30 Questions
What is the most common cause of subacute cough?
Bacterial sinusitis
Which type of cough is associated with atypical bacterial infections?
Unproductive cough
What is a potential cause of green sputum in coughing individuals?
Eosinophils
Which condition is associated with chronic cough accompanied by haemoptysis, chronic fever, and night sweats?
COPD
What is a common cause of unproductive cough?
Infection
In which condition might questioning reveal a history of antibiotic treatment for COPD?
Common cold
What is the main purpose of coughing?
To clear the airway from irritants
How long can a cough often persist after a bad cold?
3 weeks or more
Why is establishing the age of a patient important in dealing with cough cases?
To decide on the necessity of referral and treatment
When should a pharmacist consider referral to a doctor for a persistent cough?
If the cough has lasted for 2-3 weeks with no improvement
What is the usual etiology of most coughs seen in pharmacies?
Viral respiratory tract infections
What symptom would indicate an urgent need for referral for a persistent cough?
Tiredness, malaise, or fever
What is a possible cause of coughing that is common among patients with a family history of eczema, hay fever, and asthma?
Gastro-oesophageal Reflux
Why might a recurrent night-time cough be concerning in children?
It could be a symptom of asthma
What is a common symptom associated with heart failure according to the text?
Chronic cough
Why should patients with a persistent cough consider quitting smoking?
To benefit their lung health
When is it advisable to recommend health education advice about stopping smoking to patients?
When they experience persistent coughing
What might be suggested when patients have a persisting cough with talking and bending symptoms?
Heart disease referral
What may happen to a smoker's cough when they stop smoking?
It may initially worsen as the cilia cleaning action is re-established.
Why is it important for healthcare providers to mention the seriousness of smoking to individuals with a cough?
Smoking is a significant cause of COPD and lung cancer.
Why is it crucial to know about the medications taken for a cough, including those bought over the counter or borrowed from others?
To avoid potential interactions with other medications.
What type of cough may occur in patients taking Angiotensin-Converting Enzyme (ACE) Inhibitors?
Irritating, non-productive, and persistent cough.
In what situations might a pharmacist think an inappropriate cough preparation was taken?
Taking a cough suppressant for a productive cough.
Why might ACE inhibitor therapy need to be discontinued in some patients with a troublesome cough?
Due to persistent and distressing coughing.
What is the general advice to patients with coughs and colds regarding fluid intake?
To maintain or increase fluid intake
Which type of cough preparations are used to treat unproductive coughs?
Expectorants
Why might cough suppressants be useful in some cases?
To relieve dry and irritating coughs
What is the primary advantage of preparations like simple linctus for treating coughs?
They are harmless and inexpensive
What is the logic behind not using expectorants and suppressants together in cough treatment?
They cancel out each other's effects
Which antitussive drug is indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation?
Codeine
Study Notes
Cough Overview
- Coughing is a protective reflex action to clear the airway and allow normal breathing.
- Most coughs are caused by viral respiratory tract infections and are often associated with cold symptoms.
Significance of Questions and Answers
- Age: Influences the pharmacist's decision about referral to a doctor and choice of treatment.
- Duration: Most coughs are self-limiting and will resolve with or without treatment; coughs lasting over 2-3 weeks with no improvement or worsening symptoms should be referred to a GP.
- Duration and Etiology: Coughs can be classified as acute, subacute, or chronic, and may be caused by asthma, cardiovascular disease, or gastro-oesophageal reflux.
Cough Classification
- Acute: Lasts less than 3 weeks, commonly caused by viral URTI or common cold.
- Subacute: Lasts 3-8 weeks, commonly caused by bacterial sinusitis or asthma.
- Chronic: Lasts over 8 weeks, commonly caused by UACS, COPD, or GERD.
Nature of Cough
- Unproductive (dry, tickly, or tight): No sputum is produced; usually caused by viral infection or GERD.
- Productive (chesty or loose): Sputum is produced; may be caused by infection, allergy, or smoking.
Previous History
- Smoking: Exacerbates coughs and can cause coughing; smoking cessation advice should be given.
- COPD: Questioning may reveal a history of COPD, which is being treated with antibiotics.
Cough Management
- Fluid Intake: Maintaining a good fluid intake helps hydrate the lungs, and hot drinks can have a soothing effect.
- Demulcent Cough Preparations: Contain soothing substances like syrup or glycerol; used to treat unproductive coughs.
- Expectorants: Claimed to promote coughing and expulsion of bronchial secretions; used to treat productive coughs.
- Suppressants: Used to treat unproductive coughs; may cause sputum retention and be harmful in patients with chronic bronchitis.
Systemic Antitussives
- Codeine: Indicated for suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation.
- Dextromethorphan: Approved by the FDA for nonprescription use.
- Diphenhydramine: Approved by the FDA for nonprescription use.
Present Medications
- Includes prescribed medications, OTC drugs, borrowed medications, and herbal remedies.
- Important to consider interactions with cough medicine and which cough medicines have been tried already.
Test your knowledge on non-prescription drugs and parapharmaceuticals used for treating cough. Learn about the causes of coughing and how it is a protective reflex action to clear the airway when irritated or obstructed.
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