Podcast
Questions and Answers
What is the primary function of the cough reflex?
What is the primary function of the cough reflex?
- To clear the airways of mucus and irritants (correct)
- To stimulate the diaphragm
- To produce mucus
- To aid in swallowing
Where are the afferent cough receptors located?
Where are the afferent cough receptors located?
- In the upper and lower respiratory tract, pericardium, esophagus, diaphragm, and stomach (correct)
- In the brain and lungs
- Only in the lower respiratory tract
- Only in the upper respiratory tract
What is the most common cause of coughs presenting in a pharmacy?
What is the most common cause of coughs presenting in a pharmacy?
- Bacterial infection
- Viral upper respiratory tract infection (correct)
- Allergies
- Throat irritants
How is a cough classified as chronic?
How is a cough classified as chronic?
What is a characteristic of a productive cough?
What is a characteristic of a productive cough?
What is the typical appearance of secretions in a viral infection such as a cold or flu virus?
What is the typical appearance of secretions in a viral infection such as a cold or flu virus?
What is the primary goal of self-treatment of cough?
What is the primary goal of self-treatment of cough?
What type of cough is caused by upper respiratory tract infections such as influenza and common cold?
What type of cough is caused by upper respiratory tract infections such as influenza and common cold?
What is a common cause of postnasal drip?
What is a common cause of postnasal drip?
Which medication is likely to cause cough in patients with asthma or COPD?
Which medication is likely to cause cough in patients with asthma or COPD?
What is the secondary goal of self-treatment of cough?
What is the secondary goal of self-treatment of cough?
What is a common cause of chronic cough?
What is a common cause of chronic cough?
How can cough caused by allergens be treated?
How can cough caused by allergens be treated?
What is the underlying principle of cough treatment?
What is the underlying principle of cough treatment?
What is the mechanism of action of dextromethorphan at high doses?
What is the mechanism of action of dextromethorphan at high doses?
Which of the following medications should not be taken with dextromethorphan?
Which of the following medications should not be taken with dextromethorphan?
What is the primary mechanism of action of first-generation antihistamines in relieving cough?
What is the primary mechanism of action of first-generation antihistamines in relieving cough?
What is the mechanism of action of topical antitussives such as camphor and menthol?
What is the mechanism of action of topical antitussives such as camphor and menthol?
What is the primary mechanism of action of mucolytics such as N-Acetyl Cysteine?
What is the primary mechanism of action of mucolytics such as N-Acetyl Cysteine?
What is the mechanism of action of mucoregulators such as glucocorticoids?
What is the mechanism of action of mucoregulators such as glucocorticoids?
What is the primary mechanism of action of expectorants such as guaifenesin?
What is the primary mechanism of action of expectorants such as guaifenesin?
What is an additional use of N-Acetyl Cysteine?
What is an additional use of N-Acetyl Cysteine?
What is the primary use of bromhexine in patients with abnormal mucus secretions?
What is the primary use of bromhexine in patients with abnormal mucus secretions?
What is a precaution to be taken when using bromhexine in certain patients?
What is a precaution to be taken when using bromhexine in certain patients?
What is ambroxol, and what effects does it have?
What is ambroxol, and what effects does it have?
What is a contraindication for the use of ambroxol?
What is a contraindication for the use of ambroxol?
What is the primary mechanism of action of guaifenesin?
What is the primary mechanism of action of guaifenesin?
What is not an indication for the use of guaifenesin?
What is not an indication for the use of guaifenesin?
What is the primary use of sympathomimetic decongestants like ephedrine and pseudoephedrine?
What is the primary use of sympathomimetic decongestants like ephedrine and pseudoephedrine?
What is a potential side effect of sympathomimetic decongestants?
What is a potential side effect of sympathomimetic decongestants?
What is the effect of oxymetazoline and xylometazoline when applied to mucous membranes?
What is the effect of oxymetazoline and xylometazoline when applied to mucous membranes?
How long does the effect of oxymetazoline and xylometazoline last?
How long does the effect of oxymetazoline and xylometazoline last?
What is the recommended frequency of dosing for oxymetazoline and xylometazoline?
What is the recommended frequency of dosing for oxymetazoline and xylometazoline?
What is a potential complication of using oxymetazoline and xylometazoline for longer than 5 days?
What is a potential complication of using oxymetazoline and xylometazoline for longer than 5 days?
Which of the following medications should not be used in patients with hypertension?
Which of the following medications should not be used in patients with hypertension?
What is a contraindication for using Nocuf Syrup?
What is a contraindication for using Nocuf Syrup?
Why should liquorice-containing cough medication not be used in high doses for patients with hypertension?
Why should liquorice-containing cough medication not be used in high doses for patients with hypertension?
Which of the following is a reason to refer patients to their primary care provider?
Which of the following is a reason to refer patients to their primary care provider?
Study Notes
Cough Reflex and Classification
- Cough is a defensive respiratory reflex action to clear airways of mucus and irritants.
- Cough reflex is stimulated from afferent cough receptors located in the upper and lower respiratory tract, pericardium, esophagus, diaphragm, and stomach.
- The majority of coughs presenting in the pharmacy are caused by a viral upper respiratory tract infection, making most coughs self-limiting.
- Classification of cough based on duration:
- Acute: < 3 weeks
- Subacute: 3-8 weeks
- Chronic: > 8 weeks
- Classification of cough based on character:
- Productive (wet): expels secretions from the lower respiratory tract
- Non-productive (dry): a cough where no mucus is produced, often associated with viral infections, allergies, or throat irritants
Causes of Cough
- Upper respiratory tract infections (e.g., influenza, common cold)
- Lower respiratory tract infections (e.g., bronchitis, pneumonia)
- Allergic rhinitis
- Inhaled irritants (e.g., dust, smoke)
- Laryngitis or pharyngitis
- Medications (e.g., ACEIs, beta-adrenergic blockers, Aspirin, NSAIDs)
- Gastro-Esophageal Reflex Disease (GERD)
- COPD
- Heart failure
- Lung cancer
- Postnasal drip
Treatment of Cough
- Primary goal: reduce the number and severity of cough episodes
- Secondary goal: prevent complications
- Treatment is symptomatic; the underlying disorder must be treated to stop the cough
- Antitussives:
- Dextromethorphan (non-addictive, non-opioid): 15-30 mg PO q 6-8 hrs
- Non-addictive, non-opioids: first-generation antihistamines (e.g., Diphenhydramine, Promethazine), Butamirate
- Mucoactives:
- Mucolytics (e.g., N-Acetyl Cysteine, Bromhexine): decrease mucus viscosity
- Mucoregulators (e.g., Anticholinergics, Glucocorticoids): regulate mucus secretion
- Mucokinetics (e.g., Ambroxol, Bronchodilators): increase muco-ciliary clearance
- Expectorents (e.g., Guaifenesin, Hypertonic Saline): increase mucus expulsion and cough reflex
- Decongestants:
- Sympathomimetics (e.g., Ephedrine, Pseudoephedrine): treat dilated blood vessels and swollen nasal mucosa
- Topical decongestants (e.g., Oxymetazoline, Xylometazoline): reduce swelling and congestion when applied to mucous membranes
- Bronchodilators:
- B-2 agonist (e.g., Albuterol): not recommended for treatment of acute cough in non-asthmatic patients
- Anticholinergics (e.g., Ipratropium): improve acute and chronic cough
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Description
This quiz covers the basics of cough as a defensive respiratory reflex action, including its causes, stimulation, and management in a pharmacy setting. It is suitable for pharmacy students and professionals.
