Podcast
Questions and Answers
What is the primary function of antitussives in cough management?
What is the primary function of antitussives in cough management?
Which of the following statements correctly describes mucolytics?
Which of the following statements correctly describes mucolytics?
What is the significance of targeted treatment for cough?
What is the significance of targeted treatment for cough?
Which inhalation method is suggested for relieving acute cough?
Which inhalation method is suggested for relieving acute cough?
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What mechanism do peripheral antitussives utilize to reduce coughing?
What mechanism do peripheral antitussives utilize to reduce coughing?
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Which of the following is NOT a type of specific treatment for cough management?
Which of the following is NOT a type of specific treatment for cough management?
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What is the primary purpose of expectorants in cough treatment?
What is the primary purpose of expectorants in cough treatment?
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Which condition primarily requires non-specific treatment such as antitussives?
Which condition primarily requires non-specific treatment such as antitussives?
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What is the primary action of benzonatate in treating cough?
What is the primary action of benzonatate in treating cough?
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Why are opioids like codeine and hydrocodone generally not recommended for cough suppression?
Why are opioids like codeine and hydrocodone generally not recommended for cough suppression?
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What type of medication directly inhibits cough centers in the medulla?
What type of medication directly inhibits cough centers in the medulla?
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What chemical class is benzonatate chemically related to?
What chemical class is benzonatate chemically related to?
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What is the key effect of opioid-derived cough medications when used at low doses?
What is the key effect of opioid-derived cough medications when used at low doses?
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What effect does menthol have on dry, irritated air passages?
What effect does menthol have on dry, irritated air passages?
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What is a characteristic feature of central antitussives?
What is a characteristic feature of central antitussives?
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What is a common adverse effect associated with the use of opioid cough suppressants?
What is a common adverse effect associated with the use of opioid cough suppressants?
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What is a significant characteristic of chronic asthma?
What is a significant characteristic of chronic asthma?
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Which factor is most commonly linked as a predisposing condition for asthma?
Which factor is most commonly linked as a predisposing condition for asthma?
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What kind of physiological change is associated with airway smooth muscle in asthma?
What kind of physiological change is associated with airway smooth muscle in asthma?
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Which psychological aspect is noted to be prevalent among asthmatics?
Which psychological aspect is noted to be prevalent among asthmatics?
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What role does mucus secretion play in asthma pathology?
What role does mucus secretion play in asthma pathology?
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Which statement accurately describes the symptoms associated with chronic asthma?
Which statement accurately describes the symptoms associated with chronic asthma?
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What is the primary action of bromhexine in relation to mucus?
What is the primary action of bromhexine in relation to mucus?
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Which of the following mucolytics stimulates the synthesis and release of surfactant?
Which of the following mucolytics stimulates the synthesis and release of surfactant?
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What unique feature does acetylcysteine possess that aids in reducing mucus viscosity?
What unique feature does acetylcysteine possess that aids in reducing mucus viscosity?
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Which condition is NOT a therapeutic use of mucolytics?
Which condition is NOT a therapeutic use of mucolytics?
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What side effect is commonly associated with the use of potassium iodide as an expectorant?
What side effect is commonly associated with the use of potassium iodide as an expectorant?
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What is the function of expectorants in respiratory therapy?
What is the function of expectorants in respiratory therapy?
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Which drug acts indirectly on mucus rather than directly affecting its structure?
Which drug acts indirectly on mucus rather than directly affecting its structure?
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Which of the following is an antidote for acetaminophen toxicity?
Which of the following is an antidote for acetaminophen toxicity?
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What is a significant risk of long-term use of certain opioids?
What is a significant risk of long-term use of certain opioids?
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Which age group is particularly at risk for respiratory depression from codeine use?
Which age group is particularly at risk for respiratory depression from codeine use?
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What is the primary action of dextromethorphan as an opioid isomer?
What is the primary action of dextromethorphan as an opioid isomer?
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What may occur with high doses of dextromethorphan?
What may occur with high doses of dextromethorphan?
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What do mucolytics specifically do?
What do mucolytics specifically do?
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What is a common adverse effect of opioids mentioned in the content?
What is a common adverse effect of opioids mentioned in the content?
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Which of the following is NOT a characteristic of dextromethorphan?
Which of the following is NOT a characteristic of dextromethorphan?
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Which statement about bromhexine is accurate?
Which statement about bromhexine is accurate?
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Cough receptors are specialized stretch receptors located in the bronchial mucosa.
Cough receptors are specialized stretch receptors located in the bronchial mucosa.
