Drug therapy for cough

Dr. Gyanendra Raj JoshiPharmD , RPh

Cough

• Productive cough

• Unproductive cough

Sites of action for treatment

• Peripheral sites – Afferent side – Efferent side

• Central nervous system – Medullary paths – Cerebral cortex– Subcortical paths

Antitussives acting peripherally

• Demulcents – Linctus containing syrup, glycerine , liquorice – Cough drops – Water aerosol inhalation – Steam inhalation – Compound benzoin tincture

• Local anesthetics – Nebulised lidocaine

Antitussives that act centrally(cough centre suppressants)

• Opiods – Dethadone , codeine

• Non opioids– Dextromethorphan, pholcodine, noscapine

• Antihistamines– Chlorpheniramine , diphenhydramine ,

promethazine

Expectorants(Mucokinetics)

• Mucolytics :– Carbocysteine, mecysteine – Water inhalation via an aerosol– Bromhexine – Ambroxol– Dornase α

• Bronchial secretion enhancers :– Direct acting : – Reflexly acting :

Nasal decongestants

• α adrenergic receptor agonist• Mechanism • Examples • Adverse effects

Cold remedies • Benign self limited syndrome • Viral • Combination of drugs • Drugs

– Intranasal ipratropium– Cromolyn sodium – Antihistamines – Antitussives – Expectorants – Decongestants – Intranasal glucocorticoids – Leukotriene receptor antagonists – Zinc

– Vitamins and herbal remedies – Antiviral therapy – Antibiotic therapy – NSAIDS– Exercise – Face mask – Gargling – Hydration – Warm fluids