Term
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Definition
| most common viral cause of cough/cold |
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Term
| Risk Factors for Cold/Cough |
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Definition
| smoking, poor nutrition, sedentary lifestyle, chronic stress (>1 month), poor social network, fatigue, decreased defense mechanisms, sick contacts, population density |
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Term
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Definition
Appears 1-3 days after infection;
Duration: 7-10 days;
Specific: pharyngitis, rhinorrhea, sneezing, nasal congestion, cough, HA, low-grade fever, chills, malaise, myalgia |
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Term
| Signs of Complication due to Cold - 2ndary bacterial infections |
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Definition
Fever occurring 3-5 days after a cold;
Colored, thick mucus in phlegm;
- sinusitis, bronchitis, pneumonia, ear infections, asthma/COPD |
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Term
| Patient Assessment Questions for Cough/Cold |
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Definition
Pt Hx/Demographics: age, allergies, dx states, medications;
Symptoms:
- description (nature, onset, duration, severity), factors that worsen/relieve sx, what has pt done to relieve sx? |
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Term
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Definition
| ear popping, ear fullness, ear pain, hearing loss, dizziness |
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Term
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Definition
| sinus pain, fever, tooth pain, URI symptoms >7 days |
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Term
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Definition
| persistent fever, chest tightness, wheezing, dyspnea, productive cough |
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Term
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Definition
| watery eyes, itchy nose/eyes/throat, congestion, clear nasal secretions |
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Term
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Definition
| myalgia, arthalgia, fever, sore throat, non-productive cough (can be severe & last wks), tired/weak (mod.-severe, lasts 2-3 wks w/ sudden onset) |
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Term
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Definition
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Term
| Signs/Symptoms of When to Refer to a Doctor |
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Definition
| fever >101.5F, chest pain, SOB, chronic cardiopulmonary diseases, AIDS or chronic immunosuppressant therapy, elderly or frail pts, children <2 yrs old, drug-induced cough, foreign object aspiration, hemoptysis, weight loss, duration of symptoms >7 days, thick, colored sputum &/or discharge |
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Term
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Definition
Wash hands!!!
Drink plenty of fluids;
Avoid sick contacts;
Cover your nose if you sneeze/mouth if you cough; |
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Term
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Definition
Increased fluids;
Rest;
Proper nutrition as tolerated;
Increased humidity;
Saline gargles and/or nasal sprays/drops;
Medical devices (Breathe right nasal strips);
Bulb syringe (infants & young children); |
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Term
| Pharmacological Tx for Cold |
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Definition
NO CURE for common cold;
Aimed at specific symptoms, NOT underlying illness;
Only tx sx if pt deems them to be bothersome; |
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Term
| Pros of Single Ingredient Products |
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Definition
specific sx are treated;
decreased exposure to ADRs;
control over dosing/scheduling; |
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Term
| Cons of Single Ingredient Products |
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Definition
may need to take >1 product;
increased cost?
decreased compliance? |
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Term
| Pros of Multi-Ingredient Products |
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Definition
may need only 1 product;
decreased cost?
