Treatment of Cough Flashcards

1
Q

Expectorants are for which type of cough?

A

productive

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2
Q

Antitussives are used for what type of cough?

A

non productive

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3
Q

What is the purpose of Pharyngeal demulcents?

A

soothing effect on throat

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4
Q

What are some examples of pharyngeal demulcents?

A

lozenges

cough drops

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5
Q

What is the purpose of expectorants?

A

increase bronchial secretions

decrease viscosity of mucous secretions

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6
Q

What is the mechanism of action of directly acting expectorants?

A

to stimulate bronchial glands

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7
Q

What are some directly acting expectorants?

A

sodium and potassium citrate or acetate

potassium iodide

guaiacol

guaiphensin

balsam or tolu,

Vasaka

Terpin hydrate

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8
Q

What is the mechanism of action of reflexly acting expectorants?

A

irritate gastric or bronchial mucosa

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9
Q

Name some reflexly acting expectorants.

A

ammonium chloride or carbonate,

potassium iodide

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10
Q

Mucolytics

A

medicines that make the mucus less thick and sticky and easier to cough up.

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11
Q

Name some mucolytic drugs.

A

Bromhexine
ambroxol
Acetylcysteine
carbocisteine

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12
Q

How do antitussives act in general?

A

Cough centre suppressants

Reduce tussal impulses in respiratory tract

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13
Q

What are some opioids used as antitussives?

A

Codeine, pholcodeine,
Morphine, ethyl morphine

Morphine not so commonly used?

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14
Q

What are some non-opioid antitussives used?

A

noscapine

Dextromethorphan, Oxeladin,
chlophedianol

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15
Q

What are some antihistamines used as antitussives?

A

Chlorpheniramine
Diphenhydramine
promethazine

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16
Q

What is the standard antitussive?

A

codeine

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17
Q

How long does codeine suppress cough?

A

6 hours

18
Q

What drug blocks antitussive action of codeine?

A

naloxone

19
Q

What are some adverse effects of codeine?

A

constipation

drowsiness

respiratory depression

20
Q

What are some contraindications of using codeine?

A

asthmatics

diminished respiratory reserve

21
Q

Which drugs antitussive action isn’t blocked by naloxone?

A

dextrometharphan

22
Q

Describe the d-isomer and i-isomer of dextrometharphan.

A

d-isomer - increases threshold of cough centre

l-isomer - analgesic

23
Q

What are some adverse effects of dexrometharphan?

A

Dryness of mouth, vertigo, irritability

24
Q

Does detromethrphan depress mucociliary function?

A

no

25
Q

Know the different treatment approachers to cough of these various etiologies in this chart.

A

Reproduce chart.

26
Q

Do expectorants suppress cough reflex?

A

no

27
Q

What are side effects of mucolytic drugs?

A

rhinorrhea, lacrimation, GI irritation, hypersensitivity

28
Q

MOA of dextromethorphan?

A
synthetic  codeine analog]
Central Antitussive (antagonizes NMDA glutamate receptors).
29
Q

What is the benefit of using dextromethorphan over codeine?

A

mild abuse potential and less constipation

30
Q

S/E dextromethorphan.

A

May cause serotonin syndrome if combined with other serotonergic agents.

31
Q

In which drug that we discussed in treatment of cough is use of children less than 6 years of age prohibited?

A

Dextromethorphan

32
Q

MOA Benzonatate.

A

Unlike the opioids, benzonatate suppresses the cough reflex through peripheral action.

It anesthetizes the stretch receptors located in the respiratory passages, lungs, and pleura.

33
Q

Does Benzonatate have abuse potential?

A

no

34
Q

How do nasal decongestants act?

A

shrink swollen turbinates

Decrease resistance to airflow by vasoconstriction of the mucosal blood vessels which in turn reduces edema of the nasal mucosa.

35
Q

What are the most effective agents to relieve nasal congestion?

A

nasal decongestants

36
Q

What are some topical nasal decongestants?

A

Ephedrine, oxymetazoline, xylometazoline

37
Q

What are some systemic nasal decongestants?

A

Pseudoephedrine, phenylephrine

38
Q

Oxymetazoline acts through what receptors?

A

A1

39
Q

Xylometazoline acts selectively for what receptor?

A

alpha - 2

40
Q

What are some ADRs of nasal decongestants?

A

stinging, burning, dryness of the mucosa, atrophic rhinitis

41
Q

Would you use nasal decongestants for long or short period of time?

A

short periods (palliative are)

42
Q

Systemic or topical nasal decongestants. Which has more ADRs?

A

systemic