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OTC > Cough > Flashcards

Cough Flashcards

1
Q

Acute cough is a common symptom of ?

A

Viral upper respiratory tract infection
URTI

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2
Q

How many episodes kits have cough early?

A

7 to 10 episodes / yearly.

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3
Q

True or false

90% a URTI is caused by viruses ( syncytial / rhinovirus / influenza)

10% of URTI caused by bacteria
(staphylococcus pneumoniae, Haemophilus influenza, staphylococcus aureus,klebsiella pneumoniae).

A

True

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4
Q

What part of the brain is responsible for cough?

A

Cough flex center
Which get triggered by receptors located in Pharynx larynx trachea and bronchi . The neural impulses will carried to the cough center in medulla.

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5
Q

What is the most common cause of persistent, cough and children?

A

Recurrent viral bronchitis

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6
Q

What are the clinical feature of acute viral cough?

A

sudden onset
fever
Minimal sputum production
Symptoms worse at evening

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7
Q

What are the symptoms of acute viral cough?

A

Cold symptoms
1. Runny nose.
2. Sore throat.
3. Congestion (often )

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8
Q

Viral cough usually last? (it’s duration.)

A

Between 7 to 10 days
More than 14 days may suggest post, viral cough or secondary bacterial infection

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9
Q

What is the misconception about cough with mucopurulent sputum?

A

People think that it will be bacterial cause, and referral to the GP is must.

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10
Q

What diseases cause increase in mucus production?

A

Smoking
Environmental irritant
Allergy
Infection
Genetic predisposition
Foreign bodies
Chronic bronchitis
Asthma and COPD
Cystic fibrosis
Acute bronchitis
Pneumonia

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11
Q

Give me examples of condition to eliminate likely to cause
(cough causes)

A
  1. Upper airways cough syndrome:
    - post nasal drip or rhinosinusitis
    - Acute bronchitis.
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12
Q

UACS characterized by?

A

Sinus or nasal discharge
It’s flows behind the throat, causing abnormal sensation there that need to be clear frequently .

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13
Q

Other causing of UACS?

A

Allergies and post infection UACS after URTI.

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14
Q

Cough caused by allergies are

A

Nonproductive
Worsen at night
Associated sneezing , nasal discharge a blockage, conjunctivitis and itchy, oral cavity.

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15
Q

What medication we can use for UACS?

A

Antihistamine and decongestants

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16
Q

Acute bronchitis, some commonly seen in ————————— and what are its symptoms?

A
  1. Autumn and winter.
  2. Similar symptoms to URTI :
    - Fever
    - sputum production
    - Runny nose
    - Sore throat
    - Congestion
    +
    - dyspnoea
    - Wheezing
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17
Q

Acute bronchitis cough last for?

A

7 to 10 days
can be processed for three weeks

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18
Q

What are the origins of acute bronchitis?

A
  • Usually virus but it can be also bacteria.

The symptoms were resolved without antibiotic
If the patient is unwell, referral to a physician

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19
Q

Give examples of condition to eliminate unlikely causes

A

COPD
Asthma
pneumonia(community acquired)
Medicine induced cough or wheeze

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20
Q
  1. COPD characterized by?
  2. Sign and symptoms?
  3. It’s common more to whom ?
  4. What is the important factor to cause chronic bronchitis?
  5. Example of diseases undergo COPD?
A
  1. Destruction of lung tissues.
  2. Cough / sputum production/ increase breathlessness
  3. Older adults (men).
    - Symptoms: chronic cough-breathlessness-wheezing-recurrent chest infection.
  4. Smoking.
  5. Chronic bronchitis , emphysema and chronic obstructive airways disease.
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21
Q
  1. Define asthma
  2. Characterized by.?
  3. Symptoms.?
  4. Possible risk factors associated with development of asthma include?
  5. What type of cough asthma patient have ?
A
  1. Chronic inflammatory condition.
  2. Coughing, wheezing, chest tightness, shortness of breath(recurrent at night time cough).
  3. Variable symptoms, intermittent, worsen at night.
    - Symptoms get provoked by triggers, such allergens, infection, and irritant exposure.
  4. Family are personal history of atopy.
  5. Nonproductive, but mainly productive.
    - especially in children (what’s on at night and recurrent).
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22
Q
  1. What causes pneumonia?
  2. Type of cough.
  3. Sign and symptom.
  4. Most cases occurred during which season?
  5. Do we need a doctor referral or watt?
A
  1. Bacteria infection.(S.pneumoniae) 80%
  2. First 24–48 hours productive painful after that rapidly become productive with this sputum being stained red.
  3. High fever>38 , malaise, headache, and breathlessness( worsen inspiration).
  4. Autumn and winter.
  5. Urgent referral to a doctor so antibiotic can be started as soon as possible.
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23
Q

