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Applied Pharmacy Practice > Minor Ailments - Coughs & colds > Flashcards

Minor Ailments - Coughs & colds Flashcards

1
Q

Upper respiratory tract

A
  • Nasal cavity
  • Pharynx
  • Larynx
  • Cold, cough, flu, tonsillitis pharyngitis laryngitis, sinusitis and hay fever
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2
Q

What are colds?

A
  • Common infection of the upper respiratory tract
  • Most common illness
  • Mild viral infection.= over 200 diff viruses can cause it.
  • Incubation 1-4 days and symptomatic 3-4 days
  • More prevalent in winter
  • children = up to 5 colds/year
  • adults = 2-3 colds/year
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2
Q

Lower respiratory tract

A
  • Trachea
  • Primary bronchi
  • lungs
  • Bronchitis, pneumonia and influenza
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2
Q

Signs and Symptoms of colds

A
  • Cough
  • Increased mucous production throughout the tract
  • Pain/Discomfort due to local infection
  • Voice change if Larynx Involved
  • Airflow obstruction: muscular/mucus obstruction
  • Haemoptysis (coughing up blood)- Serious = s/t you can cut yourself w/i the throat from perisitent coughing)
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3
Q

How to manage colds

A
  • Most available remedies are symptomatic ( treating symptoms)
  • Anti-tussive: cough suppressant (Dextromethorphan)
  • Mild pain killers : Paracetamol
  • Sore throat sprays: Numb the pain. Contain Anaesthetics
  • Antihistamines: as decongestants or sedation in night preparations- More likely to put you to sleep
  • Non- medicinal = Steam inhalation: menthol, eucalyptus (evidence, placebo), not under 3 months
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4
Q

Management of Cold:Decongestants(1)

A
  • Nasal symptoms: Decongestants
  • Pseudoephedrine( increases bp) - POM , Phenylephrine (OTC) , (Oxymetazoline)
  • Sympathomimetic(mimics SNS): alpha adrenergic agonists: Vasoconstriction in nasal mucusa
  • Reduce the swelling of the blood vessels in the nose, which helps to open the airways.
  • Formulations: Tablets, capsules, Nasal drops, Nasal sprays, Liquids.
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5
Q

Management of Cold:Decongestants (2)

A
  • Compounds preparation: overdose of paracetamol = s/ things contain paracteamol too
  • Non selective for nasal mucosa: all produce suppressor effect : increased bp
  • Avoid in diabetes, hypertension,hyperthyroidism, pregnancy and heart disease
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6
Q

Management of Cold:Decongestants (3)

A
  • Topical decongestant: Pseudoephedrine, Phenylephedrine, Oxymetazoline, xylometazoline= more common
  • Oxymetazoline and Xylometazoline have longer duration of action >12 hrs. others quick onset but < 3 hrs
  • Reduced systemic effect= won’t cause substantial increase in bp
  • can’t use for longer than 7 days
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7
Q

Management of cold: Decongestants (4)

A
  • pseudoephedrine and ephedrine can be extracted = used in illegal manufacture of the Class A (CD) methylamphetamine.
  • Methylamphetamine = highly addictive drug = affects the CNS = can cause serious physical and psychological harm.
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8
Q

Management of cold: Decongestants (5)

A

The legal sales restrictions were put in place by MHRA in the UK on 1 April 2008 which made it illegal to sell or supply:
* product that contains more than 720 mg pseudoephedrine
or 180 mg ephedrine w/o a prescription
* combination of meds that between them add up to more than 720 mg pseudoephedrine or 180 mg ephedrine w/o a prescription
* a medicine that contains pseudoephedrine and a medicine that contains ephedrine in one transaction

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9
Q

what is Influenza?

A
  • Influenza virus A, B or C. A, B most common
  • Epidemic nature (occasionally pandemic) §Incubation phase 1-3 days
  • Early symptoms: resemble cold
  • Distinguished by v/ high fever, general discomfort , aching limbs, lack of energy. May affect the whole respiratory tract
  • May be severe - can be fatal (elderly, very young)
  • in pandemics = can be high mortality
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10
Q

Influenza

A
  • Contagious
  • Spread to others via : nasal secretions, objects and airborne saliva droplets
  • Most contagious = 1st 3 days after symptoms begin
  • Viruses can last up to 5 hrs on skin and hard surfaces
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11
Q

Spread of cold and flu

A
  • each cough, about 1.5L of air is expelled from the body
  • produces over 3000 saliva droplets in the air
  • travel at speed of about 50mph
  • Sneezes can travel 100mph & create 100,000 + droplets
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12
Q

What are Coughs?

