Cough & Cold Flashcards

1
Q

Cough suppressants

A

Opiate agonist (Codeine, hydrocodone), dextromethorphan

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2
Q

Contraindications for cough suppressants

A

Opiate agonist: <18yo, dextromethorphan <4yo

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3
Q

MoA of opiate agonist

A

mu opioid receptor agonist, acts on cough centre in brain (centrally-acting)

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4
Q

MoA of dextromethorphan

A

NMDA receptor –> block Ca, Na influx –> stimulate S1R in ER –> channel Ca into mitochondria –> channel function modulation

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5
Q

SE of the opiate agonist

A

respiratory depression, constipation, sedation

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6
Q

SE of dextromethorphan

A

confusion, nervousness; high dose: headaches; extremely high dose: euphoria

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7
Q

Which has higher risk of addiction

A

Opiate agonists. Dextromethorphan is non-narcotic

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8
Q

mucolytics

A

N-acetylcysteine, carbocisteine

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9
Q

indications of mucolytics

A

URTI, asthma, COPD, CF

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10
Q

MoA of NAC

A

Break double sulfide bonds –> decrease mucus viscosity

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11
Q

MoA of carbocisteine

A

Break double sulfide bonds –> decrease mucus viscosity

Increase sialomucin –> decrease mucus adherence to airways

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12
Q

Expectorants

A

Guaifenesin (not indicated in <2yo)

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13
Q

MoA of Guaifenesin

A

Increase volume of hydration and liquidity of mucus, decrease adherence to airways, increase mucociliary transport –> promote productive cough

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14
Q

SE of Guaifenesin

A

Nausea, vomiting, kidney stones (maintain hydration and increase urinary pH)

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15
Q

Mucokinetics

A

B2 agonist, ambroxol

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16
Q

MoA of B2 agonist

A

Increase cilia beat frequency and transportability of mucus, increase Cl/H2O secretion into mucus, decrease adherence of mucus –> increase mucociliary clearance`

17
Q

SE of B2 agonist

A

Increase mucus secretion, mucus plug

18
Q

MoA of Ambroxol

A

increase cilia beat frequency, decrease mucus adherence, stimulate surfactant production –> decrease adherence of mucus to alveolar and bronchial walls

19
Q

SE of ambroxol

A

Allergic reaction, cutaneous adverse events`

20
Q

Mucoregulators

A

Anticholinergics (ipratropium, tiotropium), macrolide (erythro/clarithro/azithromycin)

21
Q

MoA of anticholinergics

A

Block inflammation-induced M3 cholinergic receptor activation of submucosal glands –> decreased stimulated output –> decrease mucus volume

22
Q

MoA of macrolide

A

Inhibits MUC5AC gene expression and production, inhibit IL-13 induced mucus production –> decrease sputum volume

23
Q

Nasal decongestant

A

Sympathomimetic amides & direct, fast-acting imidazolin

24
Q

Sympathomimetic amides

A

Phenylephrine (a1 agonist), pseudoephedrine (a1,a2 agonist)

25
Q

Imidazolin

A

Oxymetazoline (a1,a2 agonist), xylometazoline (a2 agonist)

26
Q

MoA of decongestants

A

Vasoconstriction of BV –> decrease swelling of nasal mucosa

27
Q

SE of decongestants

A

HTN, tachycardia, tremors, restlessness

28
Q

Contraindications of decongestants

A

CVD, HTN, DM, BPH, MAOI (for oral sympathomimetic amides)

29
Q

Combination therapy

A

Nasal decongestant + antihistamine ± analgesic or antitussive
Nasal decongestant + analgesic/ antipyretic
Expectorant + antitussive or decongestants