Flashcards in Pharyngitis, cough, cold Deck (52):
What is pharyngitis usually caused by?
Group A streptococcus (GAS)
What might GAS cause
Acute rheumatic fever (rare in US)
What are the characteristics of GAS pharyngitis throat pain?
Worse on 1 side
What is the recommended initial tx of of GAS pharyngitis?
What is the dosing of amoxicillin for GAS pharyngitis?
20 mg/kg/dose (max 500 mg/dose) BID x 10 days
What medication do you avoid as first line for GAS pharyngitis and why? What is an exception?
Strep rapidly develops resistance to macrolides
Consider if PCN allergic
What is a newly recognized cause of pharyngitis?
Fusobacterium necophorum pharyngitis (FNP)
What age groups is FNP endemic to?
What % of pharyngitis does FNP cause in the specified age groups?
What could FNP develop and what is the risk with it?
Life threatening -> mortality rates of 5%
Sign that it is FNP
Lack of cough
What do you treat FNP with?
Penicillin + metronidazole
What is the rule with cough suppression?
Don't suppress indiscriminately
Do you suppress a productive cough?
When do you suppress a cough?
If tiring or sleep limiting
What do you prescribe for non-productive coughs?
Antitussives = cough suppressants
What do you prescribe for a productive cough?
How should your pt ingest the antitussive benzonatate?
Caps and softgels should be swallowed w/o chewing
What is a common antitussive?
What is dextromethorphan?
D isomer of codeine analog of levorphanol
Does dextromethorphan have analgesic and addictive properties?
What does dextromethorphan do to reduce cough?
Inhibits central (medullary) cough center
What is a common expectorant (you use it all the time)?
Guaifenesin (glyceryl guaicolate) aka Mucinex
What does guaifenesin do to respiratory tract secretions?
What is n-acetylcysteine?
What does n-acetylcysteine do?
The sulfhydryl group opens disulfide bonds in mucoproteins thereby reducing viscosity
How do you administer acetylcysteine?
Aerosolization or nebulization
What is pertussis and what is it caused by?
What do the Chinese call pertussis?
Cough of 100 days
Are atypical presentations of pertussis common? Give some examples
Completely/partially immunized pts
What population do we see the most pertussis?
Infants < 6 months
Whats a frequent sign of pertussis?
Is the incidence of pertussis increasing or decreasing?
What are some causes of rising incidence of pertussis?
Severe complications w/ whole cell vaccines
When do you consider a diagnosis of pertussis?
All children w/ cough > 14 days
What is the tx of choice for pertussis? How long do you dose it?
14 days to prevent relapse
What are some alternative agents for pertussis tx?
What do decongestants act as?
Sympathomimetics (alpha agonists)
What is an issue with decongestants and how do we deal with that?
Prolonged use can cause rebound congestion (>3-5 days)
Limit dose frequency
What are two long-acting topical decongestants?
What are some benefits of systemic decongestants?
Lower incidence of rebound congestion
Results typically last longer than topicals
What is a legal issue with systemic decongestants and why?
Sales are limited on pseudoephedrine by law
Have been used in the illegal making of methamphetamine
What are systemic decongestants? What is their systemic effect?
Alpha 1 agonist
What do systemic decongestants activate at higher concentrations?
What are the CVS AEs of phenylephrine?
What are the CNS AEs of phenylephrine?
What are the CVS AEs of pseudoephedrine?
What are the CNS AEs of pseudoephedrine?
In what chronic disease should you avoid pseudoephedrine and phenylephrine?
What does guaifenesin do to phlegm and bronchial secretions?
Helps loosen phlegm and bronchial secretions
What does guaifenesin do to secretion viscosity?
Reduces secretion viscosity