> Dorothy (34 years old) comes into your community pharmacy complaining of a **tickly throat, and an itchy runny nose.** She has had the symptoms for about a day and gets these symptoms particularly when she goes outside when it is **hot and windy.** She has tried some **homeopathic lozenges and a saline nasal spray** but has found that this helps only a little bit. She has no other symptoms, and is taking **irbesartan (Avapro®) 75mg** a day (an angiotensin II receptor antagonist) for her **hypertension**, which is well controlled. What would you do? Recommend: > 1. Paracetamol 500mg six times a day 2. **Budesonide nasal spray** 3. Benzydamine (Difflam®) sore throat spray 4. She sees her doctor immediately
Question
Dorothy (34 years old) comes into your community pharmacy complaining of a tickly throat, and an itchy runny nose. She has had the symptoms for about a day and gets these symptoms particularly when she goes outside when it is hot and windy. She has tried some homeopathic lozenges and a saline nasal spray but has found that this helps only a little bit. She has no other symptoms, and is taking irbesartan (Avapro®) 75mg a day (an angiotensin II receptor antagonist) for her hypertension, which is well controlled. What would you do? Recommend:
- Paracetamol 500mg six times a day
- Budesonide nasal spray
- Benzydamine (Difflam®) sore throat spray
- She sees her doctor immediately
Solution
Based on the symptoms described, Dorothy seems to be experiencing seasonal allergies, also known as hay fever. These symptoms are often triggered by outdoor allergens such as pollen, especially in hot and windy conditions.
The homeopathic lozenges and saline nasal spray she has tried can provide some relief, but they may not be enough to fully manage her symptoms.
Given her current medication, irbesartan (Avapro®) 75mg for hypertension, it's important to choose an allergy medication that won't interfere with it.
Option 2, Budesonide nasal spray, would be a suitable recommendation. Budesonide is a corticosteroid that can help to reduce inflammation in the nose, relieving symptoms like an itchy, runny nose. It's generally safe to use with hypertension medications.
Paracetamol (Option 1) is typically used for pain relief and wouldn't directly address her allergy symptoms. Benzydamine (Difflam®) sore throat spray (Option 3) could help with her tickly throat, but it wouldn't help with her nasal symptoms.
There's no immediate need for her to see her doctor (Option 4) unless her symptoms worsen or the recommended over-the-counter treatment doesn't help. However, if she continues to experience these symptoms regularly, it would be beneficial for her to see a doctor for a long-term management plan.
So, the recommended option would be 2. Budesonide nasal spray.
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