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PDAT1 > 3 - Cough / Cold / Allergy > Flashcards

3 - Cough / Cold / Allergy Flashcards

1
Q

Patients should not use INCS / TAC if:

Intranasal corticosteroids

A
  • First talk to your provider if:
    • ​recent nasal ulcers / surgery / unhealed nasal injuries
    • asthma meds
    • prescription steroid medications
    • currently have eye infection
      • ​glaucoma or cataracts
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2
Q

Types of Allergens

A
  • Outdoor = Seasonal
    • ​Tree pollen / Grass / Ragweed
    • Pollen.com to check pollen counts
  • Indoor = Perennial = HARDEST TO AVOID AND MANAGE
    • ​Dust mites / Animal Dander
    • Mold / Cockroach droppings
  • Airborn
    • ​Smoke / perfume / fues
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3
Q

Budesonide Nasal Spray

Rhinocort

A
  • LOWER VOLUME OF SPRAY
    • vs fluticasone / TAC
  • Scent / Alcohol free
  • No Drug interactions! (like nasacort)
  • Only indicated for Ages 6+
    • ​still potential for slow growth rate
    • see md if >2 mo use in a year
  • Dose:
    • 1-2 sprays en qd
  • ​May take Up to 2 weeks for full symptom relief
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4
Q

Dextromethophan Dose

Dayquil / Robitussin / Delsym

A

10-20mg q 4 hr

or

30mg q6-8

Max = 120mg/day

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5
Q

Allergy Drugs with NO SEDATION

A

Loratadiine

Fexofenadine

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6
Q

Guaifenesin Dose

A

only FDA approved expectorant

>12 years old

200-400mg Q4

take with a full glass of water

used for non-productive congested cough

Aka ineffective productive cough

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7
Q

FDA Public Health Advisory for

OTC cold/cough medications

A
  • Should NOT be used to treat i_nfants & children <2 years old_
    • ​mainly due to IMPROPER USAGE
  • ​For children 2-11 yrs old:
    • understand that OTC drugs do NOT shorten duration of cold
    • check drug facts, beware of overlap active ingredients
    • Only use measuring spoons / cups
    • do not use for sedation
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8
Q

Short Acting Topical Decongestants

A

4-6 hours

Phenylephrine

0.25-1% Neo-Synephrine

Levmetamfetamine

Vapor Inhalor

Propylhexedrine

Benzedrex inhaler

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9
Q

Intranasal Corticosteroids

INCS

Treatment for Allergic Rhinitis

A

Only for ALLERGIES

not for COLDS

even if symptoms are indicated, ONLY ALLERGIES

Triamcinalone (TAC) / Fluticasone Propionate

Budesonide / Fluticasone Furoate

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10
Q

Cold Symptoms

A
  • Limited to Upper Respiratory Tract
    • 1-3 days after infection
  • 1st symptom = Sore Throat
  • Days 2-3 = Nasal symptoms
  • Days 4-5 = Cough (only 20% of patients)
  • Typically does not cause soreness or fever
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11
Q

Triamcinolone Nasal Counseling

A
  • TAC use QD w/o missing a dose
    • may take up to 1 week to provide full relief/benefit
      • most will see improvement on FIRST DAY
  • Pregnancy: talk to PCP before use
  • Can be used in children 2+:
    • but potential for slowed growth rate
    • try not to use for >2 months in a year
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12
Q

When to see Doctor for SORE THROAT

A
  • If you have been in contact with someone w/ STREP THROAT
  • Sudden Onset
    • w/ fever and/or Swollen glands
      • ​or a RASH
  • ​​Trouble Swallowing liquids
  • Sore throat for >1 week
  • FRONT OF NECK = sore / stiff
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13
Q

Which allergy medications are okay for children

2y/o and older?

