Quiz 1 Flashcards
What is the common cold?
It is a viral infection of the upper respiratory tract. Usually occur from fall to spring
How are common colds transmitted?
Self-inoculation, most common way. Contact with contaminated surface.
-Inhaled
Susceptibiliy is increased ?(COLD)
by higher exposure rates, Allergic disorders affecting nose and pharynx. Stress, weekend immune system. Sleep deprivation
What are the differences between the flu and colds?
In the flu temperature is usual along with fatigue, and ache and pain
Nonpharmacologic Therapy COLD
Increase humidity, fluids, rest…….
Pharmacotherapy COLD
Decongestants
treat sinus and nasal congestion
Mechanism of Action
- Alpha-adrenergic agonists
- Stimulation of alpha receptors cause constriction of blood vessels, which decrease vessel enlargements and edemaSystemic Nasal Decongestants
Pseudoephedrine
more effective than phenylephrine,
well absorbed after oral admin.
Topical Nasal decongestants? pg 18
- Naphazoline
- Oxymetazoline
- Phenylephrine
Rhinitis Medicamentosa? pg 18
- Rebound congestion
- Associated with topical decongestants
- Topical decongestants should only be used for 3-5 days
Is runny nose and swelling due to histamine?
No those symptoms are not
Why dont 2nd generation antihistamines have any effect on the common cold?
Because there isnt any cholinergic activity
Ingredients of local anesthetics?
-Benzocaine
- Dyklonine
- Menthol
- Phenol
Effective for sore throat symptoms
Name 2 NSAIDs
Naproxen, Ibuprofen
Max dose of ibuprofen self admin?
1200 mg/day
Max dose of ibuprofen prescribed?
3200 mg/day
Daily Ibuprofen dose?
200 - 400 mg every 4 to 6 hours prn
Maximum OTC dose for naproxen
660 mg
Max Rx dose = 1000mg
Daily naproxen dose?
220 mg 6-8 hrs
Acetaminophen max OTC dose?
3250 mg/ day
Adult acetaminophen dose?
325- 1000mg q 4 to 6 h
What are some risks of NSAIDs?
- Stomach Bleeding, Ulcer
- High Blood Pressure
- Fluid Retention
- Kidney (nephrotoxicity) and Heart Problems
What is QuEST? pg 29
Quickly/Accurately assess the patient
Establish that the patient is a good self care candidate
Suggest appropriate strategy
Talk with patient
What is SCHOLAR? 30
S- Symptoms C- Characteristics H- History O- Onset (when did this begin) L- Location A- Aggravation Factors R- Remitting Factors
What is MAC
M-edications- Meds patient is taking
A-llergies- To meds or anything
C-ondition- Coexisting health conditions
What are some concerning fever symptoms?
- Change in Mental Status
- Cannot stay hydrated (children)
- Severe infection
What temperature is too high with a child less than 3 months of age?
100.1 *F
What temperature is too high with a child more than 3 months of age?
104*F
How long is too long to have a fever? less than 2 years old
For more than 24 hours
How long is too long to have a fever? Older than 2
3 days
Non Pharma approach to treating fever
Drink lots of fluids and possibly take a sponge bath
OTC Pharma treatment for fever?
Antipyretics-
Acetaminophen
Ibuprofen
Naproxen (not for
When should you refer a patient to the a doctor pertaining to a fever?
If the patient is >2 after 3 days
How many days is too long for a headache?
10 days
What are some concerning headache symptoms?
Severe head pain
Signs of Stroke, head trauma, substance abuse (secondary HA)
A physicians diagnoses is need for what type of headache?
Migraine
What OTC medicine should be used for a migraine?
NSAID, Salicylate, Cafeine, Magnesium supplement (preventative)
What OTC meds should be used for tension-type headaches
Acetaminophen, NSAID, Salicylate, Cafeine
Sinus Headache OTC meds?
Acetaminophen, NSAID, Salicylate, Decongestant
NSAIDs have a side effect of hypertension. What reasons would need to be present for a patient to not be a NSAID canditate?
- Uncontrolled HTN
- Patient taking drugs that can also cause hypertension.
- Patient is on several ANTI-HTN meds
NSAIDS have the side effect of Kidney Disease. WHat types of patients should not take NSAIDs.
- Elderly >65 yo
- Known renal dysfunction
- Patient is also taking meds that are Nephrotoxic
NSAIDs can cause GI bleeding. What patients shouldnt take them?
Elderly > 65
- Taking meds that increase bleeding risk (warfarin)
- Alcohol use
- Hx of GI bleeding or PUD
NSAIDs can cause cardiovascular disease. WHat patients should not take them?`
- History of Midocardial Infarction, Stroke, Heart Failure (HF), Peripheral Vascular Disease (PAD)
- Other CVD risk factors
NSAIDs can have allergic RXNs. What patients should not take them?
Hx of Asthma
Known allergy to ASA (Acetylsalicylic acid) or NSAIDs
NSAIDs can be nephrotoxic especially when combined with?
ACE Inhibitors (lisinophril, Enalapril, Ramipril)
Think PRIL!
Hypertension Drugs
What drugs interact with NSAIDs?
-Warfarin
- Antiplatalets
- Salicylates
-Aspirin
- AntiHypertension (ACE and Diuretics)
-Lithium
- Methotrexate
- Digoxin
(mostly related to bleeding risk and renal function)
What is Allergic Rhinitis?
Systemic Disease with predominant nasal symptoms.
Where is histamine most highly concentrated?
Skin, lungs, GI
- Concentration increases wherever there is an increase in mast cells.
Mast cell degranulation releases what? What phase is this in allergic rhinitis?
Histamine
Early phase
WHat are outdoor triggers of allergic rhinitis?
Pollen
Mold spores
Pollutants
Exclusions for self care? Allergic Rhinitis
Less than 12
Pregnant Lactating
Symptoms of uncontrolled asthma or COPD
Nonpharm AR treatment?
Allergen avoidance
Nasal wetting sprays
Intranasal Corticosteroids
May take up to 1 week to see symptom control
- 2 sprays in each nostril per day
WHat are antihistamines?
Compete with H1 receptor preventing, helps keep histamine receptor in inactive form
Intermittent Allergic Rhinitis or seasonal allergic rhinitis
Symptoms are
Persistent Allergic Rhinitis
longer than 4 weeks or 4 days per week
Name the 4 1st generation Antihistamines
Brompheniramine (Dimetapp)
Chlorpheniramine
Clemastine (travist)
Diphenhydramine (benadryl)
Name the 3 2nd gen Antihistamines
Ceterizine (Zyrtec)
Fexofenadine (Allegra)
Loratadine (Claritin)
What are the 3 classifications of coughs?
Acute 8 weeks
Pharmacological cough treatment
Oral Antitussives: When cough provides no useful functions
Codeine, Dexmethorphan, Diphenyhydramine
