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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
Dyclonine HCl MOA
Local anesthetic, temporarily numbs pharynx to relieve pain
26
Dyclonine HCl ADE's
Rash, Hives
27
Dyclonine HCl Clinical pearls
Counsel patients to avoid swallowing | Do not use for longer than 2 days
28
Cough
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
Echinacea purpurea
Purported to be an immunostimulating agent | Not reliably shown to prevent URTIs
30
Echinacea purpurea safety
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
Zinc
Reported to block adhesion of rhinovirus to nasal epithelium
32
Zinc prevention
May decrease number of colds/year if taken every day for at least 5 months
33
Zinc treatment
May reduce duration & severity of symptoms if treatment initiated within 24hrs of symptom onset Use Q2hrs while awake for duration of cold
34
Zinc ADRs/Safety
Nausea, upset stomach Bitter taste Case reports of anosmia with nasal products Avoid citrus juices within 1 hr post dose (can chelate zinc)
35
Vitamin C (ascorbic acid)
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
Airborne, Emergen-C, Immune +
Not proven effective
37
Colds in Children
avoid dehydration Biggest risk to OTC treatment of children is incorrect dosing
38
Per FDA : All OTC cough and cold meds should be avoided in kids under
2
39
Call health care provider if child is
<3 months Fever for >24 hrs in children <2 ear pain or sore throat symptoms remain after 10-14 days
40
Colds in pregnancy
avoid drug therapy in the first trimester avoid all long acting, ER or SR, or alcohol containing products
41
Pregnancy and analgesics
Acetaminophen best choice Avoid Aspirin Avoid NSAIDS in 3rd trimester
42
Pregnancy and antihistamines
Chlorpheniramine, diphenhydramine, clemastine, doxylamine safest choices Loratadine may be considered if 1st generation agent not tolerated
43
Pregnancy and cough agents
Avoid if possible due to questionable efficacy
44
Pregnancy and decongestants
avoid 1st trimester use, oxymetazoline nasal spray is drug of choice when used at recommended doses (limit to < 3-5 days of use)
45
Breastfeeding and analgesics
Acetaminophen or ibuprofen considered compatible Avoid aspirin Topical benzocaine, camphor & menthol considered compatible
46
Breastfeeding and antihistamines
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
breastfeeding and decongestants
Pseudoephedrine is considered ‘usually compatible’ but may reduce production, is considered the preferred option due to lack of data with intranasal oxymetazoline
48
Breastfeeding and cough
Dextromethorphan and guaifenesin considered compatible
49
colds and geriatrics
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
Patient counseling
Colds usually resolve in 7-10 days, if not: Use maximal doses of medications Change medications Contact your HCP
51
Seek Medical Attention if:
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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