Pharmacology of Cough and Cold Medicines

Woo, Teri Moser

doi:10.1016/j.pedhc.2007.12.007

Cited by 15 publications

(12 citation statements)

References 9 publications

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“…This could result in an "idiopathic" cough, or in a cough that does not respond to specific therapies of the associated cause(s). According to this hypothesis, a non-specific approach to cough suppression is always necessary [57]. …”

Section: Methodsmentioning

confidence: 99%

“…When the therapeutic intervention aimed at removing the underlying cause is unsuccessful, an early empiric symptomatic treatment of acute or sub-acute cough with anti-tussive agents is often needed in order to improve quality of life, restore physical and social and hopefully avoid the development of persistent cough with deterioration in the quality of life [56,57]. As far as the level of benefit is concerned, the effects of peripherally acting anti-tussives, such as levodropropizine and moguisteine, compare favorably with centrally-acting drugs, based on the evidence from clinical trials and according to the available clinical practice guidelines [47-49,51-55,61].…”

Section: Methodsmentioning

confidence: 99%

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Cough management: a practical approach

Blasio¹,

Virchow

Polverino

et al. 2011

Cough

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Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and pulmonologists. Cough is an important defensive reflex that enhances the clearance of secretions and particles from the airways and protects the lower airways from the aspiration of foreign materials. Therapeutic suppression of cough may be either disease-specific or symptom related. The potential benefits of an early treatment of cough could include the prevention of the vicious cycle of cough. There has been a long tradition in acute cough, which is frequently due to upper respiratory tract infections, to use symptom-related anti-tussives. Suppression of cough (during chronic cough) may be achieved by disease-specific therapies, but in many patients it is often necessary to use symptomatic anti-tussives, too. According to the current guidelines of the American College of Chest Physician on "Cough Suppressants and Pharmacologic Protussive Therapy" and additional clinical trials on the most frequent anti-tussive drugs, it should be possible to diagnose and treat cough successfully in a majority of cases. Among drugs used for the symptomatic treatment of cough, peripherally acting anti-tussives such as levodropropizine and moguisteine show the highest level of benefit and should be recommended especially in children. By improving our understanding of the specific effects of these anti-tussive agents, the therapeutic use of these drugs may be refined. The present review provides a summary of the most clinically relevant anti-tussive drugs in addition to their potential mechanism of action.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Cough management: a practical approach

Blasio¹,

Virchow

Polverino

et al. 2011

Cough

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“…Since the 1980s, evidence about the efficacy and safety of acute cough drugs has been called into question in the literature (Smith et al, 2008;Woo, 2008;CDC, 2007;Heineck et al, 1998;Rozenfeld et al, 1989). In 2006, the American College of Chest Physicians published nine guidelines for treating acute cough, which do not recommend use of OTC drugs (Bolser, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…In 2006, the American College of Chest Physicians published nine guidelines for treating acute cough, which do not recommend use of OTC drugs (Bolser, 2006). Another concern regarding cough medications is fixed-dose combinations because using two or more drugs in the same formulation, besides having no supporting therapeutic grounds or scientific evidence, increases the risk of adverse events (Woo, 2008;Cadime, 2000).…”

Section: Introductionmentioning

confidence: 99%

Analysis of the evidence of efficacy and safety of over-the-counter cough medications registered in Brazil

Reis

Figueras

2010

Braz. J. Pharm. Sci.

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The objective of this study was to analyze the level of evidence regarding the efficacy, effectiveness and safety of over-the-counter (OTC) cough medications registered in Brazil. The National Health Surveillance Agency database was used to identify the drugs. Clinical trials, systematic reviews, meta-analyses, and studies on safety were searched on the Medline baseline, the Cochrane Library and SIETES (System of Essential Information in Therapeutics and Health; database in Spanish). Most drugs (62.5%) were sold as a fixed-dose combination of two or more drugs. Randomized clinical trials were found for only three drugs: bromhexine, dextromethorphan and guaifenesin. No clinical trials were found for fixed-dose combinations. Systematic reviews on Cochrane did not report any evidence in favor of or against the effectiveness of cough drugs. Efficacy is also unclear, especially regarding fixed-dose combinations. The evidence for the efficacy of OTC cough medications available in Brazil is poor due to the lack of quality studies. Pharmacovigilance of OTC cough medications should be encouraged. Uniterms:Drugs/utilization studies. Cough. Drugs/nonprescription. Pharmacovigilance. Pharmacoepidemiology.O objetivo deste trabalho foi analisar o nível de evidências sobre a eficácia, a efetividade e a segurança dos medicamentos para tosse registrados no Brasil. A base de dados da Agência Nacional de Vigilância Sanitária foi empregada para identificar os medicamentos. Os ensaios clínicos, as revisões sistemáticas, as metanálises e os estudos de segurança foram pesquisados no Medline, the Cochrane Library e SIETES (Sistema de Informações Essenciais em Terapêutica e Saúde, base de dados em espanhol). A maioria dos medicamentos (62,5%) eram comercializados como associação em dose fixa com dois ou mais fármacos. Ensaios clínicos randomizados foram encontrados apenas para três fármacos: bromexina, dextrometorfano e guaifenesina; para associações a dose fixa não foram encontrados ensaios clínicos. Revisões sistemáticas publicadas pela Cochrane não encontraram evidências favoráveis ou contrárias à efetividade dos medicamentos para tosse. Essa eficácia não é clara, especialmente a das associações a dose fixa. As evidências sobre a eficácia dos medicamentos para tosse isentos de prescrição disponíveis no mercado brasileiro são fracas, devido à falta de pesquisas de boa qualidade. A farmacovigilância de medicamentos para tosse isentos de prescrição deve ser incentivada.Unitermos: Medicamentos/estudos de utilização. Tosse. Medicamentos/isentos de prescrição. Farmacovigilância. Farmacoepidemiologia.

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“…The American College of Chest Physicians suggested various guidelines for treating acute cough having no regards for OTC products [4]. Another irrational approach in cough formulations that enhances the risk of unwanted effects is the combination of two or more drugs in the same formulation, above and beyond having no supporting therapeutic grounds or scientific evidence [5]. Apart from irrational use, natural therapies are found more effective and safe compare to synthetic drugs [6,7], therefore encouraging the exploration of natural treasure for the treatment cough.…”

mentioning

confidence: 99%

Therapeutic Potential of Alkaloids in Cough Treatment

Khan¹

2015

Biol Med

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Pharmacology of Cough and Cold Medicines

Cited by 15 publications

References 9 publications

Cough management: a practical approach

Cough management: a practical approach

Analysis of the evidence of efficacy and safety of over-the-counter cough medications registered in Brazil

Therapeutic Potential of Alkaloids in Cough Treatment

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