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OTC Test 2 > Cough and Cold Part 1 Lecture > Flashcards

Cough and Cold Part 1 Lecture Flashcards

1
Q

When is cold season?

A

Late august to early april

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2
Q

Children have colds how often?

A

6-10 per year

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3
Q

Adults have colds how often?

A

2-4 colds

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4
Q

Colds are caused by viruses like?

A 
Coranavirus
Influenza
Parainfluenza
Adenovirus
Echovirus
Enterovirus
Multiple viruses
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5
Q

Main cause of the cold?

A

Rhinovirus

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6
Q

Pathophysiology of the cold?

A

Rhinovirus enters via epithelial cells in the nose and nasopharynx in order to replicate (33-35 degrees celsius)
Peak concentration occurs in 2-4 days after initial infection –> linger for 2.5 weeks
Inflammatory responses in the nasopharynx

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7
Q

What are risk factors?

A 
Smoking
Allergic Disorders
Sedentary lifestyle
Long-term stress
Day care/staying in small social circles
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8
Q

What are modes of transmission for a cold?

A 
Self-inoculation (touching a viral object)
Aerosol transmission (viral particles in mucous linger)
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9
Q

What is normal symptom progression?

A

Sore throat –> nasal congestion, rhinorrhea, sneezing (day 2-3) –> cough (day 4-5) –> symptom resolution (day 7)

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10
Q

What are symptom progressions?

A

Nasal drainage often will start out clear
- As it progresses, mucus becomes thicker and change to a yellow or green color before coming clear again
Rarely a fever over 100 degrees F

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11
Q

Symptoms of allergic Rhinitis?

A

Itchy, watery eyes and watery rhinorrhea

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12
Q

Symptoms of influenza?

A

Myalgia (muscle pain)

Moderate-severe fatigue

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13
Q

Symptoms of ashtma?

A

SOB and or wheezing

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14
Q

Symptoms of sinusitis

A

Facial pain upon Valsalva’s maneuver, tender sinuses, URTI for > 7 days

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15
Q

Symptoms of otitis media?

A

Ear pain, ear popping, hearing loss, otorrhea

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16
Q

What are exclusions for self-treatment of a cold?

A 
Fever > 101.5
Chest pain
SOB
Worsening during self-treatment
Hypersensitivity to OTC
Concurrent cardiopulmonary disease
Immunosuppression
Elderly 
Less than 9 months
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17
Q

How long does an acute cough last? Cause?

A

3 weeks

Viral URTI, pneumonia

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18
Q

How long does a subacute cough last? Cause?

A

3-8 weeks

Bacterial sinusitis

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19
Q

How long does a chronic cough last? Cause?

A

8 weeks

Meds, acid reflux, COPD, lung cancer

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20
Q

Symptoms of pneumonia/bronchitis?

A

Productive cough and or change in sputum color

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21
Q

Symptoms of whooping cough

A

Distinctive high-pitch coughing sound

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22
Q

Define dry cough

A

Nonproductive
“hacking cough”
No physiologic purpose
Caused by viral URTIs, acid reflux and some meds

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23
Q

Define wet cough

A

Lungs are attempting to expel something

- Clear, purulent, discolored, malodorous

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24
Q

What are complications of cough?

