Cough Flashcards
Opioid antitussive name?
Codeine
ADR of codeine?
CNS - sedation, confusion
Respiratory depression - risk on overdose
Do not combine with other CNS depressants
Caution for elderly. More susceptible to sedation and confusion
Abuse potential at high dose.
Not for <18 yo
ADR of Dextromethorphan?
CNS - drowsiness, confusion, dizziness, insomnia, excitement, nervousness
GIT - nausea, vomiting, stomachache
Abuse potential at high dose (dissociative anaesthetic-like effect)
Unrecommended <4 years old
Unrecommended for elderly, more susceptible to sedation and confusion.
ADR of Dextromethorphan?
CNS - drowsiness, confusion, dizziness, insomnia, excitement, nervousness
GIT - nausea, vomiting, stomachache
Abuse potential at high dose (dissociative anaesthetic-like effect)
Unrecommended <4 years old
Unrecommended for elderly, more susceptible to sedation and confusion.
ADR of Diphenhydramine?
Sedative
Anticholinergic
Unrecommended for elderly, more prone to sedation and confusion
Anticholinergic effects can precipitate dementia
Banned for narrow-angle glaucoma.
Expectorant name?
Guaifenesin
ADR of expectorant?
GI disturbance, Nausea
Caution <6 years old
Banned <2 years old
Banned for persistent cough linked to asthma or smoking
Take adequate fluid to make secretions less viscous and protect renal function. Nephrolithiasis reported on overdose. “
MOA of expectorant?
Produce respiratory tract fluids to help liquefy and reduce viscosity of tenacious secretions
Mucolytic Names?
Acetylcysteine
Carbocisteine
Mucolytics MOA?
Free sulfhydryl group opens disulphide bonds in mucoproteins
Lowers mucous viscosity
ADR of Mucolytics?
Bronchospasm - Caution for asthma
Anaphylactoid reactions - rash, hypotension, dyspnea, wheezing
GI disturbance
Carbocisteine banned in patients with active peptic ulcer
Caution for elderly with respiratory insufficiency
Mucokinetic name?
Bromhexine
MOA of Bromhexine?
Promote mucous clearance
Increase ciliary beat frequency
Lower adherence of mucus to cilia
Stimulate surfactant production, lower mucus adherence to alveolar and bronchial walls
Antioxidant as free radical scavenger
Anti-inflammatory by decreasing cytokines
Suppress influenza virus multiplication
Local anaesthetic by blocking voltage-gated Sodium channel”
ADR of bromhexine?
Allergic reactions
Cutaneous adverse effects
Caution for asthma + peptic ulcer disease
Caution <6 years old
Banned <2 years old “
Mucoregulator name?
Ipratropium
MOA of ipratropium mucoregulator?
Short-acting Muscarinic Receptor antagonist (SAMA)
Block inflammation-induced parasympathetic cholinergic M3 receptor activation of submucosal glands/goblet cells
Lower stimulated mucus output and sputum volume
No effect on basal secretion and normal viscosity”
Use of Ipratropium?
Control severe cold symptoms
Lower mucus hypersecretion from goblet cells and submucosal glands
Mast cell stabilizer name?
Cromoglicic acid
MOA of Mast cell stabilizer Cromoglicic acid?
Control Chloride channels to inhibit cellular activation
Reduce Mast cell degranulation induced by IgE-mediated FceRI crosslinking
Reduce inflammatory mediators from eosinophils, neutrophils and macrophages
Secrete Annexin A1 which inhibits prostaglandin and leukotriene production from mast cells
ADR of Mast cell stabilizer?
“1. Throat and nasal irritation, dry mouth, cough
2. Unpleasant/bitter taste”
Decongestants names?
Sympathomimetic agents:
Phenylephrine
Oxymetazoline
Naphazoline
Pseudoephedrine
Ephedrine
Nasal glucocorticoid:
Fluticasone, Mometasone
MOA of sympathomimetic agents?
Vasoconstriction of nasal blood vessels
Reduce inflammation and mucus secretion
ADR of sympathomimetic agents?
Rebound congestion - with prolonged topical intranasal use > few days
CNS stimulation - Restlessness, tremors, irritability, anxiety, insomnia
CVS - More likely with oral decongestants
Hypertension due to vasocontraction, Tachycardia (indirect sympathomimetics)
Dry mouth - Alpha 2 agonist effect on salivary gland
MOA of Fluticasone and mometasone?
Anti inflammation
Reduce congestion and mucus secretions
Uses of Codeine?
Most effective antitussive
Uses of dextromethorphan?
For non-productive cough
Most effective non-opioid antitussive
Uses of Dextromethorphan?
for non-productive cough
Most effective non-opioid antitussive
