Cough & Cold Flashcards
Cough suppressants
Opiate agonist (Codeine, hydrocodone), dextromethorphan
Contraindications for cough suppressants
Opiate agonist: <18yo, dextromethorphan <4yo
MoA of opiate agonist
mu opioid receptor agonist, acts on cough centre in brain (centrally-acting)
MoA of dextromethorphan
NMDA receptor –> block Ca, Na influx –> stimulate S1R in ER –> channel Ca into mitochondria –> channel function modulation
SE of the opiate agonist
respiratory depression, constipation, sedation
SE of dextromethorphan
confusion, nervousness; high dose: headaches; extremely high dose: euphoria
Which has higher risk of addiction
Opiate agonists. Dextromethorphan is non-narcotic
mucolytics
N-acetylcysteine, carbocisteine
indications of mucolytics
URTI, asthma, COPD, CF
MoA of NAC
Break double sulfide bonds –> decrease mucus viscosity
MoA of carbocisteine
Break double sulfide bonds –> decrease mucus viscosity
Increase sialomucin –> decrease mucus adherence to airways
Expectorants
Guaifenesin (not indicated in <2yo)
MoA of Guaifenesin
Increase volume of hydration and liquidity of mucus, decrease adherence to airways, increase mucociliary transport –> promote productive cough
SE of Guaifenesin
Nausea, vomiting, kidney stones (maintain hydration and increase urinary pH)
Mucokinetics
B2 agonist, ambroxol