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OTC Test 2 > Cough and Cold Part 1 Lecture > Flashcards

Cough and Cold Part 1 Lecture Flashcards

1
Q

When is cold season?

A

Late august to early april

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2
Q

Children have colds how often?

A

6-10 per year

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3
Q

Adults have colds how often?

A

2-4 colds

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4
Q

Colds are caused by viruses like?

A 
Coranavirus
Influenza
Parainfluenza
Adenovirus
Echovirus
Enterovirus
Multiple viruses
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5
Q

Main cause of the cold?

A

Rhinovirus

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6
Q

Pathophysiology of the cold?

A

Rhinovirus enters via epithelial cells in the nose and nasopharynx in order to replicate (33-35 degrees celsius)
Peak concentration occurs in 2-4 days after initial infection –> linger for 2.5 weeks
Inflammatory responses in the nasopharynx

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7
Q

What are risk factors?

A 
Smoking
Allergic Disorders
Sedentary lifestyle
Long-term stress
Day care/staying in small social circles
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8
Q

What are modes of transmission for a cold?

A 
Self-inoculation (touching a viral object)
Aerosol transmission (viral particles in mucous linger)
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9
Q

What is normal symptom progression?

A

Sore throat –> nasal congestion, rhinorrhea, sneezing (day 2-3) –> cough (day 4-5) –> symptom resolution (day 7)

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10
Q

What are symptom progressions?

A

Nasal drainage often will start out clear
- As it progresses, mucus becomes thicker and change to a yellow or green color before coming clear again
Rarely a fever over 100 degrees F

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11
Q

Symptoms of allergic Rhinitis?

A

Itchy, watery eyes and watery rhinorrhea

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12
Q

Symptoms of influenza?

A

Myalgia (muscle pain)

Moderate-severe fatigue

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13
Q

Symptoms of ashtma?

A

SOB and or wheezing

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14
Q

Symptoms of sinusitis

A

Facial pain upon Valsalva’s maneuver, tender sinuses, URTI for > 7 days

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15
Q

Symptoms of otitis media?

A

Ear pain, ear popping, hearing loss, otorrhea

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16
Q

What are exclusions for self-treatment of a cold?

A 
Fever > 101.5
Chest pain
SOB
Worsening during self-treatment
Hypersensitivity to OTC
Concurrent cardiopulmonary disease
Immunosuppression
Elderly 
Less than 9 months
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17
Q

How long does an acute cough last? Cause?

A

3 weeks

Viral URTI, pneumonia

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18
Q

How long does a subacute cough last? Cause?

A

3-8 weeks

Bacterial sinusitis

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19
Q

How long does a chronic cough last? Cause?

A

8 weeks

Meds, acid reflux, COPD, lung cancer

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20
Q

Symptoms of pneumonia/bronchitis?

A

Productive cough and or change in sputum color

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21
Q

Symptoms of whooping cough

A

Distinctive high-pitch coughing sound

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22
Q

Define dry cough

A

Nonproductive
“hacking cough”
No physiologic purpose
Caused by viral URTIs, acid reflux and some meds

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23
Q

Define wet cough

A

Lungs are attempting to expel something

- Clear, purulent, discolored, malodorous

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24
Q

What are complications of cough?

A 
Exhaustion and insomnia
Hoarseness
Musculoskeletal pain
Syncope
Rib fractures
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25
Q

Suppression of a productive cough leads to?

A

Lower respiratory tract infection, which is more serious and could lead to a bacterial infection

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26
Q

Exclusions for self-treatment for a cough?

A 
Fever > 101.5
Cough with thick, yellow sputum or green phlegm
Uninteded weight loss
Drenching nighttime sweats
Hemoptysis (coughing up blood)
Foreign object aspiration 
History or symptoms with asthma, COPD, or heart failure
Suspected drug-induced cough
Cough lasting > 7 days
Worsening cough
New symptoms
27
Q

Non-pharmacological options?

A 
Get adequate rest
Eat a nutritious diet as tolerated
Maintain adequate fluid intake
Increase humidifaction
Saline gargle
Hard candies
Food such as tea with lemon and honey, chicken soup and hot broths
Nasal strips
Aromatic products
28
Q

Define humidifiers

A

Cool mist

29
Q

Define vaporizer

A

Warm mist

- potential for bacterial growth and burns

30
Q

How are humidifiers and vaporizers maintained?

A

Clean daily and disinfect weekly

31
Q

What are benzocaine, menthol, pectin, dyclonine, and phenol?

A

Provides temporary relief
Can be used every 2-4 hours
Patients with allergy to anesthetics (“caines”) should avoid

32
Q

Decongestants direct acting MOA, PK, examples?

A

Bind directly to adrenergic receptors

  • Faster onset, shorter duration
  • IE: phenylephrine, oxymetazoline, tertrahydrozoline
33
Q

Decongestants indirect acting MOA, PK, examples?

