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S2 Case 3 - asthma & COPD > Pharmaceutical Management of Cough > Flashcards

Pharmaceutical Management of Cough Flashcards

1
Q

What is a cough?

A

Protective reflex action caused when airway is irritated or obstructed

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2
Q

What is an acute cough?

A

<3 weeks

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3
Q

What is a subacute cough?

A

3-8 weeks

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4
Q

What is a chronic cough?

A

> 8 weeks

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5
Q

Where is an acute cough from?

A

Viral upper respiratory tract

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6
Q

How does a chronic cough present?

A

Dry/minimally productive cough

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7
Q

What are common causes of chronic cough?

A

GORD
Asthma syndromes
Rhinitis
Drugs
Environment - eg. dust

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8
Q

What do you consider when assessing a cough?

A

Age, sex
Cough characteristics
Exacerbating features
Where?
Acute/chronic?
Worse morning, midday or night?

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9
Q

What are the specific cough syndromes?

A

Cough variant asthma
GORD
Upper airway disease
Treatment of cough due to other respiratory diseases

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10
Q

Describe cough variant asthma

A

Isolated cough in patient without objective evidence of asthma

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11
Q

What are the clinical indicators of cough variant asthma?

A

Nocturnal
Started when young
After exercise
Allergen exposure

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12
Q

How do you treat cough variant asthma?

A

Eliminate allergen
Bet-2-agontists
Antihistamines
Steroids
TAKE MEDICATION IN EVENING

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13
Q

Describe GORD

A

Patients with GORD have increased cough reflex sensitivity which improves anti-reflux therapy

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14
Q

How do you treat GORD?

A

PPI or H2 antagonist
Eliminate causative medications
Lifestyle advice

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15
Q

What is the problem with long term use of PPIs?

A

Increase pH of stomach = more likely to get an infection
Osteoporosis

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16
Q

Describe upper airways disease + cough?

A

Accompanied by nasal stuffiness, sinusitis
= secretions drain into posterior pharynx

16
Q

Describe upper airways disease + cough?

A

Accompanied by nasal stuffiness, sinusitis
= secretions drain into posterior pharynx

16
Q

Describe upper airways disease + cough?

A

Accompanied by nasal stuffiness, sinusitis
= secretions drain into posterior pharynx

17
Q

What is the treatment for upper airways disease + cough?

A

Antihistamines - limited efficacy
Trial of corticosteroid = ONLY IF PROMINENT

18
Q

When do you refer someone?

A

> 3 weeks
Sign of infection
Shortness of breath
Whooping cough in children
Recurrent nocturnal cough in kids
Adverse drug reaction
Failed medication

19
Q

What are CO2 retainers?

A

People with COPD have lower O2 saturation = giving them too much O2 dangerous

20
Q

What are things you can get OTC?

A

Expectorants
Suppressants
Demulcents

21
Q

What are examples of suppressants?

A

Codeine, pholcodine + dextromethorphan

22
Q

What are examples of expectorants?

A

Guaifenesin
Ipecacuanha

23
Q

What are suppressants?

A

Where no underlying cause
May be useful if sleep disturbed

24
Q

What are expectorants?

A

Apparent promotion of expulsion of bronchial secretions

25
Q

What are demulcents?

A

Soothing actions
Harmless + inexpensive

26
Q

Describe use of antihistamines

A

Allergy type cough
Avoid patients who are taking phenothiazines + tricyclic antidepressants
Avoid alcohol
Can make drowsy

27
Q

Describe use of sympathomimetics

A

Bronchodilator + decongestant
Care in high BP, diabetics, coronary artery disease
Interactions with beta blockers, tricyclic antidepressants

28
Q

Describe use of theophylline

A

Bronchodilation
GI irritation, palpitations, insomnia + headaches
Side effects = toxicity

29
Q

Describe use of mucolytics

A

Break mucus apart
Inhaled, oral
Relief after 60 seconds after inspiration

30
Q

What is CRP?

A

Measure of inflammation
Increased = bacterial infection
Should be less than 5

31
Q

What are some non-pharmacological actions?

A

Fluids
Paracetamol/ibuprofen = associated fever + pain
Lemon + honey
Steam
Simple linctus cough mixture

32
Q

Who are the medications for?

A

ONLY children over 6

S2 Case 3 - asthma & COPD (25 decks)

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