URTIs Flashcards
(23 cards)
What are the types of cough and causes?
Dry: asthma, GORD, ACE inhibitors, pertussis
Wet/Productive: infections, postnasal drip, smoking, TB, heart failure, lung cancer
When should you refer a patient with a cough?
Chest pain
Haemoptysis
Wheezing or dyspnea
Pain on inspiration
Chronic (>3 weeks) or recurrent
Persistent nocturnal cough in children
Debilitating in elderly
How does guaifenesin work?
Increases volume and decreases viscosity of mucus → expectoration
Adverse effects: Nausea, vomiting, urolithiasis if abused
How do opiates suppress cough?
Agonist action at μ-opioid receptors in medullary cough center
Side effects: Constipation, sedation, abuse potential
Dextromethorphan mechanism and safety?
Centrally acting NMDA antagonist
Less sedating than opioids
AE: Hallucinations, dizziness, abuse risk
What role do antihistamines play in cough?
Most common , but not recommended routinely for cough management
Diphenhydramine: H1 antagonist (drying effect + sedation)
What are demulcents and an example?
Non-pharma soothing agents
Example: Honey — helps reduce severity in children & adults
Name mucolytic agents and their role.
N-acetylcysteine, Bromhexine, Carbocysteine, Dornase alfa
↓ mucus viscosity
Caution in asthma (may trigger bronchospasm)
What causes the common cold?
Viral URTI: Rhinovirus, coronavirus, adenovirus, RSV
Signs/symptoms of a cold?
Sore throat, cough, malaise, sinus headache, body aches
Is there a cure for the common cold?
No — it’s self-limiting
Focus is on symptomatic relief
How do decongestants work?
α-adrenoreceptor agonists → vasoconstriction
Reduce mucosal swelling, improve nasal airflow
Topical vs Systemic decongestants?
Topical: Fast, local (oxymetazoline)
Systemic: Pseudoephedrine, phenylephrine (slower onset)
AE: HTN, CNS stimulation, rhinitis medicamentosa
Decongestant patient-specific cautions?
Avoid in:
Hypertension
Cardiovascular disease
Hyperthyroidism
Prostatic hypertrophy
Pregnancy/lactation
When to refer a cold?
Sinusitis not responding to decongestants
Ear pain not responding to analgesics
Flu symptoms
High-risk patients: elderly, immunocompromised, infants
What causes allergic rhinitis?
Inflammation of nasal mucosa due to allergen exposure
Allergens: pollen, dust, dander
Associated with family history of atopy
What are signs and symptoms?
Rhinorrhea, sneezing, nasal congestion, itching
Puffy/watery eyes
Sore throat, hoarseness
Mouth breathing
Allergic shiners, Dennie-Morgan lines, nasal crease
Management strategies?
Allergen avoidance
Oral antihistamines
Intranasal corticosteroids (first-line)
Mast cell stabilisers
Immunotherapy (refractory cases)
How do intranasal corticosteroids work?
↓ Inflammatory mediators (IL, histamine)
AE: Nasal burning, bleeding, throat irritation
Delayed onset (~2 weeks), minimal systemic absorption
How to administer nasal sprays properly?
Blow nose
Shake bottle
Insert nozzle (away from septum)
Spray while gently inhaling
Exhale through mouth
How do antihistamines work?
H1 receptor antagonists
↓ Vasodilation, ↓ mucus, ↓ itching
AE: Sedation (especially 1st-gen), dry mouth, dizziness
Name examples and uses of mast cell stabilisers.
Sodium cromoglycate, Lodoxamide (eye drops)
Olopatadine (dual action)
Stabilise mast cell membranes to prevent histamine release
When to refer allergic rhinitis patients?
Poor response to treatment
Nasal obstruction
Unilateral nasal discharge (esp. in children)
Associated wheezing or SOB
Purulent conjunctivitis
