Cough Flashcards
3 main types of cough (acute, subacute, chronic)
acute - less than 3 weeks
subacute - 3-8 weeks
chronic - more than 8 weeks
describe a productive cough
mucus production
associated with underlying inflammatory process so dont want to stop it
describe a nonproductive cough
irritation of the vagal nerve
feeling of tightness or wheezing due to congestion of brinchial airways
causes of cough
ACE inhibitors exacerbation of COPD asthma post nasal drip GERD infection cold
referral for cough
more than 3 weeks greater than 7 days on self treatment yellow or green discahrge (infection) fever over 40.5 or over 3 days night sweats severe headach prolonged congestion (acute sinutsitis) difficulty breathing due to irritant confusion cough up blood associated with underlying disease durg induced ear infection or croup
treatment goals of a cough
reduce number and severity of cough episodes
prevent complication
treat underlying cause
non pharms for cough
humidifier - cool mist
throat lozenge
cover mouth when coughing
wash hands
examples of antitussives
codiene
dextromethorphan
diphenhydramine
indication of dextromethorphan and codiene
suppression of NONPRODUCTIVE COUGH
dextromethorphan and codiene mechanism of action
increases cough threshold by acting centrally in medulla
dosing for dextromethorphan*
30mg every 6-8 hours
max 120mg/day
onset of action for dextropethorphan
15-30 min
age you can use dextromethorphan
over 6
side effects of DM
drowsiness, NV
drug interactions with DM
SSRI, MAOI
cyp2d6 inhibitors
toxicity effects of DM
restless euphoria hallucination mania panic
dosing of codiene
10-20mg every 4-6 hours
max 120mg/day
onset of action for codiene
1-2 hours
side effects of codiene
addiction sedation dizziness NV constipation
can you use antitussives in pregnancy/breast feeding
safe for short term use in pregnancy not breast feeding
contraindications of antitussives
in asthma,COPD, CHF, immunosuppression have to rule our not an exacerbation of the condition!!
avoid in breastfeeding and smoking
how does guaifenesin work
reduces sputum viscosity and facilitates mucus removal from the upper resp tract
dosing of guaifenesin
200-400mg every 4 hours
max 2.4g/day
side effects of guaifenesin
nausea
drowsiness
headache
conditions cautioned with expectorant
COPD because excess mucus production may be at risk for AECOPD
when do you use combo therapy
patients whose cough is productive and sleep is interrupted
acute cough associated with the common cold may be due to post nasal drip how should it be treated
anithistamine and decongestant
