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Self Care > Common Cold, Allergic Rhinitis And Cough > Flashcards

Common Cold, Allergic Rhinitis And Cough Flashcards

1
Q

Cold season

A

Late August to April

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2
Q

Pathophysiology of cold

A

Limited to upper respiratory tract: Pharynx, nasopharynx, nose, cavernous sinusoids and paranasal sinus

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3
Q

Virus causes most of colds

A

Rhino viruses

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4
Q

Peak viral concentration during the cold

A

2-4 days after initial inoculation

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5
Q

Life cycle of rhinoviruses

A

16-18 days ( in nasopharynx)

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6
Q

Transmission and risk factors for a cold

A

Self-inoculation of the nasal mucosa
Contact with viral-laden secretion on animate( eg. hands) or inanimate ( eg. doorknobs) objects
Aerosol transmission
Higher exposure rate in dense population ( classroom)
Allergic disorders affecting the nose or pharynx
Less diverse social networks
Weakened immune system due to smoking
Sedentary life style
Chronic ( more than one month) psychological stress
Sleep deprivation (Poor sleep quality or Liz than seven months of sleep per night)

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7
Q

Symptoms of cold appeared 1 to 3 days after infection

A

Sore throat

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8
Q

Symptoms of cold appeared By day two or three

A

Nasal symptoms:

  • First secretions are clear thin and or watery
  • then become thicker and color may turn yellow or green
  • as cold Resolves become clear Thin and or watery again
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9
Q

Symptoms of cold appeared by day four or five

A

Cough ( less than 20%)

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10
Q

Duration of cold

A

7 to 14 days

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11
Q

Common cold symptoms

A 
Sore throat mild to moderate
Nasal congestion
Rhinorrhea
Sneezing common
Low grade fever( less then hundred)
Chills 
Headache
Myalgia 
Cough less than 20%
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12
Q

Allergic rhinitis Symptoms

A 
Watery eyes 
Itchy nose 
Repetitive sneezing
Nasal congestion
Watery rhinorrhea
Red irritated eyes with conjunctival infection
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13
Q

Influenza symptoms

A 
Myalgia 
Arthralgia
Fever more than hundred or 102
Nasal congestion 
Sore throat
Non-productive cough
Moderate to severe fatigue
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14
Q

Exclusion criteria for self care of cold

A

Fever more than 100.4f (38c)oral measurement
Chest pain
Shortness of breath
Worsening symptoms or develop additional symptoms during self treatment
Concurrent underlying Chronic disease ( asthma, copd, chef), aids, Chronic immunosuppressant therapy
Elderly
Infants less than three months old

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15
Q

Treatment goals of colds

A

Reduce bothersome symptoms

Prevent transformation of cold viruses to others

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16
Q

General treatment approach for cold

A

Mainstay of tx = nonpharmacologic

Use single entity products targeting specific symptoms preferred over combination products

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17
Q

Nonpharmacologic therapy

A

Increase fluid intake
Adequate rest
Eat nutritious diet as tolerated
Increase humidification with steamy shower vaporizer humidifier
Saline nasal spray drops
Food products Tea With lemon And honey chicken soup hot broth

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18
Q

Decongestant

A

Indication temporary relief of sinus and nasal congestion cough associated With post nasal drip
MOA: stimulate Alpha-adrenergic receptors: constrict blood vessels=>Decreased mucosal edema and sinusoid vessel engorgement

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19
Q

Direct acting decongestant

A

Phenylephrine
Oxymetazoline
Tetrahydrozoline

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20
Q

Direct acting decongestant

A

Bind directly to adrenergic receptors

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21
Q

Direct acting decongestant DDI with TCA ( amitriptyline, nortriptyline, imipramine)

A

Increase blood pressure

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22
Q

Indirect acting decongestant

A

Ephedrine

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23
Q

Indirect acting decongestant MOA

A

Displace norepinephrine storage vesicle in prejunctional nerve endings

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24
Q

Indirect acting decongestant DDI with TCA ( amitriptyline, nortriptyline, imipramine)