increased compliance? |
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Term
| Cons of Multi-ingredient Products |
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Definition
unneeded medication;
increased exposure to ADRs;
less control over dosing/scheduling; |
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Term
| Local Anesthetics - benzocaine, dyclonine (Sucrets, Cepacol, Halls, N'ice) |
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Definition
treatments for pharyngitis;
soothing effect, coats irritated mucus membranes;
Use q3-4 hrs;
May also contain antiseptics and/or menthol/camphor;
NOT effective against viral infections |
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Term
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Definition
tx of nasal congestion;
MoA: stimulate alpha-adrenergic receptors --> constriction of blood vessels --> decrease sinus vessel engorgement & mucosal edema;
Other Effects:
- stimulate heart, stimulate CNS, contracts GI & urinary sphincters, HA, dizziness/lightheadedness;
C/Is: MAOI, severe HTN or CAD, hypersensitivity, DM, nursing mothers, thyroid conditions, elevated intraocular pressure, BPH |
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Term
| phenylephrine HCl - PE (Sudafed PE) |
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Definition
oral decongestant;
Dose: 10 mg PO q4 hrs, MAX 60 mg/day;
Less efficacious? - works no better than placebo, shorter duration of action, poor bioavailability; |
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Term
| psuedoephedrine - PSE (Sudafed) |
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Definition
oral decongestant;
Dose:
IR - 60 mg PO q4-6 hrs;
SR - 120 mg PO q12 hrs or 240 mg PO q24 hrs;
MAX dose = 240 mg/day; |
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Term
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Definition
highly adddictive, relatively inexpensive drug;
Acts as a stimulant;
may be ingested, snorted, smoked, or injected;
PSE & ephedrine are essential ingredients; |
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Term
| Methamphetamine Precursor Control Act |
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Definition
most products containing PSE must be kept behind pharmacy counter;
Purchasing PSE-containing products - at least 18 yrs old w/ photo ID, sign a log, no more than 2 packages in 1 transaction OR no more than 7500 mg PSE in any 30 day period;
Does not apply with valid prescription; |
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Term
| phenylephrine (Neo-Synephrine), oxymetazoline (Afrin) |
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Definition
topical nasal decongestant sprays;
(+): easy to use, covers large areas, quick onset of action, inexpensive;
(-): imprecise dosing, tip may become clogged, high risk of contamination |
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Term
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Definition
topical nasal decongestant drops;
(+): preferred for small children;
(-): covers small areas, awkward to use, pass into larynx, high risk of contamination; |
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Term
| levmetamfetamine or l-desoxyephedrine (Vicks Vapor Inhaler) |
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Definition
topical nasal decongestant inhaler;
(+): small, unobtrusive;
(-): lose efficacy after a few months, requires unobstructed airway & good air flow; |
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Term
| Directions for Topical Decongestant Use |
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Definition
gently blow nose;
apply correct dose;
breathe through mouth after use;
rinse tip after each use; |
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Term
| Adverse Effects of Topical Decongestants |
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Definition
burning, stinging, dryness, irritation;
rhinitis medicamentosa |
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Term
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Definition
MAJOR COUNSELING POINT;
may occur when topical decongestants are used longer than 3-5 days;
More common in shorter-acting meds;
To Prevent:
- take only as needed;
- do not use longer than 3 days;
- switch to different decongestant;
To Treat:
- stop medication;
- use normal saline drops/sprays, if needed use topical corticosteroids &/or systemic decongestants;
- should return to normal in 1-2 wks |
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Term
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Definition
tx for rhinorrhea, sneezing;
questionable efficacy;
MoA: blocks H-1 receptors;
ADRs:
