cough

Question 1

what is coughing

Answer 1

reflex response to airway irritation

-protective reflex which removed foreign materials + secretions from the bronchi+ bronchiole

Question 2

what are the 2 types of cough

Answer 2

dry

productive

Question 3

what is acute cough

Answer 3

less than 3 weeks

cause : upper respiratory tract infections

Question 4

what is sub - acute coughing

Answer 4

3-8 weeks 
causes: 
 respiratory infection 
		○ Persistent pneumonia 
		○ Acute bronchitis 
		○ Pertussis
		○ Other post infectious cough 
No an obvious respiratory infection - early development of chronic cough

Question 5

what is chronic cough

Answer 5

• Duration: more than 8 weeks
  
  • Causes: smoking or disease related
    ○ COPD
    ○ Asthma
    ○ Cancer
    ○ TB
    ○ Gastro-oesophageal reflux
    ○ Upper airway cough syndrome caused by chronic rhinitis or chronic sinusitis
  • Caused by Medicine related - angiotensin-converting enzyme inhibitor

Question 6

what can be a non-pharmacological treatment

Answer 6

honey and lemon

Question 7

what is the treatment options for children under 6

Answer 7

• Children under 6 should NOT be given OTC
  
  • Due to - side effects, allergies, sleep problems, hallucinations
  • Therefore - drink lemon and honey, cough syrup containing glycerol and honey

Question 8

what are the treatment options

Answer 8

• Antitussive - inhibit cough reflux by:
  ○ Reducing sensory reception activation
  ○ Depressing cough centre in brainstem
  
  • Sedative antihistamines
  • Mucolytics
    Expectorants

Question 9

antitussive for productive and non productive cough

Answer 9

reduce sensory reception activation
-methanol vapour - acute and short acting
topical anaesthetic

Question 10

antitussive for drug cough only

Answer 10

Dextromethorphan
codiene
pholcodine - class B CD

Question 11

what are examples of sedative antihistamines and what are their use

Answer 11

• Diphenhydramine
  
  • Chlorphenamine
  • First generation H1 antihistamine with sedative properties

Supress cough but also cause drowsiness - treatment for nocturnal cough

Question 12

mucolytics

Answer 12

○ Carbocisteine
○ Mecysteine
N-acetylcysteine

Question 13

expectorant

Answer 13

• White squill
  
  • Ipecacuanha
  • Guaifenesin
  • Creosotes
    Volatile oils
  • Reduce adhesiveness and surface tension of mucus
    Promote expulsion of mucus by encouraging productive cough and bronchial secretion

Question 14

cough and covid 19

Answer 14

25. Cough and Covid19
    
    • Encourage patient with cough to avoid lying on their back because this makes coughing ineffective
    • Management:
      ○ Honey
      ○ Then treatment : codeine linctus, codeine phosphate ( first choice)
      ○ Morphine (second choice)
      Considerations: risk of constipation, avoid cough suppressants in chronic bronchitis and bronchiectasis - cause sputum retention