24.2 Antitussives
3 min read•june 18, 2024
Coughing can be a real pain, but antitussive drugs can help. These meds work in different ways to stop that annoying tickle in your throat. Some act on your brain, while others target your airways directly.
There's a range of options, from to dextromethorphan, each with its own pros and cons. It's crucial to know how to use them safely and what side effects to watch out for. Your nurse can guide you on picking the right one for your specific cough.
Antitussive Drugs
Mechanisms of action
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Top images from around the web for Mechanisms of action
Frontiers | Mechanisms of Action for Antimicrobial Peptides With Antibacterial and Antibiofilm ... View original
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Central and peripheral mechanisms of narcotic antitussives: codeine-sensitive and -resistant ... View original
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Frontiers | Coughing in Small Animal Patients View original
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- Centrally acting antitussives suppress the by acting on the in the medulla (codeine, dextromethorphan) reduce the sensitivity of the cough reflex, decreasing the urge to cough
- Peripherally acting antitussives reduce cough by decreasing the sensitivity of cough receptors in the airways (benzonatate, ) directly inhibit the sensory receptors in the respiratory tract, reducing the impulse to cough
Indications, effects, and side effects
- Codeine indicated for dry, suppresses cough reflex and has mild analgesic and sedative properties side effects include drowsiness, , nausea, vomiting, and
- Dextromethorphan indicated for dry, nonproductive cough suppresses cough reflex without analgesic or sedative properties side effects include dizziness, drowsiness, nausea, and vomiting
- Benzonatate indicated for dry, nonproductive cough decreases sensitivity of cough receptors without CNS effects side effects include headache, drowsiness, , and numbness in mouth and throat
- Guaifenesin indicated for with thick, viscous mucus acts as an expectorant, increasing the volume and decreasing the viscosity of respiratory tract secretions side effects include nausea, vomiting, diarrhea, and stomach discomfort
Nursing considerations
- Assessment evaluate the type and severity of cough (dry, productive, duration, frequency) assess for underlying respiratory disorders or infections and review patient's medication history and allergies to guide appropriate antitussive selection
- Administration administer antitussives as prescribed, considering the appropriate route and dosage educate patients on proper use and potential side effects monitor for drug interactions, especially with CNS depressants (alcohol, sedatives)
- Monitoring assess the effectiveness of antitussive therapy in reducing cough frequency and severity monitor for adverse effects, such as drowsiness, constipation, or respiratory depression evaluate the need for continued antitussive therapy or adjustments in treatment plan based on patient response
Patient education plan
- Medication instructions explain the purpose, dosage, and administration route of the prescribed antitussive emphasize the importance of taking the medication as directed and not exceeding recommended doses to ensure safe and effective use
- Side effect management inform patients of potential side effects and how to manage them (staying hydrated for constipation, avoiding driving when drowsy) advise patients to report severe or persistent side effects to their healthcare provider for prompt intervention
- Drug interactions and precautions caution patients about the risks of combining antitussives with other CNS depressants (alcohol, sedatives) which can lead to excessive sedation or respiratory depression instruct patients to inform their healthcare provider about all medications they are taking to avoid potential interactions and ensure safe use
- Follow-up and monitoring encourage patients to keep track of their cough symptoms and the effectiveness of the antitussive medication advise patients to follow up with their healthcare provider if the cough persists, worsens, or new symptoms develop to ensure appropriate management and adjust treatment as needed
Key Terms to Review (35)
Anticholinergics: Anticholinergics are a class of drugs that block the action of the neurotransmitter acetylcholine, which is responsible for various physiological functions. These drugs are used to treat a variety of conditions, including overactive bladder, Parkinson's disease, and the side effects of certain psychiatric medications.
Asthma: Asthma is a chronic inflammatory disorder of the airways characterized by recurring episodes of breathlessness, wheezing, chest tightness, and coughing. It involves a complex interplay of airway inflammation, bronchial hyperresponsiveness, and airflow obstruction, which can significantly impact respiratory function and quality of life.
Bronchial Mucosa: The bronchial mucosa refers to the moist, protective lining of the bronchi, the main airways that carry air to and from the lungs. This specialized tissue plays a crucial role in the respiratory system, particularly in the context of antitussive medications.
