respiratory Flashcards

1
Q

what are the red flag symptoms for a cough

A
  • very high temperature / shortness of breath (could be an infection)
  • chest pain (not during coughs)
  • haemoptysis ( coughing up blood)
  • cough lasting more than 3 weeks
  • Children with stridor (an abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or larynx) should be urgently referred to
    be assessed by a GP.
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2
Q

what could a cough be a sign of in asthmatic patients

A

poorly controlled asthma

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3
Q

why should you refer a persistent night time cough in children

A

It may be a sign of asthma

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4
Q

which class of medication can cause a cough

A

ace inhibitors.

if cough is troublesome, switch to alternative e.g angiotension-2 receptor blockers

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5
Q

name an example of a demulcent cough medicine

how does it work

A

example = simple linctus (has syrup/glycerol)

demulcents form a smoothing film which may reduce coughing. (honey and lemon can do the same thing)

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6
Q

which ingredients are expectorants in cough medicines

how do they work

A

ipecacuanha, ammonium chloride and squill

in theory they are supposed to help you expel bronchial secretions

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7
Q

name examples of anti-tussives (cough suppressants) in cough medicines

how do they work

A

codeine, pholcodeine , dextromethorphan, mentol, diphenhydramine

they suppress the cough reflex mechanism

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8
Q

which patient groups should you avoid using codeine or opioid derivates for a cough

A
  • avoid completely in children under 6 due to risk of respiratory side effects
  • not recommended for children 12-18 who have problems breathing
  • breast feeding mothers
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9
Q

name some side effects of codeine or opioid derivate cough medicines

A

constipation + dependance

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10
Q

why are pholcodeine, dextromethorphan or menthol better alternatives to codeine anti-tussives (cough suppressants)

A
  • pholcodeine has slightly less side effects

- dextomethorphan + menthol provide the cough suppressants effect without the side effects of codeine/ pholcodeine

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11
Q

what type of cough would you avoid using anti-tussives (cough suppressants)

A

productive cough (patients with phlegm/mucus) as they need to be coughing/expelling this

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12
Q

which sedative anti-histamine can be used as an anti-tussive (cough suppressant)

A

diphenhydramine

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13
Q

what is the side effect of using diphendryamine in cough syrups

how can this be benefical

A

It is a sedative anti-histamine so can cause drowsiness as a side effect.

This may be benefical at night to aid sleep

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14
Q

what are the only ingredients that can be used in cough medicines for children under 6

A

glycerol/ syrup (demulcent cough medicines)

all other ingredients have no evidence of benefit but can increase risk side effects to child. As child gets older, risk of side effects reduces

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15
Q

why should you avoid giving more than one cough preparation to children at the same time

A

to avoid overdose. (different brands may contain the same active ingredients)

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16
Q

what is the difference between allergic and non-allergic rhinits (runny nose/ blocked nose)

A

allergic: watery rhinorrhoea (runny nose) + sore streaming eyes

non-allergic: chronic runny nose

17
Q

what is the first-line choice for otc medication for a cold

how does it work

A

paracetamol.

its an anti-pyretic (reduced fever) and also an analgesic

18
Q

why should you not use aspirin in children under 16

A

it can cause reyes syndrome (swelling of liver or brain which can lead to permanent brain damage/death)

19
Q

what is the benefit of taking vitamin c during a cold

A

large doses of vitamin c (more than 1g daily) have been shown to mildly reduce the duration of a cold. however taking vitamin c supplements long-term doesn’t prevent colds

20
Q

name the 2 active ingredients that can be used in oral decongestants

how do they work

A

pseudoephedrine or phenylpropanolamine

they work by constricting the nasal blood vessels which reduces odema of the nasal mucosa (lining).

21
Q

name 1 advantage and 1 disadvantage of using oral decongenstants compared to topical decongestants

A

advantage: oral decongestants do not cause rebound congestion
disadvantage: oral decongestants are not as effective as topical decongestants

22
Q

can decongestants be used in children under 6

A

no

23
Q

how long should children 6-12 use decongestants for

A

max 5 days

24
Q

name some active ingredients in topical decongestants

A

ephedrine, oxymetazoline, xylometazoline

25
Q

why should you not use topical decongestants for prolonged use

A

it can cause rebound congestion (rhinitis medicamentosa)

26
Q

which type of decongestants can cause rebound congestion (rhinits medicamentosa)

A

topical (intanasal decongestants)

27
Q

which medical conditions should you avoid using decongestants in

A
  • diabetes
  • hypertension
  • hyperthyroidism
  • raised intraocular pressure
  • prostatic hypertrophy
  • hepatic or renal impairment
  • ischaemic heart disease