Podcast
Questions and Answers
What is the main purpose of a productive cough?
What is the main purpose of a productive cough?
- To expel secretions from the lower respiratory tract (correct)
- To prevent infection
- To reduce inflammation
- To improve ventilation
Which of the following is NOT a classification of cough?
Which of the following is NOT a classification of cough?
- Recurrent (correct)
- Subacute
- Acute
- Chronic
What is a common symptom of anaerobic bacterial infections?
What is a common symptom of anaerobic bacterial infections?
- Chest pain
- Fever
- Malodor (correct)
- Purulent secretions
Which of the following is a complication of chronic cough?
Which of the following is a complication of chronic cough?
What is the term for cough that is initiated by stimulation of vagally mediated sensory pathways?
What is the term for cough that is initiated by stimulation of vagally mediated sensory pathways?
Which of the following is a cause of subacute cough?
Which of the following is a cause of subacute cough?
What is the term for the cough that is characterized by the presence of secretions that are difficult to expel?
What is the term for the cough that is characterized by the presence of secretions that are difficult to expel?
Which of the following is a risk factor for chronic cough?
Which of the following is a risk factor for chronic cough?
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 associated with viral and atypical bacterial infections?
What type of cough is associated with viral and atypical bacterial infections?
What is a common complication of cough?
What is a common complication of cough?
What is the purpose of protussives in treatment of cough?
What is the purpose of protussives in treatment of cough?
What should be treated to stop the cough?
What should be treated to stop the cough?
Why should antitussives not be used to treat productive coughs?
Why should antitussives not be used to treat productive coughs?
What is a consequence of prolonged coughing?
What is a consequence of prolonged coughing?
What is the mechanism of action of antitussives?
What is the mechanism of action of antitussives?
What is the primary mechanism of codeine in reducing cough?
What is the primary mechanism of codeine in reducing cough?
What is a potential complication of using humidifiers in nonpharmacologic therapy?
What is a potential complication of using humidifiers in nonpharmacologic therapy?
Why are coolmist humidifiers and vaporizers preferred in nonpharmacologic therapy?
Why are coolmist humidifiers and vaporizers preferred in nonpharmacologic therapy?
What is a common side effect of codeine?
What is a common side effect of codeine?
What is the purpose of propping infants upright when they sleep and raising the head of the bed at night?
What is the purpose of propping infants upright when they sleep and raising the head of the bed at night?
What is a contraindication for the use of codeine?
What is a contraindication for the use of codeine?
What is the maximum amount of codeine allowed per 100 milliliters in codeine-containing products?
What is the maximum amount of codeine allowed per 100 milliliters in codeine-containing products?
What is the purpose of using a rubber bulb nasal syringe in nonpharmacologic therapy?
What is the purpose of using a rubber bulb nasal syringe in nonpharmacologic therapy?
Combining antitussives and protussives may be beneficial in treating cough.
Combining antitussives and protussives may be beneficial in treating cough.
Codeine acts peripherally to decrease the cough threshold.
Codeine acts peripherally to decrease the cough threshold.
Codeine is contraindicated in infants under 6 months old.
Codeine is contraindicated in infants under 6 months old.
Dextromethorphan is a non-opioid antitussive that can cause respiratory depression.
Dextromethorphan is a non-opioid antitussive that can cause respiratory depression.
Concomitant use of codeine and central nervous system depressants causes subtractive CNS depression.
Concomitant use of codeine and central nervous system depressants causes subtractive CNS depression.
Diphenhydramine can cause CNS depression and exacerbate respiratory depression.
Diphenhydramine can cause CNS depression and exacerbate respiratory depression.
Humidifiers can increase environmental mold, dust mites, minerals, and microorganisms.
Humidifiers can increase environmental mold, dust mites, minerals, and microorganisms.
Codeine is contraindicated in patients with known codeine hypersensitivity only during labor.
Codeine is contraindicated in patients with known codeine hypersensitivity only during labor.
The combination of opioids and non-opioid antitussives can increase the risk of respiratory depression.
The combination of opioids and non-opioid antitussives can increase the risk of respiratory depression.
Respiratory tract irritation can be caused by inhaled medications.
Respiratory tract irritation can be caused by inhaled medications.
Coolmist humidifiers and vaporizers are preferred because they promote bacterial growth.
Coolmist humidifiers and vaporizers are preferred because they promote bacterial growth.
