Cough

Question 1

Two types of cough

Answer 1

• Non-productive = Dry, Tickly

- Productive = Chesty, Sputum

Question 2

When to refer cough?

Answer 2

• 3 weeks +
• Chest pain
• Wheezing, SOB, Pain on inspiration
• Recurrent night time cough (asthma?)
• Whooping cough
• Croup (barking cough, SOB, inspiratory stridor)
• Coloured sputum - green/yellow/brown = Bacterial chest infection?
• Blood in sputum
• pink tinged and frothy = Heart failure? Orthopnoea (lie down SOB fluid in lungs)
• rust = CAP - community acquired pneumonia = high fever, malaise, breathless pleuritic pain
• dark red = Tuberculosis = persistent fever and night sweats

Question 3

OTC for Dry cough (+ age, side effects)

Answer 3

Anti-tussives (cough suppressant) 6+

1st line - Pholcodine
1st line - Dextromethorpan

Codeine Linctus (18+) abuse potential

Question 3

OTC for Dry cough (+ age, side effects)

Answer 3

Anti-tussives (cough suppressant) 6+

1st line - Pholcodine
1st line - Dextromethorpan

Codeine Linctus (18+) abuse potential

SIDE EFFECTS = sedation and constipation

Question 4

OTC for chesty cough (and ages)

Answer 4

Expectorants 6+ (decrease sputum viscosity)

• Guaifenesin (most common + safest)
• Ipecacuanha (Covonia herbal mucus cough)
• Ammonium chloride (Unicough)
• Squill (Buttercup original cough mixture)

Antihistamines 6+ (dries secretions)

• Diphenhydramine (Benylin Chesty Cough Original)
• Promethazine (Night nurse)
• Brompheniramine
• Triprolidine (Actifed Multi-Action Chesty cough)

Question 5

What is Guaifenesin?

Answer 5

Expectorant (6+)

Question 6

Ipecacuanha (Covonia herbal mucus cough)

Answer 6

Expectorant (6+)

Question 7

Ammonium Chloride (Unicough)

Answer 7

Expectorant (6+)

Question 8

Squill (Buttercup original cough mixture)

Answer 8

Expectorant (6+)

Question 9

Diphenhydramine (Benylin Chesty Cough original)

Answer 9

Antihistamine (6+)

Question 10

Promethazine (Night Nurse)

Answer 10

Antihistamine (6+)

Question 11

Brompheniramine

Answer 11

Antihistamine (6+)

Question 12

Triprolidine (Actifed Multi-Action Chesty Cough)

Answer 12

Antihistamine (6+)

Question 13

Glycerol Age

Answer 13

Demulcent - 3+ months

Question 14

Simple linctus age

Answer 14

Demulcent - 1+

Question 15

Cough and cold remedies should not be given to children under 6 years. What about 6-12?

Answer 15

Second line for 5 days only

Question 16

Best practice for coughs

Answer 16

Warm clear fluids/lemon and honey drinks

Simple cough mixtures e.g. glycerol or simple linctus

Question 17

What is Pholcodine?

Answer 17

Anti-tussive (cough suppressant) 6+

Question 18

What is Dextromethorpan?

Answer 18

Anti-tussive (cough suppressant) 6+

Question 19

Advice for cough

Answer 19

• Dry, tickly coughs are self-limiting - usually caused by viral infection
• Do not treat chesty coughs with an anti-tussive
• Sugar-free products in diabetes e.g. Robitussin range

Question 20

If child 7 years old comes in with dry tickly cough that’s WORSE at night, what should you do?

Answer 20

Send to GP, it could be asthma

Question 21

What is codeine linctus? What age?

Answer 21

Anti-tussive, 18+