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OTC > Colds > Flashcards

Colds Flashcards

1
Q

Colds are a _____ of upper respiratory tract

A

viral infection

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2
Q

There are ______ cases annually

A

one billion

- part of top 5 diagnosed illnesses in the US

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3
Q

Approximately ______ spent annually on nonRx cold and cough

A

$7 billion

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4
Q

When is cold season?

A

late august - early april

- can occur at any time of year though

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5
Q

Colds are the leading cause of…

A

work and school absenteeism

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6
Q

Colds are limited to…

A

upper respiratory tract

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7
Q

Stimulation of sensory fibers results in…

A

sneezing

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8
Q

Cholinergic and sympathetic nerves innervate…

A

glands and arteries that supply the glands

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9
Q

The nose contains _____ nerves

A
  • sensory
  • cholinergic
  • sympathetic
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10
Q

Cholinergic stimulation leads to…

A

dilation of arterial blood flow

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11
Q

Sympathetic stimulation leads to…

A

constriction of arterial blood flow

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12
Q

Majority of colds are caused by…

A

rhinoviruses

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13
Q

Modes of viral transmission of cold:

A
  • self innoculation

- aerosol transmission

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14
Q

Pathophysiology of colds:

A
  1. rhinoviruses bind to intercellular adhesion molecule-1 receptors on respiratory epi cells in nose and nasopharynx
  2. infected cells release chemokines
  3. cytokines activate inflammatory responses
  4. inflammatory mediators and PNS causes hypersecretion of watery nasal fluid
  5. swelling of nasal mucosa
  6. inflammatory processes obstruct airways
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15
Q

Risk factors of colds:

A
  • higher exposure rates
  • less diverse social networks
  • allergic disorders affecting nose/pharynx
  • weakened immune system
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16
Q

What causes a weakened immune system?

A
  • smoking
  • sedentary life style
  • chronic psychological stress
  • sleep deprivation
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17
Q

Signs/symptoms of colds:

A
  • day 1: sore throat
  • day 2: nasal symptoms
  • day 3: cough
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18
Q

Symptoms of colds will last:

A

7 - 14 days

- coughs can last up to 3 weeks

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19
Q

Exclusions to self-treatment:

A
  • fever: > 101.5 F
  • chest pain
  • shortness of breath
  • symptoms worsening from self treatment
  • underlying cardiopulmonary disease
  • AIDS/chronic immunosuppresive therapy
  • elderly
  • infants < 9 months
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20
Q

Influenza is a highly contagious…

A

respiratory infection caused by influenza virus

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21
Q

Symptoms of flu are more abrupt in…

A

onset and severity

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22
Q

Symptoms of the flu:

A
  • high fever
  • chills
  • myalgia
  • fatigue
  • sore throat
  • stuffy nose
  • headache
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23
Q

Best way to prevent flu is to…

A

get flu vaccination every year

- for people > 6 months old

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24
Q

Flu season:

A

october - may

- peaks in january

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25
Q

Antibodies against the flu virus develops…

A

2 weeks after vaccination

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26
Q

____ vaccine is now the standard of care

A

quadrivalent

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27
Q

Rhinosinusitis is the inflammation of the…

A

mucosal lining of nasal passage and paranasal sinusitis

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28
Q

Rhinosinusitis can be caused by…

A
  • viral (90%): rhinovirus/coronavirus

- bacterial (10%): acute bacterial rhinosinusitis (ABRS)

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29
Q

Viral sinusitis symptoms:

A
  • nasal discharge that starts clear and watery and turns thick/discolored by day 4 or 5
  • nasal congestion, cough, and sore throat
  • fever/myalgias in first 24-48 hours
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30
Q

Bacterial sinusitis symptoms:

A
  • lasts > 10 days w/out improvement
  • high fever
  • purulent nasal discharge
  • facial pain
  • worsening symptoms after initial improvement
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31
Q

Cold prevention:

A
  • frequently wash hands w/ soap and water for at least 20 seconds
  • use tissues to cover mouth/nose when coughing/sneezing
  • use antiviral products to clean surfaces
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32
Q