A

Decrease ephedrine activity

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25
Q

Mixed decongestant

A

Pseudoephedrine

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26
Q

Mixed decongestant MOA

A

Both direct and indirect activity

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27
Q

Systemic Decongestants

A

Pseudoephedrine

Phenylephrine

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28
Q

Systemic Decongestants PK

A

Pseudoephedrine well absorbed
Phenylephrine has low bioavailability
Both: Short half lives every 4 to 6 hours

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29
Q

Systemic Decongestants Age limitation

A

Older than two years of age

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30
Q

Systemic Decongestants ADE

A

Cardiovascular stimulation= Increase blood pressure , tachycardia ,palpitation, arrhythmia
CNS stimulation: insomnia, anxiety, tremors , hallucinations
More common in pediatric and geriatric patients
Less common in intranasal products ( topical products =minimally absorbed)

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31
Q

Systemic Decongestants CI

A

May exacerbate diseases sensitive to alpha receptor stimulation ( HTN, DM, coronary/ ischemic heart disease, Intraocular pressure, prostatic hypertrophy)
Coridin HBP, product without decongestant (HTN Specific)
Concomitant With MAO inhibitors ( pnenelzine, selegiline)

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32
Q

Systemic Decongestants DDI

A

Pseudoephedrine and antacid => decreases pseudoephedrine elimination
Pseudoephedrine + linezolid, MAOI= Sever hypertension, HA, hyperpyrexia( More than 106.7f =medical emergency).

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33
Q

Pseudoephedrine-containing Products

A

Kept behind the counter or locked cabinet
Require state or federal ID at time of purchase and ID Match person
Seller must obtain Written or electronic logbooks
-transactions for at least two years from date of purchase
-information contained name and address of buyer name of the product quantity and date and time of transaction
Buyer sign verifying information is correct
Self certification of retailers

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34
Q

Pseudoephedrine-containing Products Quantity limit

A

Maximum 3.6 to grams in one day
Max 9 g in 30 days
Mail order or mobile vendor: Maximum 74 and 5 g in 30 days
Individual packing less than 60 mg are exempt still behind counter

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35
Q

Nexafed

A

New product of pseudoephedrine
New technology to Decrease conversion to methamphetamine
Unique polymer Matrix that inhibit the extraction And conversion of active ingredient to methamphetamine
30 mg tablets

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36
Q

Short acting intranasal decongestant

A

Ephedrine
Naphazoline
Phenylephrine

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37
Q

Long acting intranasal decongestant

A

Xylometazoline ( 8 to 10 hours)

Oxymetazoline 12 hours

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38
Q

Intranasal decongestants Age limitation

A

Older than two years

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39
Q

Intranasal decongestant ADE

A

Burning stinging sneezing local dryness

Trauma from tip of administration device

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40
Q

Intranasal decongestant rhinitis medicamentosa ( rebound congestion)

A

Short Acting products, preservative agents, long duration of treatment contributed to the problem

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41
Q

Intranasal decongestant duration of therapy

A

3 to 5 days

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42
Q

Intranasal decongestant Treatment

A

Slowly withdrawing topical decongestant ( one nostril at a time)
Replace decongestant With normal saline

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43
Q

Antihistamine monotherapy for cold

A

Not effective in decreased rhinorrhea ( nasal cavity fill with significant amount of fluid) and sneezing due to cold

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44
Q

Local anesthetics for cold ( agents)

A

Benzocaine

Phenol

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45
Q

Local anesthetics for cold ( indication)

A

Temporary relief of sore throats

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46
Q

Local anesthetics for cold Frequency

A

Every 2 to 4 hours

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47
Q

Local anesthetics for cold Age limitation

A

Children older than two years old

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48
Q

Systemic analgesic for cold ( agents)

A

ASAP
ASA
Ibuprofen
Naproxen

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49
Q

Systemic analgesic for cold Indication

A

Aches or fever associated with colds

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50
Q

Systemic analgesic for cold CI

A

ASA containing Products should not be used in children with viral illness => Reye’s syndrome

