How to spot allergies. What are allergies? What can your patients do about allergies? How allergies cause sinusitis. Module 5 Allergies

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1 Module 5 Allergies

2 What are allergies? Allergies occur when a patient s immune system has a hypersensitive response to a substance that the body comes into contact with 1a. These substances, called allergens, can be found in food, drinks or the environment 1b. They include materials such as: How to spot allergies The body s natural reactions to dust and pollen allergies include 1e,1f : Sneezing Runny nose Blocked nose/congestion Swollen and watery eyes Itchy eyes and nose Coughing Pollen Pet dander Dust Mould Nuts Bee venom There are ways to draw the distinction between allergies and a suspected cold or virus. If the congestion lasts for more than two weeks; if the eyes, nose, and the top of mouth itch; if the mucus is thin and clear; or if there is an absence of fever and aches is another clue that it's probably allergies and not a cold or other virus 2a. What can your patients do about allergies? 1. Try a saline nasal rinse that helps clear allergens like pollen from your nasal membranes, minimizing symptoms 2b. 2. Gargle with salt water to soothe a sore or scratchy throat 2c. 3. Remove your shoes outside the door and throw your clothes in the laundry basket and change into something else to remove any lingering pollen from your body and hair before you get into bed 2d. 4. If you're allergic to indoor allergens like mold and dust, open the windows and let in the fresh air, which can help clear allergens from your home 2f. 5. Wear a mask for outdoor chores 2g. 6. Rest, go to bed early, take a sick day. Overdoing it and running around when you feel awful will only make you feel worse 2h. In fact, anything can become an allergen if the immune system has a negative reaction to it 1c. If a patient is allergic to a substance, his/her immune system reacts to it as if it s dangerous and tries to destroy it 1d. How allergies cause sinusitis Sinusitis usually develops because allergies cause the passages of your nose and sinuses to swell to flush out "allergens." The inside of your nose and sinuses often swell up as you breathe in those triggers. The inflammation blocks mucus from draining, which can cause an infection -- not to mention pain and pressure3. 8 9

3 Case Study 1 Cebisa, 51, Librarian Cebisa has come to your pharmacy to ask for advice. Case Study 1 Continued: Recommendation Since Cebisa s problem is congestion and sneezing related to allergies and she s not experiencing severe pain you can recommend the following Sinutab products: She tells you that she has been sneezing for 3 days. She says that her nose runs and is especially irritated in the morning or when the wind has been blowing a lot. She would like to know what OTC product she can take that will help with her symptoms. Sinutab Sinus Allergy Congestion and Pain Sinutab Nasal Spray Sinutab Saline Nasal Spray Sinutab Sinus Allergy Congestion and Pain Sinutab Nasal Spray NEW Starts to work in 2 minutes and lasts up to 10 hours Ask the following questions Has she experienced these symptoms before? Is she experiencing congestion along with her runny nose? Is she experiencing facial pain? Does she have a headache? Does she have a fever? Does she have a cough? Does she have discoloured nasal discharge? Has she taken any other medicine for the condition? Cebisa tells you that she s definitely congested, since she s struggling to breathe through her left nostril. She says that she s not experiencing facial pain, but she gets a dull headache after she has been sneezing for a few hours. She doesn t have a cough or a fever. She tells you that she s had similar symptoms the previous summer. You establish that Cebisa is suffering from seasonal allergies. Since she doesn t have a cough or fever and her face doesn t hurt you rule out a cold, flu or sinusitis. Allergies fit the bill, since the pollen count is high and her symptoms flare up when the wind is blowing. What s it for? Sinus pain and allergy relief What s inside? Pseudoephedrine Hydrochloride 30 mg per tablet Chlorpheniramine Maleate 2 mg per tablet Paracetamol 500 mg per tablet Dosage Adults & children over 12 years: Two tablets every six to eight hours. Do not exceed 8 tablets in 24 hours. Children under 12 years: Not recommended What s it for? Fast, effective, long-lasting relief from a blocked nose Starts to work in 2 minutes8 Lasts for up to 10 hours9 What s inside? Xylometazoline Hydrochloride 1 mg per ml (0,1 % w/v) Dosage One spray into each nostril 2 to 3 times per day, as required. Do not exceed 3 sprays per day. Do not use for more than 3 days. As stipulated in Section 22A subsection 4 and 5 of the Medicines and Related Substances Act 101 of 1965, product recommendations can only be made by Pharmacists and Pharmacist Assistants acting under the personal supervision of a pharmacist (S1 S2). Any customer seeking medical advice from a Front Shop Continued on next page