Cough medications can exacerbate underlying respiratory conditions like asthma.
Cough medications can exacerbate underlying respiratory conditions like asthma.
Non-medicated lozenges can increase cough by stimulating throat irritation.
Non-medicated lozenges can increase cough by stimulating throat irritation.
Cough is a symptoms of GERD.
Cough is a symptoms of GERD.
Codeine-containing products can contain more than 200 mg of codeine per 100 milliliters.
Codeine-containing products can contain more than 200 mg of codeine per 100 milliliters.
Anaerobic bacterial infections are associated with a distinct malodor.
Anaerobic bacterial infections are associated with a distinct malodor.
Dextromethorphan is a type of opioid with analgesic properties.
Dextromethorphan is a type of opioid with analgesic properties.
Patients with impaired respiratory reserve should use codeine with caution.
Patients with impaired respiratory reserve should use codeine with caution.
Diphenhydramine is a second-generation antihistamine with antitussive activity.
Diphenhydramine is a second-generation antihistamine with antitussive activity.
Dextromethorphan has a narrow margin of safety.
Dextromethorphan has a narrow margin of safety.
The combination of monoamine oxidase inhibitors (MAOIs) and dextromethorphan may cause serotonin syndrome.
The combination of monoamine oxidase inhibitors (MAOIs) and dextromethorphan may cause serotonin syndrome.
Codeine is approximately equipotent with dextromethorphan.
Codeine is approximately equipotent with dextromethorphan.
Dextromethorphan is indicated for the treatment of productive coughs.
Dextromethorphan is indicated for the treatment of productive coughs.
Additive CNS depression occurs with the combination of dextromethorphan and psychotropic medications.
Additive CNS depression occurs with the combination of dextromethorphan and psychotropic medications.
What is a concern when combining codeine with central nervous system depressants?
What is a concern when combining codeine with central nervous system depressants?
What is a potential complication of using dextromethorphan in combination with monoamine oxidase inhibitors (MAOIs)?
What is a potential complication of using dextromethorphan in combination with monoamine oxidase inhibitors (MAOIs)?
What is a side effect of diphenhydramine that can exacerbate respiratory depression?
What is a side effect of diphenhydramine that can exacerbate respiratory depression?
What is a risk associated with using humidifiers and vaporizers in non-pharmacologic therapy?
What is a risk associated with using humidifiers and vaporizers in non-pharmacologic therapy?
What is a contraindication for the use of codeine?
What is a contraindication for the use of codeine?
What is a characteristic of dextromethorphan?
What is a characteristic of dextromethorphan?
What is a concern when using opioids and non-opioid antitussives together?
What is a concern when using opioids and non-opioid antitussives together?
What is a potential complication of respiratory tract irritation caused by inhaled medications?
What is a potential complication of respiratory tract irritation caused by inhaled medications?
What is the primary mechanism of action of codeine in reducing cough?
What is the primary mechanism of action of codeine in reducing cough?
What is a potential complication of using humidifiers in nonpharmacologic therapy?
What is a potential complication of using humidifiers in nonpharmacologic therapy?
What is the purpose of using a rubber bulb nasal syringe in nonpharmacologic therapy?
What is the purpose of using a rubber bulb nasal syringe in nonpharmacologic therapy?
What is a common side effect of codeine?
What is a common side effect of codeine?
What is the maximum amount of codeine allowed per 100 milliliters in codeine-containing products?
What is the maximum amount of codeine allowed per 100 milliliters in codeine-containing products?
What is the purpose of propping infants upright when they sleep and raising the head of the bed at night?
What is the purpose of propping infants upright when they sleep and raising the head of the bed at night?
What is a contraindication for the use of codeine?
What is a contraindication for the use of codeine?
Why are coolmist humidifiers and vaporizers preferred in nonpharmacologic therapy?
Why are coolmist humidifiers and vaporizers preferred in nonpharmacologic therapy?
What is the primary concern for patients with impaired respiratory reserve when taking codeine?
What is the primary concern for patients with impaired respiratory reserve when taking codeine?
What is the main difference between codeine and dextromethorphan?
What is the main difference between codeine and dextromethorphan?
What is the potential interaction between diphenhydramine and other medications?
What is the potential interaction between diphenhydramine and other medications?
Why should monoamine oxidase inhibitors (MAOIs) and dextromethorphan not be used together?
Why should monoamine oxidase inhibitors (MAOIs) and dextromethorphan not be used together?
