Exam 2 - Cough and Cold

Question 1

What type of infection is the common cold considered

Answer 1

Upper respiratory infection

Question 2

All of the following are symptoms of the common cold EXCEPT:

Sore throat
Itchy/watery eyes
Runny nose
Cough

Answer 2

Itchy/watery eyes

(Itching signifies allergies)

Question 3

2 year old Lexi has a cold. What do you recommend for her

Answer 3

Honey

Question 4

(T/F): honey is an appropriate recommendation for all age groups of children with a cold

Answer 4

False - can’t give to children under 12 months old due to botulism spores

Question 5

Angela is 32 years old. She has throat irritation and is congested. Which would be an appropriate treatment?

Nasal congestion - antihistamine
Runny nose - expectorants
Sore throat - topical anesthetics
Cough - decongestants

Answer 5

Sore throat - topical anesthetics

(Like chloraseptic)

Question 6

A patient with a cold should seek medical attention if symptoms do not improve in what timeframe

Answer 6

7-14 days

Question 7

Which factors differentiate the flu from a cold

Answer 7

Aches
Chills
Sudden onset

(Aches are the main one)

Question 7

Which symptoms should be exclusions for common cold OTC treatment? (SATA)

A fever > 100.4
Allergic to AI in OTC products
Shortness of breath
Sore throat

Answer 7

Fever > 100.4
Allergic to AI in OTC products
Shortness of breath

(Sore throat is not because it is a common, and the first, symptom of a cold)

Question 8

How does initial nasal discharge from a cold present

Answer 8

Clear/watery

(Yellow or green later on)

Question 9

What symptom is the main differentiator between allergic rhinitis and the common cold

Answer 9

Itchy/watery eyes

Question 10

Nate is a 3 year old boy w/ nasal congestion. What nonpharmacologic recommendations can you make?

Answer 10

Humidifier
Vicks vapo rub

(For cold, use humidifier)

Question 11

Can you use tap water in a neti pot?

Answer 11

ONLY if you boil it first

Question 11

Which cold symptoms and OTC class are matched correctly? (SATA)

Rhinorrhea & sneezing - antihistamine

Cough - antitussive

Malaise, myalgia - decongestant

Low grade fever - analgesic

Sore throat - anesthetic

Nasal congestion - antihistamine

Answer 11

Rhinorrhea & sneezing - antihistamine

Cough - antitussive

Sore throat - (topical) anesthetic

(Malaise and myalgia would need an analgesic, low grade fever would need an antipyretic, nasal congestion would need a decongestant)

Question 12

Zefrex-D contains which AI

Answer 12

Pseudoephedrine

Question 12

Sudafed PE contains what AI

Answer 12

Phenylephrine

Question 12

Mucinex-D contains which AIs

Answer 12

Pseudoephedrine and guaifenesin

Question 13

Aleve-D sinus and cold contains which AIs

Answer 13

Pseudoephedrine and naproxen

Question 14

Is phenylephrine or pseudoephedrine MORE bioavailable

Answer 14

Pseudoephedrine

(Because PE doesn’t work and PSE does)

Question 15

Mary is taking fluoxetine for anxiety and is wanting to by sudafed. What should you counsel her on?

Answer 15

Sudafed could increase her HR

(Think anxiety heart racing - also because serotonin)

Question 16

How long can patients use oral decongestants? How long can they use nasal decongestants?

Answer 16

Oral: no more than 7 days
Nasal: no more than 3 days

Question 17

The use of PSE in pregnancy is especially dangerous in what trimester

Answer 17

1st

(Because this is when organ development occurs)

Question 18

Donna has controlled HTN. Which decongestant would be SAFEST for her to use

Answer 18

Phenylephrine

Question 18

Which of the following products are likely to result in a fast heart beat and/or restlessness

Claritin
Sudafed
Chlorpheniramine
Cepacol
Allegra-D
Alavert-D

Answer 18

Sudafed
Allegra-D
Alavert-D

(Because they all contain PSE)

Question 19

(T/F): a child could present with a fever of 100.4 with a common cold

Answer 19

True

(ABOVE 100.4 is the exclusion)

Question 20

Julia comes in with her 3 year old and asks for cough medicine. What should you suggest?

Answer 20

Ask if her pediatrician has recommended cough medicine (Cough and cold products should not be used in children under 6 years old without dr recommendation)

Question 20

Which product should you recommend when your patient is sneezing and has a runny nose? Nasal decongestant Mucinex Zyrtec INCS

Answer 20

Zyrtec (because it’s an antihistamine and the pt is showing symptoms of allergic rhinitis)

Question 21

What factors lead to the misuse of OTC cough and cold products in children

Answer 21

Many combination products Dosing inaccuracies Wrong formulation (Combo products can get confusing and duplicate therapy may accidentally occur; wrong formulation occurs due to brand name recognition, but the AI may be different)

Question 22

(T/F): a mother is having trouble getting her 5 year old to sleep. Benadryl is an appropriate recommendation

Answer 22

False - you shouldn’t drug children to make them sleep

Question 22

Which OTC product is appropriate for a 2 year old with a cold to help them feel more comfortable Acetaminophen Mucinex Benadryl Naproxen

Answer 22

Acetaminophen

Question 23

Megan is pregnant and wants relief from her cold. What can you suggest

Answer 23

Hydrate Humidifier Salt gargles (Pregnant patients should always try nonpharmacologic therapy first)

Question 24

(T/F): a collegiate cross country runner needs relief from congestion. You can recommend sudafed

Answer 24

False - using PSE in college sports is considered doping

Question 25

Which antihistamine is first line treatment for allergic rhinitis in pregnancy

Answer 25

Chlorpheniramine (Chlor-trimetron - “trime” like trimester)

Question 26

Vicks vapo inhaler has what AI

Answer 26

Levmetamfetamine (People can use the whole thing at once to get high so think amphetamine)

Question 27

What schedule is Robitussin-AC

Answer 27

CV (Because it is codeine in a liquid form)

Question 28

Robitussin-DM has which AI

Answer 28

Dextromethorphan

Question 28

Which OTC could you recommend for sore throat

Answer 28

Cepacol (topical anesthetic)

Question 29

Mucinex AI

Answer 29

Guaifenesin

Question 30

Mucinex class

Answer 30

Expectorant

Question 31

Dextromethorphan class

Answer 31

Antitussive

Question 32

Jeff presents with a dry, hacky cough. What should you recommend?

Answer 32

Robitussin-DM (Use an antitussive because it isn’t a productive cough - use expectorants for productive cough)

Question 33

Mallory presents with a wet, chesty cough. What should you recommend?

Answer 33

Guaifenesin (Expectorant to loosen the crap she’s trying to cough up since it’s a productive cough)

Question 34

Sheila has a runny nose, low-grade fever, irritated throat, and congestion. What does she have?

Answer 34

Common cold (Has no indications that this could be flu or allergies)

Question 34

Jason says he has not been able to sleep because his cough is keeping him up. What do you recommend?

Answer 34

Robitussin AC (Because the codeine will help him sleep and it has an antitussive)

Question 35

Morgan has nasal congestion, itchy eyes, swelling around the eyes, and post nasal drip. What does she have

Answer 35

Allergic rhinitis (Big giveaway are the itchy eyes)

Question 36

Young Nick has a cough that sounds like a bark, pharyngitis, and a fever. What does he have?

Answer 36

Croup (barking cough = croup)

Question 37

What is the AI in ZzzQuil

Answer 37

Diphenhydramine

Question 37

Natalie has a fever, backache, runny nose, and a dry cough. What does she have?

Answer 37

Flu (Aches are the giveaway)