Non-pharmacologic cold relief:

A
  • adequate rest
  • drink lots of fluids
  • use humidifier/vaporizer b/c loosens mucus and promotes sinus drainage
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33
Q

How to relieve sore throat:

A
  • sucking on hard candy
  • gargling salt water (1 tsp salt/8 oz)
  • drinking fruit juices/hot tea w/ lemon
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34
Q

Pharmacologic cold relief:

A
  • decongestants
  • antihistamines
  • local anesthetics
  • systemic analgesics
  • cough suppressants/expectorants
  • combo products
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35
Q

Mechanism of action of decongestants:

A
  • adrenergic agonists (sympathomimetics)
    1. stimulation of alpha-adrenergic receptors leads to vasocontriction
    2. decreases sinusoid vessel engorgement and mucosal edema
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36
Q

Decongestants will temporarily relieve…

A
  • common cold symptoms
  • upper respiratory allergy
  • sinusitis
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37
Q

Types of decongestants:

A
  • direct
  • indirect
  • combo
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38
Q

Direct acting decongestants will…

A

bind directly to adrenergic receptors

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39
Q

Indirect acting decongestants will…

A

displace norepi in nerve terminals

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40
Q

Combination decongestants will…

A

do both direct and indirect activities

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41
Q

Examples of direct acting decongestants:

A
  • phenylephrine
  • oxymetazoline
  • tetrahydrozoline
42
Q

Examples of indirect acting decongestants:

A

ephedrine

43
Q

Examples of combo decongestants

A

pseudophedrine

44
Q

Systemic decongestants:

A
  • pseudoephedrine (PDE): 60 mg every 4-6 hours

- phenylephrine (PE): 10 mg every 4 hours

45
Q

Phenylephrine is less effective because…

A

it undergoes extensive systemic metabolism, which leads to low bioavailability

46
Q

Naphazoline:

A
  • topical intranasal decongestant
  • short acting
  • directions: 1-2 gtts not more than Q6H
47
Q

Phenylephrine:

A
  • topical intranasal decongestant
  • short acting
  • directions: 2-3 gtts Q4H
48
Q

Xylometazoline:

A
  • topical intranasal decongestant
  • long acting
  • directions: 2-3 gtts Q8-10H
49
Q

Oxymetazoline:

A
  • topical intranasal decongestant
  • long acting
  • directions: 2-3 gtts Q10-12H
50
Q

Topical intranasal decongestants take how long to work?

A
  • onset of action: 30 minutes

- peak effects: 1-2 H

51
Q

Adverse events of decongestants:

A
  • cardiovascular stimulation
  • CNS stimulation
  • device related effects
52
Q

Examples of cardiovascular stimulation:

A
  • elevated bp
  • tachycardia
  • palpitations
  • arrhythmias
53
Q

Examples of CNS stimulation:

A
  • restlessness
  • insomnia
  • anxiety
  • tremors
  • fear
  • hallucinations
54
Q

Examples of device related effects:

A
  • burning
  • stinging
  • sneezing
  • dryness
55
Q

Overuse of nasal congestion can lead to…

A
  • nasal spray addiction

- rebound congestion

56
Q

Rebound congestion can be avoided by…

A

stopping topical decongestant use after 3 days

57
Q

Treatment of rebound congestion:

A
  • withdrawal of topical decongestant
  • replace topical decongestant w/ topical normal saline
  • rhinostat kit
58
Q

Decongestant drug interactions:

A
  • w/ MAO inhibitors (selegiline, phenelzine)

- diseases that are sensitive to adrenergic stimulation

59
Q

Examples of diseases that are sensitive to adrenergic stimulation:

A
  • hypertension
  • coronary heart disease
  • diabetes
  • hyperthyroidism
  • prostatic hypertrophy
60
Q

T/F: pseudoephedrine can’t be used to make meth

A

F

61
Q

Methamphetamine Epidemic Act:

