OTC > Colds > Flashcards

Colds Flashcards

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1
Q

Colds are a _____ of upper respiratory tract

A

viral infection

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2
Q

There are ______ cases annually

A

one billion

- part of top 5 diagnosed illnesses in the US

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3
Q

Approximately ______ spent annually on nonRx cold and cough

A

$7 billion

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4
Q

When is cold season?

A

late august - early april

- can occur at any time of year though

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5
Q

Colds are the leading cause of…

A

work and school absenteeism

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6
Q

Colds are limited to…

A

upper respiratory tract

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7
Q

Stimulation of sensory fibers results in…

A

sneezing

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8
Q

Cholinergic and sympathetic nerves innervate…

A

glands and arteries that supply the glands

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9
Q

The nose contains _____ nerves

A
  • sensory
  • cholinergic
  • sympathetic
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10
Q

Cholinergic stimulation leads to…

A

dilation of arterial blood flow

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11
Q

Sympathetic stimulation leads to…

A

constriction of arterial blood flow

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12
Q

Majority of colds are caused by…

A

rhinoviruses

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13
Q

Modes of viral transmission of cold:

A
  • self innoculation

- aerosol transmission

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14
Q

Pathophysiology of colds:

A
  1. rhinoviruses bind to intercellular adhesion molecule-1 receptors on respiratory epi cells in nose and nasopharynx
  2. infected cells release chemokines
  3. cytokines activate inflammatory responses
  4. inflammatory mediators and PNS causes hypersecretion of watery nasal fluid
  5. swelling of nasal mucosa
  6. inflammatory processes obstruct airways
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15
Q

Risk factors of colds:

A
  • higher exposure rates
  • less diverse social networks
  • allergic disorders affecting nose/pharynx
  • weakened immune system
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16
Q

What causes a weakened immune system?

A
  • smoking
  • sedentary life style
  • chronic psychological stress
  • sleep deprivation
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17
Q

Signs/symptoms of colds:

A
  • day 1: sore throat
  • day 2: nasal symptoms
  • day 3: cough
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18
Q

Symptoms of colds will last:

A

7 - 14 days

- coughs can last up to 3 weeks

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19
Q

Exclusions to self-treatment:

A
  • fever: > 101.5 F
  • chest pain
  • shortness of breath
  • symptoms worsening from self treatment
  • underlying cardiopulmonary disease
  • AIDS/chronic immunosuppresive therapy
  • elderly
  • infants < 9 months
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20
Q

Influenza is a highly contagious…

A

respiratory infection caused by influenza virus

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21
Q

Symptoms of flu are more abrupt in…

A

onset and severity

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22
Q

Symptoms of the flu:

A
  • high fever
  • chills
  • myalgia
  • fatigue
  • sore throat
  • stuffy nose
  • headache
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23
Q

Best way to prevent flu is to…

A

get flu vaccination every year

- for people > 6 months old

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24
Q

Flu season:

