1. Chapter 15 Expectorants and Antitussive Agents

2. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 2 Expectorants and Antitussive Agents Drugs that aid in the expectoration (removal) of mucus Reduce the viscosity of secretions Stimulate the flow of respiratory secretions

3. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 3 Secretions By loosening and thinning sputum and bronchial secretions, the tendency to cough is indirectly diminished.

4. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 4 Cough Relief Relief of nonproductive coughs:  Pertussis  Common cold  Bronchitis  Laryngitis  Sinusitis  Influenza  Pharyngitis

5. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 5 Expectorants: Side Effects Common side effects  Guaifenesin  Nausea, vomiting  Gastric irritation  Terpin hydrate  Gastric upset (elixir has high alcohol content)

6. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 6 Expectorants: Nursing Implications Use with caution.  Elderly Encourage client to drink fluids. Monitor for therapeutic effects. Report a fever lasting longer than a week.

7. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 7 Antitussives Drugs used to control coughing  Opioids and nonopioids  Narcotics  Used for nonproductive coughs

8. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 8 Opioid Antitussives Suppress the cough reflex by direct action on the cough center in the medulla  Example: codeine + guiafenesin = Robitussin AC

9. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 9 Non-narcotic Antitussives Dextromethorphan  Suppresses the cough reflex by direct action on the cough center in the medulla; a chemical derivative of the opiate narcotics Result: diminished cough Produces no respiratory depression, analgesia, or dependence Example: Robitussin-DM (continues)

10. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 10 Non-narcotic Antitussives Benzonatate  A derivative of procaine (local anesthetic action); impairs the sensation of the stretch receptors in the respiratory tract  Example  Tessalon (continued)

11. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 11 Antitussive Agents: Side Effects Benzonatate  Dizziness, headache, sedation Dextromethorphan  Dizziness, drowsiness, nausea Opioids  Sedation, nausea, vomiting, lightheadedness, constipation

12. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 12 Antitussive Agents: Nursing Interventions Perform respiratory assessment. Instruct clients to:  Avoid driving or operating heavy equipment  Not drink liquids for 30 to 35 minutes after taking a cough syrup or using a cough lozenge

13. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 15 - 13 Antitussive Agents: Client Teaching Report any of the following symptoms to the health care professional:  Cough that lasts more than 2 weeks  A persistent headache  Fever  Rash