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Chronic cough is typically defined as lasting longer than four weeks.
Chronic cough is typically defined as lasting longer than four weeks.
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Gastroesophageal reflux disease (GERD) is recognized as a common cause of chronic cough.
Gastroesophageal reflux disease (GERD) is recognized as a common cause of chronic cough.
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Post-nasal drip is an uncommon cause of upper airway cough syndrome.
Post-nasal drip is an uncommon cause of upper airway cough syndrome.
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Bronchial asthma is the most common cause of chronic cough, following upper airway cough syndrome.
Bronchial asthma is the most common cause of chronic cough, following upper airway cough syndrome.
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Acute cough is most frequently caused by allergic rhinitis.
Acute cough is most frequently caused by allergic rhinitis.
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The afferent impulses from cough receptors travel to the cough center in the medulla via the sympathetic nerve.
The afferent impulses from cough receptors travel to the cough center in the medulla via the sympathetic nerve.
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Chronic sinusitis is a condition that may not lead to a chronic cough.
Chronic sinusitis is a condition that may not lead to a chronic cough.
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Specific treatment for cough includes using antibiotics for respiratory infections.
Specific treatment for cough includes using antibiotics for respiratory infections.
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Antitussives are primarily used to enhance the frequency of coughing.
Antitussives are primarily used to enhance the frequency of coughing.
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Mucolytics are used in productive coughs to facilitate the removal of bronchial secretions.
Mucolytics are used in productive coughs to facilitate the removal of bronchial secretions.
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Inhaling steam with menthol is considered ineffective for acute cough relief.
Inhaling steam with menthol is considered ineffective for acute cough relief.
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Peripheral antitussives increase afferent impulses of the cough reflex.
Peripheral antitussives increase afferent impulses of the cough reflex.
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Aspirin is an example of a specific treatment method for cough management.
Aspirin is an example of a specific treatment method for cough management.
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Expectorants are utilized to suppress cough frequency during non-productive coughs.
Expectorants are utilized to suppress cough frequency during non-productive coughs.
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Steam inhalation is one of the recommended methods for treating acute cough.
Steam inhalation is one of the recommended methods for treating acute cough.
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Benzonatate is chemically related to the local anesthetic procaine.
Benzonatate is chemically related to the local anesthetic procaine.
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Central antitussives inhibit cough receptors at the lungs.
Central antitussives inhibit cough receptors at the lungs.
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Opioids like codeine and hydrocodone are recommended for cough suppression due to their minimal side effects.
Opioids like codeine and hydrocodone are recommended for cough suppression due to their minimal side effects.
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Menthol helps moisturize dry air passages and flush out mucus.
Menthol helps moisturize dry air passages and flush out mucus.
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The effectiveness of added medication for cough is clinically proven.
The effectiveness of added medication for cough is clinically proven.
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Peripheral antitussives act by depressing cough centers in the medulla.
Peripheral antitussives act by depressing cough centers in the medulla.
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Dextromethorphan, when taken in high doses, could lead to hallucinogenic effects.
Dextromethorphan, when taken in high doses, could lead to hallucinogenic effects.
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Hydrocodone is a synthetic derivative of morphine used to treat cough.
Hydrocodone is a synthetic derivative of morphine used to treat cough.
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Codeine is recommended for children less than 5 years old due to its effectiveness.
Codeine is recommended for children less than 5 years old due to its effectiveness.
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Dextromethorphan has a higher addiction liability compared to other opioids.
Dextromethorphan has a higher addiction liability compared to other opioids.
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Bromhexine primarily increases the amount of respiratory secretions.
Bromhexine primarily increases the amount of respiratory secretions.
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The primary action of dextromethorphan is centrally suppressing coughing.
The primary action of dextromethorphan is centrally suppressing coughing.
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Children are generally less susceptible to the side effects of opioids like codeine.
Children are generally less susceptible to the side effects of opioids like codeine.
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High doses of dextromethorphan can lead to neuropsychiatric effects such as hallucinations.
High doses of dextromethorphan can lead to neuropsychiatric effects such as hallucinations.
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Mucolytics are agents that increase the viscosity of respiratory secretions.
Mucolytics are agents that increase the viscosity of respiratory secretions.
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Respiratory depression is a serious concern when using large doses of opioids.
Respiratory depression is a serious concern when using large doses of opioids.
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Bromhexine is beneficial for patients with peptic ulcers due to its mucolytic properties.
Bromhexine is beneficial for patients with peptic ulcers due to its mucolytic properties.
