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OTC > Common Cold > Flashcards

Common Cold Flashcards

1
Q

What is the common cold

A

Viral URTI

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2
Q

What occurs when the virus is exposed to the mucosa?

A

it invades the nasal and bronchial epithelia, attaching to specific receptors and causing damage to the ciliated cells, which results in inflammatory mediators leading to inflammation of the tissues lining the nose.

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3
Q

Why would a pt sneeze and feel congested?

A

the permeability of the cell wall increases, resulting in oedema

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4
Q

Why might the pt experience a cough or a sore throat?

A

fluid might drip to the back spreading the virus

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5
Q

When are cold most contagious?

A

first 1-2 days of symptoms

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6
Q

What are symptoms a pt may have with the common cold?

A

cough, runny/blocked nose and sneezing, sore throat, irritated/watery eyes, headache, fever aches and pains, earache and acute otitis media, severe pyrexia (body temp >38 or >37.5 in elderly)

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7
Q

When is the flu most common? what are symptoms of the flu?

A

winter months, abrupt symptoms occurs within hours

myalgia, chills, malaise, loss of appetite, shivering, insomnia, non-productive cough

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8
Q

what are aggravating factors when someone has the common cold?

A

headache/pain worsened when sneezing/coughing/bending over, ear pain

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9
Q

What is acute rhinosinusitis? How does it come about?

A

inflammation of one or more of the paranasal sites
following a cold, the air-filled spaces drain into the nasal cavity and filled with nasal secretions and can then becoming infected with strep and haemophilus

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10
Q

What are the symptoms of rhinosinusitis?

A

blockage or congestion
discharge or UACS
facial pain or pressure
reduction or loss of smell

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11
Q

What can exacerbate the pain ?

A

moving forwards, moving the eyes from side to side, coughing/sneezing

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12
Q

What tx is usually required?

A

analgesics for pain relief
oral and nasal sympathomimetics

antibiotics not usually prescribed but amoxicillin given or doxy if penicillin allergic

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13
Q

What is acute otitis media?

A

common in children, occurs from the common cold where the virus spreads to the middle ear, results in accumulation of pus and inflammation of the eardrum

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14
Q

What are the main types of flu and why is it important to vaccinate?

A

type A and type B - many different strains which alter their antigenic structure therefore requires vaccination

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15
Q

When would you REFER a pt who has the common cold?

A
  1. Acute sinus problems that does no respond with OTC decongestant therapy
  2. middle ear pain that doesnt respond with analgesia - most earaches are self-limiting and resolve within 3 days
  3. very old
  4. very young
  5. persisting fever, symptoms of flu and productive cough
  6. long-term conditions, such as COPD, asthma, kidney disease, diabetes
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16
Q

What are alternative therapies used for the common cold?

A

Vitamin C, Echinacea - prevention and alleviates cold symptoms, vapour inhalation (menthol crystals, oblas oil) - aids clearance of the nasal passage, recommended for those whom decongestants are C/I), saline sprays, garlic

17
Q

what are sympathomimetics? How do they work?

A

Oral decongestants - constrict dilated blood vessels and swollen nasal mucosa, easing congestion and helping breathing

18
Q

Name some sympathomimetics and what are the age restrictions?
How long should children use them for?

A

Phenylephrine >12 years
Pseudoephedrine >6 years

6-12 years should only be used for a duration of 5 days MAXIMUM

19
Q

What drugs can sympathomimetics interact with? What can occur?

A

MAOI’s - fatal hypertensive crisis - the danger of interaction persists for up to 2 weeks after tx with MAOIs is discontinued

pts with hypertension - sympathomimetics increase BP which can alter control of BP in hypertensive pts and in diabetics but with SHORT COURSES it should be ok

Avoid in pts taking BB’s

hyperthyroidism - heart irregularities

20
Q

What would be an alternative in pts that cannot take sympathomimetic drugs?

A

topical sympathomimetics

21
Q

What are the side effects associated with sympathomimetics? What advice should you give to pts when taking these?

A

insomnia, restlessness, tachycardia

do not take the dose before bedtime as their mild stimulant action can disturb sleep

22
Q

Can you give these to pregnant or BF?

A

Pregnancy - no

BF - yes

23
Q

What are the pack size restrictions for sympathomimetics?

A

max pack size are limited to 720mg

24
Q

Which products is phenylephrine available in?

A

lemsip, sudafed, beecham in doses ranging 5 and 12mg TDS/QDS for adults and children over 12 years

25
Q

What is the standard dose of pseudoephedrine?

A

60mg TDS or QDS and half the adult dose 30mg is suitable for children between 6-12 years

26
Q

Which is the safest route to use when taking sympathomimetics? Which pts are able to take it?

A

nasal administration

pregnancy after 1st trimester, pre-existing heart disease/diabetes, HTN, hyperthyroidism

27
Q

When should nasal sympathomimetics be avoided?

A

pts using MAOIs and moclobemide - risk of hypertensive crisis as some of the small quantity may be swallowed

28
Q

What are the side effects of NASAL sympathomimetics? and how long are pts allowed to take them for?

A

local irritation in 5% of pts

should not be used for longer than 5-7 days otherwise rebound congestion can occur

29
Q

Name nasal sympathomimetics. What are the age restrictions for their use?

A

oxymetazoline - >12 year
xylometazoline - >6 years - otrivine child nasal drops
ephedrine - over 12 years 1-2 drops in each nostril QDS PRN

30
Q

How frequent should oxymetazoline and xylometazoline be used ?

A

these are longer acting and require less frequent dosing - two-three times a day

31
Q

What else can be used for the tx of the common cold? Why

A

antihistamines - relieve runny nose and sneezing by their anticholinergic action

32
Q

What are the old generation antihistamines? What are the main side effects?

A

chlorphenamine, promethazine - greater anticholingeric action so greater side effects like constipation/dry mouth/sedation/blurred vision

33
Q

What are the new agents of antihistamines?

A

loratadine, cetirizine, acrivastine

34
Q

What is the best way to administer nasal drops?

A

Head downward position facing the floor

35
Q

What can be given to a baby?

A

saline drops

36
Q

What are ways to limit viral spread?

A

use disposable tissues rather than handkerchiefs
wash hands frequently especially after blowing the nose
do not share hand towels
try to avoid touching your nose

OTC (39 decks)

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