Cough suppresants, mucolytics, decongestants Flashcards
See Notes for cough reflex physiology
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acute cough
less than 3 weeks
subacute
3-8
chronic
over 8
DOC (drugs over the counter) for non-productive cough
Systemic agents:
Dextromethorphan
Diphenhydramine
Codeine
Topical agents:
Camphor
Menthol
DOC for productive cough
Expectorants like Guaifenisin…this is really the only one
Dextromethorphan is contraindicated in who
pts on monoamine oxidase inhibitors, antidepressants, pts with resp insufficiency, hepatic disease.
Monoamine oxidase inhibitors reduce the metabolism of serotonin, Dextromethorphan can cause serotonin overload which raises body temperature and leads to potentially fatal serotonin syndrome.
How does Camphor work
desensitizes TRP chanels
What do nasal decongestants do
vasoconstrict…they are alpha adrenergic agonists (sympathomimetic)…constrict blood vessels through the body. Reduce the supply of blood to nose. Remember, alpha receptors on vessels facilitate contraction.
Dont use pseudoephedrine in who
anyone with CV disease
Phenylephrine can cause what
very high HTN…thus heart rate will decrease to compensate
Oxymetazoline is what
selective alpha one agonist…jsut like phenylephrine
Mucus is what
Glycoprotein
Mucus clearance facilitated by
hydration, removing cause, trachobronchial clearance maxmized.
Know the mucolytics. there will be one on the test.
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Three stages of cough
Inspiratory, compressive (closed glottis), expulsive (open glottis)
Neuronal basis for cough
Tussive agent–> RAR receptors + C fibres –> vagus nerve–> brainstem –>cough generator (medulla) –> somatic nevers (phrenic) –> cough
What the productive colors mean
clear- bronchitis, yellow- infalmmatory, purulent–infection, malodorous - anaerobic infection
Codeine side effects and contraindication
constipation, sedation, vasodilation, orthostatic HTN, diziness,
Contraindicated in hypersensitivity, pregnancy, individuals on sedatives, prostatic hypertrophy, acute resp depression and COPD
Pseudoepehdrine mechanism
Alpha 1 and alpha 2 agonist, Basically increases norepinephrine release
Which nasal decongestant can be given to reduce the toxicity caused from tylenol overdose
N-Acetyl Cysteine reduces liver injury due to tylenol overdose
Mechanism of amilioride
ENac blocker. Prevents dehydration of the mucous. Useful in CF
WHat is rhinitis medicamentosa and what can cause it
Rebound congestion caused by overuse of oxymetazoline