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Ambroxol enhances the synthesis and release of surfactant, which helps reduce mucus adhesion to the bronchial wall.
Ambroxol enhances the synthesis and release of surfactant, which helps reduce mucus adhesion to the bronchial wall.
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Acetylcysteine acts directly on the structural components of mucus to reduce its viscosity.
Acetylcysteine acts directly on the structural components of mucus to reduce its viscosity.
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Expectorants increase the viscosity of respiratory secretions to facilitate easier removal.
Expectorants increase the viscosity of respiratory secretions to facilitate easier removal.
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Acetylcysteine is used intravenously as an antidote for paracetamol toxicity.
Acetylcysteine is used intravenously as an antidote for paracetamol toxicity.
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Iodides can stimulate production of watery mucous but may also cause side effects like painful salivary swelling.
Iodides can stimulate production of watery mucous but may also cause side effects like painful salivary swelling.
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Carbocysteine provides a more direct action on mucus compared to acetylcysteine.
Carbocysteine provides a more direct action on mucus compared to acetylcysteine.
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Chronic respiratory diseases such as bronchiectasis can benefit from the use of mucolytics.
Chronic respiratory diseases such as bronchiectasis can benefit from the use of mucolytics.
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How does menthol impact the respiratory system?
How does menthol impact the respiratory system?
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Describe the mechanism through which benzonatate operates.
Describe the mechanism through which benzonatate operates.
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What is the relationship between opioids and doses used for cough suppression?
What is the relationship between opioids and doses used for cough suppression?
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What distinguishes central antitussives from peripheral antitussives?
What distinguishes central antitussives from peripheral antitussives?
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Explain why the use of opioids for cough suppression is generally not recommended.
Explain why the use of opioids for cough suppression is generally not recommended.
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Identify the chemical classification of benzonatate.
Identify the chemical classification of benzonatate.
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What local effect does benzonatate have on the cough reflex?
What local effect does benzonatate have on the cough reflex?
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Summarize the role of central antitussives in cough management.
Summarize the role of central antitussives in cough management.
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What are traditional expectorants known to be ineffective for in clinical use?
What are traditional expectorants known to be ineffective for in clinical use?
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How does chronic inflammation contribute to the pathology of asthma?
How does chronic inflammation contribute to the pathology of asthma?
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What common symptoms are associated with asthma episodes?
What common symptoms are associated with asthma episodes?
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What are two inflammatory mediators released during asthma pathology?
What are two inflammatory mediators released during asthma pathology?
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How does acute exposure to allergens influence asthma pathology?
How does acute exposure to allergens influence asthma pathology?
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Why are over-the-counter herbal remedies for cough considered questionable?
Why are over-the-counter herbal remedies for cough considered questionable?
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What role do cytokines play in the context of asthma?
What role do cytokines play in the context of asthma?
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What is a key characteristic of bronchial asthma as a disease?
What is a key characteristic of bronchial asthma as a disease?
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What are the key symptoms of chronic asthma that would indicate a patient's condition?
What are the key symptoms of chronic asthma that would indicate a patient's condition?
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How do genetic factors contribute to the development of asthma in individuals?
How do genetic factors contribute to the development of asthma in individuals?
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In the context of asthma, what percentage of patients may have psychological factors affecting their condition?
In the context of asthma, what percentage of patients may have psychological factors affecting their condition?
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What are the effects of increased mucus secretion in asthmatic patients?
What are the effects of increased mucus secretion in asthmatic patients?
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What is the most significant predisposing factor linked to recurrent respiratory infections and asthma?
What is the most significant predisposing factor linked to recurrent respiratory infections and asthma?
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What distinguishes chronic asthma from acute asthma episodes in terms of clinical presentation?
What distinguishes chronic asthma from acute asthma episodes in terms of clinical presentation?
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What specific mechanism does N-acetylcysteine use to reduce mucus viscosity?
What specific mechanism does N-acetylcysteine use to reduce mucus viscosity?
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How does ambroxol aid in respiratory health beyond its mucolytic properties?
How does ambroxol aid in respiratory health beyond its mucolytic properties?
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What is a significant contraindication for the use of bromhexine?
What is a significant contraindication for the use of bromhexine?
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In what way does carbocysteine differ from acetylcysteine in its action on mucus?
In what way does carbocysteine differ from acetylcysteine in its action on mucus?
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List two therapeutic uses of mucolytics as mentioned.
List two therapeutic uses of mucolytics as mentioned.
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What side effects are commonly associated with potassium iodide as an expectorant?
