Antitussive Drugs

Antitussive Drugs

1. Anti tussives PREPARED BY: USHA RANI KANDULA, ASSISTANT PROFESSOR, DEPARTMENT OF ADULT HEALTH NURSING, ARSI UNIVERSITY,ASELLA,ETHIOPIA, SOUTH EAST AFRICA.

2. ANTI TUSSIVES Antitussives are drugs used to relieve cough by suppressing the cough centre in the medulla. Coughing is caused by irritation of the bronchial mucosa.

3. Coughing is a protective mechanism in that it helps to remove foreign matter and excessive secretions from the airway.

4. Antitussives are drugs used to control or bring relief from cough. They are used to treat dry non-productive cough, these agents used in antitussive affect the cough reflex.

5. These drugs act in CNS to raise the threshold of cough centre or act peripherally in the respiratory tract to reduce tarsal impulses or both these actions.

6. Mechanism of action

7. MECHANISM OF ACTION Opioid (narcotic) and nonopioid antitussive suppress the cough reflex by direct affecting the cough center; Non- opioid antitussive do this without the CNS suppression of the opioid antitussives .

8. Peripherally acting agents (glycerin, ammonium chloride ) have local anesthetic effect to decrease irritation of the pharyngeal mucosa,

9. They are available in gargles, lozenges and syrups, Lozenges increase saliva flow and therefore suppress the cough.

10. Classification of anti tussives

11. they are classified into 2 groups 1. non- opioids 2. opioids

12. NON- OPIOIDS Non- opioids are the drugs that interact with opioid receptors in the CNS produce antagonistic effect at these sites.

13. As they displace the effect of opioid molecule from the acceptor site. So they are termed as opioid antagonists.

14. non- opioids - dextromethorphan - chlophedianol - noscapine

15. DEXTROMETHORPHAN It has minimal CNS depressant action and no analgesic effect. 30 mg dose is equivalent to 15 mg of codeine.

16. DOSE Lozenge/syrup Adults : 10-30 mg every 4-8 hours maximum 120 mg/24 hours. Children : (6-12 year) 2.5-5mg every 4 hours or 7.5-15 mg every 6-8 hours maximum 60 mg /24 hour.

17. Children : (2-6 year) 1.25-2.5 mg every 4 hours or 3.75-7.5 mg every 6-8 hours maximum 30mg/24 hours.

18. CHLOPHEDIANOL It has slow and longer duration of antitussives action. Dosage : Adults: 25 mg 3-4 times a day. Children : (6-12 years) 12.5-25 mg 3-4 times a day.

19. Children : (2-6 years) 12.5 mg 3-4 times a day.

20. Noscapine Dosage : Adults : 15-30 mg 3-4 times a day maximum 120 mg/day. Children : (6-12 year) 15 mg 3-4 times day. Children : (2-6 year) 7.5 -15 mg 3-4 times a day.

21. Opioids

22. Opioids Opioids are the drugs derived from the opium poppy ( papaver somniferum ) are termed opiates.

23. Opioids - codeine - pholcodine -morphine -ethyl morphine

24. CODEINE Codein is more selective for cough center and is treated as the standard antitussives . Dose : Available in lozenges/syrup/tablets: Adult : 10-20 mg every 4-6 hourly maximum 120 mg / day.

25. Children : (6-12 year old) 5-10 mg every 4-6 hourly maximum 60 mg/day. Children : (2-6 year old) 2.5-5mg every 4-6 hourly maximum 30 mg/day.

26. Mechanism of codeine

27. MECHANISM OF CODEINE Codein acts on U-receptors in medulla oblongata. Inhibits release of excitatory neuropeptides . Suppress cough.

28. PHALCODEINE Longer acting drug 12 hours or more in dosage of 10-15 mg. ETHYLMORPHINE Similar to codein dose.

29. MORPHINE Morphine is rarely used. Dose : 2-4 mg IM.

30. Thanking you