Treatment of Cough

Question 1

Expectorants are for which type of cough?

Answer 1

productive

Question 2

Antitussives are used for what type of cough?

Answer 2

non productive

Question 3

What is the purpose of Pharyngeal demulcents?

Answer 3

soothing effect on throat

Question 4

What are some examples of pharyngeal demulcents?

Answer 4

lozenges

cough drops

Question 5

What is the purpose of expectorants?

Answer 5

increase bronchial secretions

decrease viscosity of mucous secretions

Question 6

What is the mechanism of action of directly acting expectorants?

Answer 6

to stimulate bronchial glands

Question 7

What are some directly acting expectorants?

Answer 7

sodium and potassium citrate or acetate

potassium iodide

guaiacol

guaiphensin

balsam or tolu,

Vasaka

Terpin hydrate

Question 8

What is the mechanism of action of reflexly acting expectorants?

Answer 8

irritate gastric or bronchial mucosa

Question 9

Name some reflexly acting expectorants.

Answer 9

ammonium chloride or carbonate,

potassium iodide

Question 10

Mucolytics

Answer 10

medicines that make the mucus less thick and sticky and easier to cough up.

Question 11

Name some mucolytic drugs.

Answer 11

Bromhexine
ambroxol
Acetylcysteine
carbocisteine

Question 12

How do antitussives act in general?

Answer 12

Cough centre suppressants

Reduce tussal impulses in respiratory tract

Question 13

What are some opioids used as antitussives?

Answer 13

Codeine, pholcodeine,
Morphine, ethyl morphine

Morphine not so commonly used?

Question 14

What are some non-opioid antitussives used?

Answer 14

noscapine

Dextromethorphan, Oxeladin,
chlophedianol

Question 15

What are some antihistamines used as antitussives?

Answer 15

Chlorpheniramine
Diphenhydramine
promethazine

Question 16

What is the standard antitussive?

Answer 16

codeine

Question 17

How long does codeine suppress cough?

Answer 17

6 hours

Question 18

What drug blocks antitussive action of codeine?

Answer 18

naloxone

Question 19

What are some adverse effects of codeine?

Answer 19

constipation

drowsiness

respiratory depression

Question 20

What are some contraindications of using codeine?

Answer 20

asthmatics

diminished respiratory reserve

Question 21

Which drugs antitussive action isn’t blocked by naloxone?

Answer 21

dextrometharphan

Question 22

Describe the d-isomer and i-isomer of dextrometharphan.

Answer 22

d-isomer - increases threshold of cough centre

l-isomer - analgesic

Question 23

What are some adverse effects of dexrometharphan?

Answer 23

Dryness of mouth, vertigo, irritability

Question 24

Does detromethrphan depress mucociliary function?

Answer 24

no

Question 25

Know the different treatment approachers to cough of these various etiologies in this chart.

Answer 25

Reproduce chart.

Question 26

Do expectorants suppress cough reflex?

Answer 26

no

Question 27

What are side effects of mucolytic drugs?

Answer 27

rhinorrhea, lacrimation, GI irritation, hypersensitivity

Question 28

MOA of dextromethorphan?

Answer 28

``` synthetic codeine analog] Central Antitussive (antagonizes NMDA glutamate receptors). ```

Question 29

What is the benefit of using dextromethorphan over codeine?

Answer 29

mild abuse potential and less constipation

Question 30

S/E dextromethorphan.

Answer 30

May cause serotonin syndrome if combined with other serotonergic agents.

Question 31

In which drug that we discussed in treatment of cough is use of children less than 6 years of age prohibited?

Answer 31

Dextromethorphan

Question 32

MOA Benzonatate.

Answer 32

Unlike the opioids, benzonatate suppresses the cough reflex through peripheral action. It anesthetizes the stretch receptors located in the respiratory passages, lungs, and pleura.

Question 33

Does Benzonatate have abuse potential?

Answer 33

no

Question 34

How do nasal decongestants act?

Answer 34

shrink swollen turbinates Decrease resistance to airflow by vasoconstriction of the mucosal blood vessels which in turn reduces edema of the nasal mucosa.

Question 35

What are the most effective agents to relieve nasal congestion?

Answer 35

nasal decongestants

Question 36

What are some topical nasal decongestants?

Answer 36

Ephedrine, oxymetazoline, xylometazoline

Question 37

What are some systemic nasal decongestants?

Answer 37

Pseudoephedrine, phenylephrine

Question 38

Oxymetazoline acts through what receptors?

Answer 38

A1

Question 39

Xylometazoline acts selectively for what receptor?

Answer 39

alpha - 2

Question 40

What are some ADRs of nasal decongestants?

Answer 40

stinging, burning, dryness of the mucosa, atrophic rhinitis

Question 41

Would you use nasal decongestants for long or short period of time?

Answer 41

short periods (palliative are)

Question 42

Systemic or topical nasal decongestants. Which has more ADRs?

Answer 42

systemic