congestion drugs

Question 1

Saline spray

Answer 1

Best for <6
Can cause vasoconstriction and helps with rhinorrhea

Question 2

Pseudoephedrine

Answer 2

> 12yo 60mg Q4-6H or 120SR Q12H 240mg max
<12yo 30mg Q4-6H 120max

Question 3

Phenylephrine

Answer 3

> 12 10mg Q4H max 60mg
or 0.25/0.5% 2-3 each Q4H
<12 5mg Q4H max 30mg

Question 4

Ipratropium bromide

Answer 4

> 12 x2 spray each Q4-6H limit to 4 days
only works for rhinorrhea
A/E: dryness, nose bleeds

Question 5

ozymetazoline

Answer 5

> 12yo 0.05% 2-3 sprays in each nostril Q12H

Question 6

Xylometazoline

Answer 6

> 12yo 0.05%/0.01% 2-3 sprays in each nostril Q8-10H

Question 7

Dextromethorphan

Answer 7

> 12yo 10-20mg Q4H or 30mg Q6-8H max 120mg
<12yo 5-10mg Q4H or 15mg q6-8h max 60
Watch for serotonin syndrome with MOAI

Question 8

Codeine

Answer 8

> 18 10-20mg Q4-6H

Question 9

Guaifenesin

Answer 9

> 12 200-400mg Q4H max 2400mg
<12 12mg/kg/day divided q4h max 1200

Question 10

Honey

Answer 10

Demulcent but can make cough worse
>12 15ml TID
<2.5-10ml QHS

Question 11

Zinc

Answer 11

75mg/day after Sx onset may reduce length
can decrease absorption of antibiotics and worsen oral and peptic ulcers

Question 12

elderberry

Answer 12

Could be anti inflamm and immune system activator
Has been shown to decrease cold

Question 13

menthol, camphor, eucalyptus

Answer 13

not shown to be useful, do not give to infants

Question 14

echinacea

Answer 14

no evidence for immune system activator, watch allergy, nausea, dizziness
do not take if immunosuppressed or have atopic dermatitis

Question 15

garlic

Answer 15

no evidence for cold or antiviral
but does have anti platelet and anti HTN effects

Question 16

Ginseng

Answer 16

no evidence for cold immune system activator
Decrease warfarin effect and increase effectiveness of glucose lowering medications

Question 17

Vit C

Answer 17

no evidence but well tolerated in acceptable doses

Question 18

English ivy leaf

Answer 18

no evidence for expectorant but well tolerated