Bronchitis: Bronchitis is a respiratory condition characterized by inflammation and irritation of the bronchial tubes, the airways that connect the lungs to the trachea. This inflammation can lead to increased mucus production, coughing, and difficulty breathing, particularly in the context of antitussives, which are medications used to suppress coughing.
Bronchodilation: Bronchodilation is the dilation or widening of the bronchi and bronchioles, the airways within the lungs. This process leads to increased airflow and reduced airway resistance, facilitating easier breathing. Bronchodilation is a crucial mechanism in the management of various respiratory conditions, including asthma, chronic obstructive pulmonary disease (COPD), and bronchospasm.
Capsules: Capsules are a type of solid dosage form that consists of a shell, usually made of gelatin, that contains a powdered or liquid drug formulation. They are designed to protect the drug from degradation, mask unpleasant tastes or odors, and facilitate the administration of medications.
Chronic Obstructive Pulmonary Disease: Chronic obstructive pulmonary disease (COPD) is a progressive lung condition characterized by persistent airflow obstruction, typically caused by a combination of small airway disease and parenchymal destruction. This term is important in the context of antitussives and corticosteroids, as these pharmacological interventions play a crucial role in the management of COPD symptoms and disease progression.
Codeine: Codeine is a naturally occurring opioid analgesic and antitussive (cough suppressant) drug. It is derived from the opium poppy plant and is commonly used to treat mild to moderate pain and suppress cough. Codeine's effects and uses are closely tied to its classification as a drug, its action as an opioid agonist, and its application as an antitussive medication.
Constipation: Constipation is a condition characterized by infrequent bowel movements or difficulty in passing stools. It can be a common side effect of opioid medications.
Constipation: Constipation is a common gastrointestinal condition characterized by infrequent or difficult bowel movements, often accompanied by hard, dry stool. This term is particularly relevant in the context of various medication classes, as certain drugs can either cause or alleviate constipation as a side effect or therapeutic effect.
COPD: COPD, or Chronic Obstructive Pulmonary Disease, is a progressive lung disease characterized by persistent respiratory symptoms and airflow limitation. It is a significant term in the context of 18.4 Beta-Adrenergic Blockers, 23.2 Introduction to the Lower Respiratory System, 24.2 Antitussives, and 25.3 Xanthines, Leukotriene Modifiers, and Mast Cell Stabilizers, as it impacts the management and treatment of various respiratory conditions.
Cough Center: The cough center is a region in the brainstem that coordinates the complex reflex of coughing. It is responsible for integrating sensory information from the airways and initiating the motor response that results in the characteristic cough.
Cough Reflex: The cough reflex is a protective mechanism that helps clear the airways of irritants, mucus, or foreign objects. It is an important physiological response that plays a crucial role in respiratory health and is particularly relevant in the context of antitussives, which are medications that aim to suppress or modify the cough reflex.
Cough Suppression: Cough suppression refers to the reduction or inhibition of the cough reflex, which is a protective mechanism that helps clear the airways of irritants or excess mucus. This term is particularly relevant in the context of opioid agonists and antitussives, as these classes of drugs can have a direct impact on the cough response.
CYP2D6 Inhibitors: CYP2D6 inhibitors are a class of medications that block the activity of the CYP2D6 enzyme, which is responsible for the metabolism of various drugs. This inhibition can lead to altered drug concentrations and potential side effects, making CYP2D6 inhibitors an important consideration in pharmacotherapy, particularly in the context of antitussives.
First-Pass Metabolism: First-pass metabolism refers to the process where a drug is metabolized, or broken down, by the liver and other organs before it reaches the systemic circulation and becomes available to the rest of the body. This phenomenon is particularly important when considering the bioavailability and pharmacokinetics of drugs administered through certain routes.
Glucose tablets: Glucose tablets are chewable tablets containing glucose that provide quick relief from hypoglycemia. They are commonly used by people with diabetes to rapidly increase blood sugar levels.
Hepatic Clearance: Hepatic clearance refers to the process by which the liver removes drugs and other substances from the bloodstream, playing a crucial role in the body's ability to metabolize and eliminate these compounds. This term is particularly relevant in the context of understanding the pharmacokinetics and pharmacodynamics of statins, PCSK9 inhibitors, and antitussives.