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51
Q

Antitussives and Protussives for a cold

A

Nonproductive cough associated with cold
Not Recommended
Antitussives = Questionable efficacy
Protussive= Not effective in natural colds

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52
Q

Antitussives

A

Codeine

Dextromethorphan

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53
Q

Protussive

A

Guaifenesin

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54
Q

Cold Treatment at pregnancy

A

Non drug treatment = first line

Oxymetazoline

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55
Q

Cold treatment during lactation

A 
Pseudoephedrine = First line
Intranasal phenylephrine 
Oxymetazoline 
Dextromethorphan
Guaifenesin
Benzocaine camphor, menthol
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56
Q

Complementary therapies for a cold

A

High dose zinc => GI distress

High dose vitamin C (> 4g/day)=> GI distresses

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57
Q

Risk factors for allergic rhinitis

A

Fam Heritage Of allergic disorder in one or both parents
Filaggrin (skin barrier protein) gene mutations
Increased IgE
Higher socioeconomic class
Eczema
Positive allergy skin test

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58
Q

Triggers of allergy

A 
Outdoor = pollen, mold, spores,0zone particles 
Indoor = house dust mites, mold spores, pet dander, cigarettes smoke 
Occupational = wool dust, latex, resins, biologic enzyme, organic dusts
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59
Q

Pathophysiology of allergic rhinitis

A

Phase 1 sensitization
- Allergen stimulates beta-lymphocyte-mediated IgE production
Phase 2 early phase
- rapid release of preformed mast cell mediators ( histamine, protease)
-production of additional mediators (prostaglandins, neuropeptides)

Phase 3 cellular recruitment

  • circulating leukocytes ( eosinophils) attracted to nasal mucosa
  • release Inflammatory mediators

Late phase mucus hypersecretion

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60
Q

Clinical presentation of allergic rhinitis

A

Systemic symptoms: fatigue, irritability, malaise, cognitive impairment

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61
Q

Complications of acute allergic rhinitis

A

Sinusitis

Otitis media with effusion

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62
Q

Complications of chronic allergic rhinitis

A

Nasal polyps
Sleep apnea
Sinusitis
Hyposmia( decreased sense of smell)

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63
Q

Symptoms of allergic rhinitis

A

Bilateral symptoms, worst upon awakening,improve during the day then may worsen at night
Sneezing frequent paroxysmal
Pruritis ( itching) of eyes, nose, and/or palate frequent
Nasal obstruction
Conjunctivitis ( Red irritated eyes, with prominent conjunctival blood vessels) frequent
Sinus pain ( due to congestion),throat pain ( due to postnasal drip irritation)
Anosmia, epistaxis rare

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64
Q

Allergic shiners (feature of allergic rhinitis)

A

Preorbital darkening second to venous congestion

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65
Q

Dennie’s lines (feature of allergic rhinitis)

A

Wrinkles beneath the lower eyelids

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66
Q

Allergic crease (feature of allergic rhinitis)

A

Horizontal crease near bulbar portion of nose ( 2nd to allergic salute)

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67
Q

Allergic salute( feature of allergic rhinitis)

A

Rub the tip of the nose upward with the palm of the hand

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68
Q

Allergic gape (feature of allergic rhinitis)

A

Open mouth breathing ( Second to nasal obstruction)

Nonexudative cobblestone appearance of posterior oropharynx

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69
Q

Intermittent allergic rhinitis

A

Less than four days per week or less than four weeks

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70
Q

Persistent allergic rhinitis

A

More than four days per week and more than four weeks

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71
Q

Mild allergic rhinitis

A

No troublesome symptoms

No impact on sleep or Daily activities

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72
Q

Moderate to severe allergic rhinitis

A

One or more of the following: Impaired sleep impaired daily activities troublesome symptoms

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73
Q

Treatment goals of allergic rhinitis

A

Decrease symptoms
Improve functional status
Improve sense of well being

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74
Q

General approach for allergic rhinitis

A

Allergens avoidance
Pharmacotherapy ( intranasal, corticosteroid, antihistamines, decongestant )
Immunotherapy

