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
Q

usual dose & minimum age of procodin

A

5-10mL TDS
min age: 12yo

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26
Q

What are the 3 types of sore throat lozenges available?

A
  1. difflam
  2. dorithricin
  3. dequalinium
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27
Q

What is the active ingredient in Difflam lozenges

A

Benzydamine - anti-inflammatory and anesthetic effect (numbing)
* Cetylpyridinium – antiseptic

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28
Q

What is the active ingredient in Dorithricin lozenges

A

Tyrothricin & benzalkonium chloride -
antiseptic (kills germs)
* Benzocaine - anesthetic
effect

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29
Q

usual dose & maxdose for Difflam

A

Suck 1 lozenge Q3H-
PRN, up to 12/day

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30
Q

min age for difflam

A

6yo

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31
Q

Counselling points for Difflam

A
  • Do not ingest hot food or
    drinks directly after using
    the lozenges.
  • Excess consumption may
    have a laxative effect.
32
Q

Why does eating Difflam excessively cause diarrhoea

A

Artificial sugar contents found in the
lozenges may cause diarrhea when
consumed in large amounts.
(eg. Isomalt in Difflam, Sorbitol in
Dorithricin)

33
Q

Sore throat tablet options

A
  1. serrapeptidase
  2. leftose (lysozyme)
34
Q

Dosing for Danzen

A

1-2tab TDS

35
Q

Dosing for Leftose

A
  • 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
Q

Who cannot take Leftose

A

those with egg allergy

37
Q

Gargles for Sore Throat

A

thymol gargle & chlorhexidine gargle

38
Q

min age for thymol & chlorhexidine

A

6yo (thymol)
as long as can swallow (chlorhexidine)

39
Q

Counselling for thymol

A

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
Q

Counselling for chlorhexidine

A

Do not mix with water.
* Gargle for about 30 seconds.
* Do not swallow in large
quantities.

41
Q

How to use difflam gargle solution

A

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
Q

Difference between common cold & allergic rhinitis

A

CC by virus, AR by allergens
CC has fever, cough, sore throat; AR has more nasal symptoms

43
Q

Similarity between common cold & AR

A

release of histamine which causes nasal symptoms

44
Q

Side effects of anti-histamines

A

– Dry mouth
– Dry eyes
– Blurred vision
– Dry skin
– Difficulty initiating urine (urinary retention)
– Constipation
– Drowsiness/dizziness (common for 1st gen only)

45
Q

Dosing & dosage form & min age for chlorpheniramine

A
  • 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
Q

Dosing & min age for Promethazine syrup

A
  • 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
Q

Dosing & dosage form & min age for Hydroxyzine

A

For itch or sleep
10-25mg OD to TDS-PRN

(usually for adults)
POM

48
Q

Dosing & dosage form & min age for Cetirizine

A
  • 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
Q

Dosing & dosage form & min age for Loratadine

A
  • 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
Q

MOA of decongestant

A

Narrows blood vessels in the nasal passages, reducing swelling and the feeling of congestion

51
Q

Side effects of decongestants (oral)

A
  • Affect alertness – may feel more awake/drowsy
  • Cardiovascular (heart and blood vessels) –hypertension, palpitations
52
Q

Side effects of decongestant (topical)

A
  • 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
Q

Usual Dose of Oxymetazoline Nasal Drops

A

1-2 drops each nostril BD/TDS-PRN

54
Q

Different doses & min age of Oxymetazoline nasal spray

A

0.01% - <1yo
0.025% - <6yo
0.05% - >6yo

55
Q

Decongestant Tablets (min age & dosing)
- Decold & Zyrtec D

A

Min age: 12yo
dosing: 1 tab BD

56
Q

What is the dosing for Avamys & Nasonex

A

Avamys: 1 puff per nostril OD – BD
(max: 4 sprays/day)

Nasonex: 1-2 puffs per nostril OD - BD
(max: 8 sprays/day)

57
Q

what is the min age for Prescribing nasal spray (steroid)

A

2yo

58
Q

What to counsel for nasal spray

A

It may take up to 2-3 weeks to see improvement in symptoms. Please use regularly.

59
Q

How many times do you prime Avamys

A

6 times

60
Q

How many times do you prime Nasonex

A

10 times

61
Q

What do you need to do if: you need to apply eye drops and ointment together,

A

you should apply the eye drops
first before applying the ointment. Wait for 5 minutes before applying another eye drop
or ointment.

62
Q

what if you need to wear contact lens & need to apply eye drops as well

A

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
Q

MOA & Ingredients of Naphcon-A

A

relieve red eye, itching eye
contains pheniramine & naphazoline

64
Q

min age & dose of naphcon A

A

Min age: 6yo
dose: 1-2 drops TDS/QDS

65
Q

Counselling for Naphcon-A

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
Q

Vividrin Eye Drops (MOA, Min age, Dose)

A

MOA: itchy eye
Min age: 4yo
dose: 1-2 drops TDS/QDS

67
Q

What is the Atopic Triad

A

produce increased levels of lgE antibodies. (Type 2 immune response)
This causes the typical symptoms
of asthma, AR & eczema

68
Q

which moisturiser can act as a soap substitute

A

emulsifying ointment

69
Q

How to use a soap substitute

A

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
Q

Indication for steroids

A
  • Suppress the inflammation in the skin that causes the flare-up
  • Relieve symptoms such as itchiness, redness, and rash
71
Q

Dosing of steroid creams

A

Apply thinly once to twice a day
*Note for Mometasone, the recommended dose is once daily.

72
Q

Side effects of steroid creams

A
  • 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
Q

lowest potency of steroid cream

A

Hydrocortisone cream

74
Q

highest potency of steroid cream

A

clobetasol

75
Q

Indication of betamethasone 0.1% lotion

A

Relief of itch and inflammation of the scalp including psoriasis and
seborrheic dermatitis (scalp inflammation due to excessive oil secretion)

76
Q

How to use the betamethasone 0.1% lotion

A

2-3 full sprays to the affected scalp 2 times a day, or as directed by Doctor

77
Q

Moisturizers and Steroid, which one to use first?

A

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.