Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
Productive Cough
|
Productive cough (“loose”, “chesty”, “wet”)
Productive coughs are coughs that expel: lower respiratory tract secretions; common conditions associated with productive coughs include bacterial pneumonia, bronchitis, COPD, asthma. • “effective” productive coughs – secretions easily expelled • “ineffective” productive coughs – secretions present but difficult to expel |
|
|
NonProductive Cough
|
Nonproductive coughs are coughs that do not expel lower respiratory tract secretions; common conditions associated with nonproductive coughs include viral lower respiratory tract infections, some atypical pneumonias (e.g., Mycoplasma pneumoniae), GERD, cardiac disease, and drugs.
|
|
|
Acute Cough
|
Define: < 3 weeks
Ex: Upper respiratory tract infections (e.g., common cold), lower respiratory tract infections (e.g., pneumonia), pulmonary emboli, heart failure, asthma exacerbation, COPD exacerbation |
|
|
Sub-Acute Cough
|
Define: 3-8 weeks
Ex: Postinfectious (pneumonia, pertussis, bronchitis), new or worsening upper airway cough syndrome (UACS), asthma, bronchitis, GERD |
|
|
Chronic Cough
|
Define: > 8 weeks
Ex: Most common: UACS (including postnasal drip), asthma, GERD Other: left-sided heart failure, bronchogenic carcinoma, aspiration secondary to pharyngeal dysfunction; drugs |
|
|
Identify common diseases associated with cough
|
-Upper airway cough syndrome
-Common cold -Asthma -GERD -Bronchitis -Bronchiectasis -Post-infectious -Lung Tumors -Oropharyngeal dysphagia -ACE inhibitors -Habit cough and psychogenic cough -Chronic interstitial pulmonary disease -Occupational and environmental -Tuberculosis and other infections -Peritoneal dialysis-associated cough |
|
|
State the indications for cough suppressants
|
American College Codeine and Dextromethorphan are not recommended for coughs associated with UACS or the common cold
|
|
|
State the indications for cough expectorant
|
American College of Chest Physicians 2006: Guafenesin is not recommended for any indication
|
|
|
American College of Chest Physicians 2006 Evidence Based Guidelines
|
1. Codeine and dextromethorphan are not recommended for coughs associated with UACS or the common cold.
2. Guaifenesin (glyceryl guaicolate) is not recommended for any indication. 3. Antihistamine monotherapy is not recommended for any indication. 4. Benzonatate is not recommended for any indication. 5. Children (<15 years of age) – “In children with cough, cough suppressants and other OTC cough medications should not be used as patients, especially young children, may experience significant morbidity and mortality.” “Cough should be treated based on etiology, and there is no evidence for using medication for the symptomatic relief of cough.” [From the 2006 ACCP Cough Guidelines] |
|
|
Cough Self-Exclusions
|
• hemoptysis
• significant shortness of breath • post-endotracheal intubation • coughs persist >7-10 days despite self-tx • all coughs >3 weeks duration • coughs associated w/ new symptoms • coughs that worsen during treatment • coughs associated w/ foreign body aspiration • pleuritic chest pain • fever >101.5F >3 days • coughs productive of thick yellow or • drenching night sweats, green sputum • drug-associated coughs • coughs a/w acute asthma exacerbations |
|
|
Humidifiers
|
Add water to the air; ultrasonic, impeller, evaporative; cool mist, steam (caution – increased humidity increases molds and dust mites which may worsen allergies; also disperses minerals and microorganisms into air). Steam humidifiers may burn or scald if tipped over. Change water daily, use distilled or demineralized water, clean every three days, and change filter regularly; keep humidity 30-50% and keep surrounding area dry.
|
|
|
Vaporizers
|
Humidifiers with a medication cup or well. Waterless vaporizers available.
|
|
|
Upper Airway Cough Syndrome
|
TYPE OF COUGH: Chronic
DRUG THERAPY: 1st generation antihistamine and decongestant combination4 QUALITY OF EVIDENCE: Low NET BENEFIT: Intermediate STRENGTH: Weak |
|
|
Common Cold
|
TYPE OF COUGH: Acute
DRUG THERAPY: 1st generation antihistamine and decongestant combination4 QUALITY OF EVIDENCE: Fair NET BENEFIT: Substantial STRENGTH: Strong |
|
|
Acute bronchitis
|
TYPE OF COUGH: Acute
DRUG THERAPY: 1st generation antihistamine and decongestant combination4 QUALITY OF EVIDENCE: Fair NET BENEFIT: Small/Weak STRENGTH: Weak |
|
|
Chronic bronchitis
|
TYPE OF COUGH: Acute
DRUG THERAPY: Codeine, Dextromethorphan6 QUALITY OF EVIDENCE: Fair NET BENEFIT:Intermediate STRENGTH: Moderate |
|
|
Postinfectious
|
TYPE OF COUGH: Sub-Acute
DRUG THERAPY: Codeine, Dextromethorphan6 QUALITY OF EVIDENCE: Expert Opinion NET BENEFIT: Intermediate Strength: Expert Opinion Only/Moderate |
|
|
Lung tumors
|
TYPE OF COUGH: Chronic
DRUG THERAPY: Dihydrocodeine, Hydrocodone QUALITY OF EVIDENCE: Low NET BENEFIT: Intermediate Strength: Weak |
|
|
Guaifenesin
(Humibid) OTC,Rx |
-Expectorant
-200-400mg every 4hrs -dosage forms: syrups, liquids, tablets, SR tablets -Gastrointestinal upset -Hypersensitivity |
|
|
benzonate (Tessalon) Rx
|
-Local Anesthetic
-100mg TID -capsules -Drowsiness, constipation, gastrointestinal upset -"caine" allergies |
|
|
codeine (various) OTC, Rx
|
-Central Suppressant
-10-20mg every 4-6hrs -solutions,syrups -Drowsiness, gastrointestinal upset -Hypersensitity, MAOI |
|
|
dextromethorphan (Hold DM) OTC
|
-Central Suppressant
-10-30mg every 4-6hrs -syrups, liquids, ER suspension, gelcaps, ODS, oral spray, losenges -Drowsiness, gastrointestinal upset -Hypersensitivity, MAOIs |
|
|
diphenhydramine (Benadryl) OTC, Rx
|
-Central Suppressant
-25mg every 4hrs -syrups, liq., ODS -Drowsiness, Mucosal drying -Prostatic hypertrophy, asthma, glaucoma |
|
|
State the requirements for OTC sale of Schedule C-V codeine-containing cough products.
|
Codeine OTC: Schedule C-V max 200 mg codeine per 100ml and at least one noncodeine active ingredient. Check individual state laws.
|
|
|
FDA-Approved Cough Therapies (Topical)
|
• Camphor (4.7-5.3%) & menthol (2.6-2.8%) topical ointments; OTC
• Camphor/menthol patch; OTC BID • Menthol lozenges 5 –10 mg; OTC PRN • Camphor (6.2%) & menthol (3.2%) for steam inhalation |