What side effects are commonly associated with potassium iodide as an expectorant?
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What is the primary role of expectorants in respiratory therapy?
What is the primary role of expectorants in respiratory therapy?
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What is the unique role of intravenous N-acetylcysteine aside from its mucolytic activity?
What is the unique role of intravenous N-acetylcysteine aside from its mucolytic activity?
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What are the main adverse effects associated with the long-term use of opioids like codeine?
What are the main adverse effects associated with the long-term use of opioids like codeine?
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Why is dextromethorphan considered an effective antitussive compared to traditional opioids?
Why is dextromethorphan considered an effective antitussive compared to traditional opioids?
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How does bromhexine impact respiratory mucus?
How does bromhexine impact respiratory mucus?
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What unique characteristic of children under 5 years old affects their use of codeine?
What unique characteristic of children under 5 years old affects their use of codeine?
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What neurological effects can result from high doses of dextromethorphan?
What neurological effects can result from high doses of dextromethorphan?
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Define mucolytics and their primary function in managing respiratory secretions.
Define mucolytics and their primary function in managing respiratory secretions.
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What is the impact of respiratory depression in patients using opioids, especially at high doses?
What is the impact of respiratory depression in patients using opioids, especially at high doses?
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In what way does the structure of dextromethorphan differentiate it from traditional opioids?
In what way does the structure of dextromethorphan differentiate it from traditional opioids?
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Specific treatment for cough is directed to the ______ of cough.
Specific treatment for cough is directed to the ______ of cough.
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Antitussives are used to stop ______ cough.
Antitussives are used to stop ______ cough.
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Mucolytics and expectorants are used in ______ cough to liquefy bronchial secretions.
Mucolytics and expectorants are used in ______ cough to liquefy bronchial secretions.
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Antitussives reduce the frequency or ______ of coughing.
Antitussives reduce the frequency or ______ of coughing.
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Steam inhalation with menthol is one of the best ways to relieve ______ cough.
Steam inhalation with menthol is one of the best ways to relieve ______ cough.
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Peripheral antitussives decrease afferent impulses of the ______ reflex.
Peripheral antitussives decrease afferent impulses of the ______ reflex.
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Inhaling ______ steam can be an effective way to relieve acute cough.
Inhaling ______ steam can be an effective way to relieve acute cough.
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Non-specific treatments include antitussives, mucolytics, and ______.
Non-specific treatments include antitussives, mucolytics, and ______.
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Adverse effects of opioids may include drowsiness and ______.
Adverse effects of opioids may include drowsiness and ______.
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Codeine is not recommended for children less than ______ years old.
Codeine is not recommended for children less than ______ years old.
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Dextromethorphan is a synthetic ______ of opioids.
Dextromethorphan is a synthetic ______ of opioids.
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High doses of dextromethorphan can cause ______ effects, such as sedation.
High doses of dextromethorphan can cause ______ effects, such as sedation.
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Mucolytics reduce the viscosity of respiratory secretions without increasing their ______.
Mucolytics reduce the viscosity of respiratory secretions without increasing their ______.
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Bromhexine acts on the mucus at the ______ stages within the mucus-secreting cells.
Bromhexine acts on the mucus at the ______ stages within the mucus-secreting cells.
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Children are more sensitive to respiratory ______ when using opioids.
Children are more sensitive to respiratory ______ when using opioids.
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Dextromethorphan has very few opioid effects, such as less addiction liability and analgesic ______.
Dextromethorphan has very few opioid effects, such as less addiction liability and analgesic ______.
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Benzonatate is chemically related to the local anesthetic ______.
Benzonatate is chemically related to the local anesthetic ______.
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Central antitussives inhibit cough centers in the ______.
Central antitussives inhibit cough centers in the ______.
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The efficacy of added medication is ______.
The efficacy of added medication is ______.
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Opioids like codeine and hydrocodone directly inhibit the cough center in the ______.
Opioids like codeine and hydrocodone directly inhibit the cough center in the ______.
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Menthol helps flush out mucus and moisturizes dry, irritated air ______.
Menthol helps flush out mucus and moisturizes dry, irritated air ______.
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Benzonatate depresses peripheral cough receptors at the ______.
Benzonatate depresses peripheral cough receptors at the ______.
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They are generally not recommended because of ______ effects.
They are generally not recommended because of ______ effects.
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Codeine and hydrocodone are natural derivatives of ______.
Codeine and hydrocodone are natural derivatives of ______.
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Chronic asthma is characterized by dyspnea, chest tightness, coughing, and expiratory ______.
