Cough Suppressants

Question 1

3 phases of cough

Answer 1

1. inspiratory
2. compression
3. expulsive

Question 2

neural pathways of cough

Answer 2

pharynx, carina, bronchial bifurcation, esophagus

Question 3

duration of cough

Answer 3

acute = less than 3 weeks
subacute = 3 - 8 weeks
chronic = over 8 weeks

Question 4

dextromethorphan

Answer 4

Active ingredient in cough and cold meds
MOA: directly suppresses the cough center in the medulla
contraindications: pts on monamine oxidase inhibitor (antidepressants) i.e. Libby Zion

Question 5

diphenhydramine (benadryl)

Answer 5

MOA: directly suppresses the cough center in the medulla, also is antihistamine H1 receptor antagonist
SE: CNS-drowsiness, respiratory depression
AM - blurred vision, dry mouth, urinary retention

Question 6

codeine (3-methylmorphine)

Answer 6

MOA: acts on mu receptors but has lower affinity than morphine, depresses cough reflex by direct action on cough center in CNS
*10% metabolized to morphine (sedative)
SE: respiratory depression
DO NOT USE IN CHILDREN

Question 7

Camphor (ointment)

Answer 7

MOA: initial activation of TRPA1 & TRPV1 channels, followed by desensitization

Question 8

Menthol (ointment)

Answer 8

MOA: initial activation of TRPM8 channel, followed by desensitization

Question 9

Guaifenesin (Mucinex)

Answer 9

MOA: loosens and thins lower respiratory tract secretions by increasing the V and reducing the viscosity of the secretions so they can be expelled more easily