Cough

Question 1

3 main types of cough (acute, subacute, chronic)

Answer 1

acute - less than 3 weeks
subacute - 3-8 weeks
chronic - more than 8 weeks

Question 2

describe a productive cough

Answer 2

mucus production

associated with underlying inflammatory process so dont want to stop it

Question 3

describe a nonproductive cough

Answer 3

irritation of the vagal nerve

feeling of tightness or wheezing due to congestion of brinchial airways

Question 4

causes of cough

Answer 4

ACE inhibitors
exacerbation of COPD asthma 
post nasal drip
GERD
infection 
cold

Question 5

referral for cough

Answer 5

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

Question 6

treatment goals of a cough

Answer 6

reduce number and severity of cough episodes
prevent complication
treat underlying cause

Question 7

non pharms for cough

Answer 7

humidifier - cool mist
throat lozenge
cover mouth when coughing
wash hands

Question 8

examples of antitussives

Answer 8

codiene
dextromethorphan
diphenhydramine

Question 9

indication of dextromethorphan and codiene

Answer 9

suppression of NONPRODUCTIVE COUGH

Question 10

dextromethorphan and codiene mechanism of action

Answer 10

increases cough threshold by acting centrally in medulla

Question 11

dosing for dextromethorphan*

Answer 11

30mg every 6-8 hours

max 120mg/day

Question 12

onset of action for dextropethorphan

Answer 12

15-30 min

Question 13

age you can use dextromethorphan

Answer 13

over 6

Question 14

side effects of DM

Answer 14

drowsiness, NV

Question 15

drug interactions with DM

Answer 15

SSRI, MAOI

cyp2d6 inhibitors

Question 16

toxicity effects of DM

Answer 16

restless
euphoria
hallucination 
mania
panic

Question 17

dosing of codiene

Answer 17

10-20mg every 4-6 hours

max 120mg/day

Question 18

onset of action for codiene

Answer 18

1-2 hours

Question 19

side effects of codiene

Answer 19

addiction 
sedation
dizziness
NV
constipation

Question 20

can you use antitussives in pregnancy/breast feeding

Answer 20

safe for short term use in pregnancy not breast feeding

Question 21

contraindications of antitussives

Answer 21

in asthma,COPD, CHF, immunosuppression have to rule our not an exacerbation of the condition!!
avoid in breastfeeding and smoking

Question 22

how does guaifenesin work

Answer 22

reduces sputum viscosity and facilitates mucus removal from the upper resp tract

Question 23

dosing of guaifenesin

Answer 23

200-400mg every 4 hours

max 2.4g/day

Question 24

side effects of guaifenesin

Answer 24

nausea
drowsiness
headache

Question 25

conditions cautioned with expectorant

Answer 25

COPD because excess mucus production may be at risk for AECOPD

Question 26

when do you use combo therapy

Answer 26

patients whose cough is productive and sleep is interrupted

Question 27

acute cough associated with the common cold may be due to post nasal drip how should it be treated

Answer 27

anithistamine and decongestant