A

ALL 2ndgen Antihistamines

Cromylyn Sodium

TAC

Fluticasone Furoate (sensimist

Fluticasone Propionate is 4+ y/o

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14
Q

Pregnancy & Nursing

for Cough Supressants

A

Diphenhydramine is generall PREFERRED

DM is not a teratogen, and is generally safe during pregnancy

DM products w/o ethanol are SAFE for nursing mothers

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15
Q

Sore Throat Treatment Options

A
  • Stay Hydrated / Warm Liquids = Tea/honey
    • painful swallowing can lead to DEHYDRATION
      • ​avoid citrus drinks
  • ​Salt Water Gargling = 1-1.5ts of salt in 1 cup warm water
    • ​salt water pulls liquid OUT of swollen membranes
  • Popsicles / Ice Chips
    • ​cold has NUMBING EFFECT
  • Hard Candies
    • reduce dryness / soothe pain
  • Vaporizer / Humidifyer
  • OTC PAIN MEDICATIONS for pain = Tylenol
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16
Q

Avoiding Allergens

Treatment for Allergic Rhinitis

A
  • Highest pollen conditions occur on DRY & Windy days
    • ​Pollen.com
  • ​Stay indoors:
    • highest pollen count is between 5am - 10am
  • Keep windows closed / change filters
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17
Q

Fluticasone FUROATE

flonase SENSIMIST

A
  • LOW VOLUME SPRAY
    • ​vs fluticasone propionate / TAC
  • ​Alcohol & Scent Free
    • vs fluticasone propionate
  • Approved for Ages 2+
    • ​vs 4+ for fluticasone propionate
  • ​Same indicaitions & drug interactions as fluticasone propionate
    • ​still indicate for watery EYES
    • 1 week for full effect
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18
Q

Productive Cough

A

Wet Cough

Expels secretions from LOWER respiratory tract

Can Be Effective if secretions are EASILY EXPELLED

ineffective if secretions are DIFFICULT to expel

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19
Q

Cromylyn Sodium Dose

NasalCrom

A

Mast Cell Stabilizer, okay for 2+ & pregnancy & elderly

1 spray (5.2mg) EN 3TID/4-QID

USE BEFORE SYMPTOMS

max 6 times / day

takes up to 7days for effect

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20
Q

Pregnancy / Nursing Use

of Antihistamines

A
  • Nursing: AVOID
    • excreted in breast milk
    • can inhibit lactation
  • Pregnancy: AVOID
    • unless CLEARLY NEEDED
      • benefits > risks
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21
Q

Age Considerations

for Antihistamines

A
  • Diphenhydramine = 1st gen OTC histamine
    • on BEER’s LIST
      • ​Do not use in patients 65> age
      • Risk of sedation & AC effects INCREASED
  • ​​Most antihistamines have NO DOSING for <6yrs old
    • except for Loratadine / Fexofenadine / Cetirizine/levocet
      • ​>2yrs old
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22
Q

Topical Decongestants for Pregnancy or Children?

A

DNU IN PREGNANCY

reduced uterine blood flow

All okay, including menthol for 2+ y/o

saline can be used for <2y/o

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23
Q

Cetirizine Dose

A

5-10mg QD

Drowsiness warning

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24
Q

Side Effects of

Topical Decongestants

Phenylephrine Spray / Vapor Inhalor / Benzedrex

oxymetazoline

A
  • Rebound Effect –> Vicious Cycle
    • overuse of the topical products
      • only use SHORT TERM
        • ​for COLDS not allergies
    • can cause nasal membranes to be MORE congestion
  • To treat Rebound effect:
    • D/C offending drug -> use oral Decongestants or saline
    • Takes 1-2 weeks for nasal membranes to return to normal.
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25
Q

Diphenhydramine Dose

as a Cough Supressant

A

25mg Q4 hours

okay for children 6+, but FDA PH advisory 2-11 years

Acts centrallin in medulla to increase cough threshhold

Side effects:

