Term
| What causes the common cold? |
|
Definition
| Viral pathogens - most commonly the rhinovirus. Over 100 serotypes. |
|
|
Term
| What are risk factors for a cold? |
|
Definition
young age, contact w/ school children
Crowded living conditions
Poor ventilation
Smoking |
|
|
Term
| How is the cold transmitted? |
|
Definition
- small particle Aerosols - long distances, do not settle
- large particle aerosols - droplets that settle
- direct contact/fomites |
|
|
Term
| What are symptoms of a cold compared to the flu? |
|
Definition
- Cold - Nasal congestion, rhinorrhea (runny nose), mild cough (caused by congestion). Gradual onset
- Flu - sudden onset, High fever, body aches. Severe fatigue and cough |
|
|
Term
| What is cough pathophysiology? |
|
Definition
Excitation of sensory receptors in the afferent limb of cough reflex.
- Peripheral agents inhibit sensory excitability
- Central agents inhibit in the brainstem
**Less common than congestion and rhinorrhea |
|
|
Term
| What is the goal of Tx for a cold? |
|
Definition
| Minimize symptoms and AEs. - ANTIBIOTICS DO NOT HELP! Antivirals don't either. Symptomatic Tx. |
|
|
Term
| What is used to treat nasal congestion associated with the common cold? |
|
Definition
- Topical decongestants - PE, Naphazoline, Tetrahydozoline, Oxymetazoline/Afrin, Xylometazoline. Will not raise BP, but rebound congestion after 3 days
- Sympathomimetics - alpha agonists - Pseudoephedrine and phenylephrine. Only use w/ controlled BP. Mydriasis. Interacts w/ TCAs, MAOIs, caffeine |
|
|
Term
| How can cough and cold products be used for kids? |
|
Definition
| Removed due to overdose issues - not necessarily unsafe. |
|
|
Term
| How is the sale of pseudophed restricted? |
|
Definition
Behind the counter
3.6g/day, 9g/30 days
Driver's license required
Log book kept except for <60 mg. Records kept for 2 years. |
|
|
Term
| How are antihistamines used for the common cold? |
|
Definition
- For the decrease of rhinorrhea and sneezing: 1ST gen + decongestant. 2nd gen do not work.
- Brompheniramine
- Clemastine
- Chlorpheniramine
- Diphenhydramine
- Doxylamine
**cause dry mouth and sedation, take with water |
|
|
Term
| What other nasal medications can be used for the common cold? |
|
Definition
- Ipratroprium/Atrovent - to decrease rhinorrhea. AE: HA, nasal dryness, epistaxis
- Nasal saline - safe in pregnant and children! Do not share bottle. Solubilizes/dilutes mucous |
|
|
Term
| Do cough suppressants work for the cold? |
|
Definition
No data that they actually work!
CHEST does not recommend central agents - Dxm and codeine
No medication proven to help children |
|
|
Term
| What inhaled anticholinergic relieves cough? |
|
Definition
| Ipratropium/Atrovent - CHEST grade A |
|
|
Term
| What are centrally acting cough products? |
|
Definition
Good for chronic bronchitis, not so much for a URI. Not recommended via CHEST
- Codeine - sedation, avoid alcohol and peds dosing
- Dxm - do not use w/ MAOIs. 10-20 mg q4h. Mixed data. Can be abused - 4 plateaus. Last is dissociative sedation |
|
|
Term
| How does Benzonatate/tessalon work? |
|
Definition
| A topical anesthetic on respiratory stretch receptors |
|
|
Term
|
Definition
- Increase mucous volume by changing viscosity, enhance mucociliary function/Mucokinetic agent
- Guaifenesin/Mucinex. 600-1200 q12h, max 2.4g/day. Take with water! |
|
|
Term
| What intranasal decongestants are alpha agonists? |
|
Definition
- Phenylephrine/Neosynephrine - ephedrine structure minus 4-OH
- Prophylhexedrine/Benzedrex - potential abuse |
|
|
Term
| What intranasal decongestants are imidazolines? |
|
Definition
- Oxymetazoline/Afrin
- Xylometazoline/Otrivin
- Naphazoline/Privine
- Tetrahydrozoline/Tyzine |
|
|
Term
|
Definition
Suppression centrally or peripherally of the cough reflex - involves PNS, CNS, airway SM, and respiratory mucosa
- Codeine/Robitussin AC - CENTRAL opioid acts at a lower dose than analgesia.
- Dextromethorphan - D-isomer of codeine, does not act through opioid receptors. NMDA antagonist
- Diphenhydramine - CNS sedation?
- Benzonatate - related to procaine, suppression of stretch receptors in lungs
- Camphor/Menthol - Mucokinetic, reduces sensitivity of receptors |
|
|
