{"id":211,"date":"2019-11-12T17:49:33","date_gmt":"2019-11-12T17:49:33","guid":{"rendered":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/5-8-antitussives\/"},"modified":"2025-01-16T22:26:02","modified_gmt":"2025-01-16T22:26:02","slug":"5-8-antitussives","status":"publish","type":"chapter","link":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/chapter\/5-8-antitussives\/","title":{"raw":"5.8 Antitussives","rendered":"5.8 Antitussives"},"content":{"raw":"

Dextromethorphan<\/h2>\nDextromethorphan is an example of an antitussive (see Figure 5.10[footnote]\u201cRobitussin Cough Cold Flu Congestion decongestant Relief Medicine<\/a>\u201d by Mike Mozart<\/a> is licensed under CC BY 2.0<\/a>[\/footnote]<\/sup>).\n\nMechanism of Action: <\/strong>Dextromethorphan suppresses a cough by depressing the cough center in the medulla oblongata or the cough receptors in the throat, trachea, or lungs, effectively elevating the threshold for coughing.\n\nIndications: <\/strong>Antitussives are used for a dry, hacking, nonproductive cough that interferes with rest and sleep.\n\nNursing Considerations:\u00a0<\/strong>This medication is not safe for children under the age of 4 years.\n\nSide Effects\/Adverse Effects: <\/strong>The most common side effects include nausea and drowsiness. Some clients may experience a rash or difficulty breathing. High doses may cause hallucinations and disassociation, and the drug has been reported to be used as a recreational drug.[footnote]Frandsen, G., & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer.[\/footnote]<\/sup>\n\nHealth Teaching & Health Promotion: <\/strong>Clients should take care to avoid irritants that stimulate their cough, such as smoking. Additionally, antitussive medications can cause drowsiness, and clients should avoid taking them with other CNS depressants or alcohol.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\n[caption id=\"attachment_210\" align=\"aligncenter\" width=\"492\"]\"Photo Figure 5.10 Robitussin DM, an OTC Medication Containing Dextromethorphan and Guaifenesin[\/caption]\n\nNow let's take a closer look at the medication grid on dextromethorphan & benzonatate in Table 5.8a.[footnote]This work is a derivative of\u00a0Pharmacology Notes: Nursing Implications for Clinical Practice<\/a>\u00a0by\u00a0Gloria Velarde<\/a>\u00a0licensed under\u00a0CC BY-NC-SA 4.0<\/a>[\/footnote],[footnote]Frandsen, G., & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice\u00a0<\/em>(11th ed.). Wolters Kluwer.[\/footnote],[footnote]This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the Public Domain<\/a>. [\/footnote]<\/span><\/sup>\n\nTable 5.8a Dextromethorphan & Benzonatate Medication Grid\n\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Nursing Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Non-opioid Antitussive<\/th>\ndextromethorphan<\/a>\n\n \n\n <\/td>\nTake as directed\n\nAdminister undiluted\n\nNo alcohol use due to CNS depression\n\nUse with caution in clients with respiratory disease and with those taking monoamine oxidase inhibitors\u00a0 (MAOIs)<\/td>\nTemporarily relieves coughing due to minor throat and bronchial irritation as may occur with the common cold<\/td>\nCNS: Sedation and dizziness\n\nMild gastrointestinal effects<\/td>\n<\/tr>\n
Non-opioid Antitussive<\/th>\nbenzonatate<\/a><\/td>\nBenzonatate should be taken with food to minimize the risk of gastrointestinal upset. It should be swallowed whole and not crushed, chewed, or dissolved in the mouth\n\nNo alcohol use due to CNS depression\n\nBenzonatate can cause respiratory depression in high doses, especially in clients with preexisting respiratory conditions\n\nBenzonatate may interact with other medications, including opioids, benzodiazepines, and alcohol<\/td>\nUtilized to treat of cough associated with respiratory infections and conditions such as bronchitis and pneumonia<\/td>\nCNS: Sedation and dizziness\n\nGI: Constipation and nausea\n\nHeadache\n\nDry mouth\n\nNasal congestion\n\nItching or skin rash<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Codeine\/Guaifenesin<\/h2>\nCodeine\/guaifenesin is another example of an antitussive medication. It is combination medication that contains the opioid pain medication codeine and the expectorant guaifenesin.\n\nMechanism of Action: <\/strong>Codeine works by binding to opioid receptors in the brain and spinal cord. This binding reduces the transmission of pain signals and suppresses the cough reflex in the brain stem. Guaifenesin is an expectorant that works by thinning and loosening mucus in the airways.\n\nIndications: <\/strong>Codeine is a centrally acting cough suppressant that works by reducing the cough reflex in the brain stem. It is effective at reducing both dry and productive coughs. Guaifenesin is an expectorant that works by thinning and loosening mucus in the airway.\n\nNursing Considerations: <\/strong>With the risk of respiratory depressions associated with this medication, baseline respiratory effort must be assessed. Nurses should monitor for signs of dependence as codeine has the potential for abuse and dependence.\n\nSide Effects\/Adverse Effects: <\/strong>Side effects include sedation and drowsiness. It is important to also monitor for respiratory depression, blurred vision, dry mouth, urinary retention, nausea, vomiting, and constipation.\n\nHealth Teaching & Health Promotion: <\/strong>Clients should take care to avoid irritants that stimulate their cough, such as smoking. Additionally, antitussive medications can cause drowsiness, and clients should avoid taking them with other CNS depressants or alcohol. Clients should not drive or operate heavy machinery while taking the medication due to the potential for sedation.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nNow let's take a closer look at the medication grid on codeine-guaifenesin in Table 5.8b.[footnote]This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the Public Domain<\/a>. [\/footnote]<\/span><\/sup>\n\nTable 5.8b Codeine-guaifenesin Medication Grid\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Nursing Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Opioid Antitussive<\/strong><\/td>\ncodeine-guaifenesin<\/a><\/td>\nTake as directed. Monitor for signs of abuse\/dependence\n\nAdminister in the lowest effective dose for the shortest duration possible to minimize the risk of adverse effects\n\nNo alcohol use due to CNS depression\n\nUse with caution in clients with respiratory disease and with those taking benzodiazepines, antidepressants, and other opioids<\/td>\nAlleviates coughing and loosens mucus in the airways<\/td>\nCNS: Sedation and dizziness\n\nRespiratory depression\n\nBlurred vision, dry mouth, and urinary retention\n\nGI: Constipation, nausea, and vomiting\n\n <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n ","rendered":"

