Cough, Cold & Allergies Flashcards
List the classes of cough medications
- Mucolytics
- Suppressants
- Antihistamines
- Expectorants
What is the mechanism of cough suppressants
Suppress cough
Decrease sensitivity of cough
Supress cough centre in the brain
Min Age for fluimicil & why
Minimum Age: 2yo
Risk of aspirational pneumonia
Mechanism of expectorant & the medications
Induces cough
Medication: Diphenhydramine & Guaifenesin
Mechanism of Mucolytic
Reduces viscosity of phlegm
What is the legal class, minimum age and usual dose for CODEINE
Legal class: POM
Min Age: 12yo (30mg tablet)
Usual dose: 1 tab TDS
What is the legal class, minimum age and usual dose for Dextromethorphan Linctus.
Legal Class: P-only
Min age: 2yo
Usual dose:
- 2-5yo: 2.5mL TDS
- 6-11yo: 5mL TDS
- >12yo: 10mL TDS
What are the various dosage forms of dextromethorphan available?
Syrup, Tussils Lozenge, Dexcophan tablets
What is the legal class, minimum age and usual dose for Dextromethorphan TABLETS
Legal Class: P-only
Min age: 12yo
Usual dose: 1-2 tablets TDS
What is the legal class, minimum age and usual dose for Tussils
Legal: P-only
Min age: 12yo
Usual dose: 1 lozenges TDS (on product insert is able to suck 2 at one go every 4hours)
What is the maximum number of Tussils that you can take a day
12
What is the difference between the ingredients for Diphenhydramine & Diphenhydramine-Paeds
Bena Expect: Diphenhydramine 14mg + Ammonium chloride 135mg
Diphen-Paeds: Diphenhydramine mg + Ammonium chloride 62.5mg
What is the age range that can take Diphen-Paeds syrup + the relative doses
2-5yo: 5mL TDS
6-11yo: 10mL TDS
What is the dose for bena-expect + the minimum age
Min age: 12yo
Dosing: 7.5mL TDS
What is the mechanism of action of Ammounium Chloride found in Bena Expect?
It irritates the throat to cause production of excess mucus to induce coughing
What are the relative doses & age range for GUAIFENESIN syrup
2-5yo: 5mL TDS
6-11yo: 10mL TDS
>12yo: up to 20mL TDS
Patient is a 6yo having wet cough wanting acetylcysteine, which will you give? (The exact dosage form and corresponding dosing)
Give the effervescence tablets (>6yo can take)
This is a once-daily dose which is better compared to the sachets which will be 2 sachets BD
What is the minimum age & dosing ranges of BROMHEXINE SYRUP (MUCOLIX)
2-5yo: 2.5mL TDS
6-11yo: 5mL TDS
>12yo: 10mL TDS
What is the difference between the min age for Mucolix & Bromhexine Tablet
Mucolix: 2yo
Bromhexine tablet >12yo
What is the dose of bromhexine tablet
1-2tablet TDS PRN (max 6 tablets/day)
What does Rhinathol contain?
Promethazine 2.5mg (antihistamine)
Carbocysteine 100mg (mucolytic)
What does Procodin contain
Promethazine 3.6mg (antihistamine)
Codeine 9mg (anti-tussives)
Whats the difference between procodin & dhasedyl?
They are the SAME
usual dose & minimum age of Rhinathiol
2-5 years: 2.5-5mL QDS-PRN
6-12 years: 7.5-12.5mL TDSPRN
≥12 years: 15mL TDS-PRN
usual dose & minimum age of procodin
5-10mL TDS
min age: 12yo
What are the 3 types of sore throat lozenges available?
- difflam
- dorithricin
- dequalinium
What is the active ingredient in Difflam lozenges
Benzydamine - anti-inflammatory and anesthetic effect (numbing)
* Cetylpyridinium – antiseptic
What is the active ingredient in Dorithricin lozenges
Tyrothricin & benzalkonium chloride -
antiseptic (kills germs)
* Benzocaine - anesthetic
effect
usual dose & maxdose for Difflam
Suck 1 lozenge Q3H-
PRN, up to 12/day
min age for difflam
6yo
Counselling points for Difflam
- Do not ingest hot food or
drinks directly after using
the lozenges. - Excess consumption may
have a laxative effect.
Why does eating Difflam excessively cause diarrhoea
Artificial sugar contents found in the
lozenges may cause diarrhea when
consumed in large amounts.
(eg. Isomalt in Difflam, Sorbitol in
Dorithricin)
Sore throat tablet options
- serrapeptidase
- leftose (lysozyme)
Dosing for Danzen
1-2tab TDS
Dosing for Leftose
- 5mg/mL syrup
1-2 years old: 1-2ml TDS PRN 3-6
years old: 2-3ml TDS PRN 7-12
years old: 5-6ml TDS PRN - 30mg tablet
≥12 years old: 2-3 tablet TDS-PRN
Who cannot take Leftose
those with egg allergy
Gargles for Sore Throat
thymol gargle & chlorhexidine gargle
min age for thymol & chlorhexidine
6yo (thymol)
as long as can swallow (chlorhexidine)
Counselling for thymol
Dilute 1 part of solution in 3 parts of warm water and gargle.
* Gargle for about 30 seconds.
* Do not swallow in large quantities.
Counselling for chlorhexidine
Do not mix with water.
* Gargle for about 30 seconds.
* Do not swallow in large
quantities.
How to use difflam gargle solution
15mL to be gargled or used as a
mouth rinse every 11⁄2 to 3 hours.
