Cough and Cold, Respiratory Drugs - Introduction to Pharmacology - Lecture Slides, Slides of Pharmacy

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Chapter 9

Respiratory Drugs

Cough and Cold

• Common colds are the most prevalent respiratory tract infections
• Symptoms:
  • Mild malaise
  • Runny nose
  • Sneezing
  • Scratchy throat
  • Fever

Antitussives

• Coughing clears the airways of excess secretions and foreign materials
• Antitussives can be useful for dry, nonproductive coughs by causing:

1. CNS depression of the cough center (reflex)
2. Suppression of the nerve receptors in the respiratory tract

Cough Reflex

• Stimulated by stretch receptors and irritant receptors
• Follows a series of 6 events:
  1. Inspiration interrupts regular breathing rhythm
  2. Thorax and abdominal muscles contract rapidly
  3. Airway closes

Antitussives

• benzonatate (Tessalon)
• codeine
• dextromethorphan (Delsym)
• diphenhydramine (Benadryl)
• hydrocodone-homatropine (Hycodan)
• promethazine-codeine

Drug List

Antitussives

Dextromethorphan Combos

• dextromethorphan-pseudoephedrine- brompheniramine (Bromfed-DM, Myphetane DX)
• guaifenesin-dextromethorphan (Mucinex DM)
• promethazine-dextromethorphan

Drug List

Codeine Side Effects

• Nausea
• Drowsiness
• Light-headedness
• Constipation

benzonatate (Tessalon)

• Has local anesthetic effects
• Numbs the stretch receptors in the airway, lungs, and pleura
• Very dangerous if chewed

Expectorants

• Help rid the lungs and airway of mucus when coughing
• Decrease thickness and stickiness of mucus, decrease viscosity and increase expectoration of mucus
• Used for dry and productive coughs

Water

• Can work as well as, if not better than, medication expectorants
• Staying well-hydrated thins mucus and allows for easier expectoration

guaifenesin

• Loosens phlegm and thins bronchial secretions
• Available in capsule, tablet, sustained- release, and liquid forms
• Frequently combined with other cough and cold preparations
• Okay for patients with asthma or emphysema

Decongestants

• Swelling and stuffiness are caused by vasodilation and leakage of fluids into the nasal mucosa
• Decongestants cause constriction which promotes drainage, improves nasal ventilation, and relieves stuffiness, which then allows the sinus cavities to drain

Decongestant Dispensing Issues

• Should be avoided in patients with:
  • Diabetes
  • Heart disease
  • Uncontrolled hypertension
  • Hyperthyroidism
  • Prostatic hypertrophy
  • Tourette’s syndrome

Warning!

Decongestants

• pseudoephedrine (Sudafed)

Combinations:

• APAP-clemastine-pseudoephedrine (Tavist Allergy/Sinus/Headache)
• brompheniramine-pseudoephedrine (Efidac

Drug List