Antitussives

Last updated on: 25.12.2020

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Definition
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Antitussives are drugs that suppress the cough reflex. They are used for dry irritable cough in which the elimination of the cough reflex prevents the accumulation of secretions. The most commonly used substances include dextromethorphan, codeine and its derivatives hydrocodone and dextramethorphan, the opium alkaloid noscapine, and pentoxyverine. Antitussives inhibit the cough reflex by an as yet unknown central mechanism. Peripheral effects are not involved in the antitussive action of these drugs.

Classification
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Strong antitussives

Non-opioid antitussives

Phytotherapeutics (see below)

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Classification according to groups of active substances

Opioids Antitussives:

NMDA antagonists (NMDA = N-methyl-D-aspartate) inhibit the cation channel of the NMDA receptor:

Benzylisoquinolines:

Non-opioid antitussives:

1st generation antihistamines:

Herbal antitussives (phytotherapeutic antitussives, scientific evidence is mostly lacking):

Indication
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The most important indication for antitussives is dry irritable cough, which can often occur in the context of viral infections of the respiratory tract but can also be caused by other organ diseases. In this case there is no secretion of inflammatory secretion (=unproductive cough). Antitussives may also be useful, for a limited time, in moderately productive coughs.

Remark: In principle, antitussives should only be used for a limited period of time and under strict indication.

Note(s)
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Cough is an indispensable defensive reflex of the organism. Coughing is also a common symptom of diseases such as asthma, chronic obstructive pulmonary disease (COPD) and bronchial carcinoma (Morjaria JB et al. 2013).

Last updated on: 25.12.2020