What is the primary mechanism of action of dextromethorphan in reducing cough?
What is the primary mechanism of action of dextromethorphan in reducing cough?
What is the primary indication for dextromethorphan?
What is the primary indication for dextromethorphan?
What is the potential complication of combining opioids and non-opioid antitussives?
What is the potential complication of combining opioids and non-opioid antitussives?
What is the primary mechanism of action of diphenhydramine in reducing cough?
What is the primary mechanism of action of diphenhydramine in reducing cough?
Diphenhydramine may cause _______________, especially in children.
Diphenhydramine may cause _______________, especially in children.
Diphenhydramine potentiates the depressant effects of _______________ on the CNS.
Diphenhydramine potentiates the depressant effects of _______________ on the CNS.
Chlophedianol is an alkylamine _______________ derivative with antitussive, moderate local anesthetic, and mild anticholinergic effects.
Chlophedianol is an alkylamine _______________ derivative with antitussive, moderate local anesthetic, and mild anticholinergic effects.
Diphenhydramine should be used with caution in patients with diseases potentially exacerbated by drugs with _______________ activity.
Diphenhydramine should be used with caution in patients with diseases potentially exacerbated by drugs with _______________ activity.
Diphenhydramine can cause _______________ depression and exacerbate respiratory depression.
Diphenhydramine can cause _______________ depression and exacerbate respiratory depression.
Chlophedianol is indicated for the suppression of nonproductive cough caused by _______________ or mechanical respiratory tract irritation.
Chlophedianol is indicated for the suppression of nonproductive cough caused by _______________ or mechanical respiratory tract irritation.
Diphenhydramine containing antitussives should not be used with any other _______________ containing product, including topical products.
Diphenhydramine containing antitussives should not be used with any other _______________ containing product, including topical products.
Large doses of chlophedianol are associated with _______________, vertigo, visual disturbances, nausea, vomiting, and drowsiness.
Large doses of chlophedianol are associated with _______________, vertigo, visual disturbances, nausea, vomiting, and drowsiness.
Patients with impaired respiratory reserve (e.g., asthma or COPD) or preexisting respiratory depression, ______ addicts, and individuals who take other respiratory depressants or sedatives, including alcohol, should use codeine with caution.
Patients with impaired respiratory reserve (e.g., asthma or COPD) or preexisting respiratory depression, ______ addicts, and individuals who take other respiratory depressants or sedatives, including alcohol, should use codeine with caution.
Dextromethorphan is considered approximately ______ with codeine.
Dextromethorphan is considered approximately ______ with codeine.
Dextromethorphan is a nonopioid with no ______, sedative, respiratory depressant, or addictive properties at usual antitussive doses.
Dextromethorphan is a nonopioid with no ______, sedative, respiratory depressant, or addictive properties at usual antitussive doses.
Dextromethorphan has a ______ margin of safety.
Dextromethorphan has a ______ margin of safety.
The combination of ______ oxidase inhibitors (MAOIs) and dextromethorphan may cause serotonergic syndrome.
The combination of ______ oxidase inhibitors (MAOIs) and dextromethorphan may cause serotonergic syndrome.
Diphenhydramine is a nonselective (first-generation) ______ with significant sedating and anticholinergic properties.
Diphenhydramine is a nonselective (first-generation) ______ with significant sedating and anticholinergic properties.
Diphenhydramine acts centrally in the ______ to increase the cough threshold.
Diphenhydramine acts centrally in the ______ to increase the cough threshold.
Additive CNS depression occurs with the combination of ______ and psychotropic medications.
Additive CNS depression occurs with the combination of ______ and psychotropic medications.
Codeine acts centrally on the ______ to increase the cough threshold.
Codeine acts centrally on the ______ to increase the cough threshold.
The concomitant use of codeine and ______ depressants causes additive CNS depression.
The concomitant use of codeine and ______ depressants causes additive CNS depression.
Non-medicated lozenges may reduce cough by decreasing ______ irritation.
Non-medicated lozenges may reduce cough by decreasing ______ irritation.
Diphenhydramine can cause ______ depression and exacerbate respiratory depression.
Diphenhydramine can cause ______ depression and exacerbate respiratory depression.
Humidifiers can increase environmental ______, dust mites, minerals, and microorganisms.
Humidifiers can increase environmental ______, dust mites, minerals, and microorganisms.
