Drugs for cough by babul

1. DRUGS FOR COUGH
By Dr. Babul kumari

2. WHAT IS COUGH ?

3. WHAT IS COUGH ?
 It’s a protective reflex – for expulsion of
respiratory secretions and foreign particles from
air passages.

5. COUGH ETIOLOGY
1. Upper/Lower Respiratory Tract Infection
2. Postnasal drip due to sinusitis, rhinitis
3. Smoking/Chronic Bronchitis
4. Pulmonary Tuberculosis
5. Asthmatic cough
6. Gastrointestinal reflux

6. TYPES OF COUGH
1. NON-PRODUCTIVE COUGH(Dry cough)
2. PRODUCTIVE COUGH (sputum)

7. Drugs for cough
Pharyngeal demulcent
Lozenges, cough drops, linctuses
containing syrup, glycerine, liquorice.

8. Expectorants
(a) Mucokinetics (Bronchial secretion enhancers):
Sodium or Potassium citrate,
Potassium iodide,
Guaiphenesin (Glyceryl guaiacolate),
balsum of Tolu, Vasaka, Ammonium chloride.
(b) Mucolytics:
Bromhexine,
Ambroxol,
Acetyl cysteine,
Carbocisteine

9. 3.Antitussives (Cough centre
suppressants)
(a) Opioids: Codeine, Ethylmorphine,
Pholcodeine.
(b) Nonopioids: Noscapine, Dextromethorphan,
Chlophedianol.
(c) Antihistamines: Chlorpheniramine,
Diphenhydramine, Promethazine.
(d) Peripherally acting: Prenoxdiazine.

10. DEMULCENT
 Indirect peripherally acting cough suppressants.
 They provide a protective coat over sensory
receptors on pharynx and reduce afferent
impulses from the inflamed / irritated mucosa.
 They provide relief in dry cough arising from
throat.
 Lozenges, cough drops, linctuses containing
syrup, glycerine, liquorice.

11. Expectorants
Mucokinetics
are drugs believed to increase bronchial
secretion or reduce its viscosity, facilitating
its removal by coughing.
Sodium and potassium citrate.
Potassium iodide

12. Mucokinetics
KI
 It directly or indirectly ses secretion
 Directly---irritates Bronchial gland
 Indirectly---irritates gastric secretion to se bronchial
secretion.
 A/E interfere with thyroid function
 Cause—Hypothyroidism on prolonged use.
 Contraindications—Pregnancy(fetal hypothyroidism)
Sensitive to iodine

13. MUCOLYTICS
It depolymerises mucopolysaccharides directly as
well as by liberating lysosomal enzymes—network
of fibres in tenacious sputum is broken.
Bromhexine--obtained from Adhatoda vasica (Vasaka).
S/E rhinorrhoea, lacrimation, nausea, gastric irritation
Ambroxol A metabolite of bromhexine
 Acetylcysteine It opens disulfide bonds in mucoproteins
present in sputum—makes it less viscid
S/E peptic ulcer, bronchospasm.
Carbocisteine

14. ANTITUSSIVES
drugs that act in the CNS to raise the
threshold of cough centre or act
peripherally in the respiratory tract to
reduce tussal impulses, or both these
actions.

15. OPIOIDS
Codeine ---
suppresses cough for about 6 hours.
S/E– constipation, respiratory depression and
drowsiness
Contraindication– in children(>1 Year)
Asthmatics
Pholcodeine----
no analgesic or addicting property
similar in efficacy as antitussive to codeine and is
longer acting—acts for 12 hours.

16. NONOPIOIDS
Noscapine (Narcotine)
It depresses cough
but has no narcotic, analgesic or dependence
inducing properties.
S/E: Headache, nausea occasionally
Dextromethorphan
A synthetic central NMDA (N-methyl D-aspartate)
receptor antagonist
S/E Dizziness, nausea, drowsiness; at high doses
hallucinations and ataxia.

17. ANTIHISTAMINES
relief in cough due to their sedative and
anticholinergic actions.
Chlorpheniramine ,
Diphenhydramine
and Promethazine.

18. You have to write
What is cough?
Classification of drugs for cough.
Define the terms Demulcents, Expectorants,
Antitussive agents,Mucolytics and
Mucokinetics with examples.
MOA and S/E of
KI, Codeine, Bromhexine, Acetylcysteine and
antihistamines.

19. THANK YOU