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Cough, Cold, & Allergies Flashcards

1
Q

Cold symptoms begin ____ after infection and last ____

A

1-3 days

7-14 days

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2
Q

Sneezing is a result of

A

stimulating sensory neves
ex. histamine, bradykinin

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3
Q

Congestion is a result of

A

stimulating cholinergic and sympathetic nerves

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4
Q

Physical assessment of a cold

A

slightly red pharynx
postnasal drip
nasal obstruction
tender sinuses

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5
Q

Exclusions to self care for colds

A

Fever
Chest pain
SOB
worse/new symptoms
asthma, COPD, CHF
AIDs or immunosuppressant therapy
>80 yo
< 3 months
allergic to recommended OTC

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6
Q

Nonpharm treatment of cold

A

fluids, rest, diet
humidification
salt gargles, oils
good hygiene

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7
Q

Pharmacological treatment of cold

A

Decongestants
Local anesthetics
Antihistamines
Systemic analgestics

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8
Q

Decongestants indication

A

temporary relief of nasal congestion
cough w/ post nasal drip

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9
Q

Adrenergic agonists MOA

A

constriction of blood vessels
decreased sinusoid vessel engorgement + edema

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10
Q

Types of decongestants

A

Direct acting
Indirect-acting
Mixed

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11
Q

Direct-acting decongestants

A

phenylephrine
oxymetazoline
tetrahydrozoline

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12
Q

Indirect-acting decongestants

A

displace NE from storage vesicles
ephedrine

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13
Q

Mixed decongestants

A

pseudoephedrine

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14
Q

Systemic decongestants

A

pseudoephedrine
phenylephrine

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15
Q

systemic decongestants are metabolized by ____ and ____

A

MAO

COMT

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16
Q

systemic decongestants peak concentration

A

0.5-2 hours
work quickly + short half lives

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17
Q

oral _______ is NOT as effective as a nasal decongestant

A

phenylephrine

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18
Q

systemic decongestants adverse events

A

Cardiovascular stimulation - increased BP, HR, palps, arrhyrhmias
CNS stimulation - insomnia, anxiety, hallucinations, tremors

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19
Q

Avoid systemic decongestants in combination with

A

MAOIs and ergot derivatives
(increased HTN)

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20
Q

Consider therapy modification of systemic decongestants with

A

Linezolid + SNRIs
(increased HTN + tachycardia)

