Medicines for cough and cold

Question 1

Name a cause of common cold

Answer 1

URTI infection by viruses like rhinovirus, coronavirus and respiratory syncytial virus

Question 2

What class of medication to treat runny nose/sneezing?

Answer 2

Intranasal ipratropium
intranasal/inhaled cromoglicic acid
H1 - antihistamines
intranasal corticosteroid

Question 3

What class of medication to treat sore throat and headache

Answer 3

analgesic

Question 4

What class of medication to treat fever

Answer 4

Antipyretic

Question 5

What class of medication to treat blocked nose

Answer 5

Nasal decongestants

Question 6

What class of medication to treat cough

Answer 6

Cough suppressants, expectorants, mucoactive agent

Question 7

What 2 things are nasal congestion associated with

Answer 7

Decreased sympathetic vasoconstriction of submucosal blood vessels
Increased parasympathetic stimulation of mucus secretion

Question 8

Name 1 mucoregulator

Answer 8

Ipratropium

Question 9

MOA of ipratropium

Answer 9

Short-acting muscarinic receptor antagonist
blocks inflammation-induced parasympathetic cholinergic receptor (M3) activation of submucosal glands

Question 10

What is cromoglicic acid?

Answer 10

mast cell stabiliser

Question 11

MOA of cromoglicic acid

Answer 11

Decrease mast cell degranulation induced by IgE-mediated FceRI crosslinking

leads to decreased secretion of inflammatory mediators from eosinophils, neutrophils and macrophages

Question 12

Name 3 sympathomimetic decongestants

Answer 12

phenylephrine, oxymetazoline, naphazoline, pseudoephedrine, ephedrine

Question 13

MOA of decongestant

Answer 13

direct alpha adrenoceptor agonist
alpha-1 selective: phenylephrine (oral and intranasal)
non-selective: oxymetazoline (intranasal) / naphazoline (intranasal)

indirect increase in release of adrenaline/noradrenaline

pseudoephedrine (oral) / ephedrine (intranasal)

Question 14

Name 2 nasal glucocorticoids

Answer 14

fluticasone, mometasone

Question 15

MOA of nasal glucocorticoids

Answer 15

Anti-inflammatory –> decrease mucus secretion and congestion

Question 16

Adverse effects of sympathomimetic agents, name 2

Answer 16

rebound congestion
CNS stimulation - restlessness tremors irritability anxiety insomnia
CVS - hypertension, tachycardia
Dry mouth - alpha2 agonist effect on salivary gland

Question 17

Name two types of antitussives

Answer 17

Opioid and nonopioid

Question 18

Name 1 opioid antitussive and 2 non-opioid antitussives

Answer 18

Opioid : codeine
nonopioid : dextromethorphan, diphenhydramine (h1 antihistamine)

Question 19

Name 1 expectorant

Answer 19

Guaifenesin

Question 20

MOA of expectorants

Answer 20

Increase production of respiratory tract fluids to help liquefy and reduce viscosity of tenacious secretions

Question 21

Adverse effects of expectorants

Answer 21

GIT disturbance, nausea

Question 22

What kind of cough are expectorants not for

Answer 22

persistent cough associated with asthma or smoking

Question 23

Name 2 mucolytic agent and their dosage forms

Answer 23

Acetylcysteine, carbocisteine

inhalation, effervescent tablets, oral granules, syrups

Question 24

Adverse effects of mucolytics

Answer 24

bronchospasm, anaphylactoid reaction
GIT disturbances

Question 25

MOA of mucolytics

Answer 25

Free sulfhydryl group opens disulphide bonds in mucoproteins
lowers mucous viscosity

Question 26

MOA of mucokinetics

Answer 26

promotes mucus clearance
(increase ciliary beat frequency, decrease adherence of mucus to cilia)

stimulate surfactant production: surfactant is an anti-glue factor to prevent mucus from sticking to alveolar and bronchial walls

Question 27

What kind of patients are mucokinetics contraindicated in?

Answer 27

asthma and peptic ulcer disease