Pharmacology of Dextromethorphan and Guaifenesin
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Pharmacology of Dextromethorphan and Guaifenesin

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Questions and Answers

What is the primary mechanism of action of Acyclovir?

  • Enhances immune response against viruses
  • Blocks protein synthesis in viral cells
  • Inhibits ribosomal RNA synthesis
  • Inhibits viral DNA synthesis (correct)

    • Which of the following adverse effects is NOT associated with Dextromethorphan?

  • Nervousness
  • Dizziness
  • Renal toxicity (correct)
  • Drowsiness

    • What should patients be educated to do when taking Guaifenesin?

  • Avoid fruit juices
  • Avoid high-protein foods
  • Limit fluid intake
  • Drink plenty of fluids (correct)

    • Which medication class does Dextromethorphan belong to?

    <p>Antitussive</p> Signup and view all the answers

    What is a significant contraindication for Acyclovir usage?

    <p>Caution with renal impairment</p> Signup and view all the answers

    What adverse effect is common with both Dextromethorphan and Guaifenesin?

    <p>Drowsiness</p> Signup and view all the answers

    Which interaction is associated with Dextromethorphan?

    <p>Risk of serotonin syndrome with MAOIs</p> Signup and view all the answers

    Which of the following is NOT an indication for Acyclovir?

    <p>Osteoarthritis</p> Signup and view all the answers

    What should patients taking Acyclovir do to minimize kidney side effects?

    <p>Increase fluid intake</p> Signup and view all the answers

    What condition is Guaifenesin primarily indicated for?

    <p>Chest congestion with productive cough</p> Signup and view all the answers

    What is the primary mechanism of action of Oseltamivir in the treatment of influenza?

    <p>Inhibits viral replication</p> Signup and view all the answers

    Which drug class is primarily used in the treatment of Hepatitis B?

    <p>NRTIs</p> Signup and view all the answers

    What is a common adverse effect associated with Ribavirin therapy for RSV?

    <p>Anemia</p> Signup and view all the answers

    Which of the following is an important patient education point regarding the use of Nirmatrelvir/ritonavir for COVID-19 treatment?

    <p>Should not be combined with certain medications</p> Signup and view all the answers

    Which of the following is an expectorant used in the symptomatic management of cough?

    <p>Guaifenesin</p> Signup and view all the answers

    For which condition is Palivizumab typically prescribed?

    <p>Respiratory Syncytial Virus in high-risk infants</p> Signup and view all the answers

    Which of the following statements about cough suppressants is correct?

    <p>Dextromethorphan is a common cough suppressant.</p> Signup and view all the answers

    What is the typical duration for taking Acyclovir in the treatment of Oral Herpes Simplex?

    <p>7-10 days</p> Signup and view all the answers

    Which viral infection is primarily treated with antiviral therapy within 48 hours of onset?

    <p>Influenza</p> Signup and view all the answers

    What is the role of supportive care therapies in managing viral respiratory infections?

    <p>To alleviate symptoms and provide comfort</p> Signup and view all the answers

    What is the mechanism of action of oseltamivir (Tamiflu)?

    <p>Inhibits viral neuraminidase, preventing virus release</p> Signup and view all the answers

    Which of the following medications is classified as a neuraminidase inhibitor?

    <p>Oseltamivir (Tamiflu)</p> Signup and view all the answers

    What common adverse effect is associated with nirmatrelvir/ritonavir (Paxlovid)?

    <p>Diarrhea</p> Signup and view all the answers

    Which statement is true regarding patient education for oseltamivir (Tamiflu)?

    <p>Taking with food may reduce gastrointestinal upset.</p> Signup and view all the answers

    Which adverse effect is commonly associated with benzonatate (Tessalon Perles)?

    <p>Mild GI disturbances</p> Signup and view all the answers

    What is the primary contraindication for giving oseltamivir (Tamiflu)?

