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Week 7: Cough and Cold Flashcards

1
Q

What is the most common cause of common colds?

A

Rhinovirus

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2
Q

What is the onset of common colds?

A

12-36hr lasting 1-2weeks

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3
Q

What does common colds cause?

A

Inflammation of the membranes that line nose and throat

Sinuses and missle ear are involved

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4
Q

What are the common cold symptoms?

A
  1. Sore throat
  2. Nasal stuffiness and discharge (clear, thick, or yellow/green)
  3. Dry cough mostly at night
  4. No fever or low-grade
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5
Q

What is the epidemiology of common colds?

A
  1. No difference between gender or ethnicityy
  2. Mostly in winter
  3. Can be life threatening to vulnerable groups
  4. No cure only treatment of symptoms
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6
Q

How are common colds transmitted?

A
  1. Touching contaminated surfaces than eyes, nose, mouth
  2. Hand to hand contact
  3. Aerosolized particles
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7
Q

How are common colds prevented?

A
  1. Hand washing
  2. Hand sanitizer
  3. Covering cough and sneezing
  4. Masks
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8
Q

Who is excluded from cold self-care?

A
  1. Persistant sore throat, fever, headache, nausea, or vomiting
  2. Symptoms worsen with OTC
  3. Bacterial infection
  4. Age
  5. Concurrent underlying diseases
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9
Q

What are the pharm treatments from colds?

A
  1. Decongestants
  2. cough suppressants and expectorants
  3. Antihistamine
  4. Analgesiscs
  5. Antipyretics
  6. Local anesthetics
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10
Q

What are nonpharm treatments for colds?

A
  1. Increase liquid and reexamine diet
  2. Adequate rest
  3. NAsal strips, saline spray, aspirator, and aromatic oils
  4. Humidifier/vaporizer
  5. Sleep with elevated head
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11
Q

What is the caution using decongestants?

A

Cation in patients with CVD, hyperthyroidism, diabetes, and enlarged prostate

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12
Q

What are examples of decongestants?

A
  1. Pseudoephedrine
  2. Phenylephrine
  3. Levmetamfetamine
  4. Naphazoline
  5. Oxymetazoline
  6. Propylhexedrine
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13
Q

What is pseudoephedrine?

A
  1. Alpha/beta agonist
  2. Liquid and tablet
  3. Immediate and long acting forms
  4. Sudafed
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14
Q

What is the stimulation of alpha receptors?

A

Vascocontriction in respiratory mucosa

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15
Q

What is the stimulation of beta receptors?

A

Bronchial relaxation, increased heart rate, and increased contractility

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16
Q

What is the pseudoephedrine restriction in MS?

A

3.6g per day and 7.2 g per month

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17
Q

What is the pseudoephedrine restriction (federal)?

A

3.6g per day and 9 g per month
Patients must supply their ID

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17
Q

What is phenylephrine?

A
  1. alpha adrenergic agonist
  2. Liquid and tablet
  3. Sudafed PE
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18
Q

What are the common side effects of pseudoephedrine and phenylephrine?

A
  1. Increases HR and BP
  2. Dizziness
  3. Excitability
  4. Hallucinations
  5. HA
  6. Insomnia
  7. Wosening heart failure
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19
Q

What are the counseling points for oxmetazoline (Afrin spray)?

A
  1. Not for 6 and younger
  2. May be used as acute relief in 3rd trimester
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20
Q

What is the counseling point for Propylhexedrine/Benzedrex Inhaler?

A
  1. Discard 3 months after opening
  2. Abuse/misise potential
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21
Q

What is the counseling point for naphazoline/privine spray?

A
  1. ALternative strength available for 6-12YO
  2. Not for under 6
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22
Q

What is the counseling point for Levemetamfetamine/Vicks inhaler?

A
  1. Discard 3 months after opening
  2. Don’t use more than 7 consecutive days
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23
Q

What is the counseling point for phenylephrine spray?

