72: OTC cough/cold

Question 1

Productive cough

Answer 1

-wet, chesty
-expelling secretions
-ability of lung to fight infection

Question 2

Non-productive cough

Answer 2

-dry, hacking
-no secretions
-RTI, bacteria, meds, GERD

Question 3

Cold

Answer 3

-rhinovirus
-direct contact or air transmission

Question 4

Factors that inc susceptibility to the cold

Answer 4

-poor nutrition
-smoking
-high pop density
-sedentary
-fatigue
-physical/emotional stress

Question 5

Cold v flu

Answer 5

-more gradual
-less fatigue, chest discomfort
-more congestion
-more sore throat
-no aches/chills

Question 6

When to refer a cold

Answer 6

-fever over 101.5
-new chest pain
-SOB
-worsening symptoms
-immunocompromised (aids)
-under 3 months old
-allergy to OTC meds

Question 7

Cold symptoms

Answer 7

-rhinorrhea
-congestion
-cough
-headache
-sore throat

Question 8

Pharma tx of rhinorrhea

Answer 8

-1st gen antihistamines
-2nd gen histamines
-intranasal corticosteroids

Question 9

First-gen antihistamines for rhinorrhea

Answer 9

-Benadryl (diphenhydramine)
-Unisom (doxylamine)
-also relievees sneeze!

Question 10

Cons of first gen antihistamines

Answer 10

-sedating
-short acting
-anticholinergic (avoid in older pt)

Question 11

Second gen antihistamines for rhinnorrhea

Answer 11

-Zyrtec (cetirizine)
-Allegra (fexofenadine)
-Xyzal (levocetirizine
-Clairtin (loratidine)

-daily
-non-sedating

Question 12

Intranasal corticosteroids for rhinorrhea

Answer 12

-Rhinocort (budesonide)
-Nasacort (traimcinolone)
-Flonase (fluticasone)

-good for allergies
-nasal spray

Question 13

Non pharma tx of rhinorrhea

Answer 13

-environmental
-saline washes
-nasal strips

Question 14

Congestion pharma tx

Answer 14

-oral decongestants
-nasal decongestants
-intranasal saline

Question 15

Oral decongestants

Answer 15

-sudafed (psuedoephedrine)
-avoid in uncontrolled HTN
-may cause insomnia

Question 16

Nasal Decongestants

Answer 16

-Afrin (oxymetazoline)
-max 3 days
-temp relief

Question 17

Intranasal saline for congestion

Answer 17

-useful for preg and kids
-temp relief

Question 18

Congestion non-pharma tx

Answer 18

-neti pot
-nasal aspirator
-bulb syringe

Question 19

Cough pharma tx

Answer 19

-expectorants for productive
-suppressants for non-productive

Question 20

Expectorants for productive cough tx

Answer 20

-Mucinex (guaifenesin
-low side effects
-not that effective

Question 21

Suppressants for non productive cough tx

Answer 21

-Delsym (dextromethorphan) abuse potential
-Vick’s vaporub (camphor/menthol) not for kids under 2

Question 22

Cough non pharma tx

Answer 22

-honey
-lozenges
-humdifiers/vaporizers

Question 23

Headache and Sore throat tx

Answer 23

-Tylenol
-NSAIDs

Question 24

Tylenol for HA/sore throat

Answer 24

-less side effects
-avoid w alcohol

Question 25

NSAIDs for headache/sore throat tx

Answer 25

-Motrin (ibuprofen)
-aleve (naproxen)
-Bayer (asprin)

-sometimes more effective
-inc risk for bleeding, PUD, AKI, CV risk

Question 26

Headache/sore throat nonpharma tx

Answer 26

-honey
-lozenges
-adequate rest and exercise

Question 27

PM otc

Answer 27

-diphenhydramine
-doxylamine

Question 28

cold/flu meds

Answer 28

-combo decongestant, antihistamine, cough suppressant, acetaminophen

Question 29

Other considerations for cough, cold, flu

Answer 29

-Tamiflu
-pain control
-zinc
-echinacea
-vitamin C

Question 30

Tamiflu (Oseltamivir)

Answer 30

-flu tx
-flu prophylaxis in pt at high risk of ocmplications

Question 31

tamiflu considerations

Answer 31

-efficacy for tx not established in pt beginning therapy after 48 hours of symptom onset
-can be used in infants < 8 months