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75
Q

Exclusions to self-care of allergic rhinitis

A

Children younger than 12 years old
Pregnant or lactating women
Symptoms of non-allergic rhinitis
Symptoms of otitis media, sinusitis, bronchitis, or other infections
Symptoms of undiagnosed or uncontrolled lower respiratory disease ( copd, asthma)
Symptoms are unresponsive to treatment
Sever or unacceptable side effects of treatment

76
Q

Non-pharmacological Therapy for allergic rhinitis

A

Allergen avoidance
- Lowering household humidity to less than 40%
-remove mite harboring dust ( carpets, Stuffed animal) From bedroom
Wash bedding at least weekly in hot water
Avoid activities that disturb decaying plant material
Venting food preparation area, Repairing basements, apply fungicide to moldy areas
Keep kitchen areas cleaned and tightly sealed, and treated infested area with pesticides
Avoid Outdoor activities when pollen counts are high
Use ventilation systems with high efficiency particulate air ( HEPA) Filter to remove pollen, mold spores
Use nasal wetting agents ( sailing, propylene) or irrigation with warm saline to relieve nasal mucosal irritation/dryness

77
Q

Intranasal corticosteroids (INCS)

A

Most effective treatment for nasal symptoms itching sneezing congestion
First line therapy

78
Q

Intranasal corticosteroids (INCS) MOA

A

Inhibit multiple cell types and mediators (histamine) and stop the allergic cascade

79
Q

Intranasal corticosteroids (INCS) direction

A

Take at least one week before symptoms appear Or as soon as possible before expected Allergan exposures (completed symptoms may not seen up to one week)
Instruct to shake the bottle well before each use
Discard product after 60 or 120 doses even bottle is not empty

80
Q

Intranasal corticosteroids (INCS) PK

A

Minimal systemic absorption

81
Q

Intranasal corticosteroids (INCS) ADE

A 
Well tolerated (ADE = nasal discomfort bleeding sneezing)
Serious side effects: change in vision glaucoma increased risk of infection, growth inhibition
82
Q

Intranasal corticosteroids (INCS)

A

Triamcinolone acetonide
Fluticasone propinate
Fluticasone furoate
Budesonide

83
Q

Triamcinolone acetonide (generic)

A

Nasacort allergy 24 hours ( brand)

84
Q

Triamcinolone acetonide (age limitation)

A

Older than two years old

85
Q

Triamcinolone acetonide ( Adult dose)

A

Two sprays in each nostril daily 220 mg per day

86
Q

Triamcinolone acetonide (special consideration)

A

Nasal symptoms

87
Q

Fluticasone propinate ( generic)

A

Flonase allergy relief( brand)

88
Q

Fluticasone propinate( age limitation)

A

Older than four years old

89
Q

Fluticasone propinate ( Adult dose)

A

Two sprays in each nostril daily 200 µg per day

90
Q

Fluticasone propinate ( special consideration)

A

Nasal and Ocular (Itchy watery eyes )symptoms

91
Q

Fluticasone furoate ( generic)

A

Flonase sensimist ( Brand)

92
Q

Fluticasone furoate Age limitation

A

Older than two years old for nasal treatment

Older than 12 years old for ocular treatment

93
Q

Fluticasone furoate adult dose

A

Two sprays In each nostril daily 110 mg per day

94
Q

Fluticasone furoateSpecial consideration

A

Titrate down to One Spray in each nostril Daily when symptoms improved
Shake the bottle vigorously with the cap on before each use
Prime the bottle ( cap left off more than 5 days or unused more than 30 days)

95
Q

Budesonide ( generic)

A

Rhinocort

96
Q

Budesonide Age limitation

A

Older than six years old

97
Q

Budesonide( adult dose)

A

Two sprays in each nostril 128 µg per day

98
Q

Budesonide special consideration

A

Nasal symptoms
Initial symptom control 10 hours after first dose
Complete symptoms control two weeks
Shake bottle gently before each use
Prime before first use or not used More than two days

