Wk 14: Respiratory OTC 2

Question 1

What are the causes of a cough?

Answer 1

• Upper respiratory tract viral infection
• Cold/dry atmosphere
• Smoking
• Astma/HF/allergies
• ACEi

Question 2

What are the types of coughs?

Answer 2

• Non-productive: dry tickly irritation
• Productive: sputum + difficult to clear chest

Question 3

What would you use for a dry cough?

Answer 3

Cough suppressant (antitussive):

• Codeine linctus (18): constipation + abuse
• Pholcodine linctus: less s/e
• Dextromethorphan: less potent + s/e

Question 4

Which antihistamines are used to treat a cough?

Answer 4

Diphenhydramine, promethazine

• Dry secretion
• Red freq.
• Causes drowsiness

Question 5

Which cough treatment is suitable for children, asthmatics + pregnant women?

Answer 5

Demulcents

• Glycerin, honey + lemon
• Simple linctus
• > 3 months old
• Caution: diabetics + bad dental hygiene

Question 6

Which treatment is used for a chesty cough in over 6 years old?

Answer 6

Expectorants - guaifenesin, ammonium salts, menthol

• Stim bronchial mucus secretion - liquifying sputum
• Emetic reflex response

Question 7

What are the counselling points for a cough?

Answer 7

• Inc fluid
• Sugar free remedies

Question 8

When do you refer for a cough?

Answer 8

• > 3 wks
• Coloured sputum
• Chest pain
• SOB/wheeze
• Recurrent nocturnal cough
• Whooping/croup
• ADRs
• Smoker w/ recurrent cough

Question 9

When do you refer for a sore throat?

Answer 9

> 3 wks

Question 10

What is perennial allergic rhinitis?

Answer 10

Occurs throughout year: dust, fur, fungal

Question 11

What are the symptoms of allergic rhinitis?

Answer 11

• Sneezing
• Rhinorrhoea
• Congestion
• Nasal itch
• Itchy eyes

Question 12

What is first line for allergic rhinitis?

Answer 12

• Oral antihistamine
• Take when symptoms expected
• Red rhinorrhoea, sneezing + itch
• No effect on congestion

Question 13

Which sedative oral antihistamine is used in allergic rhinitis?

Answer 13

• Chlorphenamine
• Promethazine (highly sedative)

Question 14

Which non-sedative oral antihistamine is used in allergic rhinitis?

Answer 14

• Fexofenadine (120mg) OD: 12 yrs
• Loratadine OD: 2 yrs
• Cetirizine OD: 2 yrs

Question 15

Which combination oral product is used in allergic rhinitis to relive congestion?

Answer 15

Benadryl plus - acrivastine w/ pseudoephedrine

Question 16

Which nasal preparations are used for allergic rhinitis?

Answer 16

Beclomethasone + fluticasone:

• +18
• Anti inflammatory
• 2 wks before symptoms
• S/e: dryness + irritation of nose, nose bleeds

Question 17

What is used as a prophylactic treatment for nasal + eye irritation in allergic rhinitis?

Answer 17

• Topical sodium cromoglycate (opticrom)
• Mast cell stabilizers
• QDS
• +6 yrs old

Question 18

What is an example of a POM used to stabilise mast cells?

Answer 18

• Topical lodoxamide
• Intra-ocular
• > 4yrs old
• 4 wks only

Question 19

What are the counselling points for a patient w/ allergic rhinitis?

Answer 19

• Avoid going out when pollen count is high
• Keep windows closed
• Sunglasses
• Shower after being outside
• Avoid camping/mowing lawns

Question 20

What are the counselling points for perennial allergic rhinitis?

Answer 20

• Use acaricide + fungicides
• Non-allergic pillows
• Wash bedding weekly at 60c
• Damp dust
• Vacuum regularly

Question 21

When do you refer for allergic rhinitis?

Answer 21

• Wheezing/SOB
• Prolonged/severe earache
• Facial pain
• Coloured nasal discharge
• Purulent conjunctivitis
• 5-7 days no improvement