    <p>Infants under two weeks</p> Signup and view all the answers

    Which of the following is NOT an interaction concern with nirmatrelvir/ritonavir (Paxlovid)?

    <p>Limited known interactions</p> Signup and view all the answers

    What advice should be given to patients regarding the administration of benzonatate (Tessalon Perles)?

    <p>Capsules should be swallowed whole to prevent oral mucosal anesthesia.</p> Signup and view all the answers

    What is the recommended time frame for initiating oseltamivir treatment after symptom onset?

    <p>Within 48 hours</p> Signup and view all the answers

    Which medication is primarily indicated for symptomatic relief of cough?

    <p>Benzonatate (Tessalon Perles)</p> Signup and view all the answers

    What mechanism of action does Dextromethorphan utilize to reduce cough reflex sensitivity?

    <p>Depresses the medullary cough center</p> Signup and view all the answers

    Which of the following adverse effects is primarily associated with Acyclovir?

    <p>Renal toxicity</p> Signup and view all the answers

    What adverse effect might be experienced by patients taking Guaifenesin?

    <p>Headache</p> Signup and view all the answers

    Which mechanism of action is primarily responsible for the effectiveness of Guaifenesin?

    <p>Thins mucus secretions</p> Signup and view all the answers

    Dextromethorphan has potential for abuse when taken in high doses primarily due to its effects on which system?

    <p>Dopaminergic pathways</p> Signup and view all the answers

    Which patient education point is crucial for those taking Acyclovir?

    <p>Stay hydrated to reduce kidney risks</p> Signup and view all the answers

    What is a common adverse effect shared by both Dextromethorphan and Guaifenesin?

    <p>Drowsiness</p> Signup and view all the answers

    What is a significant risk associated with the concurrent use of Dextromethorphan and SSRIs?

    <p>Serotonin syndrome</p> Signup and view all the answers

    What adverse effect is particularly concerning in patients with kidney disease when taking Acyclovir?

    <p>Renal toxicity</p> Signup and view all the answers

    What special consideration should be taken into account for children under two when prescribing Dextromethorphan?

    <p>Caution is advised</p> Signup and view all the answers

    What is the primary action of antivirals when used early in the course of a viral illness?

    <p>Reduce viral replication</p> Signup and view all the answers

    Which symptom is typically NOT associated with viral respiratory tract infections?

    <p>Diarrhea</p> Signup and view all the answers

    What is a common adverse effect associated with Ribavirin therapy for severe RSV cases?

    <p>Nausea and vomiting</p> Signup and view all the answers

    For which patient group is the antiviral Nirmatrelvir/ritonavir specifically indicated?

    <p>High-risk patients</p> Signup and view all the answers

    What is the mechanism of action of Dextromethorphan in managing cough?

    <p>Suppresses the cough reflex</p> Signup and view all the answers

    Which medication is commonly used as an expectorant for symptomatic management of cough?

    <p>Guaifenesin</p> Signup and view all the answers

    What is a common side effect of administering Oseltamivir for influenza?

    <p>Nausea</p> Signup and view all the answers

    Which medication is indicated for the severe treatment of Respiratory Syncytial Virus (RSV)?

    <p>Ribavirin</p> Signup and view all the answers

    What is the typical duration for taking Valacyclovir for the treatment of Oral Herpes Simplex?

    <p>7-10 days</p> Signup and view all the answers

    Which class of antiviral medications is used primarily for treating Hepatitis B?

    <p>NRTIs</p> Signup and view all the answers

    What is the mechanism of action of Nirmatrelvir/ritonavir (Paxlovid)?

    <p>Inhibits viral replication</p> Signup and view all the answers

    Which of the following adverse effects is associated with Oseltamivir (Tamiflu)?

    <p>Confusion</p> Signup and view all the answers

    What adverse effect is commonly observed with Nirmatrelvir/ritonavir (Paxlovid)?

