Antitussives , expectorants and mucolytics

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Antitussives , expectorants and mucolytics

  1. 1. Drug therapy for cough Dr. Gyanendra Raj Joshi PharmD , RPh
  2. 2. Cough • Productive cough • Unproductive cough
  3. 3. Sites of action for treatment • Peripheral sites – Afferent side – Efferent side • Central nervous system – Medullary paths – Cerebral cortex – Subcortical paths
  4. 4. Antitussives acting peripherally • Demulcents – Linctus containing syrup, glycerine , liquorice – Cough drops – Water aerosol inhalation – Steam inhalation – Compound benzoin tincture • Local anesthetics – Nebulised lidocaine
  5. 5. Antitussives that act centrally (cough centre suppressants) • Opiods – Dethadone , codeine • Non opioids – Dextromethorphan, pholcodine, noscapine • Antihistamines – Chlorpheniramine , diphenhydramine , promethazine
  6. 6. Expectorants(Mucokinetics) • Mucolytics : – Carbocysteine, mecysteine – Water inhalation via an aerosol – Bromhexine – Ambroxol – Dornase α • Bronchial secretion enhancers : – Direct acting : – Reflexly acting :
  7. 7. Nasal decongestants • • • • α adrenergic receptor agonist Mechanism Examples Adverse effects
  8. 8. Cold remedies • • • • Benign self limited syndrome Viral Combination of drugs Drugs – – – – – – – – – Intranasal ipratropium Cromolyn sodium Antihistamines Antitussives Expectorants Decongestants Intranasal glucocorticoids Leukotriene receptor antagonists Zinc
  9. 9. – Vitamins and herbal remedies – Antiviral therapy – Antibiotic therapy – NSAIDS – Exercise – Face mask – Gargling – Hydration – Warm fluids

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