This document discusses antitussives, or cough suppressants. It defines antitussives as drugs that relieve cough by suppressing the cough center in the medulla. Antitussives are used to treat dry non-productive coughs. They work by affecting the cough reflex center in the central nervous system or peripherally in the respiratory tract. Antitussives are classified as either non-opioids, such as dextromethorphan, or opioids like codeine. The document provides details on the mechanisms and dosages of various common 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.

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