Drowsiness / Blurred Vision

Dry Mouth

Urinary Retention

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26
Q

Difference between ALLERGY vs Cold/URI

A
  • Allergies:
    • sometimes cough, less often than cold
    • NEVER ACHES / PAINS / FEVER
      • ​sometimes fatigue / sore throat
    • ​ITCHY eyes
      • eyes can be watery in both cold and allergy
    • ​sneezing is more common
    • Duration of Symptoms very depending on TRIGGER
      • days-months
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27
Q

Counseling for Dextromethorphan

A
  • DM:
    • ​Do not use if currently taking or 2 weeks after stopping
      • ​MAO INHIBITOR
      • or SSRIs
  • ​Diphenhydramine products:
    • may cause drowsiness / avoid alcohol
  • Stop Use & see MD if:
    • cough >7 days or returns or w/ fever/rash/headache
    • cough w/ too much phlegm
    • cough that is chronic, or occurs w/ smoking / asthma
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28
Q

Considerations for

Guaifenesin (expectorant)

A

No association w/ developmental toxicity

Pregnancy / Nursing SAFE

Drink w/ FULL GLASS OF WATER

  • Ask doctor if:
    • too much phlegm beforehand or chronic cough
    • cough > 7 days
      • or comes back / fever / rash / headache
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29
Q

Exclusions for Self-Treatment

for Allergic Rhinitis

A
  • SYMPTOMS OF INFECTION
    • otitis media = ear inflammation
    • fever / wheezing / bronchitis / chest congestion
    • Thick respiratory secretions, NOT CLEAR
  • Symptoms of undiagnosed / uncontrolled ASTHMA:
    • ​wheezing / SOB / COPD
  • Pregnant:
    • common cause of nonallergic rhinitis
  • Patients who DO NOT respond or symptoms worsen
    • ​after taking OTC options
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30
Q

Topical Rub Products

A

Include Camphor / Menthol

VICKS VAPORUB

ONLY FOR EXTERNAL USE

Apply on Chest / Throat

may cover w/ loose dry cloth

allow vapors to hit nose / mouth

DO NOT APPLY TO IRRITATED SKIN

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31
Q

Nasal Strips

Breathe Right

A

Mechanically opens nasal passages

Choose the RIGHT SIZE

Lavendar scent available

Indicated for 5years and older

& PREGNANT WOMEN!

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32
Q

Phenyephrine

PE

A

Dose: 10mg q4 (adults)

  • Half life is much shorter 2-3 hours*
  • vs 6 hours for PSE*
  • Poor stability & shorter shelf-life*

Questionable efficacy vs PSE

Exhibits large individual variability in Bioavailability

Beware of HIGH Fever or no improvement in symptoms

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33
Q

Triamcinolone Nasal

TAC

Nasacort Allergy

A
  • Corticosteroid for Allergic Rhinitis, relieves symptoms of:
    • RUNNY NOSE + CONGESTION (due to allergies)
    • sneezing / nasal itching / stuffy nose
      • ​no indication for EYES and UNSCENTED
  • 1st Line therapy for Allergic Rhinitis
    • MOST EFFECTIVE TREATMENT
    • not indicated for patients with colds
  • No risk of sedation and no _drug interactions_
  • Takes about a week for results, use QD
  • ​Approved for use in Children 2+
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34
Q

Saline Topical Products

Ocean

A

Restore Moisture

Relieve Dry/Inflamed Nasal Membranes

caused by:

Colds / low humidity

Nasal decongestant OVERUSE

Nose bleeds / allergies

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35
Q

Airborne

A

No Date to show efficacy

more to PREVENT not to treat/decrease symptoms

High doses of Vit C –> may lead to kidney stones

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36
Q

Sore Throat vs STREP Throat

A
  • Most SORE throats are due to:
    • Viruses / Bacteria / Allergies
    • Smoking / Dry air / YELLING
    • Breathing through mouth often
  • Strep Throat = Most common Bacterial infection of THROAT
    • 5-10% of adult and 15-30% of children
    • associated w/
      • Fever / Swollen Glands / White patches
      • Headache / Nausea / Chills
      • Difficulty swollowing.
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37
Q