Chronic asthma is characterized by dyspnea, chest tightness, coughing, and expiratory ______.
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A significant predisposing factor for asthma is a positive family history of ______.
A significant predisposing factor for asthma is a positive family history of ______.
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Increased mucus secretion in asthma is difficult to ______.
Increased mucus secretion in asthma is difficult to ______.
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Psychological factors are present in ______% of asthmatics.
Psychological factors are present in ______% of asthmatics.
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Chronic asthma symptoms may occur particularly at ______.
Chronic asthma symptoms may occur particularly at ______.
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Recurrent respiratory infections are considered the most important ______ for asthma.
Recurrent respiratory infections are considered the most important ______ for asthma.
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Bromhexine should be avoided in patients with ______.
Bromhexine should be avoided in patients with ______.
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Ambroxol stimulates synthesis and release of ______ by type II pneumocytes.
Ambroxol stimulates synthesis and release of ______ by type II pneumocytes.
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Acetylcysteine reduces mucus viscosity by breaking ______ bonds.
Acetylcysteine reduces mucus viscosity by breaking ______ bonds.
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Intravenous N-acetylcysteine is used as an antidote for ______ toxicity.
Intravenous N-acetylcysteine is used as an antidote for ______ toxicity.
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Potassium iodide accumulates in the bronchial glands and stimulates secretion of low viscosity ______.
Potassium iodide accumulates in the bronchial glands and stimulates secretion of low viscosity ______.
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Guaifenesin is one of the most widely used over-the-counter (______) expectorants.
Guaifenesin is one of the most widely used over-the-counter (______) expectorants.
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Mucolytics are specifically used to facilitate the removal of ______ secretions.
Mucolytics are specifically used to facilitate the removal of ______ secretions.
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Carbocysteine affects the structural components of ______ instead of acting directly on it.
Carbocysteine affects the structural components of ______ instead of acting directly on it.
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Match the following terms related to asthma with their descriptions:
Match the following terms related to asthma with their descriptions:
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Match the following types of expectorants with their key features:
Match the following types of expectorants with their key features:
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Match the following terms related to inflammatory cells with their actions:
Match the following terms related to inflammatory cells with their actions:
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Match the cough treatment type with its primary function:
Match the cough treatment type with its primary function:
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Match the following mechanisms with their associated effects in asthma:
Match the following mechanisms with their associated effects in asthma:
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Match the cough medication with its specific application:
Match the cough medication with its specific application:
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Match the following characteristics with their corresponding elements in asthma management:
Match the following characteristics with their corresponding elements in asthma management:
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Match the cough characteristics with their definitions:
Match the cough characteristics with their definitions:
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Match the following aspects of bronchial fluid to their descriptions:
Match the following aspects of bronchial fluid to their descriptions:
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Match these bronchial asthma features with their outcomes:
Match these bronchial asthma features with their outcomes:
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Match the cough treatment category with its example:
Match the cough treatment category with its example:
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Match the type of cough treatment with its mechanism:
Match the type of cough treatment with its mechanism:
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Match the following terms with their corresponding functions related to bronchial asthma:
Match the following terms with their corresponding functions related to bronchial asthma:
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Match the drug to its primary effect on cough:
Match the drug to its primary effect on cough:
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Match the characteristic of cough treatments with their implications:
Match the characteristic of cough treatments with their implications:
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Match the type of cough with its potential causes:
Match the type of cough with its potential causes:
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Match the following cough medications with their mechanism of action:
Match the following cough medications with their mechanism of action:
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Match the following statements with the corresponding medications:
Match the following statements with the corresponding medications:
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Match the following terms associated with cough treatment with their definitions:
Match the following terms associated with cough treatment with their definitions:
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Match the following adverse effects with the corresponding cough medications:
Match the following adverse effects with the corresponding cough medications:
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Match the following medications with their indications:
Match the following medications with their indications:
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Match the following qualities with the corresponding cough medications:
Match the following qualities with the corresponding cough medications:
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Match the following characteristics to the respective cough treatment categories:
Match the following characteristics to the respective cough treatment categories:
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Match the following chemical affiliations with the corresponding medications:
Match the following chemical affiliations with the corresponding medications:
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Match the type of cough with its description:
Match the type of cough with its description:
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Match the condition with its related cause:
Match the condition with its related cause:
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Match the mechanism with its relevant component:
Match the mechanism with its relevant component:
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Match the type of reflex with its characteristic:
Match the type of reflex with its characteristic:
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Match the substance with its effect on cough:
Match the substance with its effect on cough:
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Match the chronic cough cause with its other name:
Match the chronic cough cause with its other name:
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Match the duration with cough classification:
Match the duration with cough classification:
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Match the medical condition with its typical demographic:
Match the medical condition with its typical demographic:
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Match the following factors with their descriptions related to asthma:
Match the following factors with their descriptions related to asthma:
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Match the following respiratory pathology effects with their outcomes:
Match the following respiratory pathology effects with their outcomes:
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Match the following symptoms of chronic asthma with their characteristics:
Match the following symptoms of chronic asthma with their characteristics:
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Match the following terms with their related definitions in the context of asthma:
Match the following terms with their related definitions in the context of asthma:
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Match the following characteristics with the type of asthma symptom they describe:
Match the following characteristics with the type of asthma symptom they describe:
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Match the following predisposing factors with their implications for asthma development:
Match the following predisposing factors with their implications for asthma development:
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Study Notes
Treatment of Cough
- Specific treatment targets underlying causes, such as antibiotics for respiratory infections.
