II. Indications
- Dry, nonproductive cough
- Cough interferes with sleep or activity
III. Precautions
- Cough Suppressants in general lack evidence of benefit (Opioid and non-Opioid)
- Avoid AlbuterolInhaler unless bronchospasm
- Avoid Antihistamines or Decongestants unless specific allergy or sinus symptoms
- Avoid Corticosteroids outside Asthma (do not shorten cough duration)
- Intranasal Atrovent may be effective for cough in Upper Respiratory Infections
- (2017) Presc Lett 25(1): 3
IV. Medications: Non-opioid Antitussives
-
Benzonatate (Tessalon Perles)
- Dose: 100 to 200 mg orally three times daily
V. Medications: Opioid Antitussives
- Precautions
- Risk of adverse effects and Opioid Abuse potential
- Opioids have minimal compelling evidence for use (and Dextromethorphan is as good as any)
- Yancy (2013) Chest 144(6):1827-38 [PubMed]
-
Dextromethorphan (Benylin DM, Delsym)
- Over-the-counter
- Risk of Drug Interactions (Serotonin Syndrome, MAO Inhibitors), Dextromethorphan Abuse
-
Codeine
- Do not use in pregnancy (Teratogenic) or Lactation (Opioid Toxicity)
-
Codeine
Cough Syrup is often abused
- Adolescents often mix with soda or Alcohol (Lean, Sizzurp, Purple Drink)
- May be used for night-time cough
-
Codeine Dose: 0.3 mg/kg up to 30 mg PO tid-qid
- Codeine may be used alone or in combination product
-
Guaifenesin with Codeine (Robitussin AC)
- Adult: 2 tsp (10 ml) q4h
- Age 6 to 12 years: 1 tsp (5 ml) q4h
- Age 2 to 6 years: 1/2 tsp (2.5 ml) q4h
-
Hydromorphone-Guaifenesin (Hycotuss)
- Adult dose: 5 ml po after meals and at bedtime prn
- Hydrocodone-Guaifenesin (Obredon)
-
Hydrocodone (Hycodan)
- Adult dose: 5 mg q4-6 hours prn
VI. Preparations: Nebulized
- Nebulized Lidocaine 1-4% Lidocaine 3 cc
- Nebulized Morphine Sulfate 5-10 mg in 3 cc of Normal Saline
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Related Studies
| Definition (NCI) | Any substance that is capable of relieving or suppressing coughing. |
| Definition (MSH) | Agents that suppress cough. They act centrally on the medullary cough center. EXPECTORANTS, also used in the treatment of cough, act locally. |
| Concepts | Pharmacologic Substance (T121) |
| MSH | D000996 |
| SnomedCT | 372593002, 320955005, 372791003, 59751001 |
| LNC | LP31462-2 |
| English | Agents, Antitussive, Antitussive Agents, Antitussive Drugs, Antitussives, Drugs, Antitussive, Antitussive Agent [TC], Antitussive, Antitussive Agent, Suppressants, Cough, Cough Suppressants, antitussive drug, antitussive drugs, antitussive, coughing suppressants, cough suppressants, antitussives, cough suppressant, Cough Medicines, Cough suppressants (substance), Cough suppressants (product), Antitussive agents, Cough suppressants, Cough suppressant, Antitussive agent (product), Antitussive agent (substance), Antitussive agent, Antitussive, NOS |
| French | Médicaments antitussifs, Agents antitussifs, Anti-tussifs, Médicaments contre la toux, Antitussifs |
| Swedish | Hostdämpande medel |
| Czech | antitusika |
| Finnish | Antitussiivit |
| Italian | Antitossivi, Farmaci antitossivi, Antitussivi, Sedativi della tosse |
| Russian | PROTIVOKASHLEVYE SREDSTVA, ПРОТИВОКАШЛЕВЫЕ СРЕДСТВА |
| Croatian | ANTITUSICI |
| Polish | Leki przeciwkaszlowe |
| Japanese | 鎮咳剤, 咳止め, せき止め, 鎮咳薬 |
| Spanish | Antitusígenos, supresores de la tos, antitusivos (producto), antitusivos, supresores de la tos (sustancia), Agentes Antitusígenos, Agentes Antitusivos, Antitusivos, Fármacos Antitusivos, Fármacos Antitusígenos, agente antitusivo (producto), agente antitusivo (sustancia), agente antitusivo, antitusivos (sustancia) |
| Portuguese | Fármacos Antitussígenos, Substâncias Béquicas, Agentes Béquicos, Agentes Antitussígenos, Medicamentos Béquicos, Antitussígenos |
| German | Antitussiva, Hustenmittel |
Ontology: Cough suppression (C0522046)
| Concepts | Sign or Symptom (T184) |
| SnomedCT | 102580004 |
| Dutch | hoestonderdrukking |
| French | Sédation de la toux |
| German | Hustenstillung |
| Italian | Soppressione della tosse |
| Portuguese | Supressão da tosse |
| Spanish | Supresión de la tos, supresión de la tos (hallazgo), supresión de la tos |
| Japanese | 咳嗽抑制, ｶﾞｲｿｳﾖｸｾｲ |
| Czech | Tlumení kašle |
| Hungarian | Köhögés csillapítás |
| English | Cough suppression, Cough suppression (finding) |
Ontology: Antitussive therapy (C1096670)
| Concepts | Therapeutic or Preventive Procedure (T061) |
| Italian | Terapia antitosse |
| Japanese | 鎮咳療法, ﾁﾝｶﾞｲﾘｮｳﾎｳ |
| Czech | Léčba antitusiky |
| Hungarian | Köhögéscsillapító kezelés |
| English | Antitussive therapy |
| Portuguese | Tratamento antitússico |
| Spanish | Terapia antitusiva |
| Dutch | antitussivumtherapie |
| French | Traitement antitussif |
| German | Therapie mit Hustenmittel |
