Cough Flashcards
What are the classifications for cough duration?
Acute - 3 to 4 weeks
Subacute - 3 to 8 weeks
Chronic - more than 8 weeks
What are the symptoms of an acute viral cough?
- Sudden onset and fever
- Minimal sputum production
- Symptoms worse in the evening
- Cold sx for 7 to 10 days
What are the symptoms of upper airways cough syndrome?
- Sinus or nasal discharge that flows behind the nose and into the throat
- Chronic cough
- Cough caused by allergies - non productive and worse at night with sneezing, nasal discharge/blockage, conjunctivitis and an itchy oral cavity
What are the symptoms of acute bronchitis?
- Fever
- Cough - usually lasts 7 to 10 days but can last up to 3 weeks
- Cold sx
- Wheeze
- Dyspnoea
Will resolve w/o abx but if systemically unwell refer
Mostly seen in AW
What are the symptoms of croup?
- Severe violent barking cough late at night
- Child may be breathless and struggle to breathe between coughing episodes
- Sx improve during the day and and recur at night
- Most resolve by 48 hours - if persisting more than 48 hours or strider/distress - med int
- Sx triggered by recent infection
What would be the treatment for croup?
- Nebulised budenoside or PO/IM Dexamethasone
Warm moist air not recommended as no evidence
What are the symptoms of COPD?
- Chronic cough
- Sputum production
- Breathlessness on exertion
- Wheezing
- Recurrent chest infections
Exacerbation of increased breathlessness and reduced activities need referred for abx/steroid therapy
Encourage smoking cessation
What are the symptoms of asthma?
- Cough - non productive and often worse at night
- Wheeze
- Chest tightness
- SOB
Sx are variable, intermittent, often worse at night and provoked by triggers
What are the symptoms of community acquired pneumonia?
- Cough that is initially non productive that rapidly becomes productive with red staining - worse at night
- Fever
- Malaise
- Headache
- Pleuritic pain
- Breathlessness
Refer urgently
What are the symptoms of HF?
- Fatigue
- SOB
- Orthopnoea - lying down
- Dyspnea
- Ankle swelling
- Productive frothy cough - pink tinge - worse at night
What are the symptoms of bronchiectasis?
- Chronic cough caused by irreversible dilation of the bronchi
- Sputum production
- Wheeze
- Chest pain
What are the symptoms of Tb?
- Fever
- Weight loss
- Night sweats
- Anorexia
- Malaise
- Chronic cough with sputum and haemoptysis
Slow onset
What are the symptoms of lung carcinoma?
- Cough with blood streaked sputum
- Fatigue
- SOB
- Chest pain
- Weight loss and appetite loss
Over 40 with more than 2 of these symptoms
What are the symptoms of a lung abscess?
- Cough initially non productive but later produces large amounts of purulent foul smelling sputum
- Pleuritic pain
- Dyspnoea
- Malaise
- Fever
What are the symptoms of a collapsed lung?
Sharp unilateral pleuritic pain and SOB - most common in young men and smokers - immediate onward referral
What specific question should you ask about a cough?
- Onset of cough - if worse mane could be UACS, bronchiectasis or chronic bronchitis
- Duration - if longer than 3 weeks could be bronchitis, 3 months could be chronic bronchitis, carcinoma
- Periodicity - recurrent could be chronic bronchitis
- recurrent in children could be asthma if fhx of eczema, asthma or hay fever - Age - children most likely URTI but could be asthma or croup
- adults could be bronchitis, pneumonia and carcinoma - Smoking - prone to recurrent cough that could develop into chronic bronchitis or COPD
- Sputum colour - rust = pneumonia
- pink tinged = left ventricular failure
- dark red = carcinoma
- bright red = burst blood vessel - Nature of sputum - thin and frothy = left ventricular failure
- thick mucoid/yellow = asthma
- foul smelling = bronchiectasis or lung abscess
What cases of cough should be referred?
- Chest pain/ pain in inspiration
- Haemoptysis
- Wheeze/SOB
- > 3 weeks
- Recurrent cough
- Persistent nocturnal cough in children
What would you give for a chesty cough?
Products with guaifenasin
What is the dose for guaifenesin products?
> 12 = 200mg qid
<12 = 100mg qid
Does guaifenesin have any drug interactions?
NO cautions, drug interactions or side effects and is okay for pregnant and BF
What would you give to suppress a cough (dry cough)?
Dextromethorphan
Does dextromethorphan have any drug interactions?
YES - MAOI, SSRI, tramadol (opioid analgesics), alcohol, anxiolytics and hypnotics - increase sedation as dex is an opioid derivative
Care with asthma as can cause response depression but is fine
Preg - avoid in 3rd trimester
BF - short periods okay but can cause poor feeding or drowsiness in baby
Does dextromethorphan have any drug interactions?
YES - MAOI, SSRI, tramadol (opioid analgesics), alcohol, anxiolytics and hypnotics - increase sedation as dex is an opioid derivative
Care with asthma as can cause response depression but is fine
Preg - avoid in 3rd trimester
BF - short periods okay but can cause poor feeding or drowsiness in baby
What if a patient is struggling to sleep?
Antihistamine preps