- Non-specific treatments include:
- Antitussives: used to suppress dry cough.
- Mucolytics and expectorants: used for productive cough to liquefy and facilitate removal of bronchial secretions.
Cough Suppressants (Antitussives)
- Definition: Drugs that reduce frequency or intensity of coughing.
- Peripheral antitussives decrease afferent impulses of the cough reflex.
- Steam inhalation (with or without menthol) is effective for relieving acute cough; it moistens dry air passages.
- Benzonatate acts as a peripheral cough suppressant by numbing lung receptors.
- Central antitussives inhibit the cough center in the medulla, including opioids like codeine and hydrocodone.
- Opioids suppress cough at lower doses than those needed for pain relief but pose risks like drowsiness, constipation, and respiratory depression, especially in young children.
- Dextromethorphan is a synthetic opioid isomer with limited opioid effects but can cause sedation and hallucinations in high doses.
Mucolytics
- Definition: Agents that reduce viscosity of respiratory secretions without increasing their volume.
- Bromhexine: disrupts acid mucopolysaccharide fibers, producing less viscous mucus; should be avoided in peptic ulcer patients.
- Ambroxol: stimulates surfactant synthesis, reducing mucus adhesion to the bronchial wall.
- N-Acetylcysteine: breaks disulfide bonds in mucus, reducing viscosity, and is an antidote for acetaminophen toxicity.
- Carbocysteine: affects structural components of mucus without directly acting on it.
Expectorants
- Definition: Drugs that increase water content and volume of respiratory secretions to facilitate removal.
- Adequate hydration is crucial for effective expectoration; expectorants complement hydration efforts.
- Potassium iodide stimulates secretion of low viscosity mucus but has numerous side effects, such as metallic taste and skin reactions.
- Guaifenesin is widely used; it promotes mucus secretion but can lead to airway smooth muscle hypertrophy and congestion.
Predisposing Factors for Respiratory Issues
- Recurrent respiratory infections are major predisposing factors.
- Genetic predispositions, including family history of asthma, can increase risk.
- Psychological factors may be present in about 40% of asthmatics.
Clinical Presentation of Chronic Asthma
- Symptoms include dyspnea, chest tightness, coughing (especially at night), and expiratory wheezing.
Cough Overview
- Coughing is a prevalent symptom in clinical practice, triggered by irritation in the bronchial mucosa.
- Specialized stretch receptors called "Cough" receptors initiate the cough reflex when stimulated, sending impulses to the cough center in the medulla via the vagus nerve.
- Cough can be acute (lasting up to eight weeks) or chronic, with various underlying causes.
Causes of Cough
- Acute Cough: Most commonly caused by respiratory infections.
-
Chronic Cough:
- Upper airway cough syndrome (post-nasal drip) is primarily due to allergic rhinitis, chronic sinusitis, or tonsillitis and is the leading cause of chronic cough.
- Bronchial asthma is the second most common cause.
- Gastroesophageal reflux disease (GERD) and other causes include ACE inhibitors, lung tumors, and congestive heart failure (CHF).
Management of Cough
- Treatment is specific to the underlying cause, such as using antibiotics for respiratory infections.
- Non-specific treatments include:
- Antitussives: Medications to suppress dry cough.
- Mucolytics and Expectorants: Help in productive cough by liquefying bronchial secretions for easier removal.
Antitussives
- Definition: Drugs that reduce the frequency and intensity of coughing.