Give example of drugs, that induce, cough or wheeze

A
  1. ACE inhibitor (pril)
  2. Beta blocker.
  3. NSAID
24
Q

Cough from ace inhibitor reserve how many days after withdrawal?

A

3 to 4 weeks to resolve completely

25
Q

What alternative of drugs you have instead of using ACRI to prevent cough

A

Angiotensin 2 receptor blocker

Have lower incidence of cough

26
Q

Example of condition to eliminate very unlikely causes

A
  1. heart failure.
  2. Bronchiectasis
  3. Tuberculosis (TB)
  4. Carcinoma of the lung.
  5. Gastro oseophageal reflux disease (GORD)
27
Q

Why is hard to diagnose heart failure in early mild cases

A

Because it has an insidious progression

28
Q

What are the early symptoms of heart failure?

A
  1. Fatigue
  2. Shortness of breath.
  3. Orthopnea.
    4 dyspnoea at night
29
Q

When the heart failure condition progress, the patient may experience?

A
  1. Ankle swelling.
  2. Reductive frothy رغوي cough with pink sputum (worsen at night).
30
Q
  1. Bronchiectasis caused by?
    2 . Characterized by.?
A
  1. Caused by irreversible dilation of the bronchi that result from previous lower respiratory tract infection.
  2. Cough of long duration.
    75% of patient coughing daily with sputum production .
31
Q
  1. Tuberculosis is caused by?
  2. Symptoms of TB?
  3. Does the patient need to be a referral?
A
  1. Bacterial infection
    - Mycobacterium tuberculosis, transmitted by inhalation.
  2. Fever, weight, loss, night sweats, anorexia, malaise, and chronic, productive, cough with haemoptysis.
  3. Yes for further investigation, which include:
    - chest x-ray
    - Sputum smear test 
32
Q
  1. Carcinoma strongly related to?
  2. Symptoms.?
A
  1. Related to age.(increasing.) 40 to 45.
  2. Cough, fatigue, shortness of breath, just pain, weight loss, and appetite loss.

-The cuff last more than three weeks .

33
Q
  1. GORD type of cough ?
  2. Symptoms.?
A
  1. Does not usually present with cough, but patient may cough when lying down.
  2. Reflux or heartburn.
    - Increase in cup for flexibility.
    - Respond well to proton pump inhibitor.
    - GORD considered in all cases of unexplained cough.
34
Q

What are the cough treatment goals?

A
  1. Reduce the number and severity of tough episodes.
  2. Brent complication.
    - Cough treatment is symptomatic.
35
Q

Mention cough complication:

A
  1. Common.
    - Exhaustion
    - Insomnia ارق
    - Musculoskeletal pain
    - Hoarseness
    - Urinary incontinence سلس البول
  2. Less common.
    - Dysrhythmias خلل فالنظم
    - Syncope اغماء
    - Stroke
    - Rip fracture
36
Q

How to differentiate between serious and nonserious condition of cough in adults?

A
  1. Cough lasting longer than three weeks consider serious.
    - UACS campers is four weeks and pharmacist can manage it.
  2. Certain symptoms.
  3. Sputum color are in.
  4. Symptoms associated with infection.
    - Fever, rhinorrhea سيلان الانف , sore throat.
  5. Presence of blood (Haemoptysis).
  6. Trigger factor.
    - Certain atmospheric factors, such as air temperature changes, pollution, dry atmosphere.
37
Q

What hinders the differentiation between clinical efficacy and normal symptoms resolution?