Anesthetic Agents for Sore throat

A

Cepacol

Chloraseptic

Sucrets

Chloraseptic SPRAY

38
Q

Anesthetic Agents

for Sore Throat

A

Sore Throat Pain

Benzocaine / Phenol / Dyclonine

Look for higher concentrations of active ingredients

Dissolve SLOWLY in mouth

for spray: keep in place for >15 seconds then spit

if numbing, avoid eating/drinking esp HOT items

39
Q

Cromolyn Sodium Spray

NasalCrom

A

Mast Cell Stabilizer

–> itching / sneezing / rhinorrhea

USE BEFORE ONSET OF SYMPTOMS

Can use for >2 yrs old & Pregnant & elderly

1 Spray EN TID/QID (max 6x/day)

takes up to 7 days for initial effect

4 weeks for MAX benifit

can cause sneezing / nasal stinging

40
Q

Side Effects / Considerations

for Antihistamines

A
  • Paradoxical Excitation
    • Insomnia / Irritability
    • Nervousness / Nightmares
  • ​Anticholinergic effects:
    • ​Dry mouth / constipation
    • Urinary retention / Blurry Vision
  • GI Effects:
    • Anorexia / Diarrhea / Abdominal pain
  • Avoid in narrow angle glaucoma / asthma
  • Do not diphenhydramine w/ others (even TOPICAL)
41
Q

Oral Decongestants

A

Only indication is Relief of Nasal Congestion

Pseudophedrine / Phenylephrine

  • Adv:
    • Longer duration of action vs topical agents
    • NOT ASSOCIATED W/ REBOUND CONGESTION
  • ​Disadvantages:
    • ​less intense vasoconstriction vs topical
    • DELAYED ONSET
42
Q

Pediatric considerations

for Topical Decongestants

A

Never Use for Children <2 years old

except for SALINE

mentholated products** should NOT be used in **<2 years old

Non-drug measures:

Humidity / fluids / Propping head up

43
Q

Fluticasone Propionate Dose

Flonase

A

2 sprays (50mcg) EN QD

for 1 week then -> 1-2 sprays

Age 4+

Also treats ITCHY/WATERY EYES

has a floral scent, use less than <6 months

HIV infection / Ketoconazole / Asthma / Steroids

44
Q

Budesonide Dose

Rhinocort

A

1-2 Sprays (32mcg) EN QD

Age 6+ only!

Low volume of spray

may take up to 2 weeks for full symptom relief

no drug interactions / scent free / alcohol free

45
Q

Antihistamine Indications

A
  • Rhinorrhea (runny nose) / Nasal Pruritus (scratchy nose)
  • Sneezing
  • Allergic Conjunctivitis / Lacrimation / Ocular Pruritis
  • Not indicated for:
    • ​Colds
      • ​no good date to support indication for pts w/ cold
    • ​NASAL CONGESTION
      • ​only decongestants are indicated for this
46
Q

Long Acting Topical Decongestants

A

12 hours

Oxymetazoline

( Afrin / Sinex )

47
Q

Topical Zinc Info

A

Proposed Anti-Viral Agent

may reduce severity / length of symptoms

Start within 24 hours of onset of symptoms

some positive results in studies

48
Q

Infection Transmission

A
  • Self-inoculation of nasal mucosa / conjuctiva
    • touching bacteria then touching self on eyes / nose / mouth
    • hand-to-hand contact
    • High exposure = Density of classrooms or daycare
  • Less common routes:
    • aerosoled particles / kissing / contact w/ inanimate obj.
  • Does not increase susceptability to colds by ITSELF
    • ​cold weather / chills / walking barefoot
      • ​only makes symptoms WORSE if already sick
49
Q

Fluticasone Furoate Dose

Flonase Sensimist

A

Same as Flonase, but 32mcg/spray

less volume of spray

and approved for Ages 2+

compared to 4+ for flonase

still indicated for itchy & watery eyes

50
Q

Fluticasone Propionate DOSING

A

2 Sprays EN QD

for 1 week then -> 1-2 sprays en qd for symptoms

Ask Doctor if >6 months of daily use

May take 1 week to provide full benefit / relief

most people have improvement on FIRST DAY

51
Q

Questions to ask regarding ailment

A

Symptoms / Duration / Fever?

