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153 > Colds 7.1 > Flashcards

Colds 7.1 Flashcards

1
Q

What is the pathophysiology for the common cold

A
  • A viral invasion
    • There are over 200 types of different colds
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2
Q

Do we care about the type of cold it is (what virus caused it)

A
  • No We don’t care about what type of the cold as we cant differentiate between the types of colds
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3
Q

Is there a vaccine for the common cold

A
  • Since there is no specific type this means there will not be a specific vaccine in the foreseeable future
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4
Q

Common symptoms of the cold day1,3,6

A

a) Day 1: sore throat rhinorrhea, sneezing
b) Day 3: nasal congestion (usually caused by rhinorrhea), sinus headache( 4 pairs of sinuses in the headache and is buildup as they cant discharge as much), plugged ears (more so with kids)
c) Day 6: cough

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5
Q

What are the symptoms of colds we usually focus on and want to treat

A
  • Nasal congestion and cough
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6
Q

At what day do people with common cold come to the pharmacy

A
  • Around day 3
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7
Q

When are symptoms worse during the day

A
  • Perceived to be worse at night
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8
Q

How long can a cough stay after the cold

A
  • Can last up to 18 days or even longer
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9
Q

What is the first thing we look at when trying to diagnose and treat with a common cold

A
  • Head cold vs chest cold
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10
Q

What is worse between head and chest cold

A
  • Start to be more concerned with chest cold
    • Head cold is easier to deal with
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11
Q

What is the common chest cold (to less common as it gets deeper into the lungs)

A
  • Bronchitis-> bronchiolitis-> pneumonia
    • We cant differentiate between them as pharmacists
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12
Q

Different types of cough types

A

a) Congested/ productive (useful to body)
b) Congested/ non productive (will become useful)
c) Dry non productive (not useful)

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13
Q

Congested/ productive cough

A
  • Useful to body
    • Cough associated with chest congestion and the expectoration of phlegm
      • Will tell them to use nothing as we cant promote them to make things better
      • Can say hot water or lemon drop
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14
Q

Congested/ non productive cough

A
  • Cough associated with chest congestion but little expectoration of phlegm
    • They will become productive eventually unless you have something wrong
      • Try to accelerate to productive, medicine doesn’t do to much
      • Can tell them to take a hot shower…
    • Could recommend an expectorant
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15
Q

Dry/ nonproductive cough

A
  • Cough not associated with chest congestion, no phlegm
    • Stimuli is far different then bronchitis
      • Can become productive and turn into bronchitis
      • Can stay like this
      • We may be able to suppress this and give relief such as DM
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16
Q

What do we do with infants and children with the common cold

A
  • We refer much quicker then someone who is older, harder to find medicines to kids, by law and morals
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17
Q

Do infants/ children get more or less colds

A
  • They get on average 8 colds a year, adults get about 1
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18
Q

Infant vs children symptoms

A

a) Infants: similar symptoms, may show early fever (up to 39C) gastrointestinal upset (diarrhea), congestion is a problem if breast feeding
b) Children: less fever like and more like adults

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19
Q

How is the cold spread

A
  • Direct contact with cold sufferer
    • Inhaled droplets
    • Eye/nose contact
    • Inanimate objects
    • Kissing? Believe that it is not because the mouth process is harder to get sick but can still get sick
      From other ways through kissing
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20
Q

Can we get a common cold from cold/ wet weather

A
  • It is a vasomotor response rather then a cold
    • For the most part does not happen, when it is very cold and then warm up quickly vice vs, all you get is a vasomotor response (runny nose) to the temperature change, only lasts a couple hours so some people credit the meds to it stopping
21
Q

Does hand washing and anti-viral tissues work with limiting spread of a cold

A

a) Hand washing: Does work to a point
- But do not need to do it extensively to get rid of every single germ
b) Anti viral tissues: Colds are going to happen either way
- Not a big player

22
Q

How to do a differential diagnosis between the common cold and others

A
  • Most common is the common cold and if you factor this out can go down the list
    • Common cold-> bronchitis/sinusitis->influenza-> covid(gets all the attention)->strep throat
23
Q

Differentiating between simple colds and influenza (the flu)

A
  • Patients use cold and flu interchangeable but treatment is usually similar
    a) Simple colds: When it gets to congestion and cough it gets our attention
    - Takes a couple days to hit
    - Doesn’t knock you out from the body stand point
    b) Influenza:
    • Hits you hard (bed rest)
    • Faster onset (could be hours)
    • Systemic symptoms (especially body aches)
    • Cough more sever (dry type)
    • Spiking fever (can kill in elderly)
24
Q

what symptoms lead us to thinking its a flu

A
  • Hits you hard (bed rest)
    • Faster onset (could be hours)
    • Systemic symptoms (especially body aches)
    • Cough more sever (dry type)
      Spiking fever (can kill in elderly)
25
Q

