9. Cough, Colds, Flu, Covid, Fever, etc. Flashcards
Pathophysiology of the Common Colds
It’s a VIRUS
* Viral invasion
* Over 200 types of viruses - makes finding a vaccine impossible for the common colds
Is there a vaccine for colds?
No!
* There are two many viruses that can cause colds and they mutate too quickly.
* Too many things around to block its pathway
* Not advisable to avoid getting the cold with a vaccine - need to strengthen our adaptive immune response
Influenza Vaccines
How are the annual flu shots developed?
Developers do their best to assess what flu strains are likely to be predominate prior to flu season and prepare the body on which subunits of flu might encounter.
* Based on what research indicates are most likely to spread and cause illness among people during the upcoming flu season
* Cannot make those predictions with the common colds.
Why is it necessary for us to not be immuned to things like the common cold?
To strengthen our adaptive immune system.
* We need to expose ourselves to viruses here and there to make sure our immune systems are working and make sure they are ready when exposed to similar pathogens in the future.
What would happen if we went common cold free?
Be more susceptible to harsher viruses such as RSV, pneumonia, COVID, etc.
What are some of the “starting points” in the process of a common Head cold?
Day 1, Day 3, Day 6, etc.
FYI: Everyone is slightly different when it comes to common head cold presentations but somewhere to start.
Day 1: Sore throat (nagging, noticable but usually mild pain), Rhinnorhea (i.e., nasal discharge ), Sneezing.
as the infection continues, inflammatory responses get more involved takes the rhinorrhea more of a nuisance or problematic
Day 3: Nasal congestion (inflammatory responses makes it more difficult to get things out of the nose - less leaking = can’t sleep), Sinus headache (from the fluid build-up causing pain from inefficient draining at the front of the face), Plugged ears
Day 6: Cough
Rhinorrhea
Runny Nose – Discharge from the nose.
* Vessel dilation in the nasal mucosa from congestion. Nose starts to leak out to cause a runny nose.
Sneezing
Stimulation of the histamine (H1) receptors on the nasal mast cells, particularly on the sensory nerve endings of the nose.
Describe some of the symptoms might encounter on Day 1 of a common head cold
FYI: Everyone is slightly different when it comes to common head cold presentations but somewhere to start.
Day 1:
* Sore throat (nagging, noticable but usually mild pain),
* Rhinnorhea (i.e., nasal discharge ),
* Sneezing
Describe some of the symptoms might encounter on Day 3 of a common head cold
FYI: Everyone is slightly different when it comes to common head cold presentations but somewhere to start.
Day 3:
* Nasal congestion (inflammatory responses makes it more difficult to get things out of the nose - less leaking = can’t sleep),
* Sinus headache (from the fluid build-up causing pain from inefficient draining at the front of the face),
* Plugged ears
**as the infection continues, inflammatory responses get more involved takes the rhinorrhea more of a nuisance or problematic **
Describe some of the symptoms might encounter on Day 6 of the common head cold
FYI: Everyone is slightly different when it comes to common head cold presentations but somewhere to start.
Day 6: Cough
What are the symptoms we as pharmacist going to zero-in on when counseling for things like a common head cold?
- Nasal Congestion - can’t sleep, can’t breathe
- Cough - can’t sleep
The most bothersome symptoms
Common Chest Colds are also known as ____
(Acute) Bronchitis
Bronchitis (i.e., chest cold) affects which respiratory tract(s)
Upper Respiratory Tract (URT)
* Affects the bronchi that causes coughing
- Dry & unproductive cough (i.e., dry, hacking cough) during the first few days before it becomes a congested & productive cough
Strep Throat - Viral or Bacterial?
Bacterial Infection
* Sore throat (e.g., pain to swallow anything)
* Red and swollen tonsils
* Fever
* Swollen lymph nodes
* Contageous - Respiratory droplets and Direct contact
Respiratory Syncytial Virus (RSV)
A common respiratory viral infection in the lungs and respiratory tract.
- Do not know if infected with RSV until they get tested (and if tests positive).
