Bronchitis, Bronchiolitis, Croup Pharm Flashcards
MoA Dextromethorphan
- Decreases the sensitivity of cough receptors and interrupts cough impulse transmission by depressing the medullary cough center through sigma receptor stimulation.
- Structurally related to codeine.
- Decreasing the sensitivity of cough receptors and interrupting cough impulse transmission leads to cough suppression
What is very dangerous side effect of dextromethorphan?
Serotonin syndrome
- can occur if used with other serotonergic drugs
Age dextromethorphan should be used in
> 4 yo
2 Adverse effects of dextromethorphan
- CNS – drowsiness, nausea, constipation
- High dose: confusion, excitement, irritability, nervousness, serotonin syndrome (nausea, vomiting, tachycardia, HTN, increased body temp), metabolic acidosis
Potential for abuse of dextromethorphan
- what dose is abusive
- outcome
- Commonly diverted agent for illicit recreational use
- High dose (>100 mg), hallucinogenic or out of body experiences like Ketamine or PCP
- Abuse can cause death, brain damage, seizure, LOC, irregular heartbeat
Anesthetic products in topical cough products
- Benzocaine
- Dyclonine
Demulcent products in topical cough products
- Pectin (short lived)
- Honey
- Glycerin
Antitussive products in topical cough products
- Dextromethorphan
- camphor
- menthol
What 4 products not recommended for bronchitis
- mucolytics
- inhaled beta2 agonists
- corticosteroids
- abx
Adult dosing recommendation for aspirin
325-650 mg PRN q 4 hrs
Max 4 gm/day
Child dosing recommendation for acetaminophen
10-15 mg/kg q 4-6 hr
max 5 dose in 24 hrs
Adult dosing recommendation for acetaminophen
650-1000 mg q 4-6 hr
max 3 grams daily
Child dosing recommendation for ibuprofen
4-10 mg/kg q 6-8 hr
max 40 mg/kg/day
Adult dosing recommendation for ibuprofen
200-800 mg q 4-6 hrs
max dose 3.2 g daily
3 Alt tx for children with bronchitis
- honey (IF > 1 yo)
- humidifcation
- treat underlying reason for cough (antihistamine for post-nasal drip and GERD treatment)