- Peripheral Antitussives: Reduce afferent impulses to the cough reflex; steam inhalation with menthol or benzoin can relieve acute cough.
- Benzonatate: A local anesthetic that depresses peripheral cough receptors.
-
Central Antitussives: Inhibit the cough center in the medulla; opioids like codeine and hydrocodone directly inhibit coughing but have significant side effects.
- Common side effects include drowsiness, constipation, and potential respiratory depression, particularly dangerous for children under five.
Mucolytics
- Definition: Agents that reduce the viscosity of respiratory secretions without increasing their volume.
- Bromhexine: Disrupts mucopolysaccharide fibers in mucus, making it less viscous and easier to expel; avoid in patients with peptic ulcers.
- Ambroxol: Stimulates surfactant production, decreasing mucus adhesion in the bronchial walls.
-
N-Acetylcysteine and Carbocysteine:
- N-Acetylcysteine breaks disulfide bonds in mucus, reducing viscosity.
- Carbocysteine influences mucus's structural components but does not act directly on the mucus.
Therapeutic Uses of Mucolytics
- Effective for chronic respiratory diseases, postoperative pulmonary complications, chronic sinusitis, and chronic otitis media.
- N-acetylcysteine is utilized as an antidote for acetaminophen toxicity aside from its mucolytic function.
Expectorants
- Definition: Drugs that increase the water content and volume of respiratory secretions, aiding in their removal.
-
Key Points:
- Adequate hydration is essential for effective expectoration.
- Potassium Iodide: Stimulates secretion of watery mucus but can cause side effects like metallic taste and salivary gland swelling.
- Guaifenesin: A widely used over-the-counter expectorant that aids in loosening mucus.
Cough Suppressants
- Menthol aids in flushing out mucus and moisturizes dry, irritated air passages.
- Benzonatate, a glycerol derivative, acts as a local anesthetic by depressing peripheral cough receptors in the lungs.
- Central antitussives inhibit the cough center in the medulla.
- Opioids, like codeine and hydrocodone, are natural derivatives that inhibit the cough center at low doses but have adverse effects including drowsiness, constipation, and potential respiratory depression, particularly in children under 5.
- Dextromethorphan is a synthetic opioid isomer with selective central antitussive action and fewer opioid effects, though high doses may lead to neuropsychiatric issues.
Mucolytics
- Agents that reduce the viscosity of respiratory secretions without increasing their quantity.
- Bromhexine disrupts mucous structure, making it less viscous and easier to expel; should be avoided in patients with peptic ulcers due to gastric mucosal barrier disruption.
- Ambroxol stimulates surfactant synthesis, reducing mucus adhesion to bronchial walls.
- N-acetylcysteine breaks disulfide bonds in mucus, while carbocysteine modifies mucus structure without acting directly on it.
- Mucolytics are used in chronic respiratory diseases and can serve as an antidote for acetaminophen toxicity.
Expectorants
- Drugs that increase water content in respiratory secretions to facilitate their removal.
- Adequate hydration is crucial for expectoration effectiveness.
- Potassium iodide stimulates the secretion of low viscosity mucus but has side effects like a metallic taste and salivary gland issues.
- Guaifenesin is a popular OTC expectorant, increasing bronchial fluid secretion.
- Traditional expectorants may lack efficacy, particularly in OTC cough mixtures.
Asthma Therapy
- Asthma is a chronic inflammatory disorder leading to airflow obstruction and recurrent respiratory symptoms.
- Frequent exposure to allergens causes inflammatory cell infiltration in bronchial walls, releasing cytokines like histamine and leukotrienes.
- Effects include airway smooth muscle hypertrophy, increased mucus production, and mucosal congestion.
- Predisposing factors include recurrent respiratory infections, genetic history of allergies, and psychological factors present in a significant portion of asthmatics.
- Clinical presentation includes dyspnea, chest tightness, nighttime coughing, and wheezing.
Treatment of Cough
- Specific treatment targets underlying causes, such as antibiotics for respiratory infections.
- Non-specific treatments include:
- Antitussives: used to suppress dry cough.
- Mucolytics and expectorants: used for productive cough to liquefy and facilitate removal of bronchial secretions.
Cough Suppressants (Antitussives)
- Definition: Drugs that reduce frequency or intensity of coughing.
- Peripheral antitussives decrease afferent impulses of the cough reflex.
- Steam inhalation (with or without menthol) is effective for relieving acute cough; it moistens dry air passages.
- Benzonatate acts as a peripheral cough suppressant by numbing lung receptors.
