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H E R
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Asniar Pascayantri, S.Si., M.Si., Apt

Physiologically…
 Cough is a normal physiological reflex
that frees the respiratory tract of
accumulated secretions and removes
particulate matter.
Pathophysiologically…
Reseptor TRP
 Cough Suppressants Expectorants Mucolytics

Cough suppressants Mucolytics

Expectorants Sympathomimetics
 Cough suppressants
Mekanisme Kerja : Centrally acting

Generik : Acetyldihydrocodeine, Helicidine,

Alloclamide, Isoaminile,
Benproperine, Menglytate,
Benzonatate, Morclofone,
Bibenzonium, Nepinalone,
Butamirate, Nicocodine,
Butetamate, Normethadone,
Caramiphen, Noscapine,
Clobutinol, Oxeladin,
Clofedanol, Oxolamine,
Cloperastine, Pentoxyverine,
Dextromethorphan, Pholcodine,
Dimemorfan, Pipazetate,
Dimethoxanate, Poppy Capsule,
Dropropizine, Prenoxdiazine,
Elecampane, Promolate,
Ethyl Orthoformate, Sodium Dibunate,
Fedrilate, Thebacon,
Fominoben, Tipepidine,
Glaucine, Zipeprol,
 Expectorants
Mekanisme : Meningkatkan ivolume sekresi pada saluran pernapasan dengan
Kerja cara memfasilitasi kerja siliari dan merangsang batuk
Generik : Ammonium Salts, Guaietolin,
Calcium Iodide, Guaifenesin,
Cocillana, Guaimesal,
Coltsfoot, Iodinated Glycerol,
Creosote, Ipecacuanha,
Elecampane, Marrubium,
Eprazinone, Senega Root,
Eprozinol, Squill,
Eriodictyon, Sulfogaiacol,
Fudosteine, Terpin,
Guacetisal, Tolu Balsam,
Guaiacol,
 Mucolytics
Mekanisme : Mengubah struktur mukus untuk mengurangi kekentalan mukus
Kerja sehingga dapat dilkeluarkan melalui kerja siliari atau rangsangan
batuk
Generik : Acetylcysteine, Erdosteine,
Ambroxol, Ethyl Cysteine Hydrochloride,
Bromhexine, Letosteine,
Brovanexine, Mecysteine,
Carbocisteine,
 Sympathomimetics
Mekanisme : Kerja agonis alfa melalui vasokontriksi pada mukosa nasal, sehingga
Kerja menyebabkan kongesti.
Generik : Amidefrine, Naphazoline,
Clonazoline, Oxymetazoline,
Ephedra, Phenylephrine,
Ephedrine, Phenylpropanolamine,
Etafedrine, Pseudoephedrine,
Fenoxazoline, Tetryzoline,
Indanazoline, Tramazoline,
Levmetamfetamine, Tuaminoheptane,
Methoxyphenamine, Tymazoline,
Methylephedrine, Xylometazoline,
Metizoline,
 Batuk…
Non-produktif
 Kadang disertai dengan flu biasa
 Therapy :
 Supresan  dextromethorphan >
codeine.
 Antihistamin dengan efek sedasi 
diphenhydramine (reduction in
cholinergic nerve transmission, or
cough suppression as a result of their
sedative effects)
 Demulcents  glycerol, honey,
liquorice, and sucrose syrups (indirect
peripherally acting cough
suppressants by providing a
protective coating over sensory
receptors in the pharynx)
Produktif
 Disertai sputum
 Kadang terjadi karena adanya penyakit lain 
chronic bronchitis, bronchiectasis, or cystic fibrosis.
 Therapy :
 Ekspektoran  ammonium salts, guaifenesin,
ipecacuanha, and sodium citrate
 Mukolitik  acetylcysteine, bromhexine,
carbocisteine, and mecysteine. Dornase alfa
pada kasus cystic fibrosis
 Agen pembasah  Inhaled aerosols of water,
sodium bicarbonate, sodium chloride,
surfactants such as tyloxapol, and proteolytic
enzymes such as chymotrypsin and trypsin.
Menthol, benzoin, or volatile oils tkurang efektif
Batuk disertai sesak
 Anti-bronkospasme
 Bronkodilator B2-agonis  salbutamol
 Antikolinergik  ipratropium bromida
 Indikasi : batuk disertai sesak pada pasien
dengan asma dan COPD
Sediaan obat batuk dan flu
 Kombinasi  Suppressants/ekspektoran + simpatomimetik + antihistamin /
+ analgesik
 Safety concern in children  antihistamines, supresan, ekspektoran, dan
dekogestan simpatomimetik, tunggal atau kombinasi
 FDA dan MHRA merekomendasikan penggunaan sediaan obat batuk dan
flu pada anak usia > 2 tahun
 < 2 tahun  paracetamol atau ibuprofen, sediaan obat batuk sederhana
(gliserol atau mada dan lemon), vapour rubs dan inhalant decongestants
 Bayi  nasal drop natrium klorida