ANTI TUSSIVES AND COUGH SUPPRESSANTS AND DRUGS FOR DRY COUGH

ANTI TUSSIVES AND COUGH SUPPRESSANTS

1. Cough
Productive Non productive
Expectorants
(mucokinetics)
Antitussives
Pharyngeal demulcents

2. Pharyngeal demulcents
Lozenges
Cough drops
linctuses
Soothening effect on the throat
Reduce afferent impulses from inflammed
pharyngeal mucosa

3. Expectorants
Increase bronchial secretions
Decrease viscosity of mucous secretions
Makes cough less tiring
MucolyticsDirectly acting
Reflexly actingSodium and potassium
citrate or acetate, Potassium
iodide, Guaiacol,
Guaiphensin, Balsum of tolu,
Vasaka, Terpin hydrate
Ammonium chloride
or carbonate,
Potassium iodide
Bromhexine
ambroxol
Acetylcysteine
carbocysteine

4. Antitussives
Cough centre suppressants
Reduce tussal impulses in respiratory tract
Opioids
Non opioids
Antihistamines
Codeine,
pholcodeine,
Morphine, ethyl
morphine
Noscapine,
Dextromethorphan,
Oxeladin,
chlophendianol
Chlorpheniramine
Diphenhydramine
promethazine

5. Codeine
Less potent than morphine
Standard antitussive
More selective for cough centre
Suppresses cough for 6 hrs
Naloxone blocks antitussive action
Adverse effects
Constipation, drowsiness
Respiratory depression
Contraindications
Asthmatics
Diminished respiratory
reserve

6. Dextrometharphan
Synthetic, as effective as codeine
d-isomer -threshold of cough centre
l-isomer -analgesic
Antitussive action not blocked by naloxone
Do not depress mucocilliary function
No constipation & addiction
Adverse effect
Dryness of mouth, vertigo, irritability

7. H
1 Antihistamines
Enhance action of antitussives and expectorants by their
sedative & anti cholinergic actions.
Used in allergic cough
Chlorpheniramine
Diphenhydramine
Promethazine

8. Bronchodilators
For cough associated with bronchial hypersensitivity
Aeromatic chest rub
Used to reduce experimentally used cough in humans
Not effective in pathological cough

9. Etiology Treatment
URI Antibiotics
Smoking, chronic bronchitisCessation of smoking
Avoid pollutants
Pulmonary TB Anti tubercular drugs
Asthma β
2 agonists
Post nasal drip Antibiotic, nasal decongestant,
H
1antihistamine
GERD Head elevation, light dinner,
antisecretory
ACE inhibitor Indomethacin, nifedipine
Treatment approaches to cough of various etiologies