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OTC Pre reg T23/24 > OTC common cold Qs > Flashcards

OTC common cold Qs Flashcards

Common cold OTC qs

1
Q

Prolonged usage of nasal decongestants

A

May cause rebound congestion (rhinitis medicamentosa), resulting in continued inappropriate use.

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2
Q

Codeine/opiod derivatives (antitussives) in children?

A

*Avoid for under 6 - respiratory SE
*Not recommended in children

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3
Q

Drug class of dextromethorphan

A

A non sedating opiate
* antitussive

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4
Q

2 AIs that have both been shown to suppress the cough reflex without the adverse effects of the opiates codeine and pholcodine.

A

Dextromethorphan (a non-sedating opiate) and menthol

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5
Q

Drug class of Diphenhydramine

A

Sedative antihistamine - causes drowsiness. May be useful in nocturnal cough

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6
Q

What are Antitussives?

A

Codeine/opioid derivatives

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7
Q

2 Examples of anti-tussives

A

Dextromethorphan
Pholcodine

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8
Q

2 Expectorants examples

A

Guiaphenesin
Ipecacuanha

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9
Q

2 Oral Nasal decongestants examples

A

Pseudoephedrine
Phenylephrine

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10
Q

Antihistamine example

A

Diphenhydramine

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11
Q

Cough and cold medication in under six =

A

NO:
antitussives
Expectorants - guiaphenesin
Nasal decongestants - pseudoephedrine
Antihistamines - dextromethorpham

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12
Q

SEof cough medicines

A

Allergic reactions
Effect of sleep
Hallucinations

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13
Q

Croup caused by?

A

Parainfluenza virus

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14
Q

Symptoms of croup

A

*Cold and develops into barking cough
* inflamed trachea/swollen
*thick mucus

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15
Q

Pregnancy safe cough medicine

A
  • Guanifenesin
    *Dextromethorphan
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16
Q

Acute cough resolves around?

A

2 weeks

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17
Q

Danger symptoms of cough?

A

*high temp - pneumonia
*SOB - pneumonia
*Chest pain not just with coughing
*Coughing up blood/haemoptysis - *TB/Pulmonary oedema
*> 21 days

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18
Q

When is pneumonia more common?

A

*Aged >65 or <2 years
*smokers/drinkers

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19
Q

Differential diagnosis in cough

A

*poorly controlled asthma
*Night time cough in children - asthma possibility
*Postnasal drip - sinusitis or hay fever

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20
Q

Mucus in sinusitis

A

Thicker and purulent

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21
Q

Mucus in hay fever

A

Watery discharge

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22
Q

Eg of medicine that brings on cough as SE

A

ACEi

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23
Q

3 ACEi eg

A

Ramipril
Lisinopril
Enalapril

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24
Q

ACEi and coughing - what to do?

A

*Alternative treatment eg an angiotensin 2 receptor antagonist
*Will take months to settle down

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25
Q

3 eg of ARB/ angiotensin 2 receptor blocker

A

*Losartan
*Candesartan
*Valsartan

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26
Q

4 Demulcents examples

A
  • Simple linctus (sugar based syrup
    *glycerin - synthetic demulcent
    *Licorice-root - natural
    *Marsh-mallow - natural”
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27
Q

Ingredients of simple linctus

A

Glycerol - soothing could suppress voluntary cough mechanism

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28
Q

Soothing ingredients

A

*Glycerol
*Honey and lemon
*Paediatric simple linctus

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29
Q

Is Anti-tussives recommended for 12 to 18 year olds

A

• Not recommended in adolescents who have breathing problems or breastfeeding mothers

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30
Q

Is anti-tussives ideal in adults

A

• No as high incidence of SEs - constipation and dependence

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31
Q

What does expectorant do?

A

Thins and loosens mucus in lungs, making it easier to cough up mucus

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32
Q

Why is there reduces SE risk of cough/cold medicines in older children

A

They weigh more, get fewer colds and can say if medicine is helping.

