COUGHS

Question 1

Cough red flags

Answer 1

> 3 weeks
Blood in sputum
High pitch breathing
Chest pains
Signs of infection - green mucus
Immunocompromised

Question 2

Dextromethorphan (cough suppressant) is licensed for what age group?

Answer 2

12 years +

Question 3

Dextromethorphan (cough suppressant) interactions

Answer 3

SSRIs, MAOIs

Question 4

Dextromethorphan (cough suppressant) adverse effects

Answer 4

GI disturbances - rare

Question 5

Simple linctus (demulcent) licensing

Answer 5

Children >12 years+ or paeds formulation >1 years
Pregnancy, breast feeding

Question 6

Simple linctus (demulcent) cautions

Answer 6

diabetes due to high sugar content

Question 7

Guaifenesin (expectorant) licensing

Answer 7

> 12 years
or Benylin chesty cough >6 years

Question 8

Guaifenesin (expectorant) brands

Answer 8

Benylin
lemsip
beechams
robitossin

Question 9

CHM Advice on coughs in children

Answer 9

Do not give sedating antihistamine to children <5 years for coughs and colds

Question 10

When would you call 999 for a cough

Answer 10

High pitch breathing / air way obstruction
Difficaulty breathing
Pale/Cold/Clammy
Anaphylaxis
Unable to swallow saliva, fluids
Drooling

Question 11

When to refer someone to A&E

Answer 11

inhaled /swallowed foreign object
Coughing up pink/red frothy mucus - pulmonary oedema

Question 12

When would you refer patient to GP surgery for a cough

Answer 12

lasting > 3 weeks
Chest pain
Signs of bacteria - green mucus
Compromised immune system
Self care failure

Question 13

What is croup?

Answer 13

inflammation of the larynx and trachea in children

Question 14

Treatment of mild croup

Answer 14

largely self-limiting, but treatment with a single dose of a corticosteroid (e.g. dexamethasone) by mouth

Question 15

Treatment of moderate - severe croup

Answer 15

Requires hospitalisation
a single dose of a corticosteroid (e.g. dexamethasone or prednisolone by mouth) or via IM or budesonide (by nebulisation) if too unwell to have it orally

Question 16

Treatment of severe croup

Answer 16

if not controlled by corticosteroid treatment, nebulised adrenaline/epinephrine solution 1 in 1000 (1 mg/mL) should be given with close clinical monitoring; the clinical effects of nebulised adrenaline/epinephrine last at least 1 hour, but usually subside 2 hours after administration. The child needs to be monitored carefully for recurrence of severe respiratory distress.