Coughs

Question 1

Define coughs

Answer 1

• a protective reflex action caused when airway is irritated or obstructed - hence purpose to clear airway to allow normal breathing
• majority are viral upper respiratory tract infections
• often associated with colds

Question 2

Treatment timescale of coughs

Answer 2

with treatment should resolve within 10-14 days

Question 3

Types of cough with symptoms

Answer 3

• Unproductive=dry, tickly, tight. No sputum, usually viral and self-limiting
• productive=chesty or loose. Sputum over secretion due to infection, allergy etc

Question 4

referral criteria for coughs

Answer 4

• long duration of 2-3 weeks (TB, HF, chronic bronchitis)
• difficulty breathing/shortness of breath
• coloured sputum (yellow/green/rusty/blood stained) sign of bacterial infection
• persistent nocturnal cough in children (asthma)
• whooping cough or croup
• wheezing
• suspected ADR
• failed medication

Question 5

lifestyle advice regarding coughs

Answer 5

• maintain fluid intake
• catch it, bin it, kill it (wash hands)
• stop smoking
• drink plenty of fluids and rest
• for aches and pains and fever that causes distress use paracetamol or ibuprofen
• warm drink of lemon and honey
• take simple cough syrup that contains glycerol, honey or lemon
• young babies: saline nasal drops or sprays help thin and clear nasal secretions. Also nasal aspirators which ‘suck out’ mucus

Question 6

define expectorant and give examples

Answer 6

promote sputum
used for chesty coughs
guaifenesin and ipecucanhua

Question 7

Examples of cough suppressants

Answer 7

coedine
pholcodiene
dextromethorphan

Question 8

Examples of demulcents

Answer 8

simple linctus 
glycerine 
lemon
honey 
(soothing effect)

Question 9

Simple linctus paediatric
Symptoms
Warnings/counselling

Answer 9

for dry coughs
Refer if still have dry cough after 5 days
DO NOT take if have: fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency
High amounts of sucrose

Question 10

Veno’s expectorant APIs

populations

Answer 10

Guaifenesin
Ipecacuanha
Squill 
Only use in >12yrs 
Fine for pregnant and breastfeeding women

Question 11

Robitussin dry cough

symptoms and APIs

Answer 11

Pholcodine
codeine
dextromethorphan
Non-productive cough 
Blocks natural coughing reflex (cough suppressant)

Question 12

Robitussin dry cough

side effects & warnings

Answer 12

GI problems, dizziness
Do NOT take if taking:
antidepressants including alcohol, antipsychotics barbiturates, hypnotics, narcotic analgesics, sedatives, tranquillisers

Question 13

Robitussin dry cough populations

Answer 13

> 12yrs only

fine in pregnancy and breastfeeding

Question 14

Benylin dry cough
APIs
Symptoms

Answer 14

Sedating antihistamine - diphenhydramine

suppresses cough and aids sleep at night

Question 15

Benylin dry cough warnings

Answer 15

Not to be used for persistent or chronic cough (e.g. in asthma)
Not to be used where cough is accompanied by excessive secretions
>12 yrs only
Do not use in pregnancy or breastfeeding

Question 16

Veno’s honey and lemon
ingredients
symptoms

Answer 16

Glycerin, honey, lemon
used if cannot use cough suppressant for dry cough
Soothes by coating back of throat

Question 17

Veno’s honey and lemon warnings/populations

Answer 17

>12 years only 
Do not exceed 8 doses in 24 hours 
High sugar content 
Do not use in diabetes 
Fine in pregnancy and breastfeeding