- photosensitivity, dry eyes, dry nose, dry mouth, blurry vision, urinary retention, constipation, tachycardia, thickening of bronchial secretions, SEDATION, CNS stimulation;
C/I's: narrow angle glaucoma, BPH, MAO-I use, newborns, preemies, nursing mothers (except chlorpheniramine);
Cautions: use in children <6 yrs, paradoxical stimulation in children, children more sensitive to CNS effects, asthma/emphysema;
Drug Interactions:
- EtOH, CNS depressants, MAO-Is |
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Term
| 1st Gen. Antihistamines - diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton) |
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Definition
non-selective, sedating;
Also activated 5-HT & alpha-adrenergic receptors, blocks cholinergic receptors --> anticholinergic side effects;
Crosses BBB --> sedation;
Only meds that help with rhinorrhea;
Dosing:
D - 25-50 mg PO q4-6 hrs;
C - 4 mg PO q4-6 hrs -- DRUG of CHOICE for pregnant women; |
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Term
| 2nd Gen. Antihistamines - cetirizine (Zyrtec), levocetirizine (Xyzal), fexofenadine (Allegra), loratadine (Claritin, Alavert), desloratadine (Clarinex) |
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Definition
"selective" for H-1 receptor --> decreased anticholinergic side effects;
- less/non-sedating;
- does NOT help with rhinorrhea (less anticholinergic side effects) |
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Term
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Definition
upper airway cough syndrome (UACS);
causes coughing &/or throat irritation;
Tx sinus infection if needed;
Use DECONGESTANTS to control nasal congestion;
Use ANTIHISTAMINES to dry up secretions;
Non-pharm measurements: keep head elevated at bedtime; |
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Term
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Definition
Causes: asthma, GERD, PND, bronchitis, CHF, COPD, smoking, ACE-Is;
Tx: Underlying causes when possible;
Classifications:
- acute, subacute, chronic;
Types: non-productive, productive;
Goal of Therapy: reduce qty & intensity of episodes & prevent complications;
Complications:
- insomnia, vomiting, hoarseness; |
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Term
| Non-Pharm Treatments for Cough |
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Definition
| humidifiers, vaporizers (cool mist, NOT warm mist), hot steamy showers, proper hydration; |
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Term
| cough suppressants (antitussives) - codeine, dextromethorphan (Delsym, Benylin), diphenhydramine (Benadryl), benzonatate (Tessalon Perles) |
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Definition
Tx for NON-PRODUCTIVE COUGH;
MoA: direct effect on cough center in medulla, increases cough threshold;
DO NOT use in productive cough UNLESS:
- pt cannot sleep, pt is vomiting due to cough; |
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Term
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Definition
RX only;
- GOLD Standard cough suppressant/antitussive;
Tx for NON-PRODUCTIVE COUGH;
ADRs: N/V, sedatoin, dizziness, constipation, CNS depression, respiratory depression, euphoria, weakness;
Drug interactions: EtOH, CNS depressants;
Dosing: 10-20 mg PO q4-6 hrs (max 120 mg/day);
CPs:
- not recommended for children <2 yrs old;
- take w/ food;
- may cause dizziness or drowsiness |
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Term
| dextromethorphan (Delsym, Benylin) |
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Definition
OTC products;
Tx of NON-PRODUCTIVE COUGH;
ADRs: uncommon but include drowsiness, NV, stomach upset, constipation;
Drug Interactions:
- EtOH, antihistamines, psychotropic meds, MAO-Is (do not use for >14 days after MAO-Is are d/c'd);
Dosing: 10-20 mg PO q4 hrs OR 30 mg po q6-8 hrs; ER - 60 mg PO q12 hrs (Max 120 mg/day);
15-30 mg = codeine 8-15 mg;
Caution: Potential for abuse (teenagers) |
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Term
| diphenhydramine (Benadryl) |
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Definition
antihistamine w/ antitussive properties;
For Tx of NON-PRODUCTIVE cough only;
Dose: 25 mg PO q4 hrs (Max 150 mg/day) |
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Term
| benzonatate (Tessalon Perles) |
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Definition
RX only;
MoA: inhibits nerve impulses to cough center (medulla);
ADRs: nausea, drowsiness, HA, dizziness, GI upset, constipation, nasal congestion;
Dose: 100-200 mg PO TID (max 600 mg/day);
CPs: swallow whole, do not break or chew |
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Term
| cough expectorants (Protussives) |