Thick or Discolored discharge?

H/O Allergy / Asthma / Bronchitis / Smoker?

What medicines are you taking?

Has anything worked for these symptoms?

Are you pregnant/breastfeeding?

Are you participating in athletic events?

If child, how old and weight?

52
Q

Fluticasone Propionate

Flonase / ClariSpray

A
  • Compared to TAC/Budesonide, also approved for:
    • Itchy / watery EYES due to allergy
  • No indication for PROPIONATE for children:
    • <4 years
      • ​also potential for slowed growth rate
      • talk to Dr if >2mo in a year of use
  • Has a light floral scent, some patients find offensive
53
Q

Topical Antitussives

A

Camphor & Menthol

Lozenge or Ointment dosage forms

only FDA approved topical antitussives

little efficacy evidence

54
Q

Side Effects

of Oral Decongestants

A
  • Increased BP
  • Cardiac Stimulation
    • ​typically only after prolonged use
  • ​May worsten symptoms of underlying diseases
    • ​Hyperthyroidism
    • CAD / Ischemid Heart disease
    • Prostatic Hypertrophy
    • Intraocular Pressure
55
Q

Pseudophedrine Dose

Sudafed

A

60mg Q6

120mg Q12 for SR

not for pregnancy nor children <6y/o

okay for breast feeding

consider stocking PSE in cabinet so you can have on hand

Pseudoephedrine is still the same safe and effective product it always was; you will just find it in a different place

56
Q

Loratadine

Claritin

A

Non-Sedating

2nd-gen-AH

Only non-drowsy 24 hour product indicated for:

Children 2 +

fexofenadine is non-drowsy BUT is BID dosing for kids

57
Q

TAC Dosing

Nasacort

A

2 sprays (55mcg) EN QD

after symptoms controlled -> 1 spray EN QD

may take up to 1 week for relief, do not miss doses

Okay for 2+, watch out for slowed growth rate <2mo

only spray that treats CONGESTION

no sedation / no drug interactions / no scent

58
Q

Differences between COMMON COLD vs Flu

A
  • Cold has:
    • headache / pain / fatigue is mild or absent
    • Common: Rhinorrhea / Nasal congestion / sneezing
      • ​both flu and cold have sore throat
    • cough is less common and is usually non-productive
    • Watery eyes
    • 5-10 day duration
    • complications:
      • sinus congestion / earache
59
Q

Pregnancy, cough medication

DPH vs DM?

A

DPH is preferred

DM is NOT considered a major teratogen

and is considered safe though.

60
Q

Nursing / Pregnant Considerations

for Oral Decongestants

A
  • Nursing Mothers:
    • only a little data, small amounts can –> breast milk and cause irritability
    • AAP considers pseudophedrine safe during breast feeding
  • ​Pregnancy:
    • ​risk in FIRST trimester
  • ​*BANNED FOR USE IN ATHLETIC EVENTS*
61
Q

Topical Decongestants Indications

A

Relief of Nasal Congestion

systemic absorption is typically minimal w/ TOPICAL dosage forms

62
Q

Cetirizine

Zyrtec

A

Drowsiness Warning

~10% of patients SEDATED

2nd-gen-antihistamine

dosing for children 2+

63
Q

Zinc Products & Dosage

Cold Eeze / Zicam

A

1 Lozenge Q2-4 hours while awake

(Max 6 lozenges per day)

