ANTITUSSIVES

-Act on the cough- control center in

the medulla to suppress the cough
reflex

- Dextromethorphan, a nonnarcotic
antitussive, is widely used in OTC cold
remedies
DEXTROMETHORPHAN
-A nonarcotic anitussives, supresses
cough center in the medulla but does
not depress respiration

-Onset of action is really fast , and its

duration is 3 to 6 hours

BRAND NAMES:
- Robitussin DM, Romilar, PediaCare,
Benylin DM
CONTRAINDICATIONS:
-COPD , Chronic productive cough, and
hypersensitivity

SIDE EFFECTS:

-Nausea, dizziness, drowsiness, and sedation

ADVERSE EFFECTS:

- Hallucination at high doses

Sympathomimetic drugs are substances that mimic the
effects of the sympathetic nervous system, such as
catecholamines, epinephrine (adrenaline),
norepinephrine (noradrenaline), dopamine, etc. Such
drugs are used to treat cardiac arrest, low
blood pressure, or even delay premature labor, among
other things.
These drugs act at the postganglionic sympathetic
terminal, either directly activating postsynaptic receptors
, blocking breakdown and reuptake, or stimulating
production and release of catecholamines.
 • Adrenergic receptor agonists

Direct stimulation of the α- and β-

adrenergic receptors can produce
sympathomimetic effects. Albuterol is a very
commonly used direct-acting β2-agonist. Other
examples include phenylephrine, isoproterenol,
and dobutamine.
•Dopaminergic agonists

Stimulation of the D1 receptor by dopaminergic agonists

such as fenoldopam is used intravenously to treat
hypertensive crisis.
•Norepinephrine transporter blockade

Classical sympathomimetic drugs are amphetamines (including MDMA),

ephedrine and cocaine, which act by blocking and reversing norepinephrine
transporter (NET) activity. NET is a transport protein expressed on the
surface of some cells that clears noradrenaline and adrenaline from the
extracellular space and into cells, terminating the signaling effects.

•Inhibition of epinephrine and norepinephrine metabolism

Inhibition of norepinephrine or epinephrine metabolism can produce

sympathomimetic effects. Both are mainly metabolized by the enzyme
monoamine oxidase (MAO), thus the monoamine oxidase inhibitor (MAOI)
drugs can induce such effects. COMT inhibitors can also decrease
metabolism of norepinephrine and epinephrine.
Side Effects and Contraindications

•Hypertension
•Cardiac arrythmias due to excessive cardiac
stimulation
•Long-term use increases mortality in heart failure
patients
•angina due to decreased myocardial
oxygen supply/demand ratio
•contraindicated in patients with coronary artery
disease
•These drugs can also precipitate
myocardial infarction and cerebrovascular stroke.
A decongestant or nasal decongestant is a type of
drug which is used to relieve nasal congestion.

The vast majority of decongestants act via

enhancing norepinephrine (noradrenaline) and
epinephrine (adrenaline) or adrenergic activity by
stimulating the α-adrenergic receptors. This
induces vasoconstriction of the blood vessels in
the nose, throat, and paranasal sinuses, which
results in reduced inflammation (swelling) and
mucus formation in these areas.
List of Decongestants Decongestants uncommon,
Common decongestants discontinued, or both,
include: include:
•Ephedrine •Cafaminol
•Levo-methamphetamine •Cyclopentamine
•Naphazoline •Epinephrine
•Oxymetazoline •Fenoxazoline
•Phenylephrine •Levonordefrin
•Phenylpropanolamine •Mephentermine
•Propylhexedrine •Metizoline
•Pseudoephedrine •Norepinephrine
•Synephrine •Tramazoline
•Tetrahydrozoline •Tuaminoheptane
•Tymazoline
How do decongestants work?
Decongestants work by narrowing blood vessels in the lining of
the nose. This reduces how much blood flows through the area
so that swollen tissue inside the nose shrinks and air can pass
through more easily.
What are some common side effects of OTC decongestants?
Healthy adults who only use decongestants once in a while usually don’t
experience side effects. However, anyone can experience side effects.
Decongestants can temporarily cause nervousness, dizziness and
sleeping problems. They can also cause heart palpitations (the feeling that
your heart is racing) or high blood pressure.
Who should not take decongestants?
If decongestants make you feel restless or make it difficult for you to
sleep, you may want to cut back on how much caffeine you drink while
taking this medicine. Do not give decongestants to children four years
old and younger.

Don’t take decongestants if you have high blood pressure that is not
controlled.

Talk to your doctor before using a decongestant if you have any of the
following health problems:
•High blood pressure
•Glaucoma
•Heart conditions
•Thyroid problems
•Diabetes
•Prostate problems
•expectorants