OTC - Cough

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Author:
skylinezts
ID:
96756
Filename:
OTC - Cough
Updated:
2011-08-22 14:30:33
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OTC Cough
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OTC - Cough
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  1. Etiology of cough
    • upper respiratory infection
    • sinusitis
    • rhinitis
    • asthma/COPD
    • GERD
    • CHF
    • drug-induced
  2. Pathophysiology of cough
    A cough is an important defense mechanism to rid the airways of mucus and foreign bodies.

    A cough may be acute (<3 weeks) or chronic (> 3 weeks)
  3. The GOLD standard treatment of cough
    codeine
  4. Three (3) antitussives & cough suppressants
    • codeine
    • dextromethorphan
    • diphenhydramine (Benadryl)
  5. MOA of antitussives
    centrally mediated suppression of cough
  6. Which agent is the only narcotic agent used for cough as antitussive?
    codeine
  7. MAX dose of codein
    10-20mg q4-6 hr (120mg/d)
  8. Role in therapy for codeine
    primarily for night cough
  9. SE of codeine
    sedation, nausea, & constipation
  10. Which agent is the only category I OTC non-narcotic antitussive?
    dextromethorphan
  11. MAX dose for dextromethorphan
    10-30 mg q 4-8hr (120mg/d)
  12. Role in Therapy for dextromethorphan
    nonproductive cough
  13. SE of dextromethorphan
    • drowsiness
    • GI effects (N/V, bloating, etc.)
  14. DI with dextromethorphan
    MAOI
  15. A category II antitussive
    diphenhydramine (Benadryl)
  16. The only antitussive that has both centrally mediated suppression of cough center AND anticholinergic
    diphenhydramine (Benadryl)
  17. MAX dose of diphenhydramine (Benadryl)
    25mg q 4hr (75mg/d MAX)
  18. Trade/Brand names (2) for dextromethorphan
    • Benylin - for liquid
    • Delsym - for suspension
  19. The only category I OTC expectorant
    guaifenesin (Robutussin, Mucinex, Humibid)
  20. MOA of expectorant
    thinning of mucus to enhance clearance
  21. MAX dose of guaifenesin (Robitussin, Mucinex, Humibid)
    MAX is 2,400 mg/d, regardless if immediate or extended release
  22. Name the immediately release & extended release guaifenesin products
    • Immediate release: Robitussin syrup
    • Extended release: Mucinex & Humibid sprinkle
  23. Role in therapy for expectorant
    productive cough
  24. SE of expectorant
    GI discomfort
  25. Patient education for expectorant
    increase fluid intake
  26. Two (2) FDA approved topical antitussive
    camphor & menthol
  27. MOA for topical antitussive
    local anesthetic effect in nasal mucosa
  28. Three (3) products availavility for topical antitussive
    • 1. lozenges
    • 2. ointment
    • 3. steam inhalation
  29. Patient education on topical antitussive
    ointment & solution are toxic if ingested
  30. Five (5) sore throat remedies
    • 1. saline gargle
    • 2. benzocaine
    • 3. dyclonine
    • 4. phenol
    • 5. menthol
  31. Combination expectorant & cough suppressant
    guaifenesin & dextromethorphan (Robitussin DM)
  32. Combination expectorant & decongestant
    guaifenesin & pseudoephedrine (Robitussin PE)

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