- Central antitussives inhibit the cough center in the medulla, including opioids like codeine and hydrocodone.
- Opioids suppress cough at lower doses than those needed for pain relief but pose risks like drowsiness, constipation, and respiratory depression, especially in young children.
- Dextromethorphan is a synthetic opioid isomer with limited opioid effects but can cause sedation and hallucinations in high doses.
Mucolytics
- Definition: Agents that reduce viscosity of respiratory secretions without increasing their volume.
- Bromhexine: disrupts acid mucopolysaccharide fibers, producing less viscous mucus; should be avoided in peptic ulcer patients.
- Ambroxol: stimulates surfactant synthesis, reducing mucus adhesion to the bronchial wall.
- N-Acetylcysteine: breaks disulfide bonds in mucus, reducing viscosity, and is an antidote for acetaminophen toxicity.
- Carbocysteine: affects structural components of mucus without directly acting on it.
Expectorants
- Definition: Drugs that increase water content and volume of respiratory secretions to facilitate removal.
- Adequate hydration is crucial for effective expectoration; expectorants complement hydration efforts.
- Potassium iodide stimulates secretion of low viscosity mucus but has numerous side effects, such as metallic taste and skin reactions.
- Guaifenesin is widely used; it promotes mucus secretion but can lead to airway smooth muscle hypertrophy and congestion.
Predisposing Factors for Respiratory Issues
- Recurrent respiratory infections are major predisposing factors.
- Genetic predispositions, including family history of asthma, can increase risk.
- Psychological factors may be present in about 40% of asthmatics.
Clinical Presentation of Chronic Asthma
- Symptoms include dyspnea, chest tightness, coughing (especially at night), and expiratory wheezing.
Cough Overview
- Cough is a common clinical symptom originating in the bronchial mucosa due to irritation.
- Specialized stretch receptors, known as "cough" receptors, stimulate a reflex response through afferent impulses via the vagus nerve to the cough center in the medulla.
- Coughs can be classified as acute (lasting up to 8 weeks) or chronic.
Causes of Cough
- Acute Cough: Most commonly caused by respiratory infections.
-
Chronic Cough:
- Upper airway cough syndrome (post-nasal drip) due to allergic rhinitis, chronic sinusitis, or tonsillitis is the most frequent cause.
- Bronchial asthma is the second most common cause.
- Gastroesophageal reflux disease (GERD) and other causes include ACE inhibitors, lung tumors, and congestive heart failure (CHF).
Management of Cough
- Specific treatment targets the underlying cause, e.g., antibiotics for respiratory infections.
- Non-specific treatments:
- Antitussives: Used to suppress dry cough.
- Mucolytics and Expectorants: Help liquefy bronchial secretions for productive cough.
Cough Suppressants (Antitussives)
- Definition: Drugs that decrease the frequency or intensity of coughing.
-
Peripheral Antitussives: Decrease afferent impulses of the cough reflex.
- Steam inhalation with menthol or tincture benzoin compound is effective for acute cough relief, loosening mucus and hydrating air passages.
- Benzonatate: A glycerol derivative, acts locally to suppress cough receptors in the lung.
-
Central Antitussives: Inhibit the cough center in the medulla.
- Opioids (codeine and hydrocodone) are effective at low doses but have adverse effects; they inhibit the cough center directly.
Expectants
- Traditional expectorants (e.g., ammonium chloride, tincture of ipecacuanha, herbal remedies) are included in various OTC cough mixtures, though their efficacy, particularly at typical dosages, is often questioned.
Bronchial Asthma Overview
- Asthma is a chronic inflammatory disorder of the airways, leading to airflow obstruction and recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.
Pathogenesis of Asthma
- Repeated exposure to allergens causes infiltration of inflammatory cells in the bronchial wall, releasing cytokines (e.g., histamine, adenosine).
- Results in airway smooth muscle hypertrophy, increased mucus production that is hard to expel, and congestion/edema of respiratory mucosa.
Predisposing Factors
- Recurrant Respiratory Infections: Key contributing factor to asthma development.
- Genetic Factors: Families with a history of allergies show higher asthma prevalence.
- Psychological Factors: Present in around 40% of asthmatic individuals.
Clinical Presentation of Chronic Asthma
- Symptoms include dyspnea (difficulty breathing), chest tightness, persistent cough (especially at night), and expiratory wheezing.
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This quiz focuses on the management of cough, including specific treatments directed at the underlying causes like respiratory infections. Non-specific treatments such as antitussives will also be covered. Test your knowledge on effective cough management strategies.