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30 Cards in this Set

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Mucus function & complications in a cold (5)
Function = trap foreign particles. However the mucus can drip in certain locations, causing complications

a.) eustachian tube = ear infections
b.) throat = post-nasal drip (cough, sore throat, laryngitis)
c) nose = rhinorrhea
d.) lungs = bronchitis, pneumonia
e.) sinuses = sinus infection/ sinus headache
Defense mechanism of respiratory system (3)
1.) vasodilation
2.) inflammation
3.) increased mucus production
Common cold
a.) etiology
b.) incidence
c.) risk factors
a.) most common is rhinovirus. other viruses are also involved
b.) transmission is either self-innoculation (hand to mucosal lining) or aerosol transmission
c.) stress for over a month, smoking, bad lifestyle (sedentary/ poor diet), around sick people, weak immune system
Signs & symptoms of cold (3-2 in order)
The 3 S's
1.) sore throat
2.) STUFFY nose/ rhinorrhea
3.) SNEEZING

2 C's
there is coughing but is is mild. also some chest discomfort
Cold
a.) incubation time
b.) duration of symptoms
a.) 1-3 days, then symptoms appear
b.) 7-10 days
Complications of cold
a.) outcomes
b.) symptoms (2)
a.) Ear infection, lung infection, sinus, COPD
b.) fever after the cold, the mucus/phelgm is colored
Signs & symptoms of secondary bacterial infection
k
When to refer a patient to MD
fever (101.5) for more than 3 days, kid is <2, more than 7 day duration, diseases (AIDs, COPD, CHF)
CAM
k
Needs/considerations of cough & cold products in KIDS. counseling points to the parents
k
Things to ask before recommending a product
4: AGE (& who is it for), allergies, diseases, med list

4: SYMPTOMS (severity, mucus, duration), what have you tried, what factors worsened/made it better
What to do for pharyngitis
Local anesthetics (N'ice, Halls, Cepacol, Sucret)
Decongestants
a.) MOA
b.) CI (4) & specific people to avoid!
c.) precaution
d.) population
a.) alpha-adrenergic stimulation = vasoconstriction = less edema in the mucosa
b.) severe HTN, DM, CAD, MAOI use: nursing & kids <12yo
c.) hyperthyroidism, BPH, HTN-DM-CAD
d.) recommend for people you don't know. this is a safe route
Topical decongestants
a.) brands
b.) pros & cons
c.) counseling
a.) neo-synephrine (phenylephrine), afrin (oxymetazoline)
b.) cheap, fast onset, covers large area; imprecise dosing, tip can be clogged, high risk of contamination
c.) gently blow nose, tilt head, exhale, close 1 nostril, spray as you gently inhale. when done, breathe through mouth & rinse the tip. DONT USE MORE THAN 3 DAYS (afrin/oxymetazoline & phenylepherine/neo-synephrine) bc of rebound congestion
If you're going to use a topical decongestant, which is the best form to use for kids?
DROPS (otrivin/ xylometazoline)
Topical decongestant forms (3)
spray, drops, inhalers (lose efficacy over time)
Rhinitis medicamentosa
a.) seen in
b.) duration
c.) to prevent
d.) to treat
a.) topical decongestants
b.) when used >3 days
c.) use prn, don't use >3 days, switch decongestant
d.) stop drug, use saline drops, normalcy returns in 1-2 weeks (use systemic decongestants or topical corticosteroids in the meantime if needed)
What is the drug of choice for pregnant women with a cold? (& dose)
Chlor-Trimeton (chlorpheniramine) 4mg PO q 4-6 hours
Antihistamine MOA
blocks histamine and cholinergic receptors. first gen antihistamines block cholinergic receptors to a much greater extect than 2nd gen antihistamines, so greater anticholinergic side-effects
Antihistamine C/I
a.) diseases
b.) people
c.) drug
a.) BPH/bladder neck obstruction, narrow angle glaucoma
b.) nursing, newborns & preemies
c.) MAOI
D-D rxns with antihistamines (3)
1.) alcohol
2.) CNS depressants
3.) MAOI
Antihistamine caution
a.) people (3)
a.) kids <6, asthma/emphysema, paradoxical excitation in kids
Antitussive
a.) indication
b.) MOA
a.) dry non-productive cough!! do not use on productive cough unless there is vomiting or insomnia
b.) acts on the cough center in the medulla to increase cough threshold
What is the gold standard antitussive?
Codeine (Rx only)
Codeine counseling points (3)
1.) not recommended for kids <2
2.) drowsiness/dizziness may occur
3.) take with food
Codeine d-d rxns (2)
alcohol, CNS depressants
Delsym
a.) class
b.) caution
c.) d-d rxns (4)
a.) antitussive
b.) teenagers bc of abuse
c.) ANTIHISTAMINES, alcohol, MAOI, psychotropic drugs
Which drug interacts with psychotropic drugs
Delsym
Which drug interacts with antihistamines?
Delsym
a.) <12 yo
b.) <2yo
c.) <6yo
d.) teenagers
a.) C/I of pseudoephedrine SUSTAINED RELEASE in kids <12
b.) codeine not recommended in kids <2
c.) caution antihistamine use
d.) no dextromethorphan