    <p>Altered taste</p> Signup and view all the answers

    What is a common adverse effect associated with Benzonatate (Tessalon Perles)?

    <p>Drowsiness</p> Signup and view all the answers

    Which medication requires initiation ideally within 48 hours of symptom onset for effectiveness?

    <p>Oseltamivir (Tamiflu)</p> Signup and view all the answers

    Which of the following correctly describes a significant contraindication for Oseltamivir?

    <p>Infants under two weeks</p> Signup and view all the answers

    What is the mechanism of action of Oseltamivir (Tamiflu)?

    <p>Inhibits the release of virus from infected cells</p> Signup and view all the answers

    Which of the following statements is correct regarding patient education for Nirmatrelvir/ritonavir?

    <p>Report any unusual side effects promptly</p> Signup and view all the answers

    Which medication should not be chewed or crushed before swallowing?

    <p>Benzonatate (Tessalon Perles)</p> Signup and view all the answers

    Which patient population is at high risk for complications from COVID-19 and may benefit from Nirmatrelvir/ritonavir?

    <p>Patients with diabetes</p> Signup and view all the answers

    Study Notes

    Dextromethorphan

    • Medication class: NMDA Receptor Antagonist, Antitussive
    • Mechanism of action: Reduces cough reflex sensitivity and transmission through medullary cough center depression
    • Indications: Cough Suppression
    • Adverse Effects: Drowsiness, dizziness, nervousness, and gastrointestinal symptoms
    • Contraindications: Use with or within two weeks of MAOIs; caution in children under two
    • Interactions: SSRIs, MAOIs (risk of serotonin syndrome)
    • Monitoring: Not generally needed
    • Patient Education: Avoid driving if drowsy; potential for abuse if taken in high doses

    Guaifenesin

    • Medication class: Expectorant
    • Mechanism of Action: Thins mucus secretions, aiding expectoration
    • Indications: Chest congestion with productive cough
    • Adverse Effects: Dizziness, drowsiness, headache, and nausea.
    • Contraindications: Caution in children under two to four years (depends on formulation)
    • Interactions: Avoid with alcohol (ethanol-containing products)
    • Monitoring: Not typically required
    • Patient Education: Drink plenty of fluids to assist in mucus thinning; may cause mild GI upset

    Acyclovir

    • Medication class: Antiviral Agent
    • Mechanism of Action: Inhibits viral DNA synthesis, preventing replication
    • Indications: Herpes simplex, varicella-zoster, and Bell's palsy
    • Adverse Effects: Renal toxicity (AKI), neurotoxicity, thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS)
    • Contraindications: Caution with renal impairment
    • Interactions: Few significant interactions
    • Monitoring: Renal function in patients with kidney disease
    • Patient Education: Stay hydrated to reduce the risk of kidney side effects

    Oseltamivir (Tamiflu)

    • Medication class: Antiviral Agent; Neuraminidase Inhibitor
    • Mechanism of Action: Inhibits viral neuraminidase, preventing virus release from infected cells
    • Indications: Influenza infection in patients older than two weeks, ideally initiated within 48 hours of symptoms
    • Adverse Effects: Nausea, vomiting, confusion, delirium, and hallucinations
    • Contraindications: Infants under two weeks
    • Interactions: Limited known interactions
    • Monitoring: Not generally required
    • Patient Education: Take with food to reduce GI upset; complete the full course even if symptoms improve early

    Nirmatrelvir/ritonavir (Paxlovid)

    • Medication class: Antiviral Agent; Cytochrome P-450 Inhibitor
    • Mechanism of Action: Inhibits viral replication
    • Indications: COVID-19 infection in high-risk patients, ideally within 72 hours of symptoms onset
    • Adverse Effects: Diarrhea, altered taste (dysgeusia)
    • Contraindications: N/A
    • Interactions: Numerous interactions due to CYP450 inhibition; caution with drugs metabolized via CYP3A4
    • Monitoring: Not generally required
    • Patient Education: Report any unusual side effects, and consult about concurrent medications due to interaction potential

