Cough and cold remidies

Dr. Theja Huruggamuwa

Common cold • Sneezing, sore throat, a stuffy nose, coughing • It is probably the most common illness• Nothing can cure a cold

What can you do for your cold or cough symptoms? • Drinking plenty of fluids • Rest• Cold and cough remedies• Pain relievers – reduce fever, headaches, and

minor aches and pains

Symptomatic treatments for colds and cough

• Antihistamines • Decongestants • Antitussives• Expectorants• Mucolytics

Antihistamine• Antihistamine drugs block the action of

histamine (H1–Histamine receptor blocker)• reducing congestion, sneezing, runny nose, and

itching that a patient suffers with an allergic attack or an infection symptoms.

• For the best result, antihistamines should be taken before allergic symptoms get well established

• but they can also be very effective if taken after the onset of symptoms.

side effects of antihistamines• Drowsinessnot recommended for anyone who may be driving or operating.The first few doses cause the most sleepiness; subsequent doses are usually less troublesome.Enhance by alcohol.

Other side effects of antihistamines• Palpitation and arrhythmias• Hypotension• Sleep disturbances• Extrapyramidal effects• Depression• Tremor• Confusion• Liver dysfunction

Cautions • Prostatic hypertrophy• Urinary retention• Glaucoma• Hepatic disease• Who on epilepsy

medications , sedatives, muscle relaxants

Contra indications• nursing mothers• Newborns• premature infants• allergic to antihistamines or any of its components

Typical antihistamines 1st generation• Sedative • Chlorphenamine

(formerly chlorpheniramine)

• Clemastine• Ketotifen • Promethazine

2nd generation•Non sedative •Acrivastine•Cetirizine•Desloratadine (a metabolite of loratadine)

•Fexofenadine•Levocetirizine (laevorotatory isomer of cetirizine)

•Loratadine•Mizolastine

First-generation 'sedating' antihistamines

• These are highly lipid-soluble• crossing the blood-brain barrier • Antagonist to H1 receptors in both the CNS and

periphery• They cause sedation, cognitive impairment,

motor retardation in certain individuals and agitation (excitement) or stimulation.

Second-generation 'non-sedating' antihistamines

• These are newer drugs.• Larger molecules and less lipophilic• less likely to cross the blood-brain barrier.• However, all antihistamines can cross the blood-brain

barrier to some degree and cause psychomotor impairment in susceptible individuals

• Sedation - although some drugs have sedating effect and sedative tendency varies from patient to patient

• Arrhythmias - occur where a relatively high dose is being taken or where there is hepatic impairment (both of which raise the plasma concentration of the drug )

antihistaminesBrand names:

piriton®, Benadryl®*, Claritin®, Dimetane®*, Hismanal®, Nolahist®*, PBZ®*, Polaramine®, Tavist®*, Zyrtec®, Xyzal®, Allegra®, Claritin®, Clarinex®, Alavert®, Chlor-Trimetron®*

Decongestants• Congestion in the nose, sinuses, and chest is due to

swollen, expanded, or dilated blood vessels (some inflammation reaction) in the mucosal membranes of the nose and air passages.

• These membranes, with a great capacity for expansion, have an abundant (rich) supply of blood vessels.

• Decongestants (a -adrenergic agonists) help to shrink the blood vessels in the nasal membranes and allow the air passages to open up.

• Chemically related to Adrenaline, (natural decongestant)

Typical decongestants In pill or liquid form• PSEUDOEPHEDRINE HYDROCHLORIDE

Sudafed®• Drixoral®, Dimetapp®, Dura-Vent®, Exgest®,

Entex®, Propagest®, Novafed®*, and• Decongestants are also available over the

counter in nasal spray form.

Effect of decongestants • jittery or nervous feeling, • causing difficulty in going to sleep• elevating blood pressure and pulse rate.

Who should not use decongestants?• who has an irregular heart rhythm, • high blood pressure, • heart disease, • glaucoma.

Antitussives• cough suppressants• directly suppresses medullary cough center• Mainly use to reduce the dry cough• Substances that can included codeine,

pholcodine, dextromethorphan (morphine derivate) and noscapine.

Codeine - Side Effects

• Drowsiness• Dizziness• Headache • blurred vision • Stomach disturbances• Nausea• Constipation• Dry mouth/nose/throat• withdrawal reactions (regularly for

a long time use -more than a few weeks or in high doses)

withdrawal symptoms -anxiety, restlessness, sweating, shaking chills and diarrhea

• To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water

• This medication can dry up and thicken mucus in your lungs, making it more difficult to breathe and clear your lungs. To help prevent this effect, drink plenty of fluids

Expectorants

• Expectorants; promote the expulsion of mucus and other materials from the respiratory tract by coughing (while enhancing the production of mucus)

• It make coughing easier.• Simple Linctus (oral solution)• N- acetylcysteine • Guaifenesin (guaiphenesin)

Mucolytic

• Mucolytic are prescribed to facilitate expectoration by reducing sputum viscosity. (loosen and thin bronchial secretions)

• In some patients with chronic obstructive pulmonary disease and a chronic productive cough, mucolytics can reduce exacerbations

• Mucolytics should be used with caution in those with a history of peptic ulceration because they may disrupt the gastric mucosal barrier

Mucolytic preparations

• Carbocisteine, Erdosteine, Dornase Alfa • Bromhexin - Bisolvon• Hypertonic sodium chloride solution • Nebulize with (3–7%) NaCl is used to mobilize lower

respiratory tract secretions in mucous consolidation (e.g. cystic fibrosis).

• Temporary irritation, such as coughing, hoarseness, or reversible bronchoconstriction may occur; an inhaled bronchodilator can be used before treatment with hypertonic sodium chloride to reduce the risk of these adverse effects.

Combination Remedies

• Antihistamines/Decongestants • Antihistamine/ Mucolytic /

Bronchodilator• Antihistamine/ Antitussive/ Expectorant• Expectorant/ Mucolytic/ Bronchdilators• Brand Names: Actifed®*, Sudafed Plus®, A.R.M.®*,

Chlor-Trimeton D®*, Claritin D®, Contac®*, CoPyronil 2®*, Deconamine®, Demazin®*, Dimetapp®*, Drixoral®*, Isoclor®*, Nolamine®, Novafed A®, Ornade®, Tavist D®*, Triaminic®*, and Trinalin®.

• Compound preparations are on sale to the public for the treatment of cough and colds but should not be used in children under 6 years

• Should be taken the correct dose

• Not to be use more than one preparation at a time

cough and cold medicines abuse • Some medicines contain ingredients that are psychoactive

(mind-altering) when taken in higher-than-recommended dosages, and some people may abuse them.

• Two commonly abused cough and cold medicines are:• Cough syrups and capsules containing dextromethorphan

(DXM). safe for stopping coughs during a cold if you take them as

directed. Taking more than the recommended amount can produce

euphoria (a relaxed pleasurable feeling) and dissociative effects (like you are detached from your body).

• Promethazine-codeine cough syrup. contain an opioid drug called codeine, which stops coughs,

but when taken in higher doses produces euphoria.