Self-Care: Cough

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Self-Care: Cough
2011-11-14 22:08:32
pharmacy cough self care

Self Care Module III Fall '11- Cough
Show Answers:

  1. What is the definition of a COUGH?
    A voluntary OR involuntary RESPIRATORY tract REFLEX
  2. What is the CLASSIFICATION and CAUSE of an ACUTE cough?
    • LESS than 3 weeks
    • Caused by: Viral URI or OTHER conditions (pulmonary emboli, pneumonia)
    • Related to POST NASAL DRIP
  3. What is the CLASSIFICATION and CAUSE of a SUBACUTE cough?
    • 3-8 Weeks
    • Caused by: Post infectious Cough, Bacterial Sinusitis
  4. What is the CLASSIFICATION and CAUSE of a CHRONIC cough?
    • 8 Weeks
    • Most COMMON: Post Nasal Drip, Pulmonary Conditions (asthma), GERD
    • ALSO: CHF, Medications (ACEI--20% due to inhibition of bradykinin break down, Non-selective Beta-blockers---due to bronchioconstriction)
  5. What are the CAUSES of a CHRONIC cough in children?
    • Foreign body ASPIRATION
    • Esophageal MOTILITY Disorders
  6. Why do ACE INHIBITORS cause a COUGH?
    They STOP the breakdown of BRADYKININ
  7. Why do Non-selective BETA-BLOCKERS cause a COUGH?
  8. What are the TWO TYPES of Coughs?
    • Productive
    • Non-productive
  9. What is a PRODUCTIVE Cough?
    • Wet or "CHESTY"
    • CLEARS secretions from LRT
    • Coughing up MUCUS
  10. What is a NONPRODUCTIVE Cough?
    • Dry or "HACKING"
    • No PHYSIOLOGIC purpose
  11. What are (6) COMMON Complications with a COUGH?
    • Exhaustion
    • Insomnia
    • Muscle Pain
    • Hoarseness
    • Excessive Sweating
    • Urinary Incontinence
  12. What are (4) LESS COMMON Complications with a COUGH?
    • Heart Arrythmias
    • Syncope--- passing out
    • Stroke--- due to increased Intracranial Pressure
    • Rib Fractures--- due to Osteoporosis
  13. A TRIAD of symptoms that usually occur with the common COLD, FLU, & ALLERGY?
    • Cough
    • Nasal Congestion
    • Allergy
  14. What is the MECHANISM of the COUGH REFLEX?
    Irritants/Particulates----(Inflammatory Mediators)---- Sensory Nerve Stimulation---- CNS Cough Reflex Center= MEDULLA
  15. What is the COUGH REFLEX Center?
  16. What can TRIGGER (5) the COUGH REFLUX?
    • Allergens
    • Pathogens
    • Enviro Pollutants
    • Job Exposures
    • Mucosal [Ion]/osmolarity
  17. The ____________________________ is the SENSORY nerve ENDINGS of respiraory epithelium.
    AFFERENT Nerve Pathway
  18. The Afferent Nerve Pathway contains receptors SENSITIVE to ___________________________ & __________________________.
    • MECHANICAL Stress
    • Specific CHEMICAL Transmitters
  19. __________________________ are activates by ONE OR MORE mechanical stimuli.
    Rapidly Acting Stretch Receptors (RAR)
  20. What MECHANICAL Stimuli activate RARs?
    • Lung Inflation
    • Bronchospasm
    • Light Touch
    • Physical changes---triggered by histamine from mast cells
  21. ________________________________ are activated DIRECTLY or SENSITIZED by a wide range of chemicals, but are realtively INSENSITIVE to mechanical stimuli.
  22. Whats CHEMICALS activate Chemoreceptors?
    • Capsaicin
    • Bradykinin
    • Adenosine
    • PGE2
    • Substance P
    • Neurokinin A
  23. What FIBERS carry informations from CHEMORECEPTORS?
    Bronchopulmonary C-fibers (Slow, thin unmyelinated nerve fibers)
  24. Bronchopulmonary C-fibers RELEASE ________________________.
    TACHYKININS------Substance P, Neurokinin A, Bradykinin
  25. What FIBERS carry information from STRETCH & CHEMORECEPTORS?
    Broncopulmonary A-delta fibers (Fast, thick myelinated nerve fibers)
  26. Where to BOTH FIBERS (C & A-delta) JOIN to carry senssory Info to the CNS?
    Afferent Branch of the VAGUS NERVE
  27. Where do extensive SYNAPSES from the VAGUS occur?
    The nulceus of the TRACTUS SOLITARIUS--associated with the Solitary Nucleus
  28. Where is the Nucleus of the TRACTUS SOLITARIUS Located?
    Upper MEDULLA OBLONGATA (each side)
  29. What FUNCTIONS does the Nucleus of the TRACTUS SOLITARIUS play a role in?
    • BP regulation
    • Cough Reflex
    • Gag Reflex
    • Sneeze Reflex
    • Vomitting
    • Inspiration
  30. What happens with the SUPPRESSION of the Medulla Oblongata?
    • Increased Threshold to elicit Cough
    • Decreased Cough Reflex
  31. 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)
  32. What (4) MAJOR NERVES are involved in the EFFERENT Pathway of a COUGH?
    • Vagus--coordinates muscles
    • Glossopharngeal--closes epiglot, controls pharynx
    • Phrenic--enervates diaphragm
    • Trigeminal--afferent sensory fxn from scalp to chin
  33. What are the PHARMACOLOGICAL Interventions of the CNS for a COUGH?
    • Opiod Receptor Agonists--Codeine, Hydrocodone
    • Dextromethorphan
    • Antihistamines--diphenhydramine, chlorpheniramine, brompheniramine, promethazine
    • Benzonatate
  34. What are the PHARMACOLOGICAL Interventions used LOCALLY for a COUGH?
    • Local anethetics
    • Benzonatate
    • Tachykinin receptor antagonists
    • Antihistamines
  35. EXCLUSIONS to Self-Care:
    • Fever (if only symptoms are fever and cough)
    • Unintended Weightloss
    • Drenching PM Sweats
    • Hemoptysis
    • Hx or Symp of underlying disease with Cough
    • Foreign Object Aspiration
    • Drug-associated (suspected)
    • Cough > 7days
    • Cool Mist Humidifiers & Vaporizers
    • Lozenges/Hard Candy
    • Hydration
  37. Avoid using COUGH & COLD medications in KIDS under the AGE ____________.
  38. The 3 OPIOID Receptors TYPES?
    • Mu, Kappa, Delta
    • ---GPCRs w/ 7 transmembrane domains
  39. Which RECEPTOR SUBTYPE for Opioids is associated with the MOST effects?
    Mu--Analgesia, Sedation, Respiratory Depression, Decreased GI Motility
  40. What are (8) IMPORTANT Opioid Receptor Agonists?
    • Euphoria--dream-like sense of well-being
    • Sedation & Drowsiness
    • Anti-Anxiety
    • Analgeisa
    • N/V
    • Respiratory Depression
    • Miosis
    • Constipation