W22 - Cough Flashcards

1
Q

what is a cough

A

reflex response to airway irritation, protective, removes foreign material and secretions from the bronchi and bronchioles

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2
Q

what is dry cough

A

usually felt in the throat as a tickle that sets off the coughing

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3
Q

how do we describe a productive

A

chesty cough usually produces phlegm.

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4
Q

how long does an acute cough last for

A

less than 3 weeks

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5
Q

what are the most common causes of an acute

A

Upper respiratory tract infections

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6
Q

What can acute cough be due to

A
acute bronchitis 
pneumonia 
acute exarcerbations of asthma 
COPD
Bronchiectasis
foreign body aspiration
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7
Q

what is sub acute cough duration

A

3-8 weeks

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8
Q

what is causes after an obvious respiratory infection

A

persistant pneumonia
acute bronchitis
pertussis
other types of post infectious cough

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9
Q

Chronic Cough duration

A

more than 8 weeks

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10
Q

Chronic Cough causes

A

smoking or disease related

angiotensin converting enzyme inhibitors

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11
Q

what are airway sensory nerves mainly carried by

A

vagus nerve where they terminate both in and under the airway epithelium

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12
Q

what fibres in the airway sensory nerves are though to control the cough

A

chemosensitive c fibres and mechanosensitive polymodal A delta fibres are thought to mediate cough

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13
Q

Cough reflex

A

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

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14
Q

what is a acute, viral cough

A

almost invariably benign and self limiting

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15
Q

what is the most common for of cough management

A

home remedy e.g. honey and lemon

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16
Q

why should OTC treatment not be given to children under 6

A

side effects

allergies

sleep problems

hallucinations

17
Q

what treatments are available for cough treatments

A

antitussivies

sedative antihistamines

mucolytics

expectorants

18
Q

what can be done to reduce sensory reception activation

A

menthol vapour

topical anaesthetic

19
Q

what is peripherally acting

A

reduce sensitivity of peripheral sensory cough receptors in pharynx and larynx to irritation

20
Q

what can we use to reduce sensitivity

A

Dextromethorphan
Codeine
Pholcodine

21
Q

what is centrally acting

A

agonists of opiod and non opiod receptors, depress the cough centre in brain stem

22
Q

what is centrally acting drugs used to treat

23
Q

what are peripherally acting drugs used to treat

A

production + non productive cough

24
Q

what cant be combined with mucolytics or expectorants

A

centrally acting drugs

25
what is dextromethorphan
non sedating opiate
26
what is codeine
an opioid analgesic that suppress cough through a direct effect on the cough centre in the medulla
27
what class of drug is codein
Class B controlled drug
28
what are the unwanted side effects of codeine
dependance inhibition of ciliarly clearnace constipation drowsiness
29
Diphenhydramine + chlorophenamine are examples of what
H1 antihistamines with sedative properties
30
what are antihistmaines with sedative properties used to treat
treatment of nocturnal cough
31
what are 3 examples of mucolytics
carbocisteine mecysteine N-acetylcysteine
32
what is the effect of mucolytic
cleave disulphide bonds cross linking mucus glycoprotein to reduce viscosity of bronchial secretion
33
what is the effect of expectorants
Reduce adhesiveness and surface tension of mucus promote expulsion of mucus by encouraging productive cough and bronchial secretion
34
what management advise can be giving to a patient
avoid lying on back take honey consider OTC
35
what considerations should be made before giving a drug
risks of constipation | avoid cough suppressants in chronic bronchitis + bronchiectasis (sputum retention)