A

Displace NE from storage vesicles in prejunctional nerve terminals

  • Slower onset, longer duration
  • Ephedrine
34
Q

Decongestants mixed MOA, PK, examples?

A

Have both direct and indirect acting properties

  • Faster onset, longer duration
  • Pseudoephedrine
35
Q

Phenylephrine side effects?

A 
Cardiovascular stimulation (hypertension, tachycardia, palpitations)
CNS stimulation (restlessness, insomnia, anxiety)
- Exacerbate certain diseases sensitive to adrenergic stimulation
36
Q

Phenylephrine Interactions and contraindications?

A

MAO-I, Methyldopa, TCA

- Concomitant use with MAOIs

37
Q

What is the combat Methamphetamine epidemic act?

A

Must be kept in secure areas

Must be logged with product name, wantity sold, name, address, time and date

38
Q

Sales per patients daily?

A

3.6 grams

39
Q

Sales per patients monthly?

A

9 grams

40
Q

Side effects of topical decongestants?

A

Burning, stinging, sneezing, local dryness

41
Q

What is the proper technique of nasal sprays?

A

Blow nose gently
Wash hands
Shake
Tilt head slightly forward and close one nostril
Insert and point back and outer side of the nose
Squeeze the nasal spray while breathing in slowly through the nose

42
Q

Define neti-pots

A

Nasal wetting agent or saline nasal irrigation

43
Q

Define antihistamines

A

First generation

Beneficial effects related to anticholinergic properties, not antihistamic properties

44
Q

Antihistamines side effects?

A

CNS effects (sedation, impaired performance) and anticholinergic effects

45
Q

Antihistamine drug interactions?

A

Alcohol or other sedating meds, MAOIs, phenytoin

- Potential for paradoxical effect in children and elderly

46
Q

SLUDGE cholinergic effects?

A 
Salvation
Lacrimation
Urination
Defecation
GI distress
Emesis
47
Q

Other non-pharmacologic options?

A

Non-medicated lozenges, hard candies, or honey –> not honey flavored but not in children less than 1 year old (risk of botulism poisoning)

48
Q

Define guaifenesin

A

Loosens and thins the lower repiratory tract secretions to make minimal productive cough more productive

49
Q

Guaifenesin side effects?

A

Nausea, vomiting, dizziness, headache, diarrhea, stomach discomfort
– take full of water and maintain adequate hydration

50
Q

Antitussives dextromethorphan side effects?

A

Acts centrally to increase the cough threshold

  • drowsiness, nausea, vomiting, stomach discomfort, constipation
  • Potential for abuse
51
Q

Dextromethorphan drug interactions?

A 
Serotonergic meds (MAOIs, SSRIs)
- Concomitant use MAOIs)
52
Q

Antitussive diphenhydramine?

A

FDA approved

Acts centrally to increase the cough threshold

53
Q

Antitussive codeine?

A

Acts to increase the cough threshold

Considered a schedule V narcotic

54
Q

Topical Antitussives Vicks VapoRub?

A

Camphor and menthol
Apply TID
Toxic if ingested
Less than 2 years old

55
Q

Topical Antitussives Vicks Baby Rub?

A

Petrolatum, fragrance, aloe extract, eucalyptus oil, lavender oil, rosemary oil
- Use in ages 3 months and older

56
Q

Echinacea purpurea?

A

Immunostimulant properties

  • Has not been shown to be effective in preventing colds
  • Avoid if: allergy to plants, history of asthma, atopy, or allergic rhinitis, autoimmune disorder
  • Not taken if pregnant or breast-feeding women or under 2 years old
57
Q

Zinc?

A

Block adhesion of rhinovirus to the nasal epithelium
Thought to inhibit viral replication by disrupting viral formation
- Do not drink with citrus juices, taste abnormalities, anosmia

58
Q

Vitamin C?

A

Acts a potent antioxidant and helps with the immune system
Can reduce duration by 8% in adults and 13.6% in children
Avoid high dosages if patients with diabetes or a history of kidney problems

59
Q

Special regulations of infants and children under 2 years?

A

Non-pharmacologic treatment only unless otherwise given permission by physician
- Maintain upright position, adequate fluid intake, increase humidity, irritate the nose with saline drops, clear with a bulb syringe

60
Q

Special regulations of children under 4?

A

Manufacturers of OTC meds update their labels to include precautions
- Non-pharmacologic treatments preferred

61
Q

Special regulations of children 4-11?

A

OTC cold meds are controversial

Use pharmacologic meds with caution

62
Q

Special regulations of pregnant women?

A

Decogestant: topical oxymetazoline
No systemic agents
Cough suppressant: dextromethorphan

63
Q

Special regulation of lactation?

A

Decongestants: topical phenylephrine, pseudoephedrine
AVOID xylometazoline and naphazoline
Cough suppressant: dextromethorphan

OTC Test 2 (9 decks)

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