1. Drug therapy for cough
Dr. Gyanendra Raj Joshi
PharmD , RPh

2. Cough
• Productive cough
• Unproductive cough

3. Sites of action for treatment
• Peripheral sites
– Afferent side
– Efferent side
• Central nervous system
– Medullary paths
– Cerebral cortex
– Subcortical paths

4. Antitussives acting peripherally
• Demulcents
– Linctus containing syrup, glycerine , liquorice
– Cough drops
– Water aerosol inhalation
– Steam inhalation
– Compound benzoin tincture
• Local anesthetics
– Nebulised lidocaine

5. Antitussives that act centrally
(cough centre suppressants)
• Opiods
– Dethadone , codeine
• Non opioids
– Dextromethorphan, pholcodine, noscapine
• Antihistamines
– Chlorpheniramine , diphenhydramine ,
promethazine

6. Expectorants(Mucokinetics)
• Mucolytics :
– Carbocysteine, mecysteine
– Water inhalation via an aerosol
– Bromhexine
– Ambroxol
– Dornase α
• Bronchial secretion enhancers :
– Direct acting :
– Reflexly acting :

7. Nasal decongestants
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α adrenergic receptor agonist
Mechanism
Examples
Adverse effects

8. Cold remedies
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Benign self limited syndrome
Viral
Combination of drugs
Drugs
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Intranasal ipratropium
Cromolyn sodium
Antihistamines
Antitussives
Expectorants
Decongestants
Intranasal glucocorticoids
Leukotriene receptor antagonists
Zinc

9. – Vitamins and herbal remedies
– Antiviral therapy
– Antibiotic therapy
– NSAIDS
– Exercise
– Face mask
– Gargling
– Hydration
– Warm fluids