Cough and Colds

Question 1

Common cold is an

Answer 1

Acute upper respiratory viral infection

Question 2

Common cold s/s

Answer 2

Rhinorrhea, nasal congestion, cough,
sneezing, sore throat, headache,
hoarseness, malaise, myalgia

Question 3

Common cold fever is

Answer 3

common in kids, rare in adults

Question 4

Common cold is self

Answer 4

Self-limited, usually benign

• No cure; just treatment of symptoms

Question 5

Common cold requires

Answer 5

no treatment, just symptomatic releive

Question 6

Common cold October 2007 FDA

Answer 6

– FDA – pediatric cough and
cold medications, younger than 4 years of
age

Question 7

Non-pharm treatments for comon colds

Answer 7

• Increased fluid intake
• Nasal saline spray or drops
• Rest
• Infants – nasal suction – secretions
• Monitor s/s of a bacterial infection
• Most resolve within 7 to 10 days

Question 8

most colds resolve within

Answer 8

7 to 10 days

Question 9

Sympathomimetics reduce

Answer 9

nasal congestion (do not reduce
rhinorrhea, sneezing, or itching)

Question 10

Sympathomimetics are active

Answer 10

alpha1-adrenergic receptors on nasal

blood vessels

Question 11

Sympathomimetics ADR

Answer 11

Adverse effects
– Rebound congestion
– CNS stimulation
– Cardiovascular effects and stroke
– Abuse (Combat Methamphetamine Epidemic Act
of 2005)

Question 12

Sympathomimetics (Oral/Nasal) factors in topical administration

Answer 12

– Should not use longer than 5 consecutive days

– Drops or sprays

Question 13

– Topical agents act more

Sympathomimetics (Oral/Nasal)

Answer 13

quickly than oral agents and are

usually more effective

Question 14

Oral agents act

Sympathomimetics (Oral/Nasal)

Answer 14

longer than topical preparations

Question 15

Systemic effects occur primarily with

Sympathomimetics (Oral/Nasal)

Answer 15

oral agents; topical agents
usually elicit these responses only when dosage is higher than
recommended

Question 16

Rebound congestion is common with

Sympathomimetics (Oral/Nasal)

Answer 16

prolonged use of topical

agents but rare with oral agents.

Question 17

Drugs for Cough

Answer 17

Antitussives

Nonopioid antitussives

Question 18

• Antitussives examples

Answer 18

– Drugs that suppress cough
– Opioid antitussives
• Codeine and hydrocodone

Question 19

Nonopioid antitussives exaples

Answer 19

• Dextromethorphan
• Diphenhydramine
• Benzonatate

Question 20

Expectorants example and note

Answer 20

Guaifenesin [Mucinex, Humibid]
– Renders cough more productive by
stimulating the flow of respiratory tract
secretions
– Higher doses may be effective

Question 21

Mucolytics examples

Answer 21

• Hypertonic saline

* Acetylcysteine

Question 22

Mucolytics react directly with

Answer 22

mucus to

make it more watery

Question 23

Mucolytics have a

Answer 23

High sulfur content, “rotten egg” smell

Question 24

Mucolytics can trigger

Answer 24

bronchospasm

Question 25

Pediatric OTC Cold use with

Answer 25

caution in young children

Question 26

Avoid OTC cold remedies in children younger than

Answer 26

4 to 6

Question 27

– Consult a health care professional before giving t

Answer 27

otc cold remedies to a child

Question 28

Avoid using antihistamine-containing products to

Answer 28

sedate children

Question 29

• Infants and young children - the symptoms of the common cold usually peak on

Answer 29

day 2 to 3 of illness and then gradually improve over

10 to 14 days

Question 30

• Recommend one or a combination of the following interventions as
first-line therapy for children with the common cold – maintain

Answer 30

adequate hydration, ingestion of warm fluids, humidified air, and/or
topical saline

Question 31

Over-the-counter (OTC) products for symptomatic relief of the common cold in children include

Answer 31

antihistamines, decongestants,
antitussives, expectorants, mucolytics, antipyretics/analgesics, and
combinations of these medications (adapted from UpToDate).

Question 32

Children <6 years – Except for antipyretics/analgesics, OTC medications for the common cold should

Answer 32

be avoided in children <6

years of age

Question 33

years of age.

• 6 to 12 years – Except for antipyretics/analgesics, we suggest not using OTC medications

Answer 33

or the common cold in children 6 to 12

years of age.

Question 34

Adolescents ≥12 years – OTC decongestants may provide

Answer 34

symptomatic relief of nasal symptoms in adolescents ≥12 years

Question 35

Anti-histamines – avoid in what patient population

Answer 35

elderly

Question 36

Anticholinergic medications – associated with multiple

adverse effects

Answer 36

(memory impairment, confusion,
hallucinations, dry mouth, blurred vision, constipation,
nausea, urinary retention, impaired sweating, and
tachycardia).

Question 37

elderly - Decongestants - may elevate

Answer 37

blood pressure and ocular
pressure, may worsen urinary obstruction and can interact
with other medications (e.g., beta blockers, methyldopa,
tricyclic antidepressants, oral hypoglycemic agents, and
MAOIs)

Question 38

elderly otc antitussives

Answer 38

s – dextromethorphan contraindicated - concurrent administration with or within 2 weeks of
discontinuing an MAO inhibitor.

Question 39

Lactation - First generation anti-histamines –

Answer 39

would
avoid - larger doses or more prolonged
use may cause effects in nursing infants
(e.g., paradoxical stimulation, irritability,
crying, or drowsiness) or decrease the
milk supply

Question 40

lactation avoid -

Answer 40

codeine (cough suppressant or
analgesic) – can cause infant drowsiness,
CNS depression, and even death.