99
Q

First generation antihistamine moa

A

Nonselective

Complete with histamine atCentral and peripheral histamine 1 ( H1) Receptor site

100
Q

First generation antihistamine PK

A

Cross Blood brain barrier
Highly selective for Histamine 1 receptors
Anticholinergic, anti serotonin, anti alpha adrenergic
Quick onset, Short duration required multiple doses

101
Q

First generation antihistamine ADE

A

CNS- sedative, appetite Stimulation
Anticholinergic = dry mouth, nose, vagina, blurred vision, urinary hesitancy/retention, constipation, reflex tachycardia
Photosensitive = use sunscreen and wear protective clothing
Paradoxical CNS stimulation, Especially in children

102
Q

First generation antihistamine CI

A

Infants, lactating women, narrow angle glaucoma

103
Q

First generation antihistamine drugs

A

Ethanolamine

Alkylamine

104
Q

Ethanolamine class (drugs)

A

Clemastine
Diphenhydramine
Doxilamine

105
Q

Ethanolamine sedation property

A

Highly sedative
Strong anticholinergic
Large dose =seizure, arrhythmia

106
Q

Alkylamine class ( drugs)

A

Chlorphenoramine
Brompheniramine
Pheniramine

107
Q

Alkylamine sedation properties

A

Moderately sedative
Strong anticholinergic
Higher risk CNS paradoxical stimulation

108
Q

Second Generation of anti-histamine MOA

A

Peripherally selective
Complete with histamine atCentral and peripheral histamine 1 ( H1) Receptor site
Inhibits release of must cell mediators

109
Q

Second Generation of anti-histamine PK

A

Do not readily cross blood brain barrier
Highly selective for Histamine 1 receptors
Fast onset
Long duration

110
Q

Second Generation of anti-histamine ADE

A

No sedation

111
Q

Second Generation of anti-histamine classes of drugs

A

Piperazine

Piperidine

112
Q

Piperazine class drugs

A

Cetirizine

Levocetirizine

113
Q

Piperidine class drugs

A

Fexofenadine

Loratadine

114
Q

Cetirizine ( brand)

A

Zyrtec

115
Q

Fexofenadine ( brand)

A

Allegra

116
Q

Loratadine brand

A

Claritin

117
Q

Levocetirizine brand

A

Xyzal

118
Q

Cetirizine dose

A

10 mg PO daily

119
Q

Fexofenadine dose

A

60 mg PO twice daily

180 mg PO daily

120
Q

Loratadine dosed

A

10 mg PO daily

121
Q

Levocetirizine dose

A

5 mg PO daily

2.5 mg PO daily less severe symptoms

122
Q

Cetirizine Age limitation

A

Older than six years old

123
Q

Cetirizine Special consideration

A

More Potent
Sedation In about 10% of patients
Longer duration than fexofenadine and loratadine

124
Q

FexofenadineAge limitation

A

Older than six years old

125
Q

Fexofenadine Special consideration

A

Should not be taken with any fruit juices together fruit juice decrease concentration of drug = directly inhibiting OATP
Separate FexofenadineAnd fruit juice by at least two hours

126
Q

Loratadine Age limitation

A

Older than six years old younger than 65 years old

127
Q

Levocetirizine Age limitation

A

Older than two years old younger than 65 years old

128
Q

LevocetirizineSpecial consideration

A

Sedation take in the evening avoid alcohol

Longer duration than fexofenadine and loratadine

129
Q

Decongestant for allergic rhinitis indications

A

Treat allergic rhinitis associated congestion

Use systemic decongestant or topical nasal decongestant ( no more than five days)

130
Q

Cromolyn Sodium MOA

A

Blocking influx of calcium into mast sell preventing mediator release
Mast cell stabilizer

131
Q

Cromolyn Sodium direction

A

One spray in each nostril 3 to 6 times daily at regular intervals

132
Q

Cromolyn Sodium Age limitation

A

Older than two years old

133
Q

Cromolyn Sodium Treatment duration

A

3 to 7 days for initial treatment efficacy
2 to 4 weeks to achieve max benefits
More effective if started before symptoms begin