Dextromethorphan<\/h2>\n

Dextromethorphan is an example of an antitussive (see Figure 5.10[1]<\/sup><\/a><\/sup>).<\/p>\n

Mechanism of Action: <\/strong>Dextromethorphan suppresses a cough by depressing the cough center in the medulla oblongata or the cough receptors in the throat, trachea, or lungs, effectively elevating the threshold for coughing.<\/p>\n

Indications: <\/strong>Antitussives are used for a dry, hacking, nonproductive cough that interferes with rest and sleep.<\/p>\n

Nursing Considerations:\u00a0<\/strong>This medication is not safe for children under the age of 4 years.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>The most common side effects include nausea and drowsiness. Some clients may experience a rash or difficulty breathing. High doses may cause hallucinations and disassociation, and the drug has been reported to be used as a recreational drug.[2]<\/sup><\/a><\/sup><\/p>\n

Health Teaching & Health Promotion: <\/strong>Clients should take care to avoid irritants that stimulate their cough, such as smoking. Additionally, antitussive medications can cause drowsiness, and clients should avoid taking them with other CNS depressants or alcohol.[3]<\/sup><\/a><\/sup><\/p>\n

\"Photo
Figure 5.10 Robitussin DM, an OTC Medication Containing Dextromethorphan and Guaifenesin<\/figcaption><\/figure>\n

Now let’s take a closer look at the medication grid on dextromethorphan & benzonatate in Table 5.8a.[4]<\/sup><\/a>,[5]<\/sup><\/a>,[6]<\/sup><\/a><\/span><\/sup><\/p>\n

Table 5.8a Dextromethorphan & Benzonatate Medication Grid<\/p>\n\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Nursing Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Non-opioid Antitussive<\/th>\ndextromethorphan<\/a><\/p>\n

 <\/p>\n

 <\/td>\n

Take as directed<\/p>\n

Administer undiluted<\/p>\n

No alcohol use due to CNS depression<\/p>\n

Use with caution in clients with respiratory disease and with those taking monoamine oxidase inhibitors\u00a0 (MAOIs)<\/td>\n

Temporarily relieves coughing due to minor throat and bronchial irritation as may occur with the common cold<\/td>\nCNS: Sedation and dizziness<\/p>\n

Mild gastrointestinal effects<\/td>\n<\/tr>\n

Non-opioid Antitussive<\/th>\nbenzonatate<\/a><\/td>\nBenzonatate should be taken with food to minimize the risk of gastrointestinal upset. It should be swallowed whole and not crushed, chewed, or dissolved in the mouth<\/p>\n

