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CDM Exam 3 > Common Cold > Flashcards

Common Cold Flashcards

1
Q

Common Cold

A

self-limited viral infection

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2
Q

most transmission of common cold is by

A

self-inoculation

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3
Q

Virus infects

A

respiratory epithelial cells

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4
Q

In common colds, we see release of

A

chemokines and inflammatory mediators

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5
Q

Symptoms of common colds are caused by

A

inflammatory mediators

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6
Q

Signs and symptoms: 1-3 days

A

Sore throat, may have watery nasal secretions

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7
Q

Signs and symptoms: 3-5 days

A

Cough (occurs in <30% of patients)

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8
Q

Signs and symptoms: 5-6 days

A

Thick nasal secretions, may be yellow or green

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9
Q

Signs and symptoms: 7-14 days

A

Symptom resolution

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10
Q

Flu symptoms

A 
More sudden onset
Less nasal (stuffy or runny) symptoms
Higher fever
Extreme tiredness
Dry cough
Aches and chills common
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11
Q

Complications of untreated cold

A

Sinusitis
Eustachian tube obstructions
Bronchitis, bacterial pneumonia
Asthma or COPD exacerbations

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12
Q

Goal of treatment

A

Reduce symptoms

There is no cure, self-limiting

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13
Q

Self care exclusions

A

Fever >101.5ºF
Underlying cardiopulmonary disease (CHF, asthma, COPD)
Shortness of breath
Chest pain
Immunosuppressed (HIV, immunosuppressant medications, etc)
Infants <9 months old
Frail elderly patients

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14
Q

Non-Pharm therapy

A 
Non-caffeinated fluids (unless restricted)
Adequate rest
Nutritious diet
Cool mist vaporizers
Steam showers
Saline gargle 
Nasal irrigation / saline spray
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15
Q

Preventing viral spread

A

Cover mouth & nose when coughing/sneezing

Wash hands frequently

  • -> Soap and water for at least 20 seconds
  • -> alcohol-based hand sanitizer with 60-80% ethanol

Use antiviral disinfectants to clean high-touch surfaces

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16
Q

Considerations

A

The common cold is a viral infection and antibiotics are not effective
Treat symptoms only as they arise
Select treatment(s) that will alleviate specific symptom(s)
Avoid treating symptoms that the patient doesn’t have
Single-entity products vs. combo

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17
Q

Nasal Congestion

A

Oral or intranasal decongestants
Choose depending on patient’s preferences and comorbidities
Can be used in combination with antihistamines if other nasal symptoms are present

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18
Q

Rhinorrhea/Sneezing

A

First line: 1st generation antihistamine

  • -> MOA is drying of nasal passages via anticholinergic effects – not a histaminergic process
  • -> Only 1st generation antihistamines have anticholinergic properties, 2nd generation antihistamines are not effective for rhinorrhea in the common cold

Alternative: intranasal ipratropium (needs Rx)

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19
Q

Benzocaine brand names

A 
Chloraseptic lozenge (benzocaine 6mg/menthol 10mg)
Cepacol lozenge (benzocaine 15mg/menthol 3.6mg)
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20
Q

Benzocaine MOA

A

Local anesthetic, temporarily numbs pharynx to relieve pain

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21
Q

Pharyngitis Medications

A

Benzocaine

Dyclonine HCl

22
Q

Benzocaine ADE’s

A

Warning: methemoglobinemia

23
Q

Benzocaine clinical pearls

A

Avoid in patients with allergy to local anesthetics

Do not use for longer than 2 days

24
Q

Dyclonine HCl brand names

A

Cepacol sore throat spray (dyclonine HCl 0.1%/glycerin 33%)

25
Q

Dyclonine HCl MOA

A

Local anesthetic, temporarily numbs pharynx to relieve pain

26
Q

Dyclonine HCl ADE’s

A

Rash, Hives

27
Q

Dyclonine HCl Clinical pearls

A

Counsel patients to avoid swallowing

Do not use for longer than 2 days

28
Q

Cough

A

Evidence does not support the effectiveness of antitussives, expectorants or 2nd generation antihistamines for symptoms of common cold
Most likely cause of cough in common cold=UACS
Combination of 1st generation antihistamine and decongestant may be effective