Codeine is contraindicated in patients with known ______ hypersensitivity.
Codeine is contraindicated in patients with known ______ hypersensitivity.
Codeine-containing products must contain one or more non-codeine active ingredients and no more than ______ mg of codeine per 100 milliliters.
Codeine-containing products must contain one or more non-codeine active ingredients and no more than ______ mg of codeine per 100 milliliters.
The most common side effects of codeine are ______, vomiting, sedation, dizziness, and constipation.
The most common side effects of codeine are ______, vomiting, sedation, dizziness, and constipation.
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Study Notes
Cough
- Cough is a vital defensive respiratory reflex that can have significant physical, psychological, and economic consequences.
- It is the most common symptom for which patients seek medical care.
Etiology of Cough
- Acute cough causes: viral URTI, pneumonia, acute left ventricular failure, asthma, and foreign body aspiration.
- Subacute cough causes: post-infectious cough, bacterial sinusitis, and asthma.
- Chronic cough causes: UACS, asthma, GERD, COPD, ACEIs, bronchogenic carcinoma, carcinomatosis, sarcoidosis, autoimmune disease, left ventricular failure, and aspiration secondary to pharyngeal dysfunction.
Clinical Presentation of Cough
- Coughs can be productive (wet or "chesty" cough) or nonproductive (dry or "hacking" cough).
- Productive coughs may be effective or ineffective, and the appearance of secretions is not always a reliable diagnostic indicator.
- Nonproductive coughs serve no useful physiologic purpose and are associated with viral and atypical bacterial infections, GERD, cardiac disease, and some medications.
- Common complications of cough include exhaustion, insomnia, musculoskeletal pain, hoarseness, excessive perspiration, and urinary incontinence.
Treatment of Cough
- The primary goal of self-treatment of cough is to reduce the number and severity of cough episodes, and the second goal is to prevent complications.
- The underlying disorder must be treated to stop the cough.
- Antitussives (cough suppressants) are used to control or eliminate cough and are the drugs of choice for nonproductive coughs.
- Protussives (expectorants) change the consistency of mucus and increase the volume of expectorated sputum and may provide relief for coughs that expel thick, tenacious secretions.
Nonpharmacologic Therapy
- Nonpharmacologic therapy includes non-medicated lozenges, humidification, interventions to promote nasal drainage, and hydration.
- Non-medicated lozenges may reduce cough by decreasing throat irritation.
- Humidifiers increase the amount of moisture in inspired air, which may soothe irritated airways.
Pharmacologic Therapy
- Codeine is a medication used to treat cough, acting centrally on the medulla to increase the cough threshold.
- Codeine-containing products must contain one or more non-codeine active ingredients and no more than 200 mg of codeine per 100 milliliters.
- Common side effects of codeine include nausea, vomiting, sedation, dizziness, and constipation.
Cough Therapy
- FDA allows various combinations of antitussives, protussives, analgesics, decongestants, and antihistamines, but combinations of antitussives and protussives are potentially counterproductive.
- Non-pharmacologic therapy includes non-medicated lozenges, humidification, interventions to promote nasal drainage, and hydration.
Non-Pharmacologic Therapy
- Non-medicated lozenges reduce cough by decreasing throat irritation.
- Humidifiers (ultrasonic, impeller, and evaporative) increase moisture in inspired air, soothing irritated airways, but high humidity may increase environmental mold, dust mites, minerals, and microorganisms.
- Vaporizers produce a medicated vapor, with cool-mist humidifiers and vaporizers preferred due to fewer bacteria growth and less risk of scalding.
- Babies and young children (up to 2 years) can't blow their noses, so a rubber bulb nasal syringe may be used to clear nasal passages and reduce cough.
- Propping infants upright when sleeping and raising the head of the bed promotes drainage of nasal secretions.
Pharmacologic Therapy
- Codeine acts centrally on the medulla to increase the cough threshold, but has side effects like nausea, vomiting, sedation, dizziness, and constipation.
- Concomitant use of codeine and CNS depressants causes additive CNS depression.
- Codeine is contraindicated in patients with known codeine hypersensitivity and during labor when a premature birth is anticipated.
Cough
- Cough is an important defensive respiratory reflex with potential physical, psychological, and economic consequences.
- Cough is the most common symptom for which patients seek medical care.
- Cough is initiated by stimulation of chemically and mechanically sensitive vagally mediated sensory pathways in laryngeal, esophageal, and tracheobronchial airway epithelium.
