Pharm
Cough Suppressant
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Cough Suppressant
, Antitussive, Cough Suppression, Antitussive Therapy, Benzonatate, Tessalon Perles
See Also
Cough Symptomatic Treatment
Cough Expectorant
Indications
Dry, nonproductive cough
Cough
interferes with sleep or activity
Precautions
Cough Suppressants in general lack evidence of benefit (
Opioid
and non-
Opioid
)
Avoid
Albuterol
Inhaler
unless bronchospasm
Avoid
Antihistamine
s or
Decongestant
s unless specific allergy or sinus symptoms
Avoid
Corticosteroid
s outside
Asthma
(do not shorten cough duration)
Intranasal
Atrovent
may be effective for cough in
Upper Respiratory Infection
s
(2017) Presc Lett 25(1): 3
Preparations
Non-opioid Antitussives
Benzonatate (Tessalon Perles)
Dose: 100 to 200 mg orally three times daily
Preparations
Opioid Antitussives
Precautions
Risk of adverse effects and
Opioid Abuse
potential
Opioid
s 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 Interaction
s (
Serotonin Syndrome
,
MAO inhibitor
s),
Dextromethorphan Abuse
Codeine
Do not use in pregnancy (
Teratogen
ic) 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
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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