3 Types of Coughs
List the 3 Types of Coughs
- Congested/Productive
- Congesed/Unproductive
- Dry/Nonproductive
What does it mean to have a “congested” cough?
- Chest feels heavy
- Whenever I cough, it hurts and feels like something is coming up [thick mucus] from the bronchi and lungs
- Wheezing and/or crackling when breathing
3 Types of Coughs
Why are Congested/Productive Coughs useful to the body?
- Associated with chest congestion and the expectoration of phlegm
- Wet, productive cough to expel the mucus
- Coughing becomes easier as things starts to loosen up.
- More phlegm is being expectorated (compared to nonproductive) with the wet sounded cough
- Would prefer to leave it be whenever possible as the cough is helping get the bad stuff out.
3 Types of Coughs
Congested/NONproductive Cough
- Also associated with Chest Congestion
- It will EVENTUALLY be useful for the body…
- Cough has NOT loosened yet… Nothing [no phlegm] is coming out yet.
- Hacking cough
- Would prefer to leave alone whenever possible because of its (future) productive aspects
- Usually occurs before the congested/productive coughs
3 Types of Coughs
Dry/NONproductive Cough
- Not useful to the body at all
- No phlegm
- Very dry cough but NOTHING ever comes out
- Raspy cough
- Would be okay to suggest or try something like an antitussive to get rid of it as it has no value
In general, what kind of congestion can we have (2)?
- Chest [congestion]
- Nasal [congestion]
However, decongestants should NOT be used for both kinds of congestions. We cannot decongest the chest - we need an expectorant!
What are decongestants for?
Nasal congestion, only!
It does not help with chest congestion.
Example: Pseudoephedrine , Phenylephrine
Expectorant
Claimed as an agent used to enhance cough effectiveness by clearing the airways and to loosen and let out the thick mucus in lungs and bronchi via phlegm.
Guaifenesin
An expectorant that is claims to help let out mucus in the lungs and bronchi.
Antitussives
Typically used as a cough suppressant
Examples:
- Dextromethorphan (DM)
- Codeine
Dextromethrophan (DM) is what kind of agent?
DM = Antitussive = Cough Suppressant related to respiratory tract infections.
Other than being used as an analgesic, what can codeine be used for?
Treat cough associated with a respiratory infection
Are antitussives (e.g., codeine, dextromethorphan) effective?
While common to use for cough via respiratory tract infection, there is little evidence to suggest valid efficacy.
However, antitussives are seen to be effective to treat coughs associated to COPD.
Antitussives vs. Decongestants vs. Expectorants
Antitussives = Cough
Decongestants = Nasal Congestion
Expectorants = Phlegm (enhancing productive cough efffects)
3 Types of Coughs
What do the Congested/Productive & Congested/Nonproductive Coughs **have in common? **
- Both are associated with chest congestion
- Both produce phlegm (BUT in different amounts)
- Because they are useful (or eventually will be useful), it is best to not take any agents whenever possible and let nature take its course.
3 Types of Cough
Which kind of cough elicits a wet, girgling cough?
Congested/Productive Cough - due to the loosening of the mucus in the lungs and bronchi which is trying to get expectorated as phlegm.
3 Types of Cough
Which cough is described as a “hacking” cough?
Congested/Nonproductive Cough - lungs and bronchi has thick mucus that has not yet loosened resulting in the heavy cough.
3 Types of Coughs
Which cough can be associated with a Smoker’s Cough or a “raspy” cough?
Dry/Nonproductive cough - Very dry cough but nothing ever comes out.
Head Cold vs. Chest Cold
- Head Cold - Throat, nose, sinuses. Easier to tolerate and nothing to worrisome and mild.
- Chest Cold - Deeper in the lungs and more involvement towards the upper respiratory tract. Between the two, would be a bit more worrisome.
- Bronchitis - Acute/Simple Chest Infection
- Bronchiolitis - Chest Infection hitting the bronchioles.
- Pneumonia - Infection that causes inflammation on one or both of our aveoli. Most worrisome of the three chest colds.