A
  • symptom not a disease
  • Bodys’ way of removing foreign material or mucus from the lungs and upper airway passage ]
  • Usually an indictaion of s/t is occouring w/i the body
  • Lasts 3+ weeks = refer to Gp or hospital
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13
Q

Classifications of cough by duration: SUBACUTE

A
  • 3-8 weeks
  • Asthma, post infection airway inflammation, postnasal drip
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13
Q

Classifications of cough by duration: ACUTE

A
  • Less than 3 weeks
  • Dry = pneumonia, cold/flu, asthma, allergen, irritant , COPD (Chronic obstructive pulmonary disease), CHF (Chronic heart failure), PE (Pulmonary embolism)
  • Chesty = Cold & flu
14
Q

Classifications of cough by duration: CHRONIC

A
  • 8+ weeks
  • Dry = medicines, allergy, reflux
  • Chesty = Infection, asthma, lung cancer, COPD (Chronic Obstructive Pulmonary Disease)
15
Q

Classification of cough: DRY

A
  • Non productive, tickly, or tight
  • No mucus/sputum production
16
Q

Classification of cough: CHESTY

A
  • Mucus production
  • Clear, yellow/green ( infection) , blood (refer)
17
Q

Treatment of cough(1)

A
  • Diff ways depending on cause
  • Most involves self-care
  • If caused by virus= no antibiotics
18
Q

Treatment of cough(2)

A
  • Cough suppressants
  • Centrally acting – dextromethorphan
  • Expectorants= chesty cough = - Hydration, ammonium salts, guaifenesin, ipecuanha, citric acid, squill,etc
  • Demulcents= v/ symptomatic;
  • Honey, glycerin, syrup, coat pharyngeal mucosa ( Viscous liquids that give a soothing effect)
19
Q

Cough suppressants- dry cough

A
  • Codeine linctus= No longer used = dose = 15-30mg
  • Dextromethorphan= widely used = dose range in adults 15-30mg e.g Sudafed Linctus 20mg/10ml e.g Covonia 6.8.mg/5ml
  • Demulcent Linctuses= act in pharynx= reduce irritation & sensitisation of sensory receptors e.g Simple Linctus. Harmless and inexpensive. ( Unless you have diabetes)
20
Q

Expectorants- Chesty cough

A
  • Makes you cough more:
    -Direct stimulant action in respiratory tract
    -Indirect activation of p-sympathetic tone secondary to gastro-intestinal irritation (in theory)
  • Water= expectorant = hydration of mucous to reduce viscosity = basis of steam inhalations. Menthol + Eucalyptus used as aid to liquidfication of mucous
21
Q

Treatment for children

A
  • Can resolve itself in a few days or up to 2 weeks
  • Non-pharmacological interventions = fluids, rest
  • Fever and pain= Paracetamol= 1st line Ibuprofen = 2nd line
    (SEE NICE FEVER guidance.)
  • Nasal congestion = Saline nasal drops, vapour rubs,
    steam inhalation
  • Cough= Warm clear fluids, lemon and honey drink.
    Glycerol or simple linctus ( = cough syrups)
  • Symptoms persist = Referral to GP
21
Q

Guaifenesin

A
  • Widely used. Readily absorbed from oral
    dose.
  • Plasma half-life 1 hour
  • Well tolerated + free of major side effects
  • barely interacts w/ other meds
  • Reported dose 100-200mg every 2-4 hours
  • No clear evidence of efficacy
22
Q

Cough treatments for children

A
  • Very little is available or should be used ( limited studeis to support safe use)
  • Under 6 = No antitussives (cough meds), expectorants, nasal decongestants, antihistamines
  • 6-12= s/ cough meds + 2nd line to best practice, No more than 5 days
  • Codeine = Not under 18
23
Q

Evidence of benefit of cough
medicines?

A
  • Cochrane systematic review
  • 26 trials in 4037 people (616 children)
  • Outcome = No good evidence for the effectiveness of
    OTC medicines in acute cough
  • Meds are dependant on individual
24
Q

OTC suppy

A
  • Ask who , what
  • airway secretions
  • duration ( 3+ weeks = refer to GP)
  • medication = i.e Ace inhibitors can cause a dry tickly cough
  • Ethical issue – professionalism vs. retailing
25
Q

Lung cancer warning signs

A
  • Cough = 3+ weeks
  • Worsening or change of a long-standing cough
  • Repeated or persistent chest infections
  • Blood in the phlegm (Haemoptysis
  • Unexplained persistent breathlessness, tiredness, lack of energy or weightloss
  • Persistent chest and/or shoulder pain
  • Unexplained persistent hoarseness
  • Unexplained swelling of the face and neck

Applied Pharmacy Practice (19 decks)

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