Cough suppressants, Decongestants, Mucolytics

Question 1

What are the 4 antitussives we must know for the test? MCDC (May Correct Dry Cough)

Answer 1

Dextromethorphan, Codine (oral)
Camphor- topical (inhaled)
Menthol- topical (inhaled or lozenges)

Question 2

What do antitussives treat?

Answer 2

Dry cough

Question 3

MOA of antitussives?

Answer 3

Directly repress the cough center in the medulla

Question 4

What liver enzyme metabolizes Dextromethorphan? What is it metabolized to?

Answer 4

CYP2D6 metabolizes dextromethorphan –> dextrorphan. Acts on MDBA receptor

Question 5

Contraindications of antitussives?

Answer 5

MAOI’s, respiratory insufficiency, liver disease

Question 6

If you take a HUGE overdose of antitussives, what happens?

Answer 6

Hallucinations. You will see the devil and Jim Morrison drinking gin and tonics together!! People abuse it and become addicted!

Question 7

MOA of camphor and menthol?

Answer 7

Desensitizes TRPV-1 –> decreased cough

Question 8

What receptors does codeine act on?

Answer 8

Mu receptors in the respiratory center of the medulla

Question 9

10% of codeine is metabolized to?

Answer 9

Morphine

Question 10

ADE of codeine?

Answer 10

Constipation, sedation, orthostatic hypotension, histamine release. Cant poop, cant stay awake, cant stand up

Question 11

What drug on our list is an “expectorant”. What do they treat? Whats the MOA?

Answer 11

Guaifenesin. Treats productive cough. MOA: loosens and thins the LRT secretions

Question 12

ADE of Guaifenesin?

Answer 12

Uric acid nephrolithiasis. Think Guai= Go away pee pee cuz ur pee pee hole is blocked

Question 13

List the decongestants

Answer 13

Pseudoephedrine, Phenylephrine, Oxymetazoline

Question 14

What is PSE’s MOA?

Answer 14

alpha 1 receptor agonist via increasing NE release. This causes vasoconstriction of the vessels of the sinuses thus less edema

Question 15

Contraindications in PSE?

Answer 15

Children/elderly, hyperthyroidism, bradycardia, heart block, uncontrolled HTN, ventricular tachycardia

Question 16

ADE of PSE?

Answer 16

1. CV stimulation
2. CNS stimulation
3. Rebound congestion
4. Tachyphylaxis
   CCR= Creedence!

Question 17

MOA of PE?

Answer 17

Directly stimulate the alpha 1 receptors –> vasoconstriction –> less edema in sinuses

Question 18

ADE of PE?

Answer 18

Same as PSE:

1. CV stimulation
2. CNS stimulation (anxiety, restlessness)
3. Rebound congestion

Question 19

This nasal spray decongestant is preferred for pregnant women?

Answer 19

Oxymetazoline (Afrin)

Question 20

You dont want to take oxymetazoline for more that how many days?

Answer 20

5 tops

Question 21

What are the 2 mucolytics?

Answer 21

Acetyl cystine & Amiloride

Question 22

MOA of acetyl cystine?

Answer 22

Substitutes a sulfhydryl radical for the disulfide bonds on mucus –> breaks up mucus

Question 23

ADE of acetyl cystine?

Answer 23

1. Bad odor of mucus
2. More mucus
3. N/V

Question 24

MOA of amiloride?

Answer 24

It is a diuretic. A sodium channel blocker. It blocks sodium from getting out of the airway. If sodium stays, water stays –> less viscous mucus

Question 25

Which mucolytic can be used to treat an acetominophen (Tylenol) overdose?

Answer 25

Acetyl cystine