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Self Care > Cough, Cold, and Flu > Flashcards

Cough, Cold, and Flu Flashcards

1
Q

What are the clinical presentations of a cold?

A

sore throat (1-3 days after exposure), nasal symptoms (2-3 days later), in 30 % of patients they will experience a cough by day 4-5

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2
Q

Contrast: Cold vs Flu

A

symptom onset (cold = gradual, flu = abrupt), fever = flu, aches = flu, chills = flu, sneezing = cold, stuffy nose = cold, sore throat = cold, headache = flu, both flu and cold pt may experience cough, but more severe in flu

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3
Q

What groups are at increased susceptibility to colds?

A

children, large groups, smokers, lack of sleep, stress

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4
Q

Name the exclusions for self-care for cold/flu:

A

-fever (temp >100.4)
-chest pain
-shortness of breath
-worsening of symptoms or new symptoms during self-treatment
-underlying chronic cardiopulmonary diseases (asthma, COPD, CHF)
-AIDS or chronic immunosuppressant therapy
-infants < 3 months of age

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5
Q

Name the exclusions for self-care for cough:

A

-difficulty breathing
-SOB
-dyspnea
-cyanosis
-hemoptysis (coughing up blood)
-weight loss
-night sweats
-cough that worsens or doesn’t improve
-fever (>100.4)
-history of tuberculosis
-immunocompromised status
-HIV
-barking cough or “whooping” sounding cough
-chronic illnesses

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6
Q

Define: decongestants

A

specifically treat sinus and nasal congestion by stimulating alpha-adrenergic receptors by constricting blood vessels. results in decreased edema, increased nasal ventilation and drainage, relieves headaches, and decreased irritation of the nostrils and mucous membrane

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7
Q

What are the pros and cons of nasal decongestants?

A

pro= induce prompt vasoconstriction with less systemic absorption (less side effects), con= potential to develop rhinitis medicamentosa (rebound congestion)

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8
Q

what are the pros and cons of oral decongestants?

A

pro= reaches deep into the nasopharyngeal and sinus passages and no rebound congestion, con= associated with more cardiovascular and CNS stimulation

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9
Q

Name (generic/brand name) nasal decongestants:

A

-levmetamfetamine (Medicated Vapor Inhaler)
-naphazoline (Privine)
-oxymetazoline (Afrin, Vicks Sinex)
-phenylephrine (Neo-Synephrine)
-propylhexedrine (Benzedrex)
-xylometazoline (Otrivine)

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10
Q

Define: Rhinitis Medicamentosa

A

rebound congestion that can occur from using nasal decongestants for more than 3 days

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11
Q

Name the nasal decongestant delivery devices:

A

-atomizer nasal spray
-metered dose pump spray
-nasal inhaler
-nasal drops

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12
Q

Counseling Points: Atomizer Nasal Spray

A

-do not shake bottle
-keep head upright
-sniff deeply while squeezing the bottle

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13
Q

Counseling Points: Metered Dose Pump Spray

A

-spray medication into air before use
-tilt head forward while administering
-sniff deeply while depressing the pump once

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14
Q

Counseling Points: Nasal Drops

A

-lie back on surface with head tilted back
-after medication administration gently tilt head from side to side
-continue to lie on back for a couple of minutes

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15
Q

Counseling Points: Nasal Inhaler

A

-warm the inhaler in hand
-sniff deeply while inhaling
-wipe the inhaler after each use

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16
Q

Adverse Effects: Decongestants

A

-cardiovascular= elevated BP, tachycardia, palpitations, arrhythmias
-CNS stimulation= restlessness, insomnia, anxiety, tremors, fears, and hallucinations

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17
Q

Name (generic/brand name) oral decongestants:

A

-Sudafed PE (phenylephrine 10 mg)
-Sudafed (pseudoephedrine 30 mg)
-Sudafed 12 Hour (pseudoephedrine 120 mg)
-Sudafed 24 Hour (pseudoephedrine 240 mg)

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18
Q

Describe the Classifications of Cough

A

-acute= less than 3 weeks
-subacute= 3-8 weeks
-chronic= >8 weeks

19
Q

What drugs can induce cough?

