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Case- Sore Throat

A mother and her 6-year-old son present a post-dated prescription for penicillin V syrup 250 mg q.d.s. × 10 days and ask to speak to the pharmacist. The child is irritable, complains of pain when swallowing and appears flushed. The mother is anxious to start antibiotic treatment straight away so that her son can get back to school and she can get back to work, but the prescription is not valid for 3 more days.


1.What are the causes of sore throat and how are they differentiated?
2a Who is at risk of sore throat and how common is it?
2b How serious is acute throat infection?
2c Are antibiotics effective for the treatment of sore throat and for how long should you treat?
2d When are antibiotics indicated for the treatment of sore throat?
3a What group of drugs does penicillin V belong to and how do they work?
3b What are the side-effects of penicillin V?
3c What are the alternatives to penicillin V for treatment of sore throat?
4a What is the oral bioavailability of penicillin V and what is the impact of administration with food?
4b What are the storage conditions and shelf-life of penicillin V oral solution?
5a What are the disadvantages of prescribing antibiotics for sore throat?
5b How should this patient’s mother be counselled regarding the post-dated prescription and symptom relief?
Causes of sore throats range from infections to injuries. Here are eight of the most common sore throat causes.
1. Colds, the flu, and other viral infections

Viruses cause about 90 percent of sore throats (2). Among the viruses that cause sore throats are:
the common cold
influenza — the flu
mononucleosis, an infectious disease that’s transmitted through saliva
measles, an illness that causes a rash and fever
chickenpox, an infection that causes a fever and an itchy, bumpy rash
mumps, an infection that causes swelling of the salivary glands in the neck

2. Strep throat and other bacterial infections
Bacterial infections can also cause sore throats. The most common one is strep throat, an infection of the throat and tonsils caused by group A Streptococcus bacteria.
Tonsillitis, and sexually transmitted infections like gonorrhea and chlamydia can also cause a sore throat.

3. Allergies
When the immune system reacts to allergy triggers like pollen, grass, and pet dander, it releases chemicals that cause symptoms like nasal congestion, watery eyes, sneezing, and throat irritation.
Excess mucus in the nose can drip down the back of the throat. This is called postnasal drip and can irritate the throat.

4. Dry air
Dry air can suck moisture from the mouth and throat, and leave them feeling dry and scratchy.

5. Smoke, chemicals, and other irritants
Many different chemicals and other substances in the environment irritate the throat, including:
cigarette and other tobacco smoke
air pollution

6. Injury
Any injury, such as a hit or cut to the neck, can cause pain in the throat. Getting a piece of food stuck in your throat can also irritate it.
Repeated use strains the vocal cords and muscles in the throat. You can get a sore throat after yelling, talking loudly, or singing for a long period of time.

7. Gastroesophageal reflux disease (GERD)
Gastroesophageal reflux disease (GERD) is a condition in which acid from the stomach backs up into the esophagus
The acid burns the esophagus and throat, causing symptoms like heartburn and acid reflux — the regurgitation of acid into your throat.

8. Tumor
A tumor of the throat, voice box, or tongue is a less common cause of a sore throat. When a sore throat is a sign of cancer, it doesn’t go away after a few days.

-Sore throats are divided into types, based on the part of the throat they affect:

Pharyngitis affects the area right behind the mouth.
Tonsillitis is swelling and redness of the tonsils, the soft tissue in the back of the mouth.
Laryngitis is swelling and redness of the voice box, or larynx.
Some factors increase the risk of developing sore throat:

- Age: children are very susceptible to viral infections ENT, especially if it is in contact with many other children (school, nursery)
- People come into contact with too much air, improperly adjusted or poorly maintained (which become “nests microbes”)

- Some business times alternating heat and cold

- People with reduced immune defense capacity

- Allergic land: in these cases, the sore throat is often seasonal

- Tobacco

- Alcoholism

- Radiotherapy
2c.Antibiotics will not help if a sore throat is caused by a virus or irritation from the air. Antibiotic treatment in these cases may cause harm in both children and adults.
Most sore throats will go away on their own without antibiotics. In some cases (like for strep throat), a lab test will need to be done to see if you need antibiotics.
Antibiotics are needed if a healthcare professional diagnoses you or your child with strep throat, which is caused by bacteria.
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