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21
Q

Short-acting nasal decongestants

A

levmetamfetamine
naphazoline
phenylephrine
propylhexedrine

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22
Q

long-acting nasal decongestants

A

oxymetazoline

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23
Q

Nasal decongestants AEs

A

burning, stinging, sneezing, dryness
trauma from tip
rebound congestion

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24
Q

Nasal decongestants should be limited to ______

A

3- 5 days

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25
Local anesthetics are used _____ for _____
every 2-4 hrs prn temporary relief of sore throats
26
Nonprescription cold medications not recommended for children ____
< 2 years old
27
Manufacturers recommend not to use in children ____
< 4 years old
28
Avoid "extra-strength, max strength, long-acting," and combo products in
Pregnancy
29
Preferred topical decongestant in pregnancy
Oxymetazoline (Afrin)
30
Which cold medications are compatible with breastfeeding
pseudoephedrine dextromethorphan guaifenesin benzocaine camphor menthol
31
Cold Trx if aches + pains
systemic analgestics
32
Cold Trx if low-grade fever
systemic antipyretics
33
Cold Trx if cough
antitussives expectorants
34
Cold Trx if congestion or rhinorrhea
saline nasal sprays decongestants
35
Cold Trx if pharyngitis
saline gargles local anesthetic sprays or lozenges
36
Cold Trx if sleeplessness
nasal decongestant sprays hs antihistamine alcohol-containing products
37
Allergic rhinitis phase 1
sensitization phase IgE production
38
Allergic rhinitis phase 2
early phase release of mast cell mediators
39
Allergic rhinitis phase 3
cellular recruitment more inflammatory mediators released
40
Allergic rhinitis phase 4
late phase mucus hypersecretion, congestion
41
Intermittent allergic rhinitis
< 4 days/week or < 4 weeks
42
Persistent allergic rhinitis
> 4 days/week or > 4 weeks
43
Episodic allergic rhinitis
occurs when in contact with exposure
44
Mild allergic rhinitis
does not impair sleep/daily activities
45
Moderate-Severe allergic rhinitis
impaired sleep impaired daily activities troublesome symptoms
46
Clinical presentation of allergic rhinitis
allergic salute allergic gape allergic shiners Dennie's lines
47
exclusion to self care for allergic rhinitis
< 12 years pregnant/lactating women nonallergic rhinitis otitis media, sinusitis, bronchitis (infections) asthma, COPD, lower respiratory disorders severe side effects of treatment
48
Most effective trx for allergic rhinitis
intranasal corticosteroids
49
pharmacological trx of allergic rhinitis
intranasal corticosteroids antihistamines decongestants mast cell stabilizer
50
start trx of allergic rhinitis ____ before symptoms or ASAP
1 week
51
Intranasal corticosteroids
budesonide fluticasone furoate fluticasone propionate triamcinolone acetonide
52
oral antihistamines indication
episodic allergic rhinitis
53
1st gen antihistamines (sedating)
diphenhydramine (benadryl) chlorpheniramine
54
2nd gen antihistamines (nonsedating)
cetirizine (Zyrtec) fexofenadine (allegra) levocetirizine (Xyzal) loratadine (Claritin)
55
Nasal antihistamines
Azelastine (Astepro)
56
side effects of nasal antihistamines
bitter taste runny nose headache sedation
57
mast cell stabilizer
cromolyn sodium (second line)
58
mast cell stabilizer indications
prevention + trx of allergic rhinitis symptoms
59
mast cell stabilizer side effects
sneezing, nasal stinging, burning
60
mast cell stabilizer dosing
1 spray each nostril 3-6 times daily
61
Do not use sedating antihistamines in ____
geriatrics
62
best allergic rhinitis options for geriatric patients
loratadine and intranasal cromolyn
63
first line allergic rhinitis trx in pregnancy
intranasal cromolyn
64
_____ and _____ are linked to cleft lip/palate and low birth weight
budesonide triamcinolone
65
allergic rhinitis trx contraindicated in lactaction
antihistamines maybe intranasal corticosteroids
66
allergic rhinitis trx if sneezing, rhinorrhea, or itching (mild, intermittent)
oral antihistamine
67
allergic rhinitis trx if sneezing, rhinorrhea, or itching (persistent or mod/severe intermittent)
intranasal corticosteroids oral antihistamines
68
allergic rhinitis trx if conjunctivitis
oral or ocular antihistamines saline
69
allergic rhinitis trx if congestion
add oral or topical decongestant
70
acute cough
< 3 weeks duration
71
subacute cough
3-8 weeks duration
72
chronic cough
> 8 weeks duration
73
productive cough
mucus
74
nonproductive cough
dry
75
exclusions to self care of cough
difficulty breathing/dyspnea cyanosis hemoptysis weight loss night sweats worse after 3-5 days, longer than 2-3 weeks < 4 years old fever barking cough whooping cough cough w/o URI symptoms or fever immunocompromised risk of HIV asthma, COPD, CHF, DM, sickle cell anemia
76
nonpharm trx of cough
hard candies, humidificaiton, hydration, nasal drainage
77
pharmacological trx of cough
antitussives for nonproductive expectorants for productive
78
can you combine antitussives and expectorants?
NO counterproductive
79
Antitussives
dextromethorphan codeine diphenhydramine chlophendianol hcl camphor menthol
80
dextromethorphan AEs
drowsiness, N/V, stomach upset, constipation
81
dextromethorphan DDIs
MAOIs + serotonin modulators Strong CYP2D6 inhibitors
82
chlophendianol hcl AEs
excitation, hyperirritability, nightmares, hallucinations, urticaria
83
chlophendianol hcl is used in combo with
guaifenesin, antihistamines, decongestants
84
topical antihistamines
camphor and menthol
85
Expectorants
guaifenesin
86
Expectorants indications
symptomatic relief of acute, ineffective productive cough
87
Expectorants AEs
N/V, dizziness, headache, rash, diarrhea, drowsiness, stomach pain
88
Is codiene recommended in children
NO
89
1st gen antihists should be used in caution in
geriatrics start at lower doses
90
avoid codiene in ____ of pregnancy
1st trimester
91
do not use ____ and ____ in lactation
codeine diphenhydrmaine

Community Pharmacy (11 decks)

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