Cough

Question 1

What is a productive cough

Answer 1

chesty with sputum

Question 2

What is a non-productive cough

Answer 2

dry and tickly

Question 3

Cough referral

Answer 3

• > 3 weeks
• chest pain
• wheezing
• shortness of breath
• pain on inspiration
• whooping cough
• croup (barking cough)
• night time cough

Question 4

Sputum referral

Answer 4

• coloured (green/yellow/brown = bacterial chest infection)
• blood in sputum refer

Question 5

Blood in sputum colours

Answer 5

Pink-tinged and frothy
— Heart failure
(with shortness of breath)

Rust
— community acquired pneumonia
(with high grade fever, breathless with chest pain)

Dark Red
— Tuberculosis
(with persistent fever and night sweats)

Question 6

OTC treatments: dry cough

Answer 6

Anti-Tussive (6 +)

• Pholcodine (1st line)
• Dextromethorpan (1st line)
• Codeine Linctus (18+)

Question 7

Anti-Tussive side effects

Answer 7

• sedation
• constipation

Question 8

OTC chesty cough: Antihistamines (6+)

Answer 8

• Night nurse (promethazine)
• Diphenydramine
  (Benylin)
• Triprolidine (Actifed)

Question 9

OTC chesty cough: Expectorants (6+)

Answer 9

• Guaifenesin (most common)
• Ammonium Chloride (unicough)

Question 10

OTC treatment for any cough: Demulcents

Answer 10

• Glycerol (3 months+)
• Simple Linctus (1+)

safe alternative for pregnant women and under 6

Question 11

What do antihistamines do to sputum

Answer 11

dries it

Question 12

What do expectorants do to sputum

Answer 12

decrease sputum viscosity

Question 13

What do Demulcents do to sputum

Answer 13

coats back of throat, reducing irritation

Question 14

Best practice for children under 6 months with cough

Answer 14

• Warm clear fluids/lemon and honey drinks
• simple cough mixtures (linctus)

Question 15

Cough Advice

Answer 15

• dry tickly coughs are self limiting (usually viral)
• do not treat chest cough with anti-tussive
  (mucus can accumulate in lung increasing chest infection)
• use sugar free products in diabetes