Histamine Receptors: Histamine receptors are a class of G protein-coupled receptors that bind the neurotransmitter histamine and play a crucial role in various physiological processes, including the regulation of cough reflex as part of the antitussive mechanism.
Levodropropizine: Levodropropizine is a centrally acting antitussive medication used to suppress cough. It is classified under the category of 24.2 Antitussives, which are drugs that act on the cough reflex to provide relief from persistent or unproductive coughing.
MAOIs: MAOIs, or Monoamine Oxidase Inhibitors, are a class of medications primarily used to treat depression. They work by inhibiting the activity of the enzyme monoamine oxidase, which is responsible for breaking down neurotransmitters like serotonin, norepinephrine, and dopamine in the brain. By preventing this breakdown, MAOIs can lead to an increase in the availability of these neurotransmitters, helping to alleviate the symptoms of depression.
Medulla oblongata: The medulla oblongata is the lower part of the brainstem, located just above the spinal cord. It is responsible for controlling various vital functions, including respiration, heart rate, and blood pressure, making it a crucial component in the context of oxygenation, gas exchange, and antitussive effects.
Mu-Opioid Receptor Agonist: A mu-opioid receptor agonist is a drug that binds to and activates the mu-opioid receptors in the body, which are involved in the perception of pain, reward, and respiratory depression. These agonists produce effects such as analgesia, sedation, euphoria, and respiratory depression.
NMDA Receptor: The NMDA (N-methyl-D-aspartate) receptor is a type of ionotropic glutamate receptor that is highly expressed in the central nervous system. It plays a crucial role in various neurological processes, including synaptic plasticity, learning, and memory formation.
Nonproductive Cough: A nonproductive cough, also known as a dry cough, is a type of cough that does not produce any mucus or phlegm. This type of cough is often associated with irritation or inflammation in the upper respiratory tract, but does not help clear out any secretions from the lungs or airways.
Opioid Antitussives: Opioid antitussives are a class of medications that suppress the cough reflex by acting on the central nervous system. They work by binding to opioid receptors in the brain and respiratory centers, reducing the sensitivity of the cough center and decreasing the urge to cough.
Pneumonia: Pneumonia is an inflammatory condition of the lungs, typically caused by an infection, that leads to the alveoli (air sacs) becoming filled with fluid or pus. This impairs the lungs' ability to take in oxygen and expel carbon dioxide, resulting in respiratory symptoms and potentially life-threatening complications.
Productive Cough: A productive cough is a type of cough that brings up mucus or phlegm from the respiratory tract. It is a common symptom associated with various respiratory conditions and can help clear the airways of excess secretions.
Respiratory Depression: Respiratory depression is a condition characterized by a decrease in the body's drive to breathe, leading to reduced respiratory rate, tidal volume, and oxygen levels in the blood. This term is particularly relevant in the context of certain drug classes and their potential to impair normal respiratory function.
Selective serotonin reuptake inhibitors (SSRIs): Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used primarily to treat depression by increasing serotonin levels in the brain. They work by blocking the reabsorption (reuptake) of serotonin into neurons, making more serotonin available.
Serotonin Syndrome: Serotonin syndrome is a potentially life-threatening condition caused by an excess of the neurotransmitter serotonin in the body. It can occur as a result of interactions between certain medications or the use of illicit drugs that affect serotonin levels.
SSRIs: SSRIs, or Selective Serotonin Reuptake Inhibitors, are a class of medications primarily used to treat depression and other mental health conditions. They work by selectively inhibiting the reuptake of the neurotransmitter serotonin, which is believed to play a crucial role in regulating mood, sleep, appetite, and other physiological processes.
Syrup: Syrup is a thick, viscous liquid that is commonly used as a sweetener or flavoring agent in various pharmaceutical and culinary applications. In the context of antitussives, syrups serve as a delivery mechanism for active ingredients that help suppress coughing.
Tablets: Tablets are a solid dosage form of medication that are typically taken orally. They are made by compressing or molding a mixture of active pharmaceutical ingredients and excipients, such as binders, disintegrants, and lubricants, into a compact and convenient form for administration.
Vagus Nerve: The vagus nerve, also known as the tenth cranial nerve, is a crucial component of the parasympathetic nervous system. It originates in the brainstem and extends throughout the body, playing a vital role in the regulation of various physiological processes, including those related to the topics of antitussives and the esophagus and stomach.