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Definition
Tx for PRODUCTIVE COUGH;
MOA: thins out & loosens mucus;
Questionable Efficacy;
Adequate hydration & humidity: hot steamy shower, cool mist vaporizer;
ADRs: N/V/D, dizziness, HA, drowsiness, STOMACH PAIN, rash; |
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Term
| guaifenesin (Mucinex, Hytuss) |
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Definition
cough expectorant (protussive)
Tx of PRODUCTIVE COUGH;
Dosing:
IR - 200-400 mg PO q4 hrs (max 2400 mg/day);
ER - 600-1200 mg PO q12 hr (max 2400 mg/day);
CPs: drink plenty of water, ER tabs - swallow whole |
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Term
| acetaminophen - APAP (Tylenol) |
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Definition
Antipyretic/analgesic;
Tx for fever & pain;
Adult Dose: 325-1000 mg po Q4-6 hrs (MAX 4000 mg/d; 2000 mg/d for alcoholics);
Childs Dose: 10-15 mg/kg/dose (max of 5 doses/day);
ADRs: hepatotoxicity w/ chronic doses;
Drug Interactions: EtOH;
CPs: Be careful w/ child's dosage forms (Infant drops: 100 mg/ml, liquid: 160 mg/5 mL, chew tabs: 80 mg & 160 mg);
- be careful w/ multi-ingredient products |
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Term
| aspirin - ASA - (Bayer, Bufferin, Ecotrin) |
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Definition
Tx for fever & pain;
Adult Dose: 650-1000 mg PO q4-6 hrs (max 4000 mg/day);
C/Is: hx of bleeding disorder, pUD, gout, warfarin;
Drug Interactions: EtOH, NSAIDs;
ADRs: gastritis, GI bleeding, tinnitus, bronchospasm, REYES SYNDROME (chilren <15 yr);
CPs: take w/ food, take w/ full glass of water, do NOT use if smells like vinegar; |
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Term
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Definition
occurs in children <15 yrs old, who are taking aspirin;
S/Sx: vomiting, CNS damage, hepatic injury, hypoglycemia;
Usually occurs after viral infection such as influenzae or chicken pox;
DO NOT USE ASA in pts <18 yrs old; |
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Term
| ibuprofen (Advil, Motrin) |
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Definition
Tx for fever & pain;
Adult Dose: 200-400 mg PO q4-6 (max 3200 mg/d);
Child Dose: 5-10 mg/kg q6-8 hrs (max 40 mg/kg/day);
ADRs: dyspepsia, heartburn, N, anorexia, epigastric pain, dizziness, fatigue, drowsiness;
Drug Interactions: HTN meds (use APAP instead), EtOH;
C/Is: ASA or other NSAID intolerance;
CPs: take w/ food, be careful w/ children's dosage forms (Drops: 40 mg/ml, Suspension: 100 mg/5 ml, Chew tabs: 50 mg) |
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Term
| Pt Counseling Points for Parents |
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Definition
Check active ingredients of OTC meds;
Only use proper measuring devices for doses;
Carefully follow dosing directions;
Understand OTC meds only help w/ symptoms & DO NOT shorten duration of cold;
Do not use OTC meds to sedate a child;
Do NOT give lower doses of adult strength meds to children; |
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Term
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Definition
immune stimulant --> decrease duration & severity;
ADRs: GI discomfort, tingling sensation in tongue, HA;
Avoid prolonged courses;
Avoid taking if: allergies to rageweed, daisies, sunflowers; hx of asthma, atopy, allergic rhinitis; immune disorders (HIV/AIDS, RA, MS, TB); concurrent tx w/ azathioprine, cyclophosphamide, cyclosporine; |
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Term
| Zinc (Cold-Eeze, Orazinc, Zicam) |
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Definition
MoA: unknown but thought to block adhesion of rhinovirus to nasal epithelium;
May decrease duration and/or severity of sx;
Currently NOT RECOMMENDED per CHEST guidelines;
Dosing: 1 lozenge q2 hrs starting w/in 24 hrs of sx;
ADRs: permanent anosmia, mainly GI (nausea, stomach upset, bad taste);
Drug Interactions: tetracycline antibiotics, Ca/Phosphorus foods, citrus drinks |
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Term
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Definition
may decrease duration & severity of sx by less than 1 day;
Dosing: 1-8 grams/day;
Doses >4 g --> diarrhea & GI upset;
ADRs: diarrhea, kidney stones, upset stomach;
CPs: drink plenty of water |
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Term
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Definition
combination of 17 ingredients, including: high dose vitamins, minerals, herbs, amino acids;
Dosing: up to 3 times daily;
Safety/efficacy NOT proven |
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