Pharm

Cough Expectorant

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Cough Expectorant, Protussive, Guaifenesin, Robitussin, Humibid, Liquibid, Guaifenex

  • Indications
  1. Infectious cough (may speed recovery)
  2. Chronic Bronchitis (clear airway mucus)
  3. Acute Sinusitis (assists with sinus drainage)
  • Guaifenesin
  1. Short acting agents (e.g. Robitussin)
    1. Ages 2 to 5 years old: 2.5 ml PO q4h
    2. Ages 6 to 12 years old: 5 ml PO q4h
    3. Adults: 10 ml PO q4h
  2. Long acting agents
    1. Mucinex (Over-the-counter)
    2. Humabid LA with new, unproven formulation
      1. Contains guiacolsulfonate (old expectorant)
  3. Discontinued agents
    1. Prior Humibid LA, Liquibid, Guaifenex LA
  4. Effect
    1. The only effective expectorant medication per FDA
    2. Paradoxically also reduces cough in URI
      1. Due to altered cough receptor sensitivity in URI
      2. Dicpinigaitis (2003) Chest 124:2178-81 [PubMed]
  • Other Expectorant Preparations (use with caution)
  1. Nebulized Hypertonic Saline
    1. Used to induce Sputum for Sputum exam and culture
  2. Terbutaline (Brethine)
    1. Beta adrenergic agonist (Tachycardia risk)
    2. Dose (age >12): 2.5 to 5 mg PO q6 hours while awake
  3. Amiloride (Midamor)
    1. Potassium sparing Diuretic