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Cough, Cold&Allergy
Cough, cold and allergy
| Question | Answer |
|---|---|
| Cough: what are the characteristics of a productive cough | wet or chesty, expels secretions from lower respiratory tract, secretions may be clear with bronchitis, purulent with infection - to treat, use an expectorant and if at night, use a supressant |
| Cough: What are the characteristics of a nonproductive cough | dry or hacking cough, associated with viral respiratory tract infections, atypical bacterial infections, GERD, cardiac disease and ACE-1. to treat, use a supressant |
| Cough: what are the characteristics of a PND | Mucous drainage from nose, frequent clearing of the throat, to treat use a 1st gen antihistamine |
| Cough: Non pharm treatment for cough | lozenges and hard candies, increase humidity (cool mist), hydrate, promote nasal drainage by using a rubber bulb or elevating the head |
| Cough: what are the drug classes for pharm therapy? | Systemic antitussives(cough suppressants), Topical antitussives, expectorants, antihistamines |
| Cough: Systemic antitussives: when to recommend? | for a productive cough that interferes with sleep |
| Cough: Systemic antitussives: What are the generic names of the drugs and their brand names? | Dextromethorophan(delsym and robitussin DM), Diphenhydramine(benadryl, 1st gen antihistamine), Codeine(not an otc drug in MO) |
| Cough: Destromethorophan (Delsym and Robitussin): Side effects | drowsiness, N/V, stomach discomfort, constipation |
| Cough: Destromethorophan (Delsym and Robitussin): contraindications | hypersensitivity, MAOIs |
| Cough: Destromethorophan (Delsym and Robitussin): Precautions | alcohol, antihistamines, CNS depressants |
| Cough: Diphenhydramine (benadryl and 1st gen antihistamines): side effects | drowsiness, disturbed coordination, blurred vision, urinary retention, dry mouth, respiratory depression |
| Cough: Destromethorophan (Delsym and Robitussin): Contraindications | hypersensitivity, MAOIs |
| Cough: Destromethorophan (Delsym and Robitussin): precautions | older adults and children may have paradoxal excitation, may enhance depressant effects of medications(benzoiazapenes, narcotics, alcohol), use with caution in patients with narrow angle glaucoma, CV, benign prostatic hyperplasia |
| Cough: What are some of the safety considerations of topical antitussives? | may splatter and cause serious burns if used near an open flame, ointments, creams and lotions are toxic if ingested, 4tsp of products containing 5% or more of camphor may be lethal for children |
| Cough: exlusions for self treatment for coughs> | cough for 7 days, fever above or equal to 103, cough with thick moucous thats yellow, green, tan or filled with puss, drug associated cough, COPD, asthma, emphysema, cough worsens as flu resolves, cough ass. with dust or particles, chest pain, night sweat |
| Cough: Single v Combo products: describe single products | generally preferred over combination products, can make specific recommendations, can easily identify if a patient is allergic to a med |
| Cough: Single v Combo products: describe combo products | Advantages: convenient, compliance, placebo effect. Disadvantages: increased risk of SE, use of unecessary drug, cost, masking other signs/symptoms |
| Cold: Etiology | Limited to the upper respiratory tract(flu, cold, sinusitis, strep throat), most common cause is the rhinovirus, others are flu virus, coronavirus, adenovirus, respiratory virus |
| Cold: Symptoms | appear 1-3 days after infection, sore throat, PND, nasal obstruction(day 2 or 3), cough (day 4-5), headache malaise, chills, low grade fever |
| Cold: How does transmission happen? | touching your nose and mucous membranes, aerosol transmission |
| Cold: nonpharm treatment | increase fluids, eat a balanced diet, adequate rest, use cool mist humidifier, saline nasal sprays, gargle warm salt water, nasal strips to open the nostrils, for children-sit them upright and use bulb syringe to clear nasal passages |
| Cold: List the classes and the names of drugs in that class | Decongestants(oral and topical), antihistamines(1st gen), Local anesthetics, Systemic analgesics(APAP, NSAIDS, Aspirin), Antitussives and protussives |
