W22 - Cough Flashcards
what is a cough
reflex response to airway irritation, protective, removes foreign material and secretions from the bronchi and bronchioles
what is dry cough
usually felt in the throat as a tickle that sets off the coughing
how do we describe a productive
chesty cough usually produces phlegm.
how long does an acute cough last for
less than 3 weeks
what are the most common causes of an acute
Upper respiratory tract infections
What can acute cough be due to
acute bronchitis pneumonia acute exarcerbations of asthma COPD Bronchiectasis foreign body aspiration
what is sub acute cough duration
3-8 weeks
what is causes after an obvious respiratory infection
persistant pneumonia
acute bronchitis
pertussis
other types of post infectious cough
Chronic Cough duration
more than 8 weeks
Chronic Cough causes
smoking or disease related
angiotensin converting enzyme inhibitors
what are airway sensory nerves mainly carried by
vagus nerve where they terminate both in and under the airway epithelium
what fibres in the airway sensory nerves are though to control the cough
chemosensitive c fibres and mechanosensitive polymodal A delta fibres are thought to mediate cough
Cough reflex
Stim of mechano and chemo receptors
afferent impulses to cough centre
second order neurons relay message to a respiratory pattern generator
efferent motor neurons stimulation
Increased respiratory muscle contraction to the respiratory movement
cough
what is a acute, viral cough
almost invariably benign and self limiting
what is the most common for of cough management
home remedy e.g. honey and lemon
why should OTC treatment not be given to children under 6
side effects
allergies
sleep problems
hallucinations
what treatments are available for cough treatments
antitussivies
sedative antihistamines
mucolytics
expectorants
what can be done to reduce sensory reception activation
menthol vapour
topical anaesthetic
what is peripherally acting
reduce sensitivity of peripheral sensory cough receptors in pharynx and larynx to irritation
what can we use to reduce sensitivity
Dextromethorphan
Codeine
Pholcodine
what is centrally acting
agonists of opiod and non opiod receptors, depress the cough centre in brain stem
what is centrally acting drugs used to treat
dry cough
what are peripherally acting drugs used to treat
production + non productive cough
what cant be combined with mucolytics or expectorants
centrally acting drugs
what is dextromethorphan
non sedating opiate
what is codeine
an opioid analgesic that suppress cough through a direct effect on the cough centre in the medulla
what class of drug is codein
Class B controlled drug
what are the unwanted side effects of codeine
dependance
inhibition of ciliarly clearnace
constipation
drowsiness
Diphenhydramine + chlorophenamine are examples of what
H1 antihistamines with sedative properties
what are antihistmaines with sedative properties used to treat
treatment of nocturnal cough
what are 3 examples of mucolytics
carbocisteine
mecysteine
N-acetylcysteine
what is the effect of mucolytic
cleave disulphide bonds cross linking mucus glycoprotein to reduce viscosity of bronchial secretion
what is the effect of expectorants
Reduce adhesiveness and surface tension of mucus
promote expulsion of mucus by encouraging productive cough and bronchial secretion
what management advise can be giving to a patient
avoid lying on back
take honey
consider OTC
what considerations should be made before giving a drug
risks of constipation
avoid cough suppressants in chronic bronchitis + bronchiectasis (sputum retention)