4 Sinutab Saline Nasal Spray What s it for? Daily nasal hygiene What s inside? Isotonic saline solution Dosage Under 2 years: Spray once into each nostril The following Sinutab product can also be used for congestion related to allergies, and has been discussed in the previous Study Pack: Sinutab Sinus Pain Extra Strength SINUTAB SINUS ALLERGY CONGESTION & PAIN Symptomatic relief of: Mild to moderate sinus and allergy pain Fever Nasal and sinus congestion Hay fever, flu and common cold 2+ years: Spray once or twice into each nostril several times per day Age: 12+ Pseudoephedrine: Decongestant helps clear congested nasal passages through vasoconstriction Starts to work in 30 mins4 Lasts up to 8 hours4 Chlorpheniramine: Antihistamine helps combat allergy features such as itchy, runny nose and eyes, and is mildly sedating Starts to work in 30 mins9 Lasts 3 6 hours5 Paracetamol: An analgesic and antipyretic active chiefly in the central nervous system, and is effective in a wide variety of mild to moderate pain conditions and in conditions associated with fever Starts to work in mins 6 Lasts 4 6 hours 6 SINUTAB Sinus Allergy Congestion and Pain. Each tablet contains: Pseudoephedrine Hydrochloride 30 mg, Chlorpheniramine Maleate 2 mg, Paracetamol 500 mg. Reg. No. 37/ 5.8/

5 SINUTAB SINUS PAIN EXTRA STRENGTH Symptomatic relief of: Severe sinus pain Fever Nasal and sinus congestion Hay fever, flu and common cold Starts to work in 2 minutes and lasts up to 10 hours SINUTAB NASAL SPRAY Symptomatic relief of: Nasal congestion caused by colds, hay fever, allergic rhinitis and sinusitis Age: 12+ Xylometazoline: Local vasoconstrictor to help open nasal passages and relieve congestion and a runny nose Age: 6+ Starts to work in 2 minutes 8 Lasts up to 10 hours 9 Pseudoephedrine: Decongestant helps clear congested nasal passages through vasoconstriction Starts to work in 30 mins4 Lasts up to 8 hours4 Chlorpheniramine: Antihistamine helps combat allergy features such as itchy, runny nose and eyes, and is mildly sedating Starts to work in 30 mins9 Lasts 3 6 hours5 SINUTAB Sinus Pain Extra Strength. Each tablet contains: Pseudoephedrine Hydrochloride 30 mg, Codeine Phosphate 10 mg, Chlorpheniramine Maleate 2 mg, Paracetamol 500 mg. Reg No. 37/5.8/0139. Codeine: An opioid-type analgesic that is metabolised to morphine in the body it exerts its actions in the central and peripheral nervous systems, and it helps to amplify the pain-relieving actions of other analgesics such as paracetamol and the NSAIDs Starts to work in 1 hour 7 Lasts 4 6 hours 7 Paracetamol: An analgesic and antipyretic active chiefly in the central nervous system, and is effective in a wide variety of mild to moderate pain conditions and in conditions associated with fever Starts to work in mins 6 Lasts 4 6 hours 6 SINUTAB Nasal Spray. Xylometazoline Hydrochloride 1 mg per ml (0,1 % w/v). Reg. No. P/16.1/184 SINUTAB SALINE SPRAY Cleans and moisturises nasal passages Supportive treatment for nasal congestion Can be used daily Age: All ages. Infants and children under the age of 2 years: One spray into each nostril. Isotonic saline solution: Physiological salt solution flushes, soothes and moisturises nasal passages 14 15

6 Test Your Knowledge You ve reached the end of the module. You can test your knowledge right away while the info is fresh, or you can complete the full Class Test in one go once you reach the end of this Study Pack. See the back page of the booklet for more details on how to complete and submit your test. Below are the questions from the Class Test that apply to the module you just 4 Which of these does not mitigate the symptoms of allergies? a Trying a saline nasal rinse b Gargling with salt water c Changing clothing to remove any lingering pollen 1 What is a substance called that one is allergic to? a Material b c d Allergen Immune negative substance Decongestant 2 Which one of the following products was not recommended in this module s case study as Cebisa does not have a head cold? a Sinutab Sinus Allergy Congestion and Pain b Sinutab Nasal Spray S2 SINUTAB Sinus Allergy Congestion and Pain. Each tablet contains: Pseudoephedrine Hydrochloride 30 mg, Chlorpheniramine Maleate 2 mg, Paracetamol 500 mg. Reg. No. 37/ 5.8/0260. S1 SINUTAB Nasal Spray. Xylometazoline Hydrochloride 1 mg per ml (0,1% w/v). Reg. No. P/16.1/184. S2 SINUTAB Sinus Pain Extra Strength. Each tablet contains: Pseudoephedrine Hydrochloride 30 mg, Codeine Phosphate 10 mg, Chlorpheniramine Maleate 2 mg, Paracetamol 500 mg. Reg No. 37/5.8/0139. c d Sinutab Saline Nasal Spray Sinutab 3-Way 3 What is the active ingredient in Sinutab Nasal Spray? a Xylometazoline Hydrochloride b c d Paracetamol Chlorpheniramine Maleate Pseudoephedrine Hydrochloride 16 17