A

The self limiting nature of acute cough.

38
Q

Differentiate between cough, suppressant and expectorant?

A
  1. Cough suppressant:
    - treat dry and productive cough.
    - example : Pholcodine
  2. Expectorant:
    - Treat wet , productive cough.
    - example : Guanifenesin/guaiphenesin
39
Q

What is the mechanism of action of guaifenesin expectorant?

A
  • stimulates secretion of respiratory tract fluid.
  • Increase sputum volume.
  • Decrease viscosity.
  • Which assist in the removal of sputum.
40
Q

Write the name of the only active ingredient that have evidence of effectiveness as expectorant?

A

Guaifenesin

41
Q

What do you mean by mycolytics?

A

Breakdown of mucus

42
Q
  1. Why mucolytic is important?
  2. Mention diseases that we use mucolytic:
  3. Give example of OTC medication.
A
  1. Is needed in diseases in which there is increase in mucus production.
  2. Cystic fibrosis, COPD,Bronchiectasis , respiratory infection, and Turberculosis.
    • N-acetylcysteine (ACC)
    • bromhexine hydrochloride (Bisolvon)
    • ambroxol hydrochloride (Mucpsolvan)
    • herbal prep(Prospan syp)
43
Q
  1. What are the cough suppressant?
    2 . Give another name to it
A
    • they directly act on the cough center to depress cough reflux .
    • Codeine
    • Standard or benchmark antitussive
    • effective at reducing cough
    • Less effect on acute cough
    • ex : pholcodeine
    • few side effects less liable to be misused.
  2. Antitussive.
44
Q

Give me example of cough, suppressant medication

A

Pholcodeine
- Antitussive activity+ sedated\ Drowsiness

45
Q

Why cough suppressant medication have less affect on acute cough

A

Patient have a greater voluntary control of the cough reflects on acute cough .

46
Q

Give two example of cough, suppressant medication (antitussive)

A

1.Pholcodeine
- 2nd line therapy

  1. Dextromethrophan (less potent)
    - Limited abuse potential
    - Fewer side effects
    - 1st line therapy
47
Q

Give me example of antihistamine medication

A

Anticholinergic
- Drying action of mucus membrane
- ex: Diphenhydramine & promethazine
- reduce frequency of cough

48
Q

Can we take a combination of antihistamine and cough, suppressant?

A

Yes
- antihistamine can help to dry up secretion through their anticholinergic side-effects.

  • If the cough is disturbing the sleep, it’s better to take the dose at night.
49
Q

What is demulcents ? ملطف

A
  • pharmacologically inert
  • Reduce irritation by coating the pharynx and prevent cough.
  • ex : glycerin, lemon, honey, Linctus
50
Q

True or false
Demulcent that soothe the throat are useful for children and pregnant women b/c they don’t have active ingredient .

A

True

51
Q

Give me examples of combination
mixtures

A
  1. Preparations contain multiple active ingredient to target different symptoms of URTI.
  2. Combination products may contain subtherapeutic doses of active ingredient.
  3. illogical combination of ingredient.
    - Cough suppressant with expectorant
    - Antihistamine with expectorant
  4. Whether to avoid the illogical combination.
  5. Should advise the patient to drink more fluid instead of taking antitussive medication. told them that the symptoms will resolve on their own.
52
Q

Antihistamine is used to treat what type of cough

A

Productive cough

53
Q

Side effect and symptoms of antihistamine medication

A
  • they can interact with other sedating medication result in increased sedation.
  • Cause dry mouth and constipation
    Because of their antimuscarinic properties
  • Avoided if the patient have glaucoma and prostate enlargement
    Because they increased intraocular pressure and urinary retention
54
Q

Why demulcents are more commonly to use?

A

Because of the restriction placed on antitussive.

55
Q

Tips for a patient education

A
  1. Suck cough drops or hard candies.
    - not less than 6
  2. Consider taking honey.
    -not less than one year
  3. Moisturize the air.(humidifier/shower)
  4. Drink fluids
  5. Avoid tobacco smoke.
  6. Gargling, warm salt, water.

OTC (1 decks)

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