HAS TO BE LOCAL = can not be taken orally

Start within 24 hrs of symptoms

long term admin can be hazardous

DO NOT USE IF PREGNANT

64
Q

Side Effects of Guaifenesin

A

NAUSEA / Vomitting

Dizziness / Headache

Rash / Diarrhea

Sedation

USUALLY MINOR

65
Q

Differences Between INFLUENZA vs Cold

A
  • Flu has:
    • sudden onset fever > 102-104
    • headache / myalgia / fatigue / weakness / exhaution
    • non-productive / persistant cough
    • eye-pain / burning
    • 1 week duration
    • complications of:
      • bronchitis / pneumonia
    • ​​both flu and cold have sore throat
66
Q

Triamcinolone Acetonide Nasal Dosing

TAC

Nasacort

A

Approved for use in Children 2+

For adults / age 12+

2 Sprays EN QD

once symptoms are controlled -> 1 Spray EN/day

Use continiuously for at least a weak

UNSCENTED

67
Q

Fexofenadine Patient Counseling

A

Fruit Juices = Grapefruit / Orange / Apple

  • Do not take with Aluminum / Magnesium Antiacids*
  • may REDUCE Bioavailability*

Renal Dysfunction –> decrease dose

For Meltable Tablets:

Take on an EMPTY STOMACH

do not chew / remove from pkg before hand

68
Q

Fexofenadine

Allegra

A

Non-Sedating

Once daily (180mg) 24 hour dose for adults

For children 2-11: 30mg BID

(has a meltable tablet dosage form)

also has special counseling points

69
Q

What allergy medications are okay for PREGNANCY?

A

Cromylyn Sodium Nasal Spray

also okay for children 2+, need to use BEFORE symptoms

Diphenhydramine is also okay for pregnancy for COUGH

but PREGNANCY is technically contraindicated because ALLERGY is common with pregnancy

70
Q

Prevention of Infections

A
  • HANDWASHING can decrease transmission
    • ​virus can survive on hands for hours
  • Not all hand sanitizers are shown to eradicate RHINOVIRUS
    • ​prefer 60-80% ethanol / isopropanol
      • chlorhexidine / povidone-iodine / 4-ammonium
    • ​LYSOL kills >99% of rhinovirus after 1 MINUTE
    • Anti-viral tissues are 10% more effective.
71
Q

Nonproductive Cough

A

Dry / Hacking Cough

No congestion / phlegm production

Occurs in <20% of patients with a COLD

72
Q

Irrigation

Neti Pot / Saline Nose Sprays

A
  • Can help with Allergy Symptoms
    • Flushes out allergen / irritant (pollen
    • Aids in removal of dried/encrusted mucus from nasal passages
  • Tips for netipot:
    • Use bottled/boiled/distilled water, no tap water
    • Saline Packs or 1ts salt-> 16oz water
73
Q

NON-Pharmacologic Options

for COLDS

A
  • Fluid intake
  • Rest
  • Nutrition:
    • chicken soup ~anti-inflammatory
  • Increased HUMIDIFICATION of air
    • steamy showers / humidifyers / vaporizers
  • for YOUNG CHILDREN:
    • Nasal aspiration / upright positioning
74
Q

Guaifenesin

Mucinex / Robitussin

A
  • Only FDA Approved Expectorant
    • ​Indicated for: Non-Productive Congested Cough
      • ​ineffective productive cough
  • Efficacy:
    • lack of evidence showing that these decrease sputum viscosity / ease expectoration
  • Important to have adequate Fluid Intake & Humidity
    • ​for expectoration
75
Q

Fluticasone Propionate DI / Considerations

flonase / clarispray

A
  • If you are taking medication for:
    • HIV (ritonavir / teleprevir / tiprnavir)
      • may INCREASE conc. of fluticasone
    • Ketoconazole
      • also may INCREASE conc of flutic
    • Asthma Medication
    • Prescription Steroid Medicine
  • ​PREGNANCY
    • talk to dr before use
76
Q

Allergic Rhinitis

A
  • Can develop at ANY AGE
    • can SUDDENLY get allergies,
      • allergy history does not matter much
    • Heredity plays a role
      • 1 parent w/ allergies -> 48%
      • 2 parents -> 70%
  • ASTHMA Present in 20% of patients
77
Q

