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    Clinical Challenge: Treating Nasal Congestion with Concomitant Hypertension

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    Clinical Challenge

    CW is a 51-year-old white male who presents to the community pharmacy requesting an over-the-counter medication recommendation to treat his stuffy nose symptoms associated with a cold.

    Before making an OTC medication recommendation, it is important to determine if the patient is a self-care candidate and does not have any exclusions to self-treatment. One effective method for gathering and assessing patient information is the QuEST/SCHOLAR-MAC problem-solving approach.1 QuEST is a mnemonic for assessing and counseling the patient. SCHOLAR-MAC is a mnemonic to assist with symptom assessment.

    Previous Clinical Challenge: Preventing drug-drug interactions with HIV ART

    Table 1

    During the patient interview, CW provides the following SCHOLAR-MAC information: He has a stuffy nose and sinus pressure that makes it hard to breathe through his nose. Attempts to clear his sinuses produce no mucus and he does not have a runny nose, postnasal drip, or fever. The problem started two days earlier in both nostrils and he has not tried any medications yet. Nothing seems to make it worse and the stuffiness lasts all day. Hot, steamy showers help, but only for 10 to 15 minutes.

    CW has hypertension, with an in-pharmacy pressure reading of 138/82 mmHg, and high cholesterol levels.

    Once the patient interview is complete, the self-care candidacy status of the patient is determined. (See Table 1 for a list of exclusions.)

    Up next: Which OTC medication would you recommend to treat CW’s nasal congestion?

    Miranda Wilhelm, PharmD
    Clinical Associate Professor, Southern Illinois University Edwardsville (SIUE) School of Pharmacy
    Cortney Mospan, PharmD, BCACP, BCGP
    Assistant Professor of Pharmacy, Wingate University School of Pharmacy, Wingate, NC


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