Download Treatment of Cough

Treatment of Cough
Cough in general
1. Cough is a forceful release of air from lungs
2. In order to protect the respiratory system by
clearing of
a. Irritants
b. Secretions
3. It can be divided into 2 types
a. Productive cough – with phlegm
b. Non – productive (Dry) cough – without
phlegm
Treatment of Cough
1. Antitussive
a. Opioid
i. Codeine (methylmorphine)
b. Non – opioid
i. Dextromethorphan
2. Expectorant
a. Guaifenesin
3. Mucolytics
a. N – actylcysteine
b. Bromhexine
c. Ambroxol (active metabolite of
Bromhexine)
Drugs/Infos
1. Codeine (Methylmorphine)
Clinical Uses
1. Dry cough
2. Diarrhea
3. Mild/moderate pain
Drugs/Infos
Dextromethorphan
Clinical Uses
1. Dry cough
Antitussive
Opioid
Mechanism of Action
1. Suppress the Mu Opioid receptor at the
CNS
a. Suppress cough stimulus at the CNS
b. Therefore reduce cough
2. Has analgesic effect
a. Therefore also being used in treatment of
pain
None Opioid
Mechanism of Action
1. Suppress cough center at Medulla
Oblongata
2. Stimulates the Sigma Receptor (opoid
receptor)
3. Antagonist the activity of NMDA
glutaminergic receptor
4. Inhibit reuptake of serotonin
Side Effects
3. Respiratory
depression
4. Drig tolerance
5. Drug dependency
6. Constipation
Side Effects
Safer compared to
codeine
1. Lesser addiction
2. Lesser constipation
Drugs/Infos
Guaifenesin
Expectorants
Mechanism of Action
Improve the ability to expectorate (remove)
the phlegm and sputum
Side Effects
1. Nausea
2. Vomiting
Clinical Use
1. Productive cough
Mucolytics
Drugs/Infos
N – Acetylcysteine
Clinical Uses
1. Productive cough
2. Antidote of PCM overdose
Bromhexine
Ambroxol (active metabolite of
Bromhexine)
Clinical uses
1. Productive cough
Mechanism of Action
1. ↓ mucus viscosity by
a. Splitting the disulfide bond that links proteins in the mucus
Has antioxidant property
1. ↓mucus viscosity by
a. Fragmenting long polysaccharide chains of mucus
b. Resulting in more watery mucus which is easier to be expelled
out
2. Stimulate surfactant secretion