Pharmaceutical Management of Cough Flashcards
what is cough?
a protective reflex action caused when the airway is irritated or obstructed
what are common cough syndromes?
- asthma
- eosinophilic bronchitis
- upper airway disease
- undiagnosed or idiopathic chronic cough
in what case is bronchial hyperesponsiveness present; cough variant asthma or eosinophilic bronchitis?
in cough variant asthma
what are clinical indicators of cough variant asthma?
- cough occurring nocturnally
- after exercise
- after allergen exposure
how would you know if it was eosinophilic bronchitis?
- there’d be no sign of asthma
- there’d be variable airflow obstruction
- evidence of eosinophilic inflammation
How do we treat cough variant asthma and eosinophilic bronchitis?
- Eliminate allergen
- Antihistamines
- Steroids
- Leukotriene receptor antagonists
How does GORD affect cough?
-increases cough reflex sensitivity
How do we manage the effects of GORD on cough?
- give PPI or H2 receptor antagonist to deal with GORD
2. eliminate causative meds e.g. CA2+ antagonists
what accompanies upper airway diseases to cause cough?
- nasal stiffness
- sinusitis
- sensation of secretions draining into the posterior pharynx from nose or sinuses (termed post-nasal drip)
how do we manage/treat upper airway disease causing cough?
antihistamines or trial of corticosteroids
what happens to lymphocytic airways in idiopathic cough?
the airways are inflamed
when do you refer a customer to see a doctor regarding their cough (red flag)?
- cough >3weeks
- sputum (sign of infection or bleeding)
- chest pain
- shortness of breath
- whooping cough
- recurrent nocturnal cough
- suspected adverse drug event
- failed medication
what is the role of expectorants?
they promote expulsion of bronchial secretions
what is the role of suppressants?
acts as a sedater
what is the role of demulcents?
soothe the area
three examples of suppressants are..?
codeine, pholcodeine, dextromethorphan
2 examples of expectorants are..?
Guaifenesin and Ipecacuanha
three examples of antihistamines are…?
- diphenhydramine
- brompheniramine
- promethazine
give an example of a sympathomimetic and what does it do?
pseudoephedrine
-works as a bronchodilator and decongestant
What is Theophylline?
a bronchodilator
give three examples of mucolytics?
- acetylcysteine
- sodium chloride
- carbocistiene
what are non-pharmacological means of treating cough?
- take plenty of fluids
- paracetamol/ ibuprofen for pain
- vapour rub for fever
- warm fluid or honey and lemon drinks
- linctus cough mixture
6 steam
can we give the cough and cold meds in this section to kids less than 6years old?
No, only as second line of treatment and only used for 5 days max!
what age group should codeine linctus not be given to for dry, unproductive cough?
children less that 18 years
