Cough, Cold & Allergies Flashcards

1
Q

List the classes of cough medications

A
  1. Mucolytics
  2. Suppressants
  3. Antihistamines
  4. Expectorants
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2
Q

What is the mechanism of cough suppressants

A

Suppress cough
Decrease sensitivity of cough
Supress cough centre in the brain

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3
Q

Min Age for fluimicil & why

A

Minimum Age: 2yo
Risk of aspirational pneumonia

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4
Q

Mechanism of expectorant & the medications

A

Induces cough
Medication: Diphenhydramine & Guaifenesin

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5
Q

Mechanism of Mucolytic

A

Reduces viscosity of phlegm

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6
Q

What is the legal class, minimum age and usual dose for CODEINE

A

Legal class: POM
Min Age: 12yo (30mg tablet)
Usual dose: 1 tab TDS

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7
Q

What is the legal class, minimum age and usual dose for Dextromethorphan Linctus.

A

Legal Class: P-only
Min age: 2yo
Usual dose:
- 2-5yo: 2.5mL TDS
- 6-11yo: 5mL TDS
- >12yo: 10mL TDS

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8
Q

What are the various dosage forms of dextromethorphan available?

A

Syrup, Tussils Lozenge, Dexcophan tablets

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9
Q

What is the legal class, minimum age and usual dose for Dextromethorphan TABLETS

A

Legal Class: P-only
Min age: 12yo
Usual dose: 1-2 tablets TDS

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10
Q

What is the legal class, minimum age and usual dose for Tussils

A

Legal: P-only
Min age: 12yo
Usual dose: 1 lozenges TDS (on product insert is able to suck 2 at one go every 4hours)

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11
Q

What is the maximum number of Tussils that you can take a day

A

12

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12
Q

What is the difference between the ingredients for Diphenhydramine & Diphenhydramine-Paeds

A

Bena Expect: Diphenhydramine 14mg + Ammonium chloride 135mg

Diphen-Paeds: Diphenhydramine mg + Ammonium chloride 62.5mg

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13
Q

What is the age range that can take Diphen-Paeds syrup + the relative doses

A

2-5yo: 5mL TDS
6-11yo: 10mL TDS

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14
Q

What is the dose for bena-expect + the minimum age

A

Min age: 12yo
Dosing: 7.5mL TDS

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15
Q

What is the mechanism of action of Ammounium Chloride found in Bena Expect?

A

It irritates the throat to cause production of excess mucus to induce coughing

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16
Q

What are the relative doses & age range for GUAIFENESIN syrup

A

2-5yo: 5mL TDS
6-11yo: 10mL TDS
>12yo: up to 20mL TDS

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17
Q

Patient is a 6yo having wet cough wanting acetylcysteine, which will you give? (The exact dosage form and corresponding dosing)

A

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

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18
Q

What is the minimum age & dosing ranges of BROMHEXINE SYRUP (MUCOLIX)

A

2-5yo: 2.5mL TDS
6-11yo: 5mL TDS
>12yo: 10mL TDS

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19
Q

What is the difference between the min age for Mucolix & Bromhexine Tablet

A

Mucolix: 2yo
Bromhexine tablet >12yo

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20
Q

What is the dose of bromhexine tablet

A

1-2tablet TDS PRN (max 6 tablets/day)

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21
Q

What does Rhinathol contain?

A

Promethazine 2.5mg (antihistamine)
Carbocysteine 100mg (mucolytic)

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22
Q

What does Procodin contain

A

Promethazine 3.6mg (antihistamine)
Codeine 9mg (anti-tussives)

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23
Q

Whats the difference between procodin & dhasedyl?

A

They are the SAME

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24
Q

usual dose & minimum age of Rhinathiol

A

2-5 years: 2.5-5mL QDS-PRN
6-12 years: 7.5-12.5mL TDSPRN
≥12 years: 15mL TDS-PRN

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25
usual dose & minimum age of procodin
5-10mL TDS min age: 12yo
26
What are the 3 types of sore throat lozenges available?
1. difflam 2. dorithricin 3. dequalinium
27
What is the active ingredient in Difflam lozenges
Benzydamine - anti-inflammatory and anesthetic effect (numbing) * Cetylpyridinium – antiseptic
28
What is the active ingredient in Dorithricin lozenges
Tyrothricin & benzalkonium chloride - antiseptic (kills germs) * Benzocaine - anesthetic effect
29
usual dose & maxdose for Difflam
Suck 1 lozenge Q3H- PRN, up to 12/day
30
min age for difflam
6yo
31
Counselling points for Difflam
- Do not ingest hot food or drinks directly after using the lozenges. - Excess consumption may have a laxative effect.
32
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)
33
Sore throat tablet options
1. serrapeptidase 2. leftose (lysozyme)
34
Dosing for Danzen
1-2tab TDS
35
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
36
Who cannot take Leftose
those with egg allergy
37
Gargles for Sore Throat
thymol gargle & chlorhexidine gargle
38
min age for thymol & chlorhexidine
6yo (thymol) as long as can swallow (chlorhexidine)
39
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.
40
Counselling for chlorhexidine
Do not mix with water. * Gargle for about 30 seconds. * Do not swallow in large quantities.
41
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
42
Difference between common cold & allergic rhinitis
CC by virus, AR by allergens CC has fever, cough, sore throat; AR has more nasal symptoms
43
Similarity between common cold & AR
release of histamine which causes nasal symptoms
44
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)
45
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
46
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
47
Dosing & dosage form & min age for Hydroxyzine
For itch or sleep 10-25mg OD to TDS-PRN (usually for adults) POM
48
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
49
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
50
MOA of decongestant
Narrows blood vessels in the nasal passages, reducing swelling and the feeling of congestion
51
Side effects of decongestants (oral)
- Affect alertness – may feel more awake/drowsy - Cardiovascular (heart and blood vessels) –hypertension, palpitations
52
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
53
Usual Dose of Oxymetazoline Nasal Drops
1-2 drops each nostril BD/TDS-PRN
54
Different doses & min age of Oxymetazoline nasal spray
0.01% - <1yo 0.025% - <6yo 0.05% - >6yo
55
Decongestant Tablets (min age & dosing) - Decold & Zyrtec D
Min age: 12yo dosing: 1 tab BD
56
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)
57
what is the min age for Prescribing nasal spray (steroid)
2yo
58
What to counsel for nasal spray
It may take up to 2-3 weeks to see improvement in symptoms. Please use regularly.
59
How many times do you prime Avamys
6 times
60
How many times do you prime Nasonex
10 times
61
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.
62
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.
63
MOA & Ingredients of Naphcon-A
relieve red eye, itching eye contains pheniramine & naphazoline
64
min age & dose of naphcon A
Min age: 6yo dose: 1-2 drops TDS/QDS
65
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.
66
Vividrin Eye Drops (MOA, Min age, Dose)
MOA: itchy eye Min age: 4yo dose: 1-2 drops TDS/QDS
67
What is the Atopic Triad
produce increased levels of lgE antibodies. (Type 2 immune response) This causes the typical symptoms of asthma, AR & eczema
68
which moisturiser can act as a soap substitute
emulsifying ointment
69
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
70
Indication for steroids
- Suppress the inflammation in the skin that causes the flare-up * Relieve symptoms such as itchiness, redness, and rash
71
Dosing of steroid creams
Apply thinly once to twice a day *Note for Mometasone, the recommended dose is once daily.
72
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
73
lowest potency of steroid cream
Hydrocortisone cream
74
highest potency of steroid cream
clobetasol
75
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)
76
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
77
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.