Cough suppresants, mucolytics, decongestants

Question 1

See Notes for cough reflex physiology

Answer 1

ok

Question 2

acute cough

Answer 2

less than 3 weeks

Question 3

subacute

Answer 3

3-8

Question 4

chronic

Answer 4

over 8

Question 5

DOC (drugs over the counter) for non-productive cough

Answer 5

Systemic agents:
Dextromethorphan
Diphenhydramine
Codeine

Topical agents:
Camphor
Menthol

Question 6

DOC for productive cough

Answer 6

Expectorants like Guaifenisin…this is really the only one

Question 7

Dextromethorphan is contraindicated in who

Answer 7

pts on monoamine oxidase inhibitors, antidepressants, pts with resp insufficiency, hepatic disease.
Monoamine oxidase inhibitors reduce the metabolism of serotonin, Dextromethorphan can cause serotonin overload which raises body temperature and leads to potentially fatal serotonin syndrome.

Question 8

How does Camphor work

Answer 8

desensitizes TRP chanels

Question 9

What do nasal decongestants do

Answer 9

vasoconstrict…they are alpha adrenergic agonists (sympathomimetic)…constrict blood vessels through the body. Reduce the supply of blood to nose. Remember, alpha receptors on vessels facilitate contraction.

Question 10

Dont use pseudoephedrine in who

Answer 10

anyone with CV disease

Question 11

Phenylephrine can cause what

Answer 11

very high HTN…thus heart rate will decrease to compensate

Question 12

Oxymetazoline is what

Answer 12

selective alpha one agonist…jsut like phenylephrine

Question 13

Mucus is what

Answer 13

Glycoprotein

Question 14

Mucus clearance facilitated by

Answer 14

hydration, removing cause, trachobronchial clearance maxmized.

Question 15

Know the mucolytics. there will be one on the test.

Answer 15

ok

Question 16

Three stages of cough

Answer 16

Inspiratory, compressive (closed glottis), expulsive (open glottis)

Question 17

Neuronal basis for cough

Answer 17

Tussive agent–> RAR receptors + C fibres –> vagus nerve–> brainstem –>cough generator (medulla) –> somatic nevers (phrenic) –> cough

Question 18

What the productive colors mean

Answer 18

clear- bronchitis, yellow- infalmmatory, purulent–infection, malodorous - anaerobic infection

Question 19

Codeine side effects and contraindication

Answer 19

constipation, sedation, vasodilation, orthostatic HTN, diziness,
Contraindicated in hypersensitivity, pregnancy, individuals on sedatives, prostatic hypertrophy, acute resp depression and COPD

Question 20

Pseudoepehdrine mechanism

Answer 20

Alpha 1 and alpha 2 agonist, Basically increases norepinephrine release

Question 21

Which nasal decongestant can be given to reduce the toxicity caused from tylenol overdose

Answer 21

N-Acetyl Cysteine reduces liver injury due to tylenol overdose

Question 22

Mechanism of amilioride

Answer 22

ENac blocker. Prevents dehydration of the mucous. Useful in CF

Question 23

WHat is rhinitis medicamentosa and what can cause it

Answer 23

Rebound congestion caused by overuse of oxymetazoline