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33
Q

Can children be given more than one cough/cold preparation?

A

No - to avoid overdose. Diff brands may have same AI.

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34
Q

What is inspiratory stridor in croup

A

*inhale harder than exhaling
* Rasping sound when child breathes in

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35
Q

When may inspiratory stridor for child with croup occur?

A

When the child is coughing or crying

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36
Q

When is croup most severe?

A

First 3 days, Symptoms often worsen at night.

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37
Q

Treatment for croup

A

viral so nothing
*Can give antipyretic if fever

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38
Q

Can you use cough preparations for a child with croup?

A

No. Especially not one which causes drowsiness.

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39
Q

Practical tips with croup

A

*sit child upright to help them breathe easier
*Enough fluid intake

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40
Q

When should Urgent referral in croup?

A

*difficulty breathing - rib up and in/intercostal or subcostal recession
*rate of breathing may be fast/tachypnoea
*Child appears agitated and pale
* child with stridor/abnormal high pitched breathing sound due to throat/ larynx blockage

41
Q

What cough preparations contain dextromethorphan and/or menthol?

A

Benylin, Robitussin

42
Q

5 frequent symptoms of cold?

A

Nasal discharge
Nasal obstruction
Sore/scratchy throat
Headache
Cough

43
Q

4 other symptoms of common cold

A

“Hoarseness
loss of taste and smell
mild burning of the eyes
* a feeling of pressure in the ears or sinuses due to obstruction and/or mucosal swelling may also occur “

44
Q

5 Common causes of cold

A

“Rhinovirus
Coronavirus
Paramyxovirus
Myxovirus
Adenovirus”

45
Q

Examples of paramyxovirus

A

“Parainfluenza
Respiratory syncytial virus”

46
Q

How long would a common cold last?

A

7 to 10 days could be up to 3 weeks

47
Q

DANGER symptoms in common cold?

A

“kids <2y have increased risk of contracting pneumonia virally.
Fever
Rapid breathing/tachypnoea
SOB
Cyanosis - blue/purple hue to skin”

48
Q

What is tachypnoea

A

Abnormal rapid breathing

49
Q

Differential diagnosis in common colds

A

Hay fever - sore eyes, watery discharge
Non allergic rhinitis - watery chronic nasal discharge

50
Q

Treatment drugs for common cold?

A

Only symptomatic relief offered

51
Q

First line choice in common cold

A

Paracetamol

52
Q

Drug class of paracetamol

A

Antipyretic

53
Q

Ibuprofen and aspirin in common cold treatment

A

Can be given as an alternative to paracetamol

54
Q

Aspirin for <16 ?

A

No - reyes syndrome.

55
Q

Vitamin use in cold symptoms

A

Vitamin C in large daily dosage >1g daily could reduce duration of cold symptoms

56
Q

3 Topical nasal decongestant examples

A

“ephedrine
oxymetazoline
xylometazoline”

57
Q

Prolonged regular use of nasal decongestants

A

Could cause rebound congestion leading to continued inappropriate use.

58
Q

Do oral decongestants cause rebound congestion

A

No. Not as effective as topical ones either.

59
Q

How do oral decongestants work?

A

Vasoconstrictor mucosal blood vessels which reduces oedema of the nasal mucoa

60
Q

When should decongestants not be given?

A

<6y and for 6-12y should be restricted to 5 days or less

61
Q

8 CI with systemic decongestants

A

*DM
*HYP
*Hyperthyroidism
Raised intraocular pressure
Prostatic hypertrophy
Hepatic/renal impairment
*Ischaemic heart disease
* MOA/monoamine oxidase inhibitors - risk of hypertensive crisis”

62
Q

Tips to give with cold

A

“Enough water intake
Flu vaccine
Self limited infection”

63
Q

Thinking about symptoms associated with the common cold, who would you consider referring to the GP

A

Infants < 3 months are susceptible to secondary bacterial infection. Also refer if having difficulty feeding.