A

october - may

- peaks in january

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25
Antibodies against the flu virus develops...
2 weeks after vaccination
26
____ vaccine is now the standard of care
quadrivalent
27
Rhinosinusitis is the inflammation of the...
mucosal lining of nasal passage and paranasal sinusitis
28
Rhinosinusitis can be caused by...
- viral (90%): rhinovirus/coronavirus | - bacterial (10%): acute bacterial rhinosinusitis (ABRS)
29
Viral sinusitis symptoms:
- nasal discharge that starts clear and watery and turns thick/discolored by day 4 or 5 - nasal congestion, cough, and sore throat - fever/myalgias in first 24-48 hours
30
Bacterial sinusitis symptoms:
- lasts > 10 days w/out improvement - high fever - purulent nasal discharge - facial pain - worsening symptoms after initial improvement
31
Cold prevention:
- frequently wash hands w/ soap and water for at least 20 seconds - use tissues to cover mouth/nose when coughing/sneezing - use antiviral products to clean surfaces
32
Non-pharmacologic cold relief:
- adequate rest - drink lots of fluids - use humidifier/vaporizer b/c loosens mucus and promotes sinus drainage
33
How to relieve sore throat:
- sucking on hard candy - gargling salt water (1 tsp salt/8 oz) - drinking fruit juices/hot tea w/ lemon
34
Pharmacologic cold relief:
- decongestants - antihistamines - local anesthetics - systemic analgesics - cough suppressants/expectorants - combo products
35
Mechanism of action of decongestants:
- adrenergic agonists (sympathomimetics) 1. stimulation of alpha-adrenergic receptors leads to vasocontriction 2. decreases sinusoid vessel engorgement and mucosal edema
36
Decongestants will temporarily relieve...
- common cold symptoms - upper respiratory allergy - sinusitis
37
Types of decongestants:
- direct - indirect - combo
38
Direct acting decongestants will...
bind directly to adrenergic receptors
39
Indirect acting decongestants will...
displace norepi in nerve terminals
40
Combination decongestants will...
do both direct and indirect activities
41
Examples of direct acting decongestants:
- phenylephrine - oxymetazoline - tetrahydrozoline
42
Examples of indirect acting decongestants:
ephedrine
43
Examples of combo decongestants
pseudophedrine
44
Systemic decongestants:
- pseudoephedrine (PDE): 60 mg every 4-6 hours | - phenylephrine (PE): 10 mg every 4 hours
45
Phenylephrine is less effective because...
it undergoes extensive systemic metabolism, which leads to low bioavailability
46
Naphazoline:
- topical intranasal decongestant - short acting - directions: 1-2 gtts not more than Q6H
47
Phenylephrine:
- topical intranasal decongestant - short acting - directions: 2-3 gtts Q4H
48
Xylometazoline:
- topical intranasal decongestant - long acting - directions: 2-3 gtts Q8-10H
49
Oxymetazoline:
- topical intranasal decongestant - long acting - directions: 2-3 gtts Q10-12H
50
Topical intranasal decongestants take how long to work?
- onset of action: 30 minutes | - peak effects: 1-2 H
51
Adverse events of decongestants:
- cardiovascular stimulation - CNS stimulation - device related effects
52
Examples of cardiovascular stimulation:
- elevated bp - tachycardia - palpitations - arrhythmias
53
Examples of CNS stimulation:
- restlessness - insomnia - anxiety - tremors - fear - hallucinations
54
Examples of device related effects:
- burning - stinging - sneezing - dryness
55
Overuse of nasal congestion can lead to...
- nasal spray addiction | - rebound congestion
56
Rebound congestion can be avoided by...
stopping topical decongestant use after 3 days
57
Treatment of rebound congestion:
- withdrawal of topical decongestant - replace topical decongestant w/ topical normal saline - rhinostat kit
58
Decongestant drug interactions:
- w/ MAO inhibitors (selegiline, phenelzine) | - diseases that are sensitive to adrenergic stimulation
59
Examples of diseases that are sensitive to adrenergic stimulation:
- hypertension - coronary heart disease - diabetes - hyperthyroidism - prostatic hypertrophy
60
T/F: pseudoephedrine can't be used to make meth
F
61
Methamphetamine Epidemic Act:
- written in 2005 - classified pseudoephedrine as "scheduled listed chemical product" - purchase restrictions
62
What are the purchase restriction on pseudoephedrine :
- need a valid ID - limit of 3.6 g/day - limit of 9g/month
63
T/F: monotherapy of antihistamines are enough to treat colds
F, need combo of first gen antihistamines and decongestants
64
Systemic analgesics are used to treat...
- aches | - fever
65
Examples of systemic analgesics:
- aspirin: avoid in children - acetaminophen - ibuprofen: NSAID - naproxen: NSAID
66
Directions for aspirin:
325-650 mg Q4-6H | - max: 4g/day
67
Directions for acetaminophen:
650 mg PO Q4-6H | - max: 3g/day
68
At high doses of acetaminophen...
there's a risk of liver toxicity
69
Directions for ibuprofen:
400 mg PO Q4-6H | - max: 1.2 g/day
70
Directions for naproxen:
200 mg Q8-12H | - max: 600 mg/day
71
Local anesthetics provide temporary relief of...
sore throat
72
Examples of local anesthetics:
- benzocaine | - dyclonine hydrochloride
73
Forms of local anesthetics:
- lozenges | - sprays
74
T/F: local anesthetics are effective for viral infections
F
75
Local anesthetics can be used every...
2-4H
76
Onset of local anesthetics occur...
immediately on contact
77
Adverse effects of local anesthetics:
- mouth tingling - mouth numbness - irritation
78
Avoid use of local anesthetics in...
- children < 2 YO
79
Cough suppressants are used to treat...
nonproductive coughs | - reduces cough frequency
80
Examples of cough suppressants:
- codeine - dextromethorphan - topical agents
81
Expectorants are used to treat...
symptomatic relief of productive cough (Guaifenesin) - reduces chest discomfort from excess mucus
82
T/F: combination products are inconvenient
F, are convenient
83
Combination products carry the risk of...
unnecessary drugs
84
Special populations:
- pregnant women - breastfeeding women - pediatrics - elderly
85
Providers recommend ____ therapy for pregnant women
nonRx
86
Avoid _______ in first trimester b/c of possible birth defects
pseudoephedrine
87
Preferred topical decongestant during pregnancy:
oxymetazoline
88
Preferred decongestant for lactating mothers:
pseudoephedrine
89
Risk of _________ w/ systemic decongestant use in lactating mothers:
decreased milk production
90
FDA made a public health advisory for OTC products in pediatrics during what year?
2008
91
FDA stated...
- should avoid use of OTC cough and cold medications in children < 2 YO - potential serious and life threatening adverse effects
92
In October 2008, manufacturers voluntarily updated labels advising non-use in children ______ YO
< 4
93
FDA guidelines in 2011 for liquid nonRx products that included dispensing device:
- dosing device needs to be included w/ all oral liquid nonRx products - device needs to be calibrated to dose recommended in product directions - device used only w/ product - markings remain visible when liquid is in device
94
Dosing for elderly:
- start low and go slow
95
Treatment of sore throat:
local anesthetics and/or systemic analgesics
96
Treatment of dry, nonproductive cough:
cough suppressant
97
Treatment of wet, mucus-producing cough:
expectorant
98
Treatment of nasal congestion:
topical/systemic decongestants
99
Treatment of aches and pains:
systemic analgesics
100
Treatment of fever:
systemic antipyretics
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