Week 6: Cough and Cold Medications

Question 1

Decongestant oral and nasal examples

Answer 1

Oral: Phenylephrine HCL, Pseudoephedrine (Sudafed)

Nasal: oxymetazoline (Afrin)

Question 2

Oral decongestants MOA

Answer 2

Alpha 1 agonists (sympathomimetics FIGHT OR FLIGHT):

• mimic the endogenous catecholamines of the SNS
• vasoconstriction by stimulating the Alpha 1 receptors in the mucosa of the resp. tract, thus temporarily reducing swelling and inflammation = nasal decongestion

**used to treat symptoms

Question 3

Decongestants cautions and ontraindications

Answer 3

• avoid in HTN and CAD
• oral NO < 4 years old; NOT recommended in pregnancy and lactation
• NO with beta blockers or MAOI therapy
• topical/nasal: do not use for longer than 3 days (can cause rebound congestion)

Question 4

Decongestants ADRs

Answer 4

• anxiety, restlessness, headache, insomnia, psychological disturbances, tremors, HTN, tachycardia (fight or flight symptoms)
• topical: nasal irritation and rebound congestions with prolonged use

Question 5

Examples of Antitussive medications

Answer 5

• Dextromethorphan
• Codeine
• Benzonatate

Question 6

Dextromethorphan and Codeine MOA

Answer 6

• acts centrally in the medulla to elevate the threshold for coughing
• affects serotonin
• suppresses the cough reflex
• risk for abuse

Question 7

Benzonatate (Tessalon perles) MOA & education

Answer 7

• anesthetize the stretch receptors in the respiratory passages, calming the cough
• numbs the lungs and more relaxed
• cross BBB
• need prescription!
• educate: swallowing whole, no chewing cus it can anesthesize oral mucosa

Question 8

Antitussive medications cautions/ contraindications

Answer 8

• avoid in persistent/chronic cough caused by smoking, asthma, or emphysema
• additive CNS depression when dextromethorphan or codeine is used with CNS depressants - can decrease respiratory drive
• do not self-medicate cough lasting > 7 days

Question 9

Antitussive ADRs

Answer 9

• codeine: CNS depressant
• dextromethorphan and codeine: drowsiness, dizziness, and GI upset
• benzonatate: chest numbness, dizziness, GI upset, headache, and “chilly” sensation

Question 10

guaifenesin (Mucinex) [expectorant] MOA

Answer 10

• decreases the surface tension of mucus making the mucus more thin and loose for clearance

Question 11

Expectorant/Mucinex indication for use

Answer 11

• for cough from common cold or upper respiratory infections

dry nonproductive cough w/ mucus in resp tract

Question 12

Expectorant/Mucinex ADRs

Answer 12

• GI upset - D/N/V
• drowsiness - dizziness

Question 13

Expectorant/Mucinex cautions/ contraindications

Answer 13

• do not use for persistent cough, cough r/t high fever or lasting > 7 days
• do not use for cough r/t heart failure or ACE inhibitor therapy