Any infant/elderly person who appears significantly more unwell than would be expected for a common cold or influenza – may suspect pneumonia.

Infants/elderly - ask questions to rule out meningitis and septicaemia/blood poisoning.

Children who may have a foreign body in their nose – purulent/pus filled discharge, usually from only one side of the nose and without other cold symptoms. 


64
Q

Paracetamol overdose leads to?

A

“N&V
Eventual hepatic failure - not apparent 4-6 days”

65
Q

When should aspirin and ibuprofen be avoided

A

“Pregnancy
3rd trimester - bleeding risk with aspirin, prolongation of pregnancy with both drugs”

66
Q

When is paracetamol the only option as an analgesic?

A

Pt with history of hypersensitivity to aspirin or NSAIDs or active peptic ulceration.

Oral anticoagulants
MTX
Thiazides
diuretics
ACEi

67
Q

What is Haemophilia

A

Disorder where blood does not clot properly

68
Q

2 Thiazide egs

A

“Bendroflumethiazide
Indapamide”

69
Q

What can NSAIDs provoke that makes paracetamol the analgesia of choice?

A

Renal failure.
*Especially in pt with renal/cardiac/hepatic impairment
OR
*in conjunction with diuretics or ACEi”

70
Q

Aspirin and antiplatelet activity?

A

Has marked antiplatelet activity.

71
Q

Paracetamol sale restriction?

A

100 tablets/capsules.

72
Q

Aspirin sale restriction?

A

100 tablets/capsules.

73
Q

Can you give paracetamol to babies < 2 months

A

No

74
Q

What age can you not give paracetamol to

A

< 2 months

75
Q

Paracetamol infant syrup age and strength

A

”< 6 years
5ml dose = 120mg paracetamol”

76
Q

Paracetamol Six plus syrup and strength

A

”> 6 years
5ml dose = 250mg paracetamol”

77
Q

Max dose of paracetamol

A
  • 4 doses in 24 hours
  • wait at least 4 hours between doses
78
Q

How much Infant syrup 120mg/5ml in

3min old

A

2.5mL

79
Q

How much Infant syrup 120mg/5ml in
6-24month old

A

5mL

80
Q

How much Infant syrup 120mg/5ml in
2-4years

A

7.5mL

81
Q

How much Infant syrup 120mg/5ml in
4-6year

A

10mL

82
Q

How much six plus syrup 250mg/5ml in

A

5mL

83
Q

How much six plus syrup 250mg/5ml in

A

7.5mL

84
Q

How much six plus syrup 250mg/5ml in

A

10mL

85
Q

Dose of ibuprofen

A

TDS

86
Q

Can you give ibuprofen to children < 3 months

A

No unless advised by dr

87
Q

What is the max amount of pseudoephedrine and ephedrine supplied OTC

A

*No more than 720mg pseudoephedrine or 180mg ephedrine.
*Pseudoephedrine cannot be sole at same time as ephedrine.
*Can be misused to make crystal meth. “

88
Q

Max amount of pseudoephedrine OTC

A

720mg

89
Q

Max amount of ephedrine OTC

A

180mg

90
Q

Can pseudoephedrine and ephedrine be sold OTC?

A

No. Can be missed to make crystal meth.

91
Q

Age restriction for nasal decongestant

A

> 12 years.

92
Q

CI for nasal decongestant

A

HYP
DM

93
Q

Max duration of nasal decongestant

A

•7 days due to rebound congestion.

94
Q

MAOi and decongestions lead to?

A

Hypertensive crisis.

95
Q

MAOi and decongestion interaction can last?

A

Up to 2 weeks after taking MAOi for treatment

96
Q

Pregnancy and nasal decongestant?

A

Avoid.

97
Q

Non sedating antihistamine example

A

Acrivastine

98
Q

Sedating antihistamine example

A

Promethazine

OTC Pre reg T23/24 (7 decks)

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