Sore Throat in Community Pharmacy
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Background:
A 47-year-old man presents to his Community Pharmacy with a history of sore throat for the last 2 days. He takes ramipril 5mg daily for hypertension and has no other medical or medication history. He has no known allergies. He has not been to his doctor yet and has been drinking hot lemon and honey to relieve his symptoms.
Observations & Examination Findings:
- Patient appears well otherwise
- Temperature: 37.6°C
Symptoms:
- Sore throat for the last 2 days
- No cough, sneezing, runny or stuffy nose or nasal drip
- Reports sensation of painful swelling in throat.
- There are no pus or no pus-filled white spots on the tonsils.
Your role context:
In your community pharmacy you offer the point-of-care sore throat test to identify the presence of Streptococcus A bacteria.
You are authorised to prescribe medications in line with Pharmacy First programme.
Learning prompts for the student:
1. Assessment:
- Based on the patient’s symptoms and history, what is your initial working diagnosis and what leads you to this diagnosis? What differential diagnoses do you consider?
- What red flag symptoms or signs would prompt you to refer him to the GP?
2. Investigations:
- What further investigations could be conducted (by the GP) to ascertain further information about the patient’s presentation?
3. Management plan:
- Outline your management plan for this patient.
- What would you recommend for this patient to provide relief?
4. Counselling:
- What information should be provided to the patient regarding his management plan?
- What safety-netting advice do you provide to the patient in the event that the infection does not resolve, or he deteriorates?
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