Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory Block: Pharmacology > Treatment of Coughs and Colds 2 > Flashcards

Treatment of Coughs and Colds 2 Flashcards

1
Q

What is a cough?

A

A protective mechanism to remove an irritant or an airway obstruction from the respiratory tract. It can be potentially beneficial and it may be undesirable to suppress it in certain circumstances.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an acute cough?

A
  • lasts for 3 weeks or less
  • often caused by a cold, allergic rhinitis, acute bacterial sinusitis, asthma, pneumonia, congestive heart failure or Bordetella Pertussis infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a sub-acute cough?

A
  • lasts for 3-8 weeks

- post-infection cough, due to asthma, sub-acute bacterial sinusitis or Bordetella Pertussis infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a chronic cough?

A
  • Lasts for more than 8 weeks
  • due to post-nasal drip, allergic rhinitis, vasomotor rhinitis, chronic bacterial sinusitis, asthma (kids), GERD< ACE inhibitors, smoking, physiological causes or habit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What constitutes a mild cough?

A

Due to airway irritation or inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What constitutes a severe cough?

A

Persistent and distressing to patient, interfere with patient’s quality of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a productive cough?

A
  • associated with accumulation of secretions, phlegm and mucous from the respiratory tract
  • protective cough, clear lungs, reduces congestion, reduces the potential sites for bacterial infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a non-productive cough?

A
  • dry and irritating

- due to irritation of mucous membranes in upper respiratory tract or post nasal drip or tracheitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What 3 components are involved in the cough reflex?

A
  1. Cough centre in CNS (medulla)
  2. Cough receptors in URT (vagus and afferents to cough center)
  3. Diaphragm, abdominal and intercostal muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How should a cough related to bacterial infection be treated?

A

Antimicrobial agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How should a cough related to bronchospasm be treated?

A

Bronchodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How should a cough be treated if there is no bacterial infection or bronchospasm?

A

Simple cough linctus or other demulcent, safe preparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How should a dry, severe cough that disturbs sleep & is resistant to simple linctus be treated?

A

Rule out other serious underlying cause and prescribe an antitussive for a few nights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How should a chronic, tenacious, sputum producing cough be treated?

A

Mucolytic, expectorant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How should a cough following a viral infection be treated?

A

Bronchodilator aerosol may be useful (e.g. salbutamol or ipratropium bromide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are demulcents useful for?

A

Relieve dry, irritating coughs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do demulcents work?

A

Form a protective coat over irritated mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In what form are demulcents available?

A

As simple syrup or lozenges

- simple linctus (BP), glycerol, honey, cherry, licorice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do humidifying aerosols and steam inhalers do?

A

Liquefy nasal secretions, rehydration of irritated oropharyngeal areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What forms of humidifying aerosols and steam inhalers are available?

A

Volatile compounds

e.g. Friar’s Balsam, menthol, eucalyptus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What do expectorants do?

A

Help to expel bronchial secretions

  • stimulate production of watery, less viscous mucous
  • stimulate vagal system to increase respiratory secretions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What main side effect may be caused by expectorants?

A

Act indirectly via GIT, cause mild gastric irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What drug is an effective expectorant?

A

Guaiphenesin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which expectorants are not recommended for clinical use?

A

Ammonium chloride, ipecacuanha & squill are sometimes included in compound mixtures - such polycomponent mixtures are not recommended for clinical use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What do mucolytics do?

A
  • Reduce sputum viscosity, alter chemical structure of mucous
  • Enhances sputum transport by the tracheobronchial cilia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is important with mucolytics to reduce sputum viscosity?

A

Adequate hydration is important to reduce sputum viscosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the main 5 mucolytics used in the treatment of cough?

A
  1. N-Acetylcysteine
  2. Bromhexine
  3. Carbocisteine
  4. Mesna
  5. Dornase alfa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is N-Acetylcysteine used for?

A

Used in CF and other respiratory conditions that produce viscous mucous
Also used as an antidote in paracetamol poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the mechanism of action of N-Acetylcysteine?

A

Split disulphide bonds in mucoproteins to reduce viscosity of secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

N-Acetylcysteine: contraindications

A

Contraindicated in asthmatics and patients with a history of peptic ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the adverse effects of N-Acetylcysteine?

A

Bronchospasm, nausea, vomiting, stomatitis, tinnitus, fever, urticaria, skin rashes, anaphylactic reactions (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does bromhexine do?

A

Reduces viscosity of bronchial secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where should caution be used when giving Bromhexine?

A

Caution in patients with history of symptoms of peptic ulceration, asthma

34
Q

What are some of the adverse effects of Bromhexine?

A

GIT effects, allergic reactions

- Transient increase in serum aminotransferase

35
Q

What does Carbocisteine do?

A

Reduce viscosity of bronchial secretions

Also used as an antidote in paracetamol poisoning

36
Q

What are contraindications and cautions for Carbocisteine use?

A

CI in active peptic ulceration

Caution in patients with a history of peptic ulcer disease and porphyria

37
Q

What are the adverse effects of Carbocisteine?

A

Headache, GIT disturbances, skin rashes

38
Q

What is Mesna used for?

A

Used topically to reduce sputum viscosity

- ampules, an endotracheal tube or tracheotomy cannula, also nasal spray

39
Q

What should be done when giving Mesna to avoid complication?

A

Bronchial aspiration in patients unable to cough or expectorate to avoid pooling of secretions in lung

40
Q

What is the main adverse effect of Mesna?

A

Bronchospasm can occur, especially in asthmatics

41
Q

What is Dornase alfa?