A

May be an acute relief for pregnancy

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24
What are the side effects of topical decongestants?
1. Burning/stinging 2. Dry nose 3. Runny nose 4. Sneezing
25
What is the counseling point for all topical decongestants?
Rebound congestion so limit to 3 days
26
What topical nasal decongestants can be used for 2-6YO?
1. Oxymetazoline (0.025mg/mL): 2-3 drops each nostril Q10-12H 2. Phenylephrine (0.0125mg/mL): 2-3 drops Q4H
27
What are OTC products for sore throat?
Lozenges and throat sprays
28
API of lozenges for sore throat?
1. Benzocaine 2. Menthol 3. Pectin 4. Dyclonine
29
API of throat sprays?
Phenol
30
Counseling points for using a nasal spray?
1. Use the same side hand to pull your nose open and spray away from your septum. Spray it outwards. 2. Use small sniffs. 3. Do NOT snort! you will swallow the medicine and it will taste bad 4. Lean your head forward NOT backwards.
31
What is the difference between 1st and 2nd get antihistamine?
1st is Sedating 2nd is non-drowsy
32
What are examples of 1st gen antihistamine?
1. Diphenydramine (Benadryl) 2. Brompheniramine 3. Chlorphenirame
33
What are examples of 2nd gen antihistamine?
1. Loratidine (Claritin) 2. Certirizine (Zyrtec) 3. Fexofenadine (Allegra)
34
What are the DDIs associated with antihistamine?
1. Alcohol 2. CNS depressants 3. Anticholinergic 4. Potassium chloride (increasing risk of stomach ulcers)
35
What is the ADR of sedating antihistmines?
1. Chlorpheniramine can increase effects of phenytoin 2. Diphenhydramine increase effects of metoprolol and brexiprazole
36
What are the ADRs of non-sedating antihistamine?
1. Fexofenadine interacts with ketoconazole, erythromycin, and antacids, fruit juices 2. Loratadine interacts with amiodarone
37
What kind of drugs are used for sore throat?
Local anesthetics and non-drug measures
38
What kind of drugs are used for pain and fever?
Systemic analgesics and antipyretics
39
What is the the dose of fever analgesics for children?
Weight based not age based
40
What are complementary therapies for cold?
1. Echinacea 2. Elderberry 3. Honey
41
What is the caution using echinacea?
Drug interaction with CYP3A4substrates with low oral bioavailibity (verapamil, cyclosporine, and tacrolimus)
42
What is the caution using elderberry?
Possible decrease in effects of immunosuppressant agents
43
What is the caution using honey?
Should not be given to children younger than 1 year with risk of botulism
44
What is the important defensive reflex for airway protection?
Cough
45
What are the characteristics of acute coughs?
1. Less than 3 weeks 2. Virul URTI, acute bacterial sinusitis, bronchitis, pertussis, pneumonia 3. Allergic rhinitis 4. COPD exacerbations 5. Environmental irritants
46
What are the characteristics of subacute coughs?
1. 3-8 weeks 2. Postinfectious 3. CHF with fluid overload
47
What are the characteristics of chronic coughs?
1. (8+ weeks) 2. Asthma or asthma-like conditions 3. UACS 4. GERD 5. COPD, chronic bronchitis
48
What are the exclusions of coughing self-care?
1. Dyspnea 2. Weight loss 3. Hemoptysis 4. Night sweats 5. 100.4 oral temp 6. Worsening cough 3-5 days 7. Less than 4 YO 8. Immunocompromised 9. Barking or whooping cough 10. Tuberculosis 11. Chronic illness
49
What is a wet cough?
1. Productive (chesty) 2. Effective or ineffective 3. Secretions are clear with bronchitis and purulent 4. Malorder due to anaerobic bacterial infections
50
What is a dry cough?
1. Nonproductive (hacking) 2. Viral and atypical bacterial infections, GERD 3. Serves no physiologic purpose
51
What are the treatment goals of coughs?
1. Reduce the number and severity of coughing episodes 2. Prevent complications 3. Ultimately recognizing the underlying disorder or condition, required for effective and definitive management
52
What are the non pharm treatment for coughs?
1. Lozenges 2. Humidifier 3. Water 4. Saline rinse 5. Elevated sleeping
53
What are the pharm treatments for coughs
1. Robutussin 2. Delsym 3. Mucinex
54
Codeine? Onset: Duration: Contraindications:
O: 15-30 min D: 3-6 hours C: Children 6-12 and 2-6
55
Dextromethorphan hydrobromide? Onset: Duration: Contraindications:
O: 15-30 min D: 4-6 hours
56
Dephenhydramine HCl? Onset: Duration: Contraindications:
O: 15 min D: 4-6 hr
57
Guaifensin contradiction?
Not for chronic cough
58
OTC oral antitussives and expectorants?
1. Codeine 2. Dextromethorphan Her 3. Dephenhydramine HCl 4. Guaifensin
59
What are the topical antitussives for adults and children older than 2?
1. Ointments 2. Lozenges 3. Inhalation
60
what are the diphenhydramine DDI?
1. Brexpiprazole 2. Metoprolol 3. Anticholinergics (Ipratropium, tiotropium, umeclindinium)
61
What are the dextromethorphan DDI?
1. Strong CYP2D6 inhibitors 2. Serotonin reuptake inhibitors 3. MAO inhibitors (rasagiline, selegiline, isocarboxazid, phenelzine, trranycypromine)
62
Interaction between diphenhydramine and brexiprazole
1. Increased risk of brex toxicity 2. Reduce brex dose by 25% or avoid combo
63
Interaction between diphenhydramine and metoprolol?
1. Increased metoprolol serum concentrations and hypertension 2. Reduce metoprolol dose or avoid combo
64
Interaction between diphenhydramine and anticholinergics?
1. enhanced anticholinergic effect 2. Avoid combo
65
Interactions between dextromethorphan and strong CYP2D6 inhibitors?
1. Inhibitors decrease dex metabolism increasing psychoactive effects 2. Avoid concurrent use
66
Interactions between dextromethorphan and serotonin reuptake inhibitors?
1. Modulators increase serotonergic effects of dex 2. Avoid concurrent use
67
Interactions between dextromethorphan and MAO inhibitors?
1. MAO inhibitors increase dex and serotonergic adverse effects 2. Avoid concurrent use
68
Special pop use for codeine?
1. Not for children 2. Increased congenital birth defects 3. Excreted in milk and drowsiness in infants 4. Sedation of older adults
69
Special pop for dextrometorphan?
1. Safe for pregnancy 2. Not know for milk 3. Sedation of older adults
70
Special pop for diphenhydramine?
1. Pregnancy 2. Excreted in milk and irritable infants, decrease flow of milk 3. Elderly: dizziness, sedation, confusion, hypotension (Beers criteria) 4. Children and elderly, paradoxical excitation (restlessness and irritability)

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