    Benzonatate (Tessalon Perles)

    • Medication class: Antitussive, Non-narcotic
    • Mechanism of Action: Suppresses cough by anesthetizing respiratory stretch receptors
    • Indications: Symptomatic relief of cough
    • Adverse Effects: Mild GI disturbances, drowsiness
    • Contraindications: Children under 10 years due to risk of choking
    • Interactions: Minimal known interactions
    • Monitoring: None typically required
    • Patient Education: Do not chew or crush; swallow capsules whole to avoid oral mucosal anesthesia

    Most Common Viral Pathogens Associated with Respiratory Tract Infections:

    • Influenza (A and B), Respiratory Syncytial Virus (RSV), Parainfluenza, Rhinovirus, Adenovirus, and COVID-19 (SARS-CoV-2)

    Typical Presentation of Viral Respiratory Tract Infection:

    • Symptoms include cough, sneezing, rhinorrhea, sore throat, headache, malaise, and fever.

    Vaccination and Antiviral Treatment:

    • Vaccination: COVID-19, Influenza, RSV, Varicella (Chickenpox), Shingles, Hepatitis A & B, HPV
    • Antiviral Therapy: Influenza (Oseltamivir), COVID-19 (Nirmatrelvir/ritonavir for high-risk patients), and RSV (Ribavirin for severe cases)

    Supportive Care Therapies:

    • Hydration, rest, analgesics/antipyretics, humidified air, saline nasal sprays, and hot drinks for sore throat relief

    Pathophysiology of Viral Pulmonary Infections:

    • Viral infections lead to inflammation, causing increased sputum production and cough as the body attempts to clear the airways.

    When Antivirals are Appropriate:

    • Antivirals are indicated when they can reduce viral replication early in the course of illness (e.g., within 48 hours for influenza) or for high-risk individuals (e.g., Paxlovid for COVID-19).

    Symptomatic Management for Cough:

    • Dextromethorphan (antitussive), Benzonatate (cough suppressant), Guaifenesin (expectorant), and honey.

    Symptomatic Management for RSV in Pediatric Patients:

    • Supportive care, bronchodilators, glucocorticoids, Ribavirin (for severe cases), and monoclonal antibodies like Palivizumab for high-risk infants.

    Prescription for Oral Herpes Simplex Prevention:

    • Valacyclovir: 1g PO daily or Acyclovir: 400 mg PO twice daily

    Prescription for Oral Herpes Simplex Treatment:

    • Valacyclovir: 1g PO daily for 7-10 days or Acyclovir: 400mg PO three times daily for 7-10 days

    Drug Classes for Treating Hepatitis B and C:

    • Hepatitis B: NRTIs (e.g., Tenofovir, Entecavir), Pegylated Interferon.
    • Hepatitis C: NS5A inhibitors (e.g., Ledipasvir-sofosbuvir, Sofosbuvir-velpatasvir)

    Dextromethorphan

    • Medication Class: NMDA Receptor Antagonist, Antitussive
    • Mechanism of Action: Reduces cough reflex sensitivity and transmission through medullary cough center depression
    • Indications: Cough suppression
    • Adverse Effects: Drowsiness, dizziness, nervousness, gastrointestinal symptoms
    • Contraindications: Use with or within two weeks of MAOIs; caution in children under two
    • Interactions: SSRIs, MAOIs (risk of serotonin syndrome)

    Guaifenesin

    • Medication Class: Expectorant
    • Mechanism of Action: Thins mucus secretions, aiding expectoration
    • Indications: Chest congestion with productive cough
    • Adverse Effects: Dizziness, drowsiness, headache, nausea
    • Contraindications: Caution in children under two to four years (depends on formulation)
    • Interactions: Avoid with alcohol (ethanol-containing products)