| Cold: When is it appropriate to use Decongestants? | to relieve nasal and ear congestion, cough associated to PND |
| Cold: When is it appropriate to use antihistamines? | if the patient wants to dry up their runny nose |
| Cold: When is it appropriate to use local anesthetics? | to temporarily relieve sore throats |
| Cold: When is it appropriate to use systemic analgesics? | patients who complain about throat pain and aches or low grade fever |
| Cold: when is it appropriate to use antitussives or protussives? | when the patient wants to supress a cough or cough up what is in their throat |
| Cold: what drugs are in the degongestant class? (oral and topical) | Oral: pseudophedrine and phenylephrine. Topical: Oxymetazoline (long acting), xylometazoline, phenylephrine, naphazoline, epinephrine |
| Cold: what drugs are in the local anesthetic class? | benzocaine, phenol, menthol, dyclonine hydrochloride |
| Cold: Which is preferred? phenylephrine or pseudophedrine? | Pseudophedrine, its longer acting and has much less precautions and side effects |
| Cold: what are the side effects of systemic decongestants? | CV stimulation, irregular HR, restlessness, insomnia, anxiety, tremors |
| Cold: what are the side effects of topical decongestants | local area irritation (burning, stinging, sneezing, or local dryness) |
| Cold: what are the precautions associated with systemic degongestants? | HTN, CHD, ischemic HD, diabetes mellitus, glaucoma, hyperthyroidism |
| Cold: what are the precautions associated with topical decongestants? | rebound congestion, imprecise dosing, long v short acting, nasal polypse |
| Cold: what is rebound congestion? How do you prevent it? | With prolonged vasoconstriction, the mucosa becomes less responsive and reversal of vasodilation occurs, patients feel congestion even when product is discontinues, to prevent this, dont use more than 3-5 days |
| Cold: Exclusions for self treatment | fever over 101.5, chest pain, shortness of breath, worsening symptoms, asthma, CHF, COPD, AIDS, frail patients of advanced age, infants under 9mo, Hypersensitivity |
| Allergy: what are some common allergens? | grass, pollen, mold spores, house dust mites, cockroaches, cigarette smoke, mold, pet dander, wool dust, latex, resins, chemicals |
| Allergy: what are the signs and symptoms of allergic rhinnitis? | red irritated eyes, rhinorrhea, itchy eyes, nose and palate, frequent sneezing PND, cough due to PND, nasal congestion |
| Allergy: nonpharm for allergy | avoid allergens, lower household humidity to 40%, keep house clean and wash sheets, avoid outdoor activity when allergy counts are high, use filters |
| Allergy: describe 1st gen antihistamines | sedating, cross the blood brain barrier, bind to H1 receptors in CNS as well as peripheral receptors |
| Allergy: describe 2nd gen antihistamines | slight to no sedating effects, doesnt cross BBB, bind only to H1 receptors |
| Allergy: Name drugs that are 1st gen antihistamines | Brompheniramine, chloropheniramine, dimenhydranate, diphenhydramine, doxylamine |
| Allergy: Name drugs that are 2nd gen antihistamines | Loratadine, cetrizine, fexofenadine |
| Allergy: there are 9 1st gen drugs, list them in least to most sedating order | Pheniramine, brompheniramine, chlorpheniramine, triprolidine, pyrilamine, thonzylamine, clemastine, diphenhydramine, doxylamine |
| Allergy: What are some nasal wetting agents? | Loratadine(alavert, claratin), Cetrizine(zyrtec), Fexofenadine (allegra). They dont have anticholinergic properties. |
| Allergy: anitihistamine SE? | sedation/drowsiness, anticholinergic effects |
| Allergy: antihistamine contraindications? | acute asthma exasurbation, peptic ulcer, symptomatic BPH, newborns, narrow angle glaucoma, nursing mothers, MAOIs |
| Allergy: Exclusions for self care | Children under 12, pregnant or lactating women, symptoms of non-allergic rhinnitis, otitis media, sinusitis, bronchitis, infection, asthma, COPD, lower respiratory disorder, Mod-severe allergic rhinitis |
Created by:
carlypentland
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