Hold it in the mouth or gargle for
at least 30 seconds.
spit it out after that
Difference between common cold & allergic rhinitis
CC by virus, AR by allergens
CC has fever, cough, sore throat; AR has more nasal symptoms
Similarity between common cold & AR
release of histamine which causes nasal symptoms
Side effects of anti-histamines
– Dry mouth
– Dry eyes
– Blurred vision
– Dry skin
– Difficulty initiating urine (urinary retention)
– Constipation
– Drowsiness/dizziness (common for 1st gen only)
Dosing & dosage form & min age for chlorpheniramine
- 4mg/5mL syrup
1-2 years old: up to 1mL BD-PRN
2-5 years old: up to 2.5mL TDS-PRN
6-12 years old: up to 5mL TDS-PRN - 4mg tablet
≥ 12 years: 1 tab TDS-PRN, up to 6
tabs/day
Dosing & min age for Promethazine syrup
- 5mg/5mL syrup
≥ 2 years (by weight):
0.125mg/kg/dose, up to
12.5mg/dose TDS/QDS-PRN - For nausea/vomiting
≥ 2 years (by weight): 0.25- 1mg/kg/dose, up to 25mg/dose TDS-
QDS-PRN
Dosing & dosage form & min age for Hydroxyzine
For itch or sleep
10-25mg OD to TDS-PRN
(usually for adults)
POM
Dosing & dosage form & min age for Cetirizine
- 1mg/mL syrup
6months-1 year: 2.5mL OD-PRN
1-5 years: 2.5mL OD/BD-PRN
≥ 6 years: 5mL OD/BD-PRN - 10mg tablet
1 tab OD-PRN
Dosing & dosage form & min age for Loratadine
- 1mg/mL syrup
≤30kg, 2 to 12 years: 5mL OD-PRN
>30kg, 2 to 12 years: 10mL OD-PRN - 10mg tablet
1 tab OD-PRN
MOA of decongestant
Narrows blood vessels in the nasal passages, reducing swelling and the feeling of congestion
Side effects of decongestants (oral)
- Affect alertness – may feel more awake/drowsy
- Cardiovascular (heart and blood vessels) –hypertension, palpitations
Side effects of decongestant (topical)
- Rebound congestion (worsening of nasal symptoms) triggered by prolonged use of topical decongestants
(Do not use for more than 5 consecutive days. If necessary, stop for 2 days before restarting.) - Nasal irritation
- Dry mouth & throat
Usual Dose of Oxymetazoline Nasal Drops
1-2 drops each nostril BD/TDS-PRN
Different doses & min age of Oxymetazoline nasal spray
0.01% - <1yo
0.025% - <6yo
0.05% - >6yo
Decongestant Tablets (min age & dosing)
- Decold & Zyrtec D
Min age: 12yo
dosing: 1 tab BD
What is the dosing for Avamys & Nasonex
Avamys: 1 puff per nostril OD – BD
(max: 4 sprays/day)
Nasonex: 1-2 puffs per nostril OD - BD
(max: 8 sprays/day)
what is the min age for Prescribing nasal spray (steroid)
2yo
What to counsel for nasal spray
It may take up to 2-3 weeks to see improvement in symptoms. Please use regularly.
How many times do you prime Avamys
6 times
How many times do you prime Nasonex
10 times
What do you need to do if: you need to apply eye drops and ointment together,
you should apply the eye drops
first before applying the ointment. Wait for 5 minutes before applying another eye drop
or ointment.
what if you need to wear contact lens & need to apply eye drops as well
deoends if the eyedrops got preservative (if have then have to apply without the contact lens
you can put them on 15 minutes after applying the eye drops.
Otherwise, your lens may be damaged by the preservatives present in the eye drops.
MOA & Ingredients of Naphcon-A
relieve red eye, itching eye
contains pheniramine & naphazoline
min age & dose of naphcon A
Min age: 6yo
dose: 1-2 drops TDS/QDS
Counselling for Naphcon-A
- Do not use more than 3 consecutive days. If necessary, stop for 2 days before restarting.
- It may discolour contact lens. If needed, wait for at least 15 minutes before putting the lenses back in.
- Discard 1 month after opening.
Vividrin Eye Drops (MOA, Min age, Dose)
MOA: itchy eye
Min age: 4yo
dose: 1-2 drops TDS/QDS
What is the Atopic Triad
produce increased levels of lgE antibodies. (Type 2 immune response)
This causes the typical symptoms
of asthma, AR & eczema
which moisturiser can act as a soap substitute
emulsifying ointment
How to use a soap substitute
Wet the body, rub Emolin with water between your palms until it lathers, then apply to entire
body, except face and scalp. Wash off with water.
* It will leave a thin film of ointment on the skin.
* Floor may be oily and slippery after using this ointment. Caution is needed to avoid falls.
* Keep away from flames
Indication for steroids
- Suppress the inflammation in the skin that causes the flare-up
- Relieve symptoms such as itchiness, redness, and rash
Dosing of steroid creams
Apply thinly once to twice a day
*Note for Mometasone, the recommended dose is once daily.
Side effects of steroid creams
- Skin atrophy (skin thinning)
- Hypopigmentation (lightening of skin tone)
- Impaired skin healing (wounds may heal more slowly, infections take longer to recover)
- Dry skin
lowest potency of steroid cream
Hydrocortisone cream
highest potency of steroid cream
clobetasol
Indication of betamethasone 0.1% lotion
Relief of itch and inflammation of the scalp including psoriasis and
seborrheic dermatitis (scalp inflammation due to excessive oil secretion)
How to use the betamethasone 0.1% lotion
2-3 full sprays to the affected scalp 2 times a day, or as directed by Doctor
Moisturizers and Steroid, which one to use first?
Steroid should be applied first, wait 10-15 minutes before applying moisturizers.
There is no “correct” order of application, but the general rule of thumb is to apply the topical product with higher water content first, followed by the more oil-based one 10 to 15 minutes later.