Exclusions for Self-Treatment

for COLDS

A
  • Do not use if:
    • Fever > 100.4 (oral)
    • Chest Pain / SOB
      • or underlying pulmonary disease (COPD/asthma)
    • Worsening of symptoms
      • during self-treatment
    • AIDS / Chronic immunosuppresant therapy
    • Elderly / infants <3 months of age
78
Q

Diphenhydramine

Pregnancy / Contraindications

A

okay with pregnancy, preferred over DM

AVOID ALCOHOL!

on Beer’s list

DNU in pts 65+, due to AC / sedation

79
Q

Fexofenadine Dose

A

60mg q12

180mg q24

Non-Sedating

but 30mg BID CHEW dosing for kids 2-11

avoid fruit juice / kidney fxn

Al / Mg antacids

80
Q

Allergic Rhinitis TREATMENT

A
  • Avoid Allergens!
  • Immunotherapy
  • Pharmacotherapy:
    • Nasal Steroids
    • Antihistamines (2nd gen preferred)
    • Mast Cell Stabilizers
    • Decongestants
81
Q

Age for Self-Treatment to be Excluded

for COUGH

A

children <4 y/o

82
Q

Pregnancy / Nursing

for Topical Decongestants

A

Pregnancy - Potential for

Reducing Uterine Blood flow

Briggs - No human data for breat feeding

can be compatable

83
Q

Counseling for Topical Decongestants

Phenylephrine Spray / Vapor Inhalor / Benzedrex

oxymetazoline

A

Notify MD if: Insomnia / Tremor

Weakness / Irregular Heart beat

Do NOT exceed recommended dosage or duration

<3 days

Stinging / Burning / Drying

of NASAL MUCOSA may occur

84
Q

Loratadine Dose

A

10mg Qd

non drowsy

good for 2+

85
Q

Levocetirizine

Xyzal

A

Taken in the EVENING

Drowsiness warning

dosing for children 2+

2nd-gen-antihistamine

  • Not recommended for >65 yrs old*
  • or kidney disease*
86
Q

Issues with Robitussin DM

A

Has both DM & Guaifenesin

Guaifenesin = INCREASES secretions of Lower respiratory

DM = decreases the cough threshhold

together may cause retention of secretions

can lead to INFECTION / AIRWAY OBSTRUCTION

87
Q

Antitussives

for COUGH

A
  • Supress cough reflex by acting on cough center @ medulla
  • Indicated to decrease frequency of cough:
    • ​for Dry / Non-productive cough
  • Examples of FDA approvedd ingredients:
    • Dextromethorphan
    • Diphenhydramine
    • Codeine
    • Chlophendianol
88
Q

Primatine Mist / Tablets

A
  • Tablets = Ephedrine
  • Mist = Epinephrine (not available)
  • NOT RECOMMENDED IN ANY PATIENT
    • for temporary relief of SOB due to asthma
  • RX Bronchodialators are MORE EFFECTIVE
    • ​asthma patients are not good candidates for self-care
89
Q

Levocetirizine Dosing

Xyzal

A

5mg QD

TAKEN IN THE EVENING

drowsiness warning

not recommended in >65 y/o

or kidney disease

90
Q

Exclusions to Self-Treamtment

of COUGH

A
  • Cough w/ thick yellow or green sputum/phlegm
    • likely the cold can be treated (T_REAT UNDERLYING DISORDER TO STOP THE COUGH FIRST!)_
  • ​CHILDREN < 4 y/o
  • _​_Cough w/:
    • Chest Pain / SOB / tight-feeling throat
    • Swollen Legs/ankles
    • Rash / hemoptysis
  • Fever / Night Sweats
  • Chronic Cough > 7 days, or if worsens w/ treatment
  • H/O COPD / Asthma / Bronchitis / CHF
  • Suspected drug-associated cough
91
Q

TAC IS ALSO APPROVED FOR CONGESTION

A

TAC IS ALSO APPROVED FOR CONGESTION

PDAT1 (27 decks)

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