134
Q

Cromolyn Sodium ADE

A

Sneezing burning stinging

135
Q

Antihistamines CI during the pregnancy

A

Fexofenadine ( Allegra)

136
Q

Antihistamines CI during lactation

A

Cetirizine
Diphenhydramine
Fluticasone propionate

137
Q

General duration of therapy of antihistamines

A

14 days

138
Q

Pathophysiology of cough

A

Initiated by stimulation of sensory pathways in laryngeal, esophageal, tracheobronchial airway epithelium
Medullary brainstem network = cough control center process sensory input and stimulate motor efferents
Voluntary cough is controlled by cerebral cortex
Cough start with deep inspiration
Follow by closure of the glottis and forceful contraction of the chest wall, abdominal wall and diaphragmatic muscles against the closed glottis

139
Q

Acute cough

A 
Less than three weeks
Viral URTI
Pneumonia
Acute left ventricular heart failure 
Asthma 
Foreign body aspiration
140
Q

Subacute cough

A

3 to 8 weeks
Post infectious cough
Bacterial sinusitis
Asthma

141
Q

Chronic cough

A

More than eight weeks
GERD, COPD
ACEI ( lisinopril, benazepril)
Left ventricular heat failure

142
Q

Productive cough clinical Presentation

A

Wet, chesty, phlegm
Expels secretions from the lower respiratory tract
Effective ( secretions easily expelled)
Ineffective ( difficult to expel secretions)

143
Q

Nonproductive cough clinical presentation

A

Dry, hacking, tickling in the throat

Causes: viral and atypical bacterial infection, GERD, cardiac disease

144
Q

Cough Secretions

A

Not a reliable diagnostic indication
Clear= bronchitis
Purulent = bacterial infection

145
Q

CI For self-care for cough

A

Children younger than four years of age
Cough more than seven days or that comes and goes
High fever more than 103 or lower fever that does not improve with self care
Cough with: Shortness of breath ,chest pain chills ,night sweats, hemoptysis, rash, persistent headache, tight feeling in the throat, swollen legs/ankles, cyanosis, unintentional weight loss, rash, persistent headache
Thick, yellow, tan, or green mucus or pus like secretions
Worsens after cold or flu but resolved
Drag induced cough ( ACEI)
Chronic diseases with cough: asthma, COPD, heart failure chronic bronchitis, cough associated with inhalation of dust, particles or objects

146
Q

Treatment goals for cough

A

Decreased number and severity of cough episodes
Prevent complications
Cough treatment = symptomatic
-Need to treat underlying disorder

147
Q

Antitussives ( cough suppressants)

A

Drug of choice For nonproductive cough

Should not use in productive cough unless benefits risks ( nocturnal cough)

148
Q

Protussive ( expectorant)

A

Change consistency of mucus
Increase volume of sputum
Provide relief for cough that expel thick , tenacious secretion

149
Q

Cough Nonpharmacologic therapy

A

Non-medicated lozenges/ hard candies
Increased humidity
Stay well hydrated

150
Q

Codein Special consideration

A 
C V
Prescription antitussives 
Gold standard
Pregnancy category C( only use if benefit >> risk)
Caution in elderly ( sedation)
151
Q

Codein MOA

A

Acts centrally on medulla to increase cough threshold

152
Q

Codein ADE

A

N/v/dizziness constipation sedation

153
Q

Codein DOA

A

Quick onset 15 to 30 minutes

Duration 4 to 6 hours

154
Q

( brand) Benzonatate

A

Tessalon perles

155
Q

Benzonatate MOA

A

Topical anesthetic action on the respiratory stretch receptors

156
Q

Benzonatate ADE

A

N/ dizziness/ HA, sedation, numbness of tongue, month and throat ( capsules are broken or chew)

157
Q

Benzonatate Special consideration

A

Done chew or crash

Rx

158
Q

Benzonatate dose

A

100 to 200 mg 3 times a day as needed

159
Q

Dextromethorphan ( brand)

