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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
3 eg of ARB/ angiotensin 2 receptor blocker
* Losartan * Candesartan * Valsartan
26
4 Demulcents examples
* Simple linctus (sugar based syrup * glycerin - synthetic demulcent * Licorice-root - natural * Marsh-mallow - natural"
27
Ingredients of simple linctus
Glycerol - soothing could suppress voluntary cough mechanism
28
Soothing ingredients
* Glycerol * Honey and lemon * Paediatric simple linctus
29
Is Anti-tussives recommended for 12 to 18 year olds 
• Not recommended in adolescents who have breathing problems or breastfeeding mothers
30
Is anti-tussives ideal in adults
• No as high incidence of SEs - constipation and dependence
31
What does expectorant do?
Thins and loosens mucus in lungs, making it easier to cough up mucus
32
Why is there reduces SE risk of cough/cold medicines in older children
They weigh more, get fewer colds and can say if medicine is helping.
33
Can children be given more than one cough/cold preparation?
No - to avoid overdose. Diff brands may have same AI.
34
What is inspiratory stridor in croup
* inhale harder than exhaling * Rasping sound when child breathes in
35
When may inspiratory stridor for child with croup occur?
When the child is coughing or crying
36
When is croup most severe?
First 3 days, Symptoms often worsen at night.
37
Treatment for croup 
viral so nothing * Can give antipyretic if fever
38
Can you use cough preparations for a child with croup?
No. Especially not one which causes drowsiness.
39
Practical tips with croup
* sit child upright to help them breathe easier * Enough fluid intake
40
When should Urgent referral in croup?
* 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
What cough preparations contain dextromethorphan and/or menthol? 
Benylin, Robitussin
42
5 frequent symptoms of cold? 
Nasal discharge Nasal obstruction Sore/scratchy throat Headache Cough
43
4 other symptoms of common cold
"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
5 Common causes of cold
"Rhinovirus Coronavirus Paramyxovirus Myxovirus Adenovirus"
45
Examples of paramyxovirus
"Parainfluenza Respiratory syncytial virus"
46
How long would a common cold last?
7 to 10 days could be up to 3 weeks
47
DANGER symptoms in common cold?
"kids <2y have increased risk of contracting pneumonia virally. Fever Rapid breathing/tachypnoea SOB Cyanosis - blue/purple hue to skin"
48
What is tachypnoea 
Abnormal rapid breathing
49
Differential diagnosis in common colds
Hay fever - sore eyes, watery discharge Non allergic rhinitis - watery chronic nasal discharge
50
Treatment drugs for common cold?
Only symptomatic relief offered
51
First line choice in common cold
Paracetamol 
52
Drug class of paracetamol
Antipyretic
53
Ibuprofen and aspirin in common cold treatment
Can be given as an alternative to paracetamol
54
Aspirin for <16 ?
No - reyes syndrome.
55
Vitamin use in cold symptoms
Vitamin C in large daily dosage >1g daily could reduce duration of cold symptoms
56
3 Topical nasal decongestant examples
"ephedrine oxymetazoline xylometazoline"
57
Prolonged regular use of nasal decongestants
Could cause rebound congestion leading to continued inappropriate use.
58
Do oral decongestants cause rebound congestion
No. Not as effective as topical ones either.
59
How do oral decongestants work?
Vasoconstrictor mucosal blood vessels which reduces oedema of the nasal mucoa
60
When should decongestants not be given?
<6y and for 6-12y should be restricted to 5 days or less
61
8 CI with systemic decongestants
* DM * HYP * Hyperthyroidism Raised intraocular pressure Prostatic hypertrophy Hepatic/renal impairment * Ischaemic heart disease * MOA/monoamine oxidase inhibitors - risk of hypertensive crisis"
62
Tips to give with cold
"Enough water intake Flu vaccine Self limited infection"
63
Thinking about symptoms associated with the common cold, who would you consider referring to the GP 
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
Paracetamol overdose leads to?
"N&V Eventual hepatic failure - not apparent 4-6 days"
65
When should aspirin and ibuprofen be avoided
"Pregnancy 3rd trimester - bleeding risk with aspirin, prolongation of pregnancy with both drugs"
66
When is paracetamol the only option as an analgesic?
Pt with history of hypersensitivity to aspirin or NSAIDs or active peptic ulceration. Oral anticoagulants MTX Thiazides diuretics ACEi
67
What is Haemophilia
Disorder where blood does not clot properly 
68
2 Thiazide egs
"Bendroflumethiazide Indapamide"
69
What can NSAIDs provoke that makes paracetamol the analgesia of choice?
Renal failure.  * Especially in pt with renal/cardiac/hepatic impairment OR * in conjunction with diuretics or ACEi"
70
Aspirin and antiplatelet activity?
Has marked antiplatelet activity.
71
Paracetamol sale restriction?
100 tablets/capsules.
72
Aspirin sale restriction?
100 tablets/capsules.
73
Can you give paracetamol to babies < 2 months
No 
74
What age can you not give paracetamol to 
< 2 months 
75
Paracetamol infant syrup age and strength
"< 6 years 5ml dose = 120mg paracetamol"
76
Paracetamol Six plus syrup and strength
"> 6 years 5ml dose = 250mg paracetamol"
77
Max dose of paracetamol
* 4 doses in 24 hours * wait at least 4 hours between doses
78
How much Infant syrup 120mg/5ml in 3min old
2.5mL
79
How much Infant syrup 120mg/5ml in 6-24month old
5mL
80
How much Infant syrup 120mg/5ml in 2-4years
7.5mL
81
How much Infant syrup 120mg/5ml in 4-6year
10mL
82
How much six plus syrup 250mg/5ml in
5mL
83
How much six plus syrup 250mg/5ml in
7.5mL
84
How much six plus syrup 250mg/5ml in
10mL
85
Dose of ibuprofen
TDS
86
Can you give ibuprofen to children < 3 months
No unless advised by dr
87
What is the max amount of pseudoephedrine and ephedrine supplied OTC
* 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
Max amount of pseudoephedrine OTC
720mg
89
Max amount of ephedrine OTC
180mg
90
Can pseudoephedrine and ephedrine be sold OTC?
No. Can be missed to make crystal meth.
91
Age restriction for nasal decongestant
> 12 years. 
92
CI for nasal decongestant
HYP  DM
93
Max duration of nasal decongestant
• 7 days due to rebound congestion.
94
MAOi and decongestions lead to?
Hypertensive crisis.
95
MAOi and decongestion interaction can last?
Up to 2 weeks after taking MAOi for treatment
96
Pregnancy and nasal decongestant?
Avoid.
97
Non sedating antihistamine example
Acrivastine 
98
Sedating antihistamine example
Promethazine

OTC Pre reg T23/24 (7 decks)

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