Cough Suppressants, Decongestants, Mucolytics - Drugs listed Flashcards
(23 cards)
Dextromethorphan
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class:
Antitussive
MOA:
Suppresses cough reflex by direct action on the cough center in the medulla
Metabolism:
Must be activated to active metabolite by CYP2D6
Adverse Effects:
Excitability Tachycardia, Insomnia (N/V/D as well)
Contraindications:
MAOI (monoamine oxidase inhibitors) - Can cause SEROTONIN SYNDROME (siezures, jerky movements, cardiac arrest)
Other:
Large Margin of safety at 12 to 75 therapeutic doses, acts on NMDA (N-methyl D-aspartyl) receptor for glutamate to produce hallucinogenic effects
Diphenhydramine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class:
Anti-histamine/Antitussive
MOA:
Anticholinergic effects
Adverse Effects:
Drowsiness, Respiratory depressure, Dry mouth, Urinary Retention, constipation, SEROTONIN SYNDROME
Contraindications:
Prostate hypertrophy, Urinary obstruction, Asthma, COPD
Other:
Can be used in Parkinsonism (due to anti-muscarinic effects), and insomnia
Codeine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Antitussive and opoid analgesic
MOA
Direct action on cough center in the CNS
Metabolism
10% metabolized to morphine and other products
Adverse Effects
Constipation, Histamine Release, vasodilation, orthostatic hypotension, dizziness
Contraindications
Hypersensitivity, Labor of premature birth, pregnancy category C, prostatic hypertrophy, respiratory depression (COPD etc)
Other
May lead to adverse effects in children after tonsillectomy or adenoidectomy
Benzonatate
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Nonnarcotic antitussive agent
MOA
Decreases sensitivity of stretch (TRPV-1) receptors in the airways by its local anesthetic effect (used for patients with emphysema)
Metabolism
nothing mentioned
Adverse Effects
Hypersensitivity reactions, Skin rash, confusion, hallucinations
Contraindications
Do not take with antihistamines, sleep or anxiety meds, muscle relaxors, or anxiety med.
DO NOT GIVE TO INDIVIDUALS allergic to tetracain or procaine
Other
***NOT contraindicated with diseases like emphysema b/c it doesn’t act centrally in breathing like other antitussives)
Camphor
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Topical Antitussives
MOA
Activates then desensitizes TRPM8, TRPV1 and TRPA1 on sensory nerve endings
Metabolism - none
Adverse Effects - none listed
Contraindications - none listed
Other
Note that Camphor is only used via inhalation, NOT LOZENGES
Menthol
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Topical Antitussives
MOA
Activates then desensitizes TRPM8, TRPV1 and TRPA1 on sensory nerve endings
Metabolism - none
Adverse Effects - none listed
Contraindications - none listed
Other
Can be used in lozenge, unlike camphor
Guanfenesin
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Exectorant
MOA
Increased the volume of secretions and reduces viscosity (only FDA approved expectorant)
Metabolism
Nothing mentioned
Adverse Effects
Uric acid nephrolithiasis (kidney stones), Dry mouth, N/V/D.
Contraindications
Hypersensitvity
Other
Phenylephrine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Sympathomimetics
MOA
DIRECT Stimulation of alpha 1-adrenergic receptors leading to blood vessel constriction. (decreases nasal edema)
Metabolism
Rapidly metabolized by MOA (monoamine oxidase) and COMT (catecholamine methy-transferase) in GI mucosa, liver and other tissues
Adverse Effects
None if used topically
Contraindications
Other
Oxymetazoline
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Sympathomimetics
MOA
DIRECT Stimulation of alpha 1-adrenergic receptors leading to blood vessel constriction. (decreases nasal edema) It also is a partial alpha2 agonist
Metabolism
Unlike phenylephrine it is NOT Rapidly metabolized by MOA (monoamine oxidase) and COMT (catecholamine methy-transferase)
Adverse Effects
None if used topically
Contraindications
None stated
Other
Preferred topical agent during pregnancy
Pseudoephedrine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Sympathomimetic
MOA
INDIRECT alpha adrenergic Receptors by causing Norepinephrine release from adrenergic nervse
Metabolism
Pseudoephedrine is metabolized to only a minor extent by N-demethylation to nor-pseudoephedrine
Adverse Effects
CV stimulation (tachycardia and arrythmia), CNS stimulation (insomnia, hallucinations); may cause Rebound congestion
Contraindications
Hyperthyroidism, Heart defects, Uncontrolled HTN
Other
Levamfetamine (Levoamphetamine, Vicks Vapor)
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Sympathomimetic
MOA
Stimulation of alpha adrenergic receptors
Metabolism
Adverse Effects
Contraindications
Other
Propylhexedrine
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Sympathomimetic
MOA
Stimulation of alpha adrenergic receptors
Iodides-Iodinated Glycerol
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Expectorant
MOA
Unclear
Metabolism
Adverse Effects
Contraindications
Other
Saline
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Bland areosol
MOA
Saline acts as an irritant to induce coughing. Hypertonic saline can increase the volume of mucus.
Metabolism
Adverse Effects
Contraindications
Other
Guiafenesin
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Expectorant
MOA
At high doses stimulates bronchial gland secretion
Metabolism
Adverse Effects
Contraindications
Other
Bromohexine (Bisolvon)
Drug Class
MOA
Metabolism
Adverse Effects
Contraindications
Other
Drug Class
Expectorant
MOA
Increases the production of serous mucous in the respiratory tract and decreases the viscosity of phlegm
Metabolism
Adverse Effects
Contraindications
Other
N-Acetyl Cysteine
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS
Administration
Aerosol or direct instillation into ET tube
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.
Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator
Other
May be given in acute liver injury due to Tylenol overdose
Acetadote
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS
Administration
Aerosol or direct instillation into ET tube
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.
Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator
Other
May be given in acute liver injury due to Tylenol overdose
Erdosteine
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS
Administration
Aerosol or direct instillation into ET tube
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.
Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator
Other
May be given in acute liver injury due to Tylenol overdose
Carbocysteine
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
Breaks disulfide bonds in mucous by subsituting a sulfhydryl radical for -HS
Administration
Aerosol or direct instillation into ET tube
Adverse Effects
Bronchospasm, DO NOT MIX WITH Antibiotics in same nebulizer. Smells like rotten eggs.
Contraindications
Acute asthma attack (not much evidence of this), If used with asthma use 10% and mix with bronchodilator
Other
May be given in acute liver injury due to Tylenol overdose
Dornase Alfa (pulmozyme)
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
Clone of the natural human pancreatic DNAase enzyme that digests extracellular DNA.
Adverse Effects
Voice alteration, Pharyngitis/laryngitis, Conjuctivitis, CHINESE OVARY CELL PRODUCTS (used in other recombinant proteins like EPO)
Contraindications
Only works on infected sputum since it contains great amounts of DNA
Sodium Bicarbonate
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
2% NaHCO3 solutions are used to increase the pH of mucus by weakening carbohydrate side chains
Administration
Injection directly into the trachea or aerosolized
Adverse Effects
Can be irritating, especially if higher concentrations are used
Amiloride (as respiratory agent)
Drug Class
MOA
Metabolism
Administration
Adverse Effects
Contraindications
Other
Drug Class
Mucolytic
MOA
Diuretic: Inhibitor of ENaC on respiratory epithelium. More Na+ is left in the bronchioles and secretions become less viscous
Administration
Amiloride is nebulized in a 0.3% solution of NaCl
Adverse Effects
Contraindications
Other