Etiology of Cough
- Acute cough: viral URTI, pneumonia, acute left ventricular failure, asthma, foreign body aspiration.
- Subacute cough: post-infectious cough, bacterial sinusitis, asthma.
- Chronic cough: UACS, asthma, GERD, COPD, ACEIs, bronchogenic carcinoma, carcinomatosis, sarcoidosis.
Clinical Presentation of Cough
- Coughs are described as productive or nonproductive.
- Productive cough expels secretions from the lower respiratory tract.
- The appearance of secretions is not always a reliable diagnostic indicator.
Dextromethorphan
- Considered approximately equipotent with codeine, dextromethorphan is a nonopioid with no analgesic, sedative, respiratory depressant, or addictive properties.
- Dextromethorphan acts centrally in the medulla to increase the cough threshold.
- Indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation.
- Has a wide margin of safety, with uncommon side effects including drowsiness, nausea, vomiting, stomach discomfort, or constipation.
Diphenhydramine
- Diphenhydramine is a nonselective antihistamine with significant sedating and anticholinergic properties, acting centrally in the medulla to increase the cough threshold.
- Indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation.
- Second-generation antihistamines (e.g., loratadine and fexofenadine) lack antitussive activity.
Cough Therapy
- FDA allows various combinations of antitussives, protussives, analgesics, decongestants, and antihistamines, but combinations of antitussives and protussives are potentially counterproductive.
- Non-pharmacologic therapy includes non-medicated lozenges, humidification, interventions to promote nasal drainage, and hydration.
Non-Pharmacologic Therapy
- Non-medicated lozenges reduce cough by decreasing throat irritation.
- Humidifiers (ultrasonic, impeller, and evaporative) increase moisture in inspired air, soothing irritated airways, but high humidity may increase environmental mold, dust mites, minerals, and microorganisms.
- Vaporizers produce a medicated vapor, with cool-mist humidifiers and vaporizers preferred due to fewer bacteria growth and less risk of scalding.
- Babies and young children (up to 2 years) can't blow their noses, so a rubber bulb nasal syringe may be used to clear nasal passages and reduce cough.
- Propping infants upright when sleeping and raising the head of the bed promotes drainage of nasal secretions.
Pharmacologic Therapy
- Codeine acts centrally on the medulla to increase the cough threshold, but has side effects like nausea, vomiting, sedation, dizziness, and constipation.
- Concomitant use of codeine and CNS depressants causes additive CNS depression.
- Codeine is contraindicated in patients with known codeine hypersensitivity and during labor when a premature birth is anticipated.
Cough
- Cough is an important defensive respiratory reflex with potential physical, psychological, and economic consequences.
- Cough is the most common symptom for which patients seek medical care.
- Cough is initiated by stimulation of chemically and mechanically sensitive vagally mediated sensory pathways in laryngeal, esophageal, and tracheobronchial airway epithelium.
Etiology of Cough
- Acute cough: viral URTI, pneumonia, acute left ventricular failure, asthma, foreign body aspiration.
- Subacute cough: post-infectious cough, bacterial sinusitis, asthma.
- Chronic cough: UACS, asthma, GERD, COPD, ACEIs, bronchogenic carcinoma, carcinomatosis, sarcoidosis.
Clinical Presentation of Cough
- Coughs are described as productive or nonproductive.
- Productive cough expels secretions from the lower respiratory tract.
- The appearance of secretions is not always a reliable diagnostic indicator.
Dextromethorphan
- Considered approximately equipotent with codeine, dextromethorphan is a nonopioid with no analgesic, sedative, respiratory depressant, or addictive properties.
- Dextromethorphan acts centrally in the medulla to increase the cough threshold.
- Indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation.
- Has a wide margin of safety, with uncommon side effects including drowsiness, nausea, vomiting, stomach discomfort, or constipation.
Diphenhydramine
- Diphenhydramine is a nonselective antihistamine with significant sedating and anticholinergic properties, acting centrally in the medulla to increase the cough threshold.
- Indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation.
- Second-generation antihistamines (e.g., loratadine and fexofenadine) lack antitussive activity.