    Acyclovir

    • Medication Class: Antiviral Agent
    • Mechanism of Action: Inhibits viral DNA synthesis, preventing replication
    • Indications: Herpes simplex, varicella-zoster, and bell palsy
    • Adverse Effects: Renal toxicity (AKI), neurotoxicity, thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS)
    • Contraindications: Caution with renal impairment

    Oseltamivir (Tamiflu)

    • Medication Class: Antiviral Agent; Neuraminidase Inhibitor
    • Mechanism of Action: Inhibits viral neuraminidase, preventing virus release from infected cells
    • Indications: Influenza infection in patients older than two weeks, ideally initiated within 48 hours of symptoms
    • Adverse Effects: Nausea, vomiting, confusion, delirium, hallucinations
    • Contraindications: Infants under two weeks

    Nirmatrelvir/ritonavir (Paxlovid)

    • Medication Class: Antiviral Agent; Cytochrome P-450 Inhibitor
    • Mechanism of Action: Inhibits viral replication
    • Indications: COVID-19 infection in high-risk patients, ideally within 72 hours of symptom onset
    • Adverse Effects: Diarrhea, altered taste (dysgeusia)
    • Interactions: Numerous interactions due to CYP450 inhibition; caution with drugs metabolized via CYP3A4

    Benzonatate (Tessalon Perles)

    • Medication Class: Antitussive, Non-narcotic
    • Mechanism of Action: Suppresses cough by anesthetizing respiratory stretch receptors
    • Indications: Symptomatic relief of cough
    • Adverse Effects: Mild GI disturbances, drowsiness
    • Contraindications: Children under 10 years due to risk of choking

    Common Viral Pathogens Associated with Respiratory Tract Infections

    • Influenza (A and B), Respiratory Syncytial Virus (RSV), Parainfluenza, Rhinovirus, Adenovirus, and COVID-19 (SARS-CoV-2)

    Typical Presentation of Viral Respiratory Tract Infection

    • Symptoms include cough, sneezing, rhinorrhea, sore throat, headache, malaise, and fever

    Vaccination and Antiviral Treatment

    • Vaccination: COVID-19, Influenza, RSV, Varicella (Chickenpox), Shingles, Hepatitis A & B, HPV
    • Antiviral Therapy: Influenza (Oseltamivir), COVID-19 (Nirmatrelvir/ritonavir for high-risk patients), and RSV (Ribavirin for severe cases)

    Supportive Care Therapies

    • Hydration, rest, analgesics/antipyretics, humidified air, saline nasal sprays, and hot drinks for sore throat relief

    Pathophysiology of Viral Pulmonary Infections

    • Viral infections lead to inflammation, causing increased sputum production and cough as the body attempts to clear the airways

    When Antivirals are Appropriate

    • Antivirals are indicated when they can reduce viral replication early in the course of illness (e.g., within 48 hours for influenza) or for high-risk individuals (e.g., Paxlovid for COVID-19)

    Symptomatic Management for Cough

    • Dextromethorphan (antitussive), Benzonatate (cough suppressant), Guaifenesin (expectorant), and honey

    Symptomatic Management for RSV in Pediatric Patients

    • Supportive care, bronchodilators, glucocorticoids, Ribavirin (for severe cases), and monoclonal antibodies like Palivizumab for high-risk infants

    Prescription for Oral Herpes Simplex Prevention

    • Valacyclovir: 1g PO daily or Acyclovir: 400 mg PO twice daily

    Prescription for Oral Herpes Simplex Treatment

    • Valacyclovir: 1g PO daily for 7-10 days or Acyclovir: 400 mg PO three times daily for 7-10 days

    Drug Classes for Treating Hepatitis B and C

    • Hepatitis B: NRTIs (e.g., Tenofovir, Entecavir), Pegylated Interferon.
    • Hepatitis C: NS5A inhibitors (e.g., Ledipasvir-sofosbuvir, Sofosbuvir-velpatasvir)

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