/
5. Sore Throat - NHS Choices. Available at: https://www.nhs.uk/conditions/sore-throat/
6. Glandular Fever - NHS Choices. Available at: https://www.nhs.uk/conditions/glandular-fever/
7. Sore throat (acute): antimicrobial prescribing visual summary. Available at: https://www.nice.org.uk/guidance/ng84/resources/visual-summary-pdf-4723226606
8. Managing acute sore throat, NICE Guidelines. Available at: https://www.nice.org.uk/guidance/ng84/chapter/Recommendations#managing-acute-sore-throat
9. Simard Savoie 1978, Topical Anaesthetic Activity of Benzydamine
10. de Looze et al 2016, Efficacy of flurbiprofen 8.75 mg spray in patients with sore throat due to an upper respiratory tract infection: A randomised controlled trial
11. B Schachtel et al 2018, Onset of analgesia by a topically administered flurbiprofen lozenge: a randomised controlled trial using the double stopwatch method
12. S Mathivanan et al 2016, Effect of econazole and benzydamine on sensory neurons in culture
Online references last accessed December 2019
Difflam Spray™ (benzydamine hydrochloride) Prescribing Information
Presentation: Difflam™ Spray contains benzydamine hydrochloride 0.15% w/v. Each metered dose pump spray delivers approximately 175ml per puff. It also contains the following inactive ingredients: glycerol, saccharin, sodium bicarbonate, ethanol, methylhydroxybenzoate, mouthwash flavour, polysorbate 20, purified water. Indications: Difflam™ Spray is a locally acting analgesic and anti-inflammatory treatment for the throat and mouth. It is used to treat various painful oropharyngeal conditions such as mouth ulcers, sore throat, sore mouth or gums, dental pain. Dosage and administration: Adults and elderly: 4 to 8 puffs, 1½ to 3 hourly. Children aged 6-12: 4 puffs, 1½ to 3 hourly. Children under 6: One puff per 4kg body weight, up to a maximum 4 puffs, 1½ to 3 hourly. Contra-indications: Patients with known hypersensitivity to ingredients. Interactions: None known. Pregnancy and lactation: Difflam™ Spray should not be used in pregnancy or lactation unless considered essential by the physician. There is no evidence of a teratogenic effect in animal studies. Undesirable effects: Serious (frequency not known): Anaphylactic reaction which can be potentially life-threatening. Hypersensitivity reactions. (Uncommon): Oral tissue numbness or 'stinging' sensations in the mouth may occur which may disappear on continuing treatment. (Very rare): pruritus rash, urticaria, photosensitivity reaction, laryngospasm/bronchospasm. Prescribers should consult the Summary of Product Characteristics in relation to side-effects. Special precautions for storage: Do not store above 30ºC. Do not refrigerate or freeze. Keep out of reach of children. Basic price (UK): 30ml bottle £4.24 Marketing Authorization number: PL 46302/0160 Legal category: P Marketing Authorisation Holder: Mylan Products Ltd, Station Close, Potters Bar, Hertfordshire, EN6 1TL, United Kingdom. Date of Revision of Prescribing Information: October 2019. The SmPC for this product, including adverse reactions, precautions, contra-indications, and method of use can be found at: http://www.mhra.gov.uk/Safetyinformation/Medicinesinformation/SPCandPILs/index.htm and from Mylan Medical Information, Building 4, Trident Place, Hatfield Business Park, Mosquito Way, Hatfield, Hertfordshire, AL10 9UL, phone no. 01707 853000, Email: info@mylan.co.uk.
Difflam™ Sore Throat Rinse (benzydamine hydrochloride) Prescribing Information
Presentation: Difflam™ Sore Throat Rinse contains benzydamine hydrochloride 0.15% w/v. It also contains the following inactive ingredients: ethanol (96% v/v), glycerol, saccharin sodium, mouthwash flavour, polysorbate 20, methyl hydroxybenzoate, quinoline yellow (E104), patent blue V (E131), purified water. Presented as a gargle/oral rinse in a 200ml glass bottle. Indications: Locally acting analgesic and anti-inflammatory treatment for the relief of painful inflammatory conditions of the throat including pharyngitis. Dosage and administration: Rinse or gargle with 15ml (using measuring cup provided) every 1½-3 hours as required. Expel solution from the mouth after use. If stinging occurs the rinse may be diluted with water. Uninterrupted treatment should not exceed seven days, except under medical supervision. It is not suitable for children aged 12 years or under. Contra-indications: Patients with hypersensitivity to ingredients. Interactions: None known. Pregnancy and lactation: Difflam™ Sore Throat Rinse should not be used in pregnancy or lactation unless considered essential by the physician. There is no evidence of a teratogenic effect in animal studies. Undesirable effects: Serious (frequency not known): Anaphylactic reaction which can be potentially life-threatening. Hypersensitivity reactions. (Uncommon): Oral tissue numbness or 'stinging' sensations in the mouth may occur. (Very rare): pruritus rash, urticaria, photosensitivity reaction, laryngospasm/bronchospasm. Prescribers should consult the Summary of Product Characteristics in relation to side-effects. Special precautions for storage: Store between 5-30ºC. Do not freeze and do not leave uncartonned bottle in direct sunlight. Basic price (UK): 200ml bottle £4.64 Product licence number: PL 46302/0161 Legal category: P Marketing Authorisation Holder: Mylan Products Ltd, Station Close, Potters Bar, Hertfordshire, EN6 1TL, United Kingdom. Date of preparation of prescribing information: Sept 2018
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