Diphenhydramine
- Symptoms of diphenhydramine overdose include mild to severe CNS depression, hypotension, and CNS stimulation
- Causes excitability, especially in children
- Potentiates the depressant effects of narcotics, nonnarcotic analgesics, benzodiazepines, tranquilizers, and alcohol on the CNS
- Intensifies the anticholinergic effect of MAOIs and other anticholinergics
- Should be used with caution in patients with diseases potentially exacerbated by drugs with anticholinergic activity
Chlophedianol
- Centrally acting oral antitussive
- Indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation
- Has antitussive, moderate local anesthetic, and mild anticholinergic effects
- Side effects include excitation, hyperirritability, nightmares, hallucinations, hypersensitivity, and urticaria
- Patients with impaired respiratory reserve or preexisting respiratory depression should use with caution
Dextromethorphan
- Nonopioid with no analgesic, sedative, respiratory depressant, or addictive properties at usual antitussive doses
- Acts centrally in the medulla to increase the cough threshold
- Indicated for the suppression of nonproductive cough caused by chemical or mechanical respiratory tract irritation
- Has a wide margin of safety
- Side effects with usual doses are uncommon, but may include drowsiness, nausea or vomiting, stomach discomfort, or constipation
- Additive CNS depression occurs with alcohol, antihistamines, and psychotropic medications
Nonpharmacologic Therapy
- Includes non-medicated lozenges, humidification, interventions to promote nasal drainage, and hydration
- Non-medicated lozenges may reduce cough by decreasing throat irritation
- Humidifiers increase the amount of moisture in inspired air, which may soothe irritated airways
- Vaporizers produce a medicated vapor
- Propping infants upright when they sleep and raising the head of the bed at night promotes drainage of nasal secretions
Pharmacologic Therapy
- Codeine containing products must contain one or more non-codeine active ingredients and no more than 200 mg of codeine per 100 milliliters
- Codeine acts centrally on the medulla to increase the cough threshold
- The most common side effects are nausea, vomiting, sedation, dizziness, and constipation
- Concomitant use of codeine and CNS depressants causes additive CNS depression
- Contraindicated in patients with known codeine hypersensitivity and during labor when a premature birth is anticipated
Nonpharmacologic Therapy
- Non-medicated lozenges reduce cough by decreasing throat irritation
- Humidifiers (ultrasonic, impeller, and evaporative) soothe irritated airways by increasing moisture in inspired air
- Vaporizers produce a medicated vapor, with coolmist humidifiers and vaporizers preferred due to fewer bacteria growth and lower scalding risk
- Babies and young children up to 2 years old cannot blow their noses, so a rubber bulb nasal syringe is used to clear nasal passages and reduce cough
- Propping infants upright when sleeping and raising the head of the bed promotes nasal secretion drainage
Pharmacologic Therapy
Codeine
- Codeine-containing products must contain one or more non-codeine active ingredients and no more than 200 mg of codeine per 100 milliliters
- Codeine acts centrally on the medulla to increase the cough threshold
- Side effects include nausea, vomiting, sedation, dizziness, and constipation
- Contraindications: known codeine hypersensitivity, labor when premature birth is anticipated, impaired respiratory reserve, preexisting respiratory depression, drug addicts, and individuals taking other respiratory depressants or sedatives
Dextromethorphan
- Equipotent with codeine, but nonopioid with no analgesic, sedative, respiratory depressant, or addictive properties at usual antitussive doses
- Acts centrally in the medulla to increase the cough threshold
- Indicated for suppressing nonproductive cough caused by chemical or mechanical respiratory tract irritation
- Wide margin of safety, but side effects include drowsiness, nausea or vomiting, stomach discomfort, or constipation
- Additive CNS depression occurs with alcohol, antihistamines, and psychotropic medications
Diphenhydramine
- Nonselective (first-generation) antihistamine with sedating and anticholinergic properties
- Acts centrally in the medulla to increase the cough threshold
- Indicated for suppressing nonproductive cough caused by chemical or mechanical respiratory tract irritation
- Side effects include excitability, especially in children, and potentiates CNS depressant effects of other drugs
- Contraindications: diseases exacerbated by anticholinergic activity, such as narrow angle glaucoma, stenosing peptic ulcer, and cardiovascular disease
Chlophedianol
- Centrally acting oral antitussive with antitussive, moderate local anesthetic, and mild anticholinergic effects
- Indicated for suppressing nonproductive cough caused by chemical or mechanical respiratory tract irritation
- Side effects include excitation, hyperirritability, nightmares, hallucinations, hypersensitivity, and urticaria
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