A

Recombinant human DNase

- administered via IH

42
Q

What is Dornase alfa used for?

A

Used in cystic fibrosis patients

43
Q

What are negative effects of Dornase alfa?

A
  • Voice alteration

- Expensive

44
Q

What are useful combinations to use for a productive cough?

A
  1. Mucolytic and bronchodilator (Bisolvon Linctus)

2. Mucolytic and expectorant

45
Q

Antitussives: where do they have potential benefit?

A

Seldom required to suppress a cough

  • Non-productive cough may have benefit
  • Productive cough: may cause retention of mucous, promote stasis, encourage development of infection (treat with antimicrobials)
46
Q

What are the main side effects of antitussives?

A

Constipation and respiratory depression

47
Q

What is another significant concern with the majority of antitussives?

A

Abuse and addiction may be a problem

- some cough mixtures contain up to 40% alcohol = aggravates or may lead to alcoholism

48
Q

When are antitussives contraindicated?

A

Contraindicated in liver disease

49
Q

Antitussives come in combination with what other drugs?

A

Sympathomimetics, antihistamines, expectorants, etc.

50
Q

Which class of antitussives is centrally acting?

A

Opioid derivatives

51
Q

What is the mechanism of action of the opioid derivative antitussives?

A

Act on cough center
- decreased efferent impulses
= cough suppression

52
Q

What are the three opioid derivative antitussives?

A
  1. Dextromethorphan
  2. Pholcodine
  3. Codeine
53
Q

What effect does Dextromethorphan have on the body?

A

Direct action on cough center in the medulla

  • effect equal to codeine
  • no analgesic and little sedative effect
54
Q

What are the pharmacokinetics of Dextromethorphan?

A

Oral absorption rapid
Duration: 6 hours
Excreted in urine

55
Q

In which patients should Dextromethorphan be used with caution?

A

Asthma, emphysema, liver impairment, respiratory depression

56
Q

What are adverse effects of Dextromethorphan?

A

Dizziness, GIT effects

57
Q

What are the drug interactions with Dextromethorphan?

A
  • Alcohol, benzo’s, phenothiazines, TCA
  • Severe reactions with MAOI
  • Drugs inhibiting cytochrome P450 2D6
58
Q

What are the symptoms of Dextromethorphan overdose?

A

Confusion, excitation, respiratory depression

59
Q

What is the risk of dependency with Pholcodine use?

A

Pholcodine is a semi-synthetic derivative or morphine, but it is not metabolized into morphine in the liver
= little if any analgesic or euphoria - not often abused

60
Q

What are the pharmacokinetics of Pholcodine?

A
  • Rapid absorption after oral administration
  • Effect = 4-5 hours
  • Long T1/2 - 1x or 2x daily dosing
61
Q

What is the efficacy of Pholcodine?

A

At least as effective as Codeine

62
Q

What are the adverse effects of Pholcodine?

A
  • Nausea and vomiting
  • Constipation
  • Biliary colic, epigastric pain
63
Q

What are the adverse effects of Pholcodine when given in high doses?

A

HIGH DOSES: sedation, paradoxical excitement, ataxia, respiratory depression

64
Q

What is an important drug reaction with Pholcodine?

A

Pholcodine cough suppressants have been associated with anaphylaxis in some patients given NMBs during general anesthesia.
- Pholcodine purported as a potent stimulator of IgE production
- IgE had apparent cross-reactivity with suxamethonium (a neuromuscular blocking agent)
= increased incidence in anaphylaxis

65
Q

For which patients can Codeine be used?

A

Chronic bronchitis patients, not URTI

66
Q

What are some of the side effects of Codeine?

A

Greater SE

- constipation, drowsiness, no analgesia, ABUSE POTENTIAL HIGH

67
Q

What is a side effect of Codeine that only occurs at high doses?

A

Increases histamine release

68
Q

In which age group is Codeine contraindicated?

A

C/I in children under 2 years of age

69
Q

Which is the cough suppressants is the most likely to be abused?

A

Codeine

- be aware of codeine addicts

70
Q

What is the action of Codeine in the lungs?

A

Decreases secretions in bronchioles - thickens sputum - decreases ciliary activity

71
Q

What is the MOA of peripherally acting antihistamines (1st generation)?

A

Block cholinergic nerve impulses - dry up secretions - mucous plug formation
- dry up nasal secretions

72
Q

What should peripherally acting antihistamines (1st generation) not be used for?

A

Not for productive cough or asthmatics

73
Q

What is important about Promethazine?

A

Causes sedation

74
Q

What is important about Chlorpheniramine?

A

Less sedation

75
Q

What is important about Diphenhydramine?

A

Potent antitussive, sedative

76
Q

What is important about Tripolidine?

A

Acts for up to 12 hours

77
Q

What are the side effects of the peripherally acting antihistamines (1st generation)?

A

Anti-cholinergic SE:

  • dry mouth
  • urine retention
  • constipation
  • blurred vision
78
Q

Which bronchodilators are used in the management of coughs and colds?

A
  1. Selective beta-2 adrenoreceptor agonists e.g. Salbutamol
  2. Methylxanthines e.g. Theophylline
  3. Ephedrine, indirect acting sympathomimetic
79
Q

Which bronchodilator is often found in OTC preparations?

A

Ephedrine

80
Q

Where is chest physiotherapy useful?

A

Chest physiotherapy is very useful especially in chronic bronchitis, cystic fibrosis & recovery phases of severe chest infection

Respiratory Block: Pharmacology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions