Cough Chapter 12 PDF
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PCOM School of Pharmacy
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Summary
This document details the different types of coughs and potential treatments including both pharmacological and non-pharmacological treatments. The text discusses the pathophysiology, clinical presentation, and special considerations for various populations.
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12 ough Chapter ing e Cough= involuntary (re ex) controlled by cough center in medulla oblongata in brain stem ~voluntary cough is controlled by cerebral cortex Cough occurs in 3 phases: 1)Inspiratory 2)Compressive 3)Expulsive Pathophysiology...
12 ough Chapter ing e Cough= involuntary (re ex) controlled by cough center in medulla oblongata in brain stem ~voluntary cough is controlled by cerebral cortex Cough occurs in 3 phases: 1)Inspiratory 2)Compressive 3)Expulsive Pathophysiology: -triggers= smoke, perfumes, scents, throat irritation/tickles, noxious fumes, speech, exercise, cold/dry air, eating, and humidity Clinical Presentation: -Productive/Wet Cough -Non-productive/Dry Cough (associated with viral respiratory tract infections, GERD, cardiac diseases, and some meds) Non-pharm: -stay well hydrated -reduce throat irritation -increase moisture in air -treat underlying cause of cough OTC- pharm: Anti-tussive= Cough SUPPRESSANT ~control or eliminate cough ~ONLY for non-productive coughs** -Topical anti-tussive= Menthol or Camphor -Codeine (schedule 2 drug!) ~side e ects= nausea, vomiting, sedation, dizziness -Dextromethorphan (Delsym) ~side e ects= uncommon at usual doses (but can be nausea, vomiting, diarrhea, drowsiness, or constipation) -Diphenhydramine (Benadryl) ~1st gen. Antihistamine ~anti-tussive dose lower than antihistamine dose ~side e ects= drowsiness, respiratory distress, blurred vision, dry mouth, urinary retention, and dry respiratory secretions **do NOT use with other diphenhydramine containing products Protussive= COUGH EXPECTORANT ~change consistency of mucus and increase volume of expectorated sputum -Guaifenesin (glyceryl guiacoloase) MUCINEX*** ~NOT for chronic, ONLY acute relief! ~side e ects= nausea, vomiting, diarrhea, headache, rash, diarrhea, drowsiness, stomach pain ***Special populations*** ~Pregnancy= Dextromethorphan (Delsym) is SAFE, can also take Guaifenesin (Mucinex) ~Lactation= do NOT use Codeine, Dextromethorphan (Delsym), or Diphenhydramine (Benadryl)!! BAD ~Elderly= start at low dose for Codeine, Dextromethorphan (Delsym), and Diphenhydramine (Benadryl) (may cause sedating e ect) **Drug Interaction between Phenytoin & Benadryl -Phenytoin inhibits CYP450 & Benadryl is metabolized by CYP450