A

hypertensive medications such as angiotensin converting enzyme inhibitors (ACE-I) (ex. lisinopril) and beta blocker (ex. metoprolol)

20
Q

Describe: Productive “Wet” Cough

A

evacuation of secretion from the lower respiratory tract, if clear= bronchitis, purulent= bacterial infection, discolored (yellow)= post-nasal discharge

21
Q

Describe: Nonproductive “Dry” Cough

A

caused by gastroesophageal reflux disease (GERD) or drug induced

22
Q

Name antitussives:

A

-dextromethorphan
-diphenhydramine
-camphor & menthol
-codeine

23
Q

Describe: dextromethorphan

A

-MOA: acts centrally in the medulla to increase cough threshold
-indication: ideal for nonproductive “dry” cough
-potential for abuse due to the PCP effects (mild CNS stimulation, alcohol-like intoxication, hallucinations)
-must be 18 years old or older to buy

24
Q

Drug Interactions: dextromethorphan

A

-warnings: SSRIs and SNRIs due to decreased metabolism of dextromethorphan
-contraindicated: MAOIs (and for 14 days after discontinuation) due to increased risk of serotonin syndrome

25
Q

What is suggested for best expectorant activity?

A

8-10 glasses of water/day

26
Q

Describe: guaifenesin

A

-MOA: loosen and thins lower respiratory tract secretions making it easier to expel mucus (limited data supporting efficacy)
-indication: ideal for productive “wet” cough

27
Q

Side Effects: first-generation antihistamines

A

-CNS depression
CNS stimulation
-anticholinergic effects ( dryness, blurred vision, urinary retention, constipation)

28
Q

Drug Interactions: first-generation antihistamines

A

-warnings: lower respiratory tract diseases or individuals that require mental alertness
-contraindications: glaucoma, asthma, BPH, bladder neck obstruction, use of MAOIs

29
Q

What are nonpharmacological options to treat cold/flu?

A

-lozenges/demulcents, humidifications, nasal irrigation, hydration

30
Q

Describe: Lozenges/Demulcents

A

primarily used to relieve sore throat using analgesics and sometimes benzocaine to provide short-term comfort

31
Q

When would caution be used when suggesting hydration to patients?

A

pt with heart failure or renal failure

32
Q

Diabetes and Cold/Flu medication?

A

avoid decongestants due to risk of increased blood sugar and avoid formulations containing sugar

33
Q

Hypertension and Cold/Flu medication?

A

recommend patients to monitor blood pressure and use product for shortest duration needed due to the risk of increased BP from CNS stimulation. suggest coricidin (decongestant free) that is specially formulated for patients with high BP

34
Q

Pregnancy and Cold/Flu medications?

A

-dextromethorphan= okay
-guaifenesin= contraindicated in first trimester use
-decongestants (pseudoephedrine/phenylephrine)= contraindicated in first trimester use
-antihistamines= okay

35
Q

Describe: Vitamin C (L-ascorbic acid)

A

-shortens durations of common cold
-dose: adults= 2,000 mg/day (pt with chronic liver/kidney conditions, gout, history of calcium oxalate kidney stone should not take take more than 1,000 mg/day)
-SE= diarrhea, nausea, heartburn, headache, insomnia

36
Q

Describe: Echinacea

A

-popular herbal supplement
-has evidence of anti-inflammatory, antiviral, and antimicrobial, but therapeutic efficacy is unclear
-showed to reduced the risk of developing cold by more than 50% and shorten duration of cold by 1.5 days
-may stimulate immune system and interaction with immune suppresents

37
Q

Describe: Elderberry

A

-has antibacterial, antiviral, and antioxidant benefits
-contain Flavonoids that enhance production of cytokines and stimulate immune system
-large quantities may be toxic
-may stimulate immune system and at risk of exacerbations of autoimmune disorders

38
Q

Describe: Zinc

A

-conflicting evidence, but studies have shown that it can reduce symptoms by one day
-SE: dry mouth, nausea
-contraindications: avoid zinc nasal products, excess zinc = copper deficiency, quinolone & tetracycline antibiotics, iron

39
Q

What are the factors that lead to OTC misuse in children and adolescents?

A

-combination products that contain the same ingredient
-lack of proper dosing
-unintentional overdose when giving wrong formulation
-using kitchen spoons to dose liquid medications

40
Q

What can you give children for colf/flu?

A

-ocean spray to loosen thick nasal mucus
-saline drops in infants <6 months and suctioning with rubber bulb
-vicks vapor rub (> 2 years, due to toxicity of camphor in infants) for local anesthetic effect at nerve endings in upper respiratory tract to relieve cough
-vicks baby made without camphor

41
Q

Counseling in Pediatrics: Decongestants or Antitussives

A

DO NOT use in children younger than 4 years old

42
Q

Counseling in Pediatrics: First-generation Antihistamines

A

DO NOT use in children younger than 6 years old

43
Q

Counseling in Pediatrics: Acetaminophen and Ibuprofen

A

weight-based dosing

Self Care (23 decks)

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