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Common cold lecture for PCI

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Question
Answer
What is the most common complication of the common cold in children?   Otitis media  
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Five ways of preventing the common cold.   1. Wash hands frequently; 2. Drink plenty of fluids; 3. Get plenty of rest; 4. Exercise regularly; 5. Quit smoking/smoke free environment  
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Name a nonpharmacologic method of relieving pharyngitis.   Saline gargle ~ 1/2 tsp of salt per 8 oz of water, or hard candies  
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When do you refer a patient w/ pharyngitis to PCP?   Sore throat persisting for several days; or associated w/ fever, headache, nausea, or vomiting  
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What are the direct-acting decongestants and their MOA?   Phenylephrine, oxymetazoline, tetrahydrozoline; bind directly to adrenergic receptors  
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What is the MOA for indirect-acting decongestants?   Displace norepinephrine from storage vesicles.  
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Which has the slowest onset, direct-acting, or indirect-acting decongestants?   Indirect-acting  
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Which has the longest duration of action, direct-acting, or indirect-acting decongestants?   Indirect-acting  
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Give an example of a mixed (direct and indirect actions) decongestant.   Pseudoephedrine  
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Generic name and adult dosing of Sudafed.   Pseudophedrine, 60 mg q 4-6 hr  
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Contraindications for Sudafed   hypertension, hyperthyroidism, benign prostatic hyper, coronary heart disease, elevated interocular pressure (narrow angle glaucoma, lactation  
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Generic name and adult dosing of Sudafed PE   Phenylephrine, 10 mg 1 4 hr  
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Generic name and adult dosing of Afrin.   Oxymetazoline, 2-3 sprays each nostril 1 12 hr NMT 3 days  
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Result of using Afrin for more than 3 days   Thinitis medicamentosa (rebound congestion)  
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DI for Sudafed.   MAOIs, TCAs, methyldopa  
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DI for first generation antihistamines   Alcohol or other sedating medications, MAOIs, phenytoin  
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Contraindications for first generation antihistamines   Newborns, narrow-angle glaucoma, BPH  
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Generic name and adult dosing of Mucinex   Guaifenesin ER tablets, 600-1200 mg po BID (Max 2400mg/day)  
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Adult dosing ofdestromethorphan   30-60 mg q 6-8 hrs  
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DI for dextromethorphan.   MAOIs, CNS depressants, Alzheimer's medications  
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What kind of decongestants may be used for a pregnant woman?   Topical - oxymetazoline is preferred  
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What kind of decongestants should be avoided for a pregnant woman?   Systemic agents  
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What kind of cough suppressants can be used for a pregnant woman?   Guaifenesin, DXM  
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What kind of decongestants can be used with a female who is lactating?   Tophical phenylephrine is preferred  
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Avoid which decongestants for a female who is lactating?   Xylometazoline and napazoline. Systemic agents may decrease milk production  
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What kind of decongestant steps can be taken for children under the age of 2 yo?   Saline nasal drops, bulb suction of nose, humidification of inspired air  
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PCP referral to PCP for cold symptoms?   Fever > 101.5F; Cough phlegm becomes green or foul smelling; Chest pain; Shortness of breath; Significant worsening of symptoms beyond normal duration; Significant underlying comorbidity (CHF/COPD/Severe asthma); Immunosuppressed  
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