Card Set Information
pharmacy cough self care
Self Care Module III Fall '11- Cough
What is the definition of a COUGH?
A voluntary OR involuntary RESPIRATORY tract REFLEX
What is the CLASSIFICATION and CAUSE of an ACUTE cough?
LESS than 3 weeks
: Viral URI or OTHER conditions (pulmonary emboli, pneumonia)
Related to POST NASAL DRIP
What is the CLASSIFICATION and CAUSE of a SUBACUTE cough?
: Post infectious Cough, Bacterial Sinusitis
What is the CLASSIFICATION and CAUSE of a CHRONIC cough?
: Post Nasal Drip, Pulmonary Conditions (asthma), GERD
: CHF, Medications (ACEI--20% due to inhibition of bradykinin break down, Non-selective Beta-blockers---due to bronchioconstriction)
What are the CAUSES of a CHRONIC cough in children?
Foreign body ASPIRATION
Esophageal MOTILITY Disorders
Why do ACE INHIBITORS cause a COUGH?
They STOP the breakdown of BRADYKININ
Why do Non-selective BETA-BLOCKERS cause a COUGH?
They cause BRONCHIOCONSTRICTION
What are the TWO TYPES of Coughs?
What is a PRODUCTIVE Cough?
Wet or "CHESTY"
CLEARS secretions from LRT
Coughing up MUCUS
What is a NONPRODUCTIVE Cough?
Dry or "HACKING"
No PHYSIOLOGIC purpose
What are (6) COMMON Complications with a COUGH?
What are (4) LESS COMMON Complications with a COUGH?
Syncope--- passing out
Stroke--- due to increased Intracranial Pressure
Rib Fractures--- due to Osteoporosis
A TRIAD of symptoms that usually occur with the common COLD, FLU, & ALLERGY?
What is the MECHANISM of the COUGH REFLEX?
Irritants/Particulates----(Inflammatory Mediators)---- Sensory Nerve Stimulation---- CNS Cough Reflex Center= MEDULLA
What is the COUGH REFLEX Center?
What can TRIGGER (5) the COUGH REFLUX?
The ____________________________ is the SENSORY nerve ENDINGS of respiraory epithelium.
AFFERENT Nerve Pathway
The Afferent Nerve Pathway contains receptors SENSITIVE to ___________________________ & __________________________.
Specific CHEMICAL Transmitters
__________________________ are activates by ONE OR MORE mechanical stimuli.
Rapidly Acting Stretch Receptors (RAR)
What MECHANICAL Stimuli activate RARs?
Physical changes---triggered by histamine from mast cells
________________________________ are activated DIRECTLY or SENSITIZED by a wide range of chemicals, but are realtively INSENSITIVE to mechanical stimuli.
Whats CHEMICALS activate Chemoreceptors?
What FIBERS carry informations from CHEMORECEPTORS?
Bronchopulmonary C-fibers (Slow, thin unmyelinated nerve fibers)
Bronchopulmonary C-fibers RELEASE ________________________.
TACHYKININS------Substance P, Neurokinin A, Bradykinin
What FIBERS carry information from STRETCH & CHEMORECEPTORS?
Broncopulmonary A-delta fibers (Fast, thick myelinated nerve fibers)
Where to BOTH FIBERS (C & A-delta) JOIN to carry senssory Info to the CNS?
Afferent Branch of the VAGUS NERVE
Where do extensive SYNAPSES from the VAGUS occur?
The nulceus of the TRACTUS SOLITARIUS--associated with the Solitary Nucleus
Where is the Nucleus of the TRACTUS SOLITARIUS Located?
Upper MEDULLA OBLONGATA (each side)
What FUNCTIONS does the Nucleus of the TRACTUS SOLITARIUS play a role in?
What happens with the SUPPRESSION of the Medulla Oblongata?
Increased Threshold to elicit Cough
Decreased Cough Reflex
What is the COORDINATION of Nerve Impulses in the EFFERENT PATHWAY?
CLOSE Epiglottis (following deep inspiration)
SYNCHRONIZED Contraction (of diaphragm, intercostal and abdominal muscles)
COUGH Rapidly (expel 2-3L of air)
What (4) MAJOR NERVES are involved in the EFFERENT Pathway of a COUGH?
Glossopharngeal--closes epiglot, controls pharynx
Trigeminal--afferent sensory fxn from scalp to chin
What are the PHARMACOLOGICAL Interventions of the CNS for a COUGH?
Opiod Receptor Agonists--Codeine, Hydrocodone
Antihistamines--diphenhydramine, chlorpheniramine, brompheniramine, promethazine
What are the PHARMACOLOGICAL Interventions used LOCALLY for a COUGH?
Tachykinin receptor antagonists
EXCLUSIONS to Self-Care:
Fever (if only symptoms are fever and cough)
Drenching PM Sweats
Hx or Symp of underlying disease with Cough
Foreign Object Aspiration
Cough > 7days
NON-PHARMACOLOGICAL Therapy for a COUGH?
Cool Mist Humidifiers & Vaporizers
Avoid using COUGH & COLD medications in KIDS under the AGE ____________.
The 3 OPIOID Receptors TYPES?
Mu, Kappa, Delta
---GPCRs w/ 7 transmembrane domains
Which RECEPTOR SUBTYPE for Opioids is associated with the MOST effects?
Mu--Analgesia, Sedation, Respiratory Depression, Decreased GI Motility
What are (8) IMPORTANT Opioid Receptor Agonists?
Euphoria--dream-like sense of well-being
Sedation & Drowsiness