Definition
Anti-tussive agents are medications designed to suppress or alleviate coughing. They relieve excessive or non-productive coughing associated with various respiratory conditions or respiratory tract irritation.
Classification of Anti-Tussive Agents
Anti-tussive agents can be classified into different categories based on their mechanisms of action:
1. Opioid-Based Anti-Tussives:
Opioid-based antitussives suppress coughing by affecting the central nervous system. These medications contain opioids, which are either derived from the opium poppy plant or synthesized to have similar properties. The main purpose of opioid-based antitussives is to dampen the cough reflex in the brain, providing relief from excessive or non-productive coughing.
Examples: codeine and hydrocodone
2. Non-Opioid Anti-Tussives:
Non-opioid antitussives are a class of medications used to suppress coughing without the use of opioids. These agents act centrally on the cough center in the brain, providing relief from excessive or non-productive coughing. Unlike opioid-based antitussives, non-opioid options are generally considered safer in terms of the risk of dependence and abuse.
Example: dextromethorphan
3. Peripheral Anti-Tussives:
Medications in the class of peripheral antitussives suppress coughing by acting peripherally in the respiratory tract. Unlike central anti-tussives, which affect the cough center in the brain, peripheral anti-tussives work locally to reduce sensitivity in the airways and decrease the urge to cough. These agents often provide relief from coughing without the involvement of opioid mechanisms.
Example: benzonatate
Pharmacological Actions of Anti-Tussive Agents
1. Opioid-Based Anti-Tussives:
Act on the central nervous system to suppress the cough reflex.
Codeine, for example, has both antitussive and analgesic properties.
2. Non-Opioid Anti-Tussives:
Dextromethorphan acts centrally on the cough center in the brain to suppress coughing.
It does not produce analgesic or addictive effects at therapeutic doses.
3. Peripheral Anti-Tussives:
Benzonatate numbs the stretch receptors in the respiratory passages, reducing the cough reflex.
Dose:
– Dosage varies depending on the specific anti-tussive agent and formulation (liquid, tablet, or capsule).
– Adherence to recommended dosages is essential to prevent side effects and achieve therapeutic benefits.
Indications of Anti-Tussive Agents
Indicate anti-tussive agents to relieve coughing, especially in non-productive or irritating coughs.
People use these medications to address conditions like the common cold, respiratory infections, and postnasal drip.
Contraindications of Anti-Tussive Agents
1. Opioid-Based Anti-Tussives:
Contraindicated in individuals with respiratory depression, asthma, and certain gastrointestinal conditions.
Due to the risk of respiratory suppression, healthcare providers do not recommend using it in pediatric patients.
2. Non-Opioid Anti-Tussives:
Individuals with a history of serotonin syndrome should use dextromethorphan with caution.
Contraindicated in patients taking monoamine oxidase inhibitors (MAOIs).
3. Peripheral Anti-Tussives:
Avoid using benzonatate if you have a history of hypersensitivity to local anesthetics, as it is contraindicated in such cases.
Considerations:
Patients with underlying respiratory conditions should use anti-tussive agents cautiously because suppressing cough may hinder the removal of mucus.
Patient Education:
Healthcare providers should educate patients about the proper use of anti-tussive medications, adherence to recommended dosages, and the importance of seeking medical attention if the cough persists or worsens.
Anti-tussive agents play a valuable role in managing cough symptoms, providing relief, and improving the overall quality of life for individuals with respiratory conditions. However, healthcare professionals should guide their use to ensure appropriate selection and safe administration.
