Acute Cough (complete) Flashcards
what are some non pharm measure for cough?
hydration and humidification;
nasal saline irrigation, or nasal suctioning in young children
is cough drop beneficial?
ok for symptom relief, but it may also increase cough severity and duration
is antihistamine recommended for cough? first vs second generation - which is better?
diphenhydramine may have a small effect on cough caused by upper respiratory tract infections - anticholinergic properties may reduce postnasal drip;
2nd gen - lacks significant anticholinergeic effects - not effective for acute cough unless secondary to allergic rhinitis
Cough due to viral infections appears to arise from stimulation of the cough reflex in the upper respiratory tract caused by..?
postnasal drip
which decongestants can be helpful with postnasal drip?
oxymetazoline, xylometazoline, pseudoephedrine, phenylephrine
is anticholinergic helpful in cough?
yes - ipratropium - reduces mucus secretion in the airways and can be recommended for symptoms of rhinitis or the common cold.
how does antitussive work to supress cough?
exact mechanism is unknown but the brainstem is thought to be the main region where antitussive agents act to inhibit motor control of cough.
for cough due to COPD, what is shown to be effective?
codeine and dextromethoprphan supresses cough counts by 40-60% - may be used for short-term relief.
what is Clofedanol (chlophedianol) ?
OTC antitussive agent (recently been reclassified) - little evidence available for efficacy
is guaifenesin effective?
lack of evidence to support the efficacy
what about honey for cough?
effective cough suppressant in children and adults - administered before sleep;
better than no treatment, placebo, or diphenhydramine, and no different from DM.
better than placebo or salbutamol for reducing the duration of cough.
what is the MOA for honey?
demulcent, antioxidant, antibacterial
what is caution for honey?
only for older kids older than 1 year
is zinc effective for cough?
conflicting results - insufficient evidence;
zinc lozenges may slow recovery time and may cause adverse events including unpleasant taste, mouth irritation and nausea
what about benzocaine, phenol, menthol?
reduce sensitivity of peripheral nociceptors - evidence is poor
ivy/thyme syrups?
modest efficacy - but no evidence regarding their tolerability, no recommendations can be made until further studies are conducted
when should bronchodilators used?
only for cough due to obstructive lung disease such as asthma or COPD.
what about inhaled corticosteroids?
potential benefit for respiratory infection
what are the cough syrup ingredient that is not indicated less than 6 years old? and why?
DM, guaifenesin, 1st gen antihistamine (diphenhydramine) - due to very rare serious side effects (seizure, heart rate increase, decreased level of consciousness, abnormal heart rhythms and hallucinations) as well as misuse and overdose.
for children 6 years and older, which can be used?
DM
clofedanol (chlophedianol) in kids?
2 years and older
codeine or other opiods for kids?
no, only 18 years and older.
what is the dose for honey for kids 1-18 yrs?
2.5-10ml HS
what is the precaution of honey?
no if younger than 1 year or immunocompromised patients, or who have structural abnormalities of the GI tract. if allergic to pollen
