general

Question 1

types of cough

Answer 1

1. productive - sputum ** never suppress**
2. unproductive - dry ** suppress**

Question 2

who do we NOT give antitussives?

Answer 2

mainly
1. bronchial asthma
2. suppurative lesion coughs
3. children

Question 3

what do peripheral acting antitussives do ?

Answer 3

they reduce input of stimuli from resp tract - impulses dont reach CNS

Question 4

DEMULSCENTS : action

Answer 4

form a soothing protective layer

Question 5

DEMULSCENTS : types

Answer 5

1. warm water vapor ( below larynx as inhalation can reach)
2. lozenges ( above larynx - cant reach distal)
3. syrups - very short acting
4. linctus

Question 6

MUCOLYTICS : action

Answer 6

they reduce sputum viscocity - easier to cough it up (lysing action)

• inhaled or nebulized = best to reach distal lungs
• oral ? often for male infertility

Question 7

MUCOLYTICS : ACETYL/CARBO/ME-CYSTEINE

Answer 7

• free sulfhydryl groups
• break disulfide bonds of mucus - smaller size

Question 8

MUCOLYTICS : BROMHEXINE :

Answer 8

• depolym of mucopolysaccharide fibers = mucus is large but more runny

Question 9

DORNASE ALFA

Answer 9

• ” recombinant human DNAse I “
• mucolytic used for CYSTIC FIBROSIS
• cleaves extracellular DNA in sputum ( from neutrophils) = lowering its viscosity for easier clearance

Question 10

EXPECTORANTS : action

Answer 10

• increase volume and liquefy bronchial secretions - do NOT lyse !!
• best for thick productive cough

Question 11

EXPECTORANTS : GUAIFENESIN :

Answer 11

• mentholyated vapor = hydrates = less adhesion and ST = easier removal
• u have to drink alot of water
  ** risk of placebo effect **

Question 12

MIXED COUGH PREPARATIONS :

Answer 12

• expectorant / antitussive + antihistamine / decongestant ( vasoconstrictor)
• reduce viscosity AND formation of sputum ( by low blood flow)
• nausea , headaches …
  ** check ingredients **

Question 13

CNS ACTING DRUGS : CODEINE :

Answer 13

• ” methylmorphine”
• opioid
• antitussive dose = 15mg , analgesic = 60mg
• to morphine via CYP2D6
• X mucociliary clearance ** obst + inf**
• constip
• sedation
• dependance + abuse

Question 14

CNS ACTING DRUGS : DEXTROMETHORPAN :

Answer 14

• nonopioid , non narcotic
  = best !!!!
• same effect as codeine , but NO constip or low mucociliary clearance or addiction

Question 15

H1-R BLOCKERS : DIPHENHYDRAMINE :

Answer 15

• block histamine H1 receptors
• central anticholinergic = dries secretions
  + sedation = retains secretions to reduce cough
• if for a child - ONLY at night