Cough and Colds Flashcards
Common cold is an
Acute upper respiratory viral infection
Common cold s/s
Rhinorrhea, nasal congestion, cough,
sneezing, sore throat, headache,
hoarseness, malaise, myalgia
Common cold fever is
common in kids, rare in adults
Common cold is self
Self-limited, usually benign
• No cure; just treatment of symptoms
Common cold requires
no treatment, just symptomatic releive
Common cold October 2007 FDA
– FDA – pediatric cough and
cold medications, younger than 4 years of
age
Non-pharm treatments for comon colds
- Increased fluid intake
- Nasal saline spray or drops
- Rest
- Infants – nasal suction – secretions
- Monitor s/s of a bacterial infection
- Most resolve within 7 to 10 days
most colds resolve within
7 to 10 days
Sympathomimetics reduce
nasal congestion (do not reduce rhinorrhea, sneezing, or itching)
Sympathomimetics are active
alpha1-adrenergic receptors on nasal
blood vessels
Sympathomimetics ADR
Adverse effects – Rebound congestion – CNS stimulation – Cardiovascular effects and stroke – Abuse (Combat Methamphetamine Epidemic Act of 2005)
Sympathomimetics (Oral/Nasal) factors in topical administration
– Should not use longer than 5 consecutive days
– Drops or sprays
– Topical agents act more
Sympathomimetics (Oral/Nasal)
quickly than oral agents and are
usually more effective
Oral agents act
Sympathomimetics (Oral/Nasal)
longer than topical preparations
Systemic effects occur primarily with
Sympathomimetics (Oral/Nasal)
oral agents; topical agents
usually elicit these responses only when dosage is higher than
recommended
Rebound congestion is common with
Sympathomimetics (Oral/Nasal)
prolonged use of topical
agents but rare with oral agents.
Drugs for Cough
Antitussives
Nonopioid antitussives
• Antitussives examples
– Drugs that suppress cough
– Opioid antitussives
• Codeine and hydrocodone
Nonopioid antitussives exaples
- Dextromethorphan
- Diphenhydramine
- Benzonatate
Expectorants example and note
Guaifenesin [Mucinex, Humibid] – Renders cough more productive by stimulating the flow of respiratory tract secretions – Higher doses may be effective
Mucolytics examples
- Hypertonic saline
* Acetylcysteine
Mucolytics react directly with
mucus to
make it more watery
Mucolytics have a
High sulfur content, “rotten egg” smell
Mucolytics can trigger
bronchospasm
Pediatric OTC Cold use with
caution in young children
Avoid OTC cold remedies in children younger than
4 to 6
– Consult a health care professional before giving t
otc cold remedies to a child
Avoid using antihistamine-containing products to
sedate children
• Infants and young children - the symptoms of the common cold usually peak on
day 2 to 3 of illness and then gradually improve over
10 to 14 days
• Recommend one or a combination of the following interventions as
first-line therapy for children with the common cold – maintain
adequate hydration, ingestion of warm fluids, humidified air, and/or
topical saline
Over-the-counter (OTC) products for symptomatic relief of the common cold in children include
antihistamines, decongestants,
antitussives, expectorants, mucolytics, antipyretics/analgesics, and
combinations of these medications (adapted from UpToDate).
Children <6 years – Except for antipyretics/analgesics, OTC medications for the common cold should
be avoided in children <6
years of age
years of age.
• 6 to 12 years – Except for antipyretics/analgesics, we suggest not using OTC medications
or the common cold in children 6 to 12
years of age.
Adolescents ≥12 years – OTC decongestants may provide
symptomatic relief of nasal symptoms in adolescents ≥12 years
Anti-histamines – avoid in what patient population
elderly
Anticholinergic medications – associated with multiple
adverse effects
(memory impairment, confusion,
hallucinations, dry mouth, blurred vision, constipation,
nausea, urinary retention, impaired sweating, and
tachycardia).
elderly - Decongestants - may elevate
blood pressure and ocular
pressure, may worsen urinary obstruction and can interact
with other medications (e.g., beta blockers, methyldopa,
tricyclic antidepressants, oral hypoglycemic agents, and
MAOIs)
elderly otc antitussives
s – dextromethorphan contraindicated - concurrent administration with or within 2 weeks of
discontinuing an MAO inhibitor.
Lactation - First generation anti-histamines –
would avoid - larger doses or more prolonged use may cause effects in nursing infants (e.g., paradoxical stimulation, irritability, crying, or drowsiness) or decrease the milk supply
lactation avoid -
codeine (cough suppressant or
analgesic) – can cause infant drowsiness,
CNS depression, and even death.
