Pharmaco exam 1 - cold drugs

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leamusic
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261738
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Pharmaco exam 1 - cold drugs
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2014-02-13 01:13:34
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Pharmaco exam cold drugs
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Pharmaco exam 1 - cold drugs
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Pharmaco exam 1 - cold drugs
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  1. Topicals
    • gargle warm salt water
    • topical anesthetics: sprays, lozenges, oral disintegrating strips (just numb for a bit!) - benzocaine, dyclonine Hcl
    • use q 2-4 hours 
    • volatile oils: vicks vapo rub
  2. throat lozenges
    • coat throat with a soothing barrier to prevent cough receptor irritation 
    • go for sugar-free
    • only work while in mouth
    • ZINC lozenges & vitamin C may decrease cold severity 
    • intranasal zinc = BAD!!!! (stick with lozenge!!!!)
  3. adrenergic agonists
    • aka: sympathomimetics 
    • stimulate alpha-receptors: constrict blood vessels (so you can breathe easier), decrease sinusoid vessel engorgement, decrease mucosal edema 
    • direct & indirect
    • **watch for pts with high bp & heart issues
  4. Decongestants
    • temporary relief of nasal and Eustachian tube congestion, and cough associated with post-nasal drip 
    • ORAL: pseudoephedrine (Sudafed), phenylephrine (Sudafed PE) --> can't be converted, short acting, less effective 
    • Make sure you're not doubling up on stimulants
  5. Pseudoephedrine Access
    • Behind the pharmacy counter
    • Qty: 3.6 gm/day (120 tabs) & 9 gm/30 days (300 tabs)
    • Nexafed - new pseudophed product
  6. Topical Decongestants: Nasal
    • *alternative to pseudophedrine
    • Short acting (4-6 hrs): neo-synephrine, privine, vicks inhaler, Benzedrex inhaler, dristan decongestant)
    • Intermediate acting (8-10 hrs): Otrivin  
    • Long acting (12 hrs): Afrin, Duration, Neo-Synephrine 12 hr)
    • Other choices: nasal steroids, saline NS
  7. rebound congestion
    • take topical nasal decongestant no longer than 3-5 days! 
    • have the WORST clogged nose ever
    • people get hooked on this medication 
    • more common w/ short acting
  8. antihistamines
    • *Inhibit mechanically triggered cough 
    • --> FIRST generation ONLY 
    • (NOT Allegra, Zyrtec, or Claritin)
    • *Reduce secretions & post-nasal-drip associated with URI 
    • *LOTS of side-effects (sedation, drying...) 
    • Combo (decongestant/antihistamine) have positive results!!
  9. Diphenhydramine (antihistamine)
    • Only antihistamine that is also an FDA approved anti-tussive 
    • *workes centrally on medulla to increase cough threshold
    • suppression of non-productive cough caused by chemical/mechanical respiratory tract irritation 
  10. Histamines - generation difference
    • 1st gen side effects = drying (reduces rhinorrhea) 
    • 2nd gen have NO effects on symptoms 
    • **ACCP recommends combo of 1st generation H1 WITH decongestant for cough associated with the common cold
  11. OVERALL RECOMMENDATION FOR CONGESTION?
    pseudophedrine + antihistamine 

    or just a decongestant (pseudophedrine)
  12. OVERALL FOR A COUGH?
    • same as congestions + naproxen (NSAID)
    • pseudophedrine + antihistamine + naproxen
  13. Cough - exclusion from self-care
    • could worsened during self-care/new symptoms
    • fever > 101.5F
    • thick yellow/green phlegm 
    • duration >7 days
    • weight loss, night sweats, hemoptysis 
    • ACE inhibitor: BP med has a side effect of a cough that will never go away! 
  14. Cough Assessment
    • - Productive (wet) vsnon-productive (dry)
    • - Effective vs in-effective (cannot expel secretions)
    • - “Pro-Tussive” = Expectorant, thins things out
    • - "Anti-Tussive” = Cough Suppressant, stops tickle in throat
  15. Robitussin DM

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