A 
Exhaustion and insomnia
Hoarseness
Musculoskeletal pain
Syncope
Rib fractures
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25
Suppression of a productive cough leads to?
Lower respiratory tract infection, which is more serious and could lead to a bacterial infection
26
Exclusions for self-treatment for a cough?
``` Fever > 101.5 Cough with thick, yellow sputum or green phlegm Uninteded weight loss Drenching nighttime sweats Hemoptysis (coughing up blood) Foreign object aspiration History or symptoms with asthma, COPD, or heart failure Suspected drug-induced cough Cough lasting > 7 days Worsening cough New symptoms ```
27
Non-pharmacological options?
``` Get adequate rest Eat a nutritious diet as tolerated Maintain adequate fluid intake Increase humidifaction Saline gargle Hard candies Food such as tea with lemon and honey, chicken soup and hot broths Nasal strips Aromatic products ```
28
Define humidifiers
Cool mist
29
Define vaporizer
Warm mist | - potential for bacterial growth and burns
30
How are humidifiers and vaporizers maintained?
Clean daily and disinfect weekly
31
What are benzocaine, menthol, pectin, dyclonine, and phenol?
Provides temporary relief Can be used every 2-4 hours Patients with allergy to anesthetics ("caines") should avoid
32
Decongestants direct acting MOA, PK, examples?
Bind directly to adrenergic receptors - Faster onset, shorter duration - IE: phenylephrine, oxymetazoline, tertrahydrozoline
33
Decongestants indirect acting MOA, PK, examples?
Displace NE from storage vesicles in prejunctional nerve terminals - Slower onset, longer duration - Ephedrine
34
Decongestants mixed MOA, PK, examples?
Have both direct and indirect acting properties - Faster onset, longer duration - Pseudoephedrine
35
Phenylephrine side effects?
``` Cardiovascular stimulation (hypertension, tachycardia, palpitations) CNS stimulation (restlessness, insomnia, anxiety) - Exacerbate certain diseases sensitive to adrenergic stimulation ```
36
Phenylephrine Interactions and contraindications?
MAO-I, Methyldopa, TCA | - Concomitant use with MAOIs
37
What is the combat Methamphetamine epidemic act?
Must be kept in secure areas | Must be logged with product name, wantity sold, name, address, time and date
38
Sales per patients daily?
3.6 grams
39
Sales per patients monthly?
9 grams
40
Side effects of topical decongestants?
Burning, stinging, sneezing, local dryness
41
What is the proper technique of nasal sprays?
Blow nose gently Wash hands Shake Tilt head slightly forward and close one nostril Insert and point back and outer side of the nose Squeeze the nasal spray while breathing in slowly through the nose
42
Define neti-pots
Nasal wetting agent or saline nasal irrigation
43
Define antihistamines
First generation | Beneficial effects related to anticholinergic properties, not antihistamic properties
44
Antihistamines side effects?
CNS effects (sedation, impaired performance) and anticholinergic effects
45
Antihistamine drug interactions?
Alcohol or other sedating meds, MAOIs, phenytoin | - Potential for paradoxical effect in children and elderly
46
SLUDGE cholinergic effects?
``` Salvation Lacrimation Urination Defecation GI distress Emesis ```
47
Other non-pharmacologic options?
Non-medicated lozenges, hard candies, or honey --> not honey flavored but not in children less than 1 year old (risk of botulism poisoning)
48
Define guaifenesin
Loosens and thins the lower repiratory tract secretions to make minimal productive cough more productive
49
Guaifenesin side effects?
Nausea, vomiting, dizziness, headache, diarrhea, stomach discomfort -- take full of water and maintain adequate hydration
50
Antitussives dextromethorphan side effects?
Acts centrally to increase the cough threshold - drowsiness, nausea, vomiting, stomach discomfort, constipation - Potential for abuse
51
Dextromethorphan drug interactions?
``` Serotonergic meds (MAOIs, SSRIs) - Concomitant use MAOIs) ```
52
Antitussive diphenhydramine?
FDA approved | Acts centrally to increase the cough threshold
53
Antitussive codeine?
Acts to increase the cough threshold | Considered a schedule V narcotic
54
Topical Antitussives Vicks VapoRub?
Camphor and menthol Apply TID Toxic if ingested Less than 2 years old
55
Topical Antitussives Vicks Baby Rub?
Petrolatum, fragrance, aloe extract, eucalyptus oil, lavender oil, rosemary oil - Use in ages 3 months and older
56
Echinacea purpurea?
Immunostimulant properties - Has not been shown to be effective in preventing colds - Avoid if: allergy to plants, history of asthma, atopy, or allergic rhinitis, autoimmune disorder - Not taken if pregnant or breast-feeding women or under 2 years old
57
Zinc?
Block adhesion of rhinovirus to the nasal epithelium Thought to inhibit viral replication by disrupting viral formation - Do not drink with citrus juices, taste abnormalities, anosmia
58
Vitamin C?
Acts a potent antioxidant and helps with the immune system Can reduce duration by 8% in adults and 13.6% in children Avoid high dosages if patients with diabetes or a history of kidney problems
59
Special regulations of infants and children under 2 years?
Non-pharmacologic treatment only unless otherwise given permission by physician - Maintain upright position, adequate fluid intake, increase humidity, irritate the nose with saline drops, clear with a bulb syringe
60
Special regulations of children under 4?
Manufacturers of OTC meds update their labels to include precautions - Non-pharmacologic treatments preferred
61
Special regulations of children 4-11?
OTC cold meds are controversial | Use pharmacologic meds with caution
62
Special regulations of pregnant women?
Decogestant: topical oxymetazoline No systemic agents Cough suppressant: dextromethorphan
63
Special regulation of lactation?
Decongestants: topical phenylephrine, pseudoephedrine AVOID xylometazoline and naphazoline Cough suppressant: dextromethorphan

OTC Test 2 (9 decks)

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