Pharmacological Management of Cough: Antitussives, Expectorants, and Mucolytics

Introduction

Cough is a common symptom of respiratory infections and chronic pulmonary diseases. Pharmacological agents such as antitussives, expectorants, and mucolytics play a significant role in symptom relief and airway clearance.

Types of Cough Medications

Antitussives

These drugs suppress the cough reflex, primarily used in nonproductive coughs.

• Opioid Antitussives: Codeine and hydrocodone act on the central nervous system to reduce cough.
• Non-Opioid Antitussives: Dextromethorphan is a common OTC medication that works similarly without narcotic effects.

Expectorants

Expectorants help in loosening mucus, making it easier to expel.

• Guaifenesin: The most widely used expectorant, promoting mucus clearance.

Mucolytics

Mucolytic agents break down mucus for easier expulsion.

• Acetylcysteine: Used in conditions like COPD and cystic fibrosis.
• Carbocisteine: Another effective mucolytic for chronic bronchial conditions.

Adverse Effects and Drug Interactions

Common Side Effects

• Opioid antitussives may cause sedation and constipation.
• Dextromethorphan can lead to dizziness and gastrointestinal disturbances.
• Guaifenesin may cause mild nausea.
• Acetylcysteine may trigger allergic reactions or bronchospasms.

Drug Interactions

• Codeine should not be combined with CNS depressants due to respiratory depression risks.
• Dextromethorphan can interact with MAO inhibitors, causing serotonin syndrome.
• Acetylcysteine may interfere with some antibiotics.

Conclusion

Understanding the pharmacological approach to cough management helps optimize treatment while minimizing adverse effects. Patients should consult healthcare professionals before initiating cough therapy.