No alcohol use due to CNS depression<\/p>\n

Benzonatate can cause respiratory depression in high doses, especially in clients with preexisting respiratory conditions<\/p>\n

Benzonatate may interact with other medications, including opioids, benzodiazepines, and alcohol<\/td>\n

Utilized to treat of cough associated with respiratory infections and conditions such as bronchitis and pneumonia<\/td>\nCNS: Sedation and dizziness<\/p>\n

GI: Constipation and nausea<\/p>\n

Headache<\/p>\n

Dry mouth<\/p>\n

Nasal congestion<\/p>\n

Itching or skin rash<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Codeine\/Guaifenesin<\/h2>\n

Codeine\/guaifenesin is another example of an antitussive medication. It is combination medication that contains the opioid pain medication codeine and the expectorant guaifenesin.<\/p>\n

Mechanism of Action: <\/strong>Codeine works by binding to opioid receptors in the brain and spinal cord. This binding reduces the transmission of pain signals and suppresses the cough reflex in the brain stem. Guaifenesin is an expectorant that works by thinning and loosening mucus in the airways.<\/p>\n

Indications: <\/strong>Codeine is a centrally acting cough suppressant that works by reducing the cough reflex in the brain stem. It is effective at reducing both dry and productive coughs. Guaifenesin is an expectorant that works by thinning and loosening mucus in the airway.<\/p>\n

Nursing Considerations: <\/strong>With the risk of respiratory depressions associated with this medication, baseline respiratory effort must be assessed. Nurses should monitor for signs of dependence as codeine has the potential for abuse and dependence.<\/p>\n

Side Effects\/Adverse Effects: <\/strong>Side effects include sedation and drowsiness. It is important to also monitor for respiratory depression, blurred vision, dry mouth, urinary retention, nausea, vomiting, and constipation.<\/p>\n

Health Teaching & Health Promotion: <\/strong>Clients should take care to avoid irritants that stimulate their cough, such as smoking. Additionally, antitussive medications can cause drowsiness, and clients should avoid taking them with other CNS depressants or alcohol. Clients should not drive or operate heavy machinery while taking the medication due to the potential for sedation.[7]<\/sup><\/a><\/sup><\/p>\n

Now let’s take a closer look at the medication grid on codeine-guaifenesin in Table 5.8b.[8]<\/sup><\/a><\/span><\/sup><\/p>\n

Table 5.8b Codeine-guaifenesin Medication Grid<\/p>\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Nursing Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Side\/Adverse Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
Opioid Antitussive<\/strong><\/td>\ncodeine-guaifenesin<\/a><\/td>\nTake as directed. Monitor for signs of abuse\/dependence<\/p>\n

Administer in the lowest effective dose for the shortest duration possible to minimize the risk of adverse effects<\/p>\n

No alcohol use due to CNS depression<\/p>\n

Use with caution in clients with respiratory disease and with those taking benzodiazepines, antidepressants, and other opioids<\/td>\n

Alleviates coughing and loosens mucus in the airways<\/td>\nCNS: Sedation and dizziness<\/p>\n

Respiratory depression<\/p>\n

Blurred vision, dry mouth, and urinary retention<\/p>\n

GI: Constipation, nausea, and vomiting<\/p>\n

 <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

  1. \u201cRobitussin Cough Cold Flu Congestion decongestant Relief Medicine<\/a>\u201d by Mike Mozart<\/a> is licensed under CC BY 2.0<\/a> ↵<\/a><\/li>
  2. Frandsen, G., & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer. ↵<\/a><\/li>
  3. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  4. This work is a derivative of\u00a0Pharmacology Notes: Nursing Implications for Clinical Practice<\/a>\u00a0by\u00a0Gloria Velarde<\/a>\u00a0licensed under\u00a0CC BY-NC-SA 4.0<\/a> ↵<\/a><\/li>
  5. Frandsen, G., & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice\u00a0<\/em>(11th ed.). Wolters Kluwer. ↵<\/a><\/li>
  6. This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the Public Domain<\/a>. ↵<\/a><\/li>
  7. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  8. This work is a derivative of DailyMed<\/a>\u00a0by\u00a0U.S. National Library of Medicine<\/a> in the Public Domain<\/a>. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":83,"menu_order":8,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[48],"contributor":[],"license":[],"class_list":["post-211","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":186,"_links":{"self":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/211","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/users\/83"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/211\/revisions"}],"predecessor-version":[{"id":212,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/211\/revisions\/212"}],"part":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/186"}],"metadata":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/211\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/media?parent=211"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=211"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/contributor?post=211"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.ccconline.org\/accnursingpharmacology\/wp-json\/wp\/v2\/license?post=211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}