A

Delsym

OTC

160
Q

Dextromethorphan MOA

A

Act centrally in the medulla to increase cough threshold

161
Q

Dextromethorphan ADE

A

Drowsiness/n/v ( well tolerated)

162
Q

Dextromethorphan DDI

A

Monoamine oxidase inhibitors ( MAOI) =» serotonin syndrome

Alcohol antihistamine psychotropic

163
Q

Diphenhydramine brand

A

Benadryl

OTC

164
Q

Diphenhydramine MOA

A

Nonselective first generation antihistamine
Act centrally in the medulla to increase cough threshold
Significant sedation and anticholinergic effects

165
Q

Diphenhydramine ADE

A 
Drowsiness 
Disturbed coordination 
Respiratory Depression
Anticholinergic ADE 
Paradoxical excitation In children
166
Q

Diphenhydramine DDI

A

Potentiate depressant effects ( Narcotic, analgesic, alcohol)
Intensify anticholinergic activity (MAOI, other anticholinergic)

167
Q

Diphenhydramine Caution

A

Drug disease DDI ( worsen disease due to anticholinergic effect)
Narrow angle glaucoma, asthma, hypertension, benign prostatic hypertrophy, elevated intraocular pressure

168
Q

Diphenhydramine Special consideration

A

First generation antihistamine plus systemic decongestant => Acute cough , post nasal drip and throat clearing
Avoid in elderly ( anticholinergic effect)
Pregnancy category B

169
Q

Dextromethorphan Caution

A

Take 14 days after d/c MAOI

Overdose = confusion excitation irritability drowsiness severe n/v

170
Q

Dextromethorphan Special consideration

A

Ineffective for cough due to common cold
Use for short term symptomatic relief of cough associated with bronchitis acute and chronic and Post-infectious subacute cough
Abused for euphoric effect
Pregnancy category
Caution in Elderly sedation

171
Q

Chlophedianol MOA

A

Antihistamines derivatives

Centrally acting antitussives

172
Q

Chlophedianol ADE

A 
Excitation
hyper-irritability
Nightmares
Hallucinations
Hives
173
Q

Chlophedianol DDI

A

MAOI - Should not take Chlophedianol for at least 14 days after MAOI discontinuation

174
Q

Chlophedianol Caution

A

Overdose = dry mouth vertigo Visual disturbances , n/v , drowsiness

175
Q

Chlophedianol Special consideration

A 
Slow onset
Longer duration ( vs codeine)
176
Q

Guaifenesin brand

A

Mucinex

177
Q

Guaifenesin Indication

A

Expectorant

Symptomatic relief of acute ineffective productive cough

178
Q

Guaifenesin dose

A

Immediate release 200 to 400 mg PO every four hours maximum 2.4 g a day
Extended release 600 to 1200 mg PO every 12 hours maximum 224 g per day

179
Q

Guaifenesin MOA

A

Loosens and thins Lower Respiratory tract secretions
Making minimally productive cough more productive
Well tolerated

180
Q

Guaifenesin ADE

A

N/v, dizziness, HA, rash, diarrhea, drowsiness, stomach pain
Large dose might cause renal calculi (Take with full glass of water)

181
Q

Topical antitussives

A

Camphor menthol not for chronic cough
Ointments = Camphor Menthol
Lozenges = menthol
Inhalation= camphor menthol

182
Q

Topical antitussives counseling points

A

Camphor and menthol ointments creams and solutions May cause serious burns if:

  • near an open flame
  • Placed in hot water or in microwave oven
183
Q

Topical antitussives DDI

A

Menthol +warfarin = decreases warfarin response

184
Q

Pediatric for self care treatment of cough and colds

A

FDA: Cough and cold products Are not recommended for use in children younger than two years old
No FDA approved dosing ( CI)
Manufacture: Do not use in children younger than four years of age

185
Q

Follow up and duration of therapy

A

When to seek medical attention
No improvement in 7 to 10 days
Cough persists more than three weeks even with some symptomatic improvement with self-care
Duration of therapy seven days

Self Care (6 decks)

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