29
Q

Echinacea purpurea

A

Purported to be an immunostimulating agent

Not reliably shown to prevent URTIs

30
Q

Echinacea purpurea safety

A

Avoid in children <2, pregnancy, breastfeeding moms, those with allergies to ragweed/daisies/mums/marigolds
May potentiate PO hypoglycemic agents
May increase INR with warfarin

31
Q

Zinc

A

Reported to block adhesion of rhinovirus to nasal epithelium

32
Q

Zinc prevention

A

May decrease number of colds/year if taken every day for at least 5 months

33
Q

Zinc treatment

A

May reduce duration & severity of symptoms if treatment initiated within 24hrs of symptom onset
Use Q2hrs while awake for duration of cold

34
Q

Zinc ADRs/Safety

A

Nausea, upset stomach
Bitter taste
Case reports of anosmia with nasal products
Avoid citrus juices within 1 hr post dose (can chelate zinc)

35
Q

Vitamin C (ascorbic acid)

A

Prevention: Not effective to prevent colds
Treatment: does not appear to be effective at reducing symptom severity/duration

ADRs:
Doses >2g/day associated with GI complaints and diarrhea

36
Q

Airborne, Emergen-C, Immune +

A

Not proven effective

37
Q

Colds in Children

A

avoid dehydration

Biggest risk to OTC treatment of children is incorrect dosing

38
Q

Per FDA : All OTC cough and cold meds should be avoided in kids under

A

2

39
Q

Call health care provider if child is

A

<3 months

Fever for >24 hrs in children <2

ear pain or sore throat

symptoms remain after 10-14 days

40
Q

Colds in pregnancy

A

avoid drug therapy in the first trimester

avoid all long acting, ER or SR, or alcohol containing products

41
Q

Pregnancy and analgesics

A

Acetaminophen best choice
Avoid Aspirin
Avoid NSAIDS in 3rd trimester

42
Q

Pregnancy and antihistamines

A

Chlorpheniramine, diphenhydramine, clemastine, doxylamine safest choices

Loratadine may be considered if 1st generation agent not tolerated

43
Q

Pregnancy and cough agents

A

Avoid if possible due to questionable efficacy

44
Q

Pregnancy and decongestants

A

avoid 1st trimester use, oxymetazoline nasal spray is drug of choice when used at recommended doses (limit to < 3-5 days of use)

45
Q

Breastfeeding and analgesics

A

Acetaminophen or ibuprofen considered compatible
Avoid aspirin
Topical benzocaine, camphor & menthol considered compatible

46
Q

Breastfeeding and antihistamines

A

1st generation antihistamines may reduce milk production & cause sedation or paradoxical excitation in infant, loratadine is antihistamine of choice
Dextromethorphan and guaifenesin probably ok, limited data
Alcohol in formulations not a safety hazard at recommended doses

47
Q

breastfeeding and decongestants

A

Pseudoephedrine is considered ‘usually compatible’ but may reduce production, is considered the preferred option due to lack of data with intranasal oxymetazoline

48
Q

Breastfeeding and cough

A

Dextromethorphan and guaifenesin considered compatible

49
Q

colds and geriatrics

A

Use single agents & local vs. systemic dosage forms when possible
Analgesics: Use acetaminophen instead of NSAIDs when possible to avoid drug interactions and renal effects
1st generation antihistamines: sedation & cognitive ADEs
Assess for drug-drug and drug-disease interactions

50
Q

Patient counseling

A

Colds usually resolve in 7-10 days, if not:

Use maximal doses of medications
Change medications
Contact your HCP

51
Q

Seek Medical Attention if:

A

Symptoms worsen while self-treating
Symptoms of bacterial infection
Sore throat persists or is associated with persistent fever, headache, nausea or vomiting

CDM Exam 3 (8 decks)

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