Within the flu vs cold medication what change

A
  • With flu treatment all they add is acetaminophen or a pain killer as the flu has more body aches
26
Q

Non pharmacologic treatment for influenza

A
  • Recommend fluids and rest
    • Reduce spread of virus by: washing hands, cover mouth when coughing/ sneezing, staying at home when not feeling well
27
Q

Pharmacologic treatment of influenza

A

a) OTC
- Analgesics, antipyretics to aid fever, headache or myalgia
- Acet or ibuprofen
b) Prescription therapy
- Antivirals: may reduce symptoms if started within 48 hours and the sooner the better

28
Q

When can pharmacists prescribe oral antiviral agents

A
  • Pharmacists can only prescribe oral antiviral agents when an epidemic or pandemic is declared by chief medical health officer for sask
29
Q

What is the most common virus causing a simple cold

A
  • Rhinovirus
30
Q

Covid 19 symptoms in comparison to the flu and common cold

A
31
Q

How to tell if its asthma

A
  • Persistent cough (maybe greater at night)
    • No cold like symptoms (Although the common cold is one of the most common inducer of asthma)
    • Wheezing/ shortness of breath
    • Chest tightness
32
Q

What are symptoms of asthma commonly triggered by

A
  • Exercise, allergens, cold
33
Q

Differential diagnosis of GERD

A
  • Gastroesophageal reflux disease (occurs when stomach acid keeps flowing back in the esophagus)
    • Irritated throat/ heartburn
    • Unproductive/ dry cough (Can cause a chronic cough)
34
Q

Differential diagnosis of Post nasal drip

A
  • Sore throat (with throat clearing)
    • Unproductive cough
    • Sinus involvement often
    • Enough of it can cause a dry unproductive cough, not in chest rather back of the throat
      • Cause of chronic coughing
      • A lot of attempting to clear throat
35
Q

Differential diagnosis of allergic rhinitis

A
  • “summertime colds”
    - Colds are a lot less common in the summer so this is a very good indicator
    • Seasonal or chronic
    • Last longer then colds ( Common colds can last 5-20 days while this can last all summer)
    • Rhinitis, sneezing, itch, ocular symptoms,
    • Cough is rare (unless allergies cause PND)
36
Q

When trying to differentiate between conditions do we only look at the symptoms they have

A

We look at both the ones that they have and don’t have

37
Q

Smokers cough

A
  • Often worse in morning
    • Minimal sputum
    • Don’t think of from the get go
    • Smoker usually says that they smoke
    • 40% of smokers have a cough compared to 12% of non smokers
38
Q

What can smokers cough cause

A

a) Chronic bronchitis (COPD)
- Ends with this
- Lots of sputum

39
Q

Treatment of smokers cough

A
  • Quit smoking (right after quitting cough often increases)
    • Stay hydrated
    • Salt water
    • Cough drops or lozenges
    • Inhale mink vapors
    • Elevate head while sleep
    • Spoonful of honey
40
Q

Acute bronchitis

A
  • Lower resp tract infection
    • Chest cold
    • Similar to common cold but increased cough
    • Cough started non-productive and becomes productive
41
Q

How long can acute bronchitis last

A
  • Up to three weeks
42
Q

What does green sputum in acute bronchitis mean (viral or bacterial)

A
  • Is not necessarily bacterial but could rather a process of the inflammatory response
43
Q

ACE inhibitors within cough

A

CE inhibitors are important in high blood pressure treatment
- About 8% of ACEi patients use antitussives (cough suppressant)
- Can get a cough (dry, raspy) when using ACEi but could take up to 1 year to occur
- If this happens discontinue agent and prescribe a new one (cough should clean in 1 week up to 3 months)

44
Q

Who is strep throat common in

A
  • Kids: 37% in 5-15y, while 15% in adults
45
Q

Strep throat symptoms

A
  • Increase fever and pain
    • Cough is less common
    • Exudate/ swollen glands/ rash
46
Q

What type of infection is sore throat, strep throat, tonsillitis

A
  • Need to do testing for strep and hard to tell by looking
    a) Sore throat: viral
    b) Strep: bacterial
    c) Tonsillitis: the tissue in the case
47
Q

How to diagnose strep (GABHS)

A
  • If they have fever, no cough, tender lymph nodes, tonsillar exudate (fluid that leaks out)
    • Have a 50:50 chance of being right
    • And consider empiric treatment with antibiotics (not us)
48
Q

Are antibiotics needed for strep throat

A
  • Strep can cause effects on other tissues (rheumatic fever-> heart or kidney damage)
    • Even though it is a bacterial infection we give antibiotics to ensure no damage on other organs
49
Q

how long does it take bacterial or viral sore throats to resolve

A
  • 40% symptom free in 3 days and 85% are symptom free in 7 days whether bacterial or viral
    • If it resolves in 3-5 days it was just a sore throat

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