392 MANAGEMENT PROTOCOL FOR PROBLEM ON COUGH, COLDS OR DIFFICULTY OF BREATHING NOT ASSOCIATED WITH FEVER: ADULT PATIENT (Flow Chart No. 7) PLANA: 1. 0 2. 0 3. 0 5. 0 6. o Determin e patient's knowledge on the management of the problems presented Based on 1. 0, give/prescribe over-the-counter medicine or herbal medicine for cough and colds, specif)ing accurately the method of preparation (specifically for herbal medicine), the dose and frequency of intake. 2. J If mucus is thick and seems trapped in the chest, give/presc ribe a mucoly"tic preparation like those containing glyceryl guiacolate, carbocystei. n or ambroxol. A decoction ofsampaloc leaves or oregano leaves can also be given. 2. 2 If cough is dry or occurs very often, give/prescribe an antitussive preparati on like those containing dextromethorphan or butamirate citrate. A decoctioo of lagundi leaves cim also be given. 2. 3 If cough is associated \\ith a wheezing sound, give/prescribe a prepar. 1tior1 for asthma like those containing salbutamol, terbutaline ' formoterol, etc. 2. 4 If there is runny nose or nasal decongestion, give/prescribe decongestant. Advice the patient to: 3. 1 stop smoking or avoid exposure to smoke; 3. 2 avoid crowded places; _ 3. 3 drink plenty of water and juice but not caffeine or cola-containing drinks 3. 4 have steam inhalation for 10-. 15 minutes as often as the patient likes; there is no need to add anything to the water. drain mucus from the lungs by postural drainage when needed and this is done as follows: 3,5. 1 Jet the patie. at lie face down partly on the bed with his head and chest hanging over the edge and ms elbows on the floor; pound him/her ligbt Jy on the back; 3. 5. 2 3. 5. 3 ask the patient to take a deep breath and then cough as ha. rd as he/she could; If there is epigastric pain or history of intake of medicine for ulcer or recent history of intake of medicines causing gastric irritation, do the following: 4. 1 Give/prescribe medicine for ulcer. 4. 2 Advice the patient to avoid spicy food, sour food, and caffeine-containing drinks. · 4. 3 Advice the patient lo avoid lying down immedia tely after a meal 4-4 Advice patient to take small frequent meals. Advice the patient to observe the effe<-1 of the above intervention and to have a follow-up after two or three days or earlier if any. RED symptom develops. Do home visit if patient fails to return for follow-up after three days. Do the following during follow-up: 7. 1 Ask the patient if there was improvement in his condition. after the management or interventions were started. 