A
  • written in 2005
  • classified pseudoephedrine as “scheduled listed chemical product”
  • purchase restrictions
62
Q

What are the purchase restriction on pseudoephedrine :

A
  • need a valid ID
  • limit of 3.6 g/day
  • limit of 9g/month
63
Q

T/F: monotherapy of antihistamines are enough to treat colds

A

F, need combo of first gen antihistamines and decongestants

64
Q

Systemic analgesics are used to treat…

A
  • aches

- fever

65
Q

Examples of systemic analgesics:

A
  • aspirin: avoid in children
  • acetaminophen
  • ibuprofen: NSAID
  • naproxen: NSAID
66
Q

Directions for aspirin:

A

325-650 mg Q4-6H

- max: 4g/day

67
Q

Directions for acetaminophen:

A

650 mg PO Q4-6H

- max: 3g/day

68
Q

At high doses of acetaminophen…

A

there’s a risk of liver toxicity

69
Q

Directions for ibuprofen:

A

400 mg PO Q4-6H

- max: 1.2 g/day

70
Q

Directions for naproxen:

A

200 mg Q8-12H

- max: 600 mg/day

71
Q

Local anesthetics provide temporary relief of…

A

sore throat

72
Q

Examples of local anesthetics:

A
  • benzocaine

- dyclonine hydrochloride

73
Q

Forms of local anesthetics:

A
  • lozenges

- sprays

74
Q

T/F: local anesthetics are effective for viral infections

A

F

75
Q

Local anesthetics can be used every…

A

2-4H

76
Q

Onset of local anesthetics occur…

A

immediately on contact

77
Q

Adverse effects of local anesthetics:

A
  • mouth tingling
  • mouth numbness
  • irritation
78
Q

Avoid use of local anesthetics in…

A
  • children < 2 YO
79
Q

Cough suppressants are used to treat…

A

nonproductive coughs

- reduces cough frequency

80
Q

Examples of cough suppressants:

A
  • codeine
  • dextromethorphan
  • topical agents
81
Q

Expectorants are used to treat…

A

symptomatic relief of productive cough
(Guaifenesin)
- reduces chest discomfort from excess mucus

82
Q

T/F: combination products are inconvenient

A

F, are convenient

83
Q

Combination products carry the risk of…

A

unnecessary drugs

84
Q

Special populations:

A
  • pregnant women
  • breastfeeding women
  • pediatrics
  • elderly
85
Q

Providers recommend ____ therapy for pregnant women

A

nonRx

86
Q

Avoid _______ in first trimester b/c of possible birth defects

A

pseudoephedrine

87
Q

Preferred topical decongestant during pregnancy:

A

oxymetazoline

88
Q

Preferred decongestant for lactating mothers:

A

pseudoephedrine

89
Q

Risk of _________ w/ systemic decongestant use in lactating mothers:

A

decreased milk production

90
Q

FDA made a public health advisory for OTC products in pediatrics during what year?

A

2008

91
Q

FDA stated…

A
  • should avoid use of OTC cough and cold medications in children < 2 YO
  • potential serious and life threatening adverse effects
92
Q

In October 2008, manufacturers voluntarily updated labels advising non-use in children ______ YO

A

< 4

93
Q

FDA guidelines in 2011 for liquid nonRx products that included dispensing device:

A
  • dosing device needs to be included w/ all oral liquid nonRx products
  • device needs to be calibrated to dose recommended in product directions
  • device used only w/ product
  • markings remain visible when liquid is in device
94
Q

Dosing for elderly:

A
  • start low and go slow
95
Q

Treatment of sore throat:

A

local anesthetics and/or systemic analgesics

96
Q

Treatment of dry, nonproductive cough:

A

cough suppressant

97
Q

Treatment of wet, mucus-producing cough:

A

expectorant

98
Q

Treatment of nasal congestion:

A

topical/systemic decongestants

99
Q

Treatment of aches and pains:

A

systemic analgesics

100
Q

Treatment of fever:

A

systemic antipyretics

OTC (23 decks)

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