Antitussive Agents :: adverse effects
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Mesh-terms: Analgesics :: adverse effects; Antacids :: adverse effects; Antitussive Agents :: adverse effects; Coffee :: adverse effects; Drug Utilization; Ethanol :: adverse effects; Female; Fetus :: drug effects; Histamine H1 Antagonists :: adverse effects; Humans; Hypnotics and Sedatives :: adverse effects; Infant, Newborn; Nasal Decongestants :: adverse effects; Nonprescription Drugs; Pesticides :: adverse effects; Pregnancy :: drug effects; Smoking :: complications; Solvents :: adverse effects; Sweetening Agents :: adverse effects; Tea :: adverse effects;
Department of Emergency Medicine, Western Pennsylvania Hospital, Pittsburgh 15224, USA.
Pseudoephedrine and dextromethorphan are therapeutic constituents of numerous commonly used, over-the-counter cough and cold preparations. Although this drug combination is generally considered quite safe if utilized in recommended doses, overmedication or overdose can result in serious neurologic and cardiovascular abnormalities that occasionally can be life-threatening. We present a case of a 2-year-old child who developed hyperirritability, psychosis, and ataxia after being overmedicated with a pseudoephedrine/dextromethorphan combination cough preparation, and discuss probable mechanisms of toxicity and risk factors for adverse events.
BACKGROUND: This study aimed to assess and compare the effectiveness of lidocaine and bronchodilator inhalation treatments for rapid cough suppression in patients with chronic obstructive pulmonary disease (COPD). METHODS: Prospective comparison study carried out in a tertiary emergency department. Consecutive COPD patients presenting with intractable cough were randomly assigned to receive lidocaine or terbutaline inhalation treatments for cough suppression. Patients with dyspnoea, unstable vital signs, and pneumonia or neoplasm on chest x ray were excluded. A subjective, 10 point questionnaire based cough severity score was used for assessing the outcome. RESULTS: The final study sample included 127 patients (mean (SD) age, 69.2 (12.1) years; 33.1% women) of whom 62 received nebulised lidocaine and 65 nebulised bronchodilator. The cough severity score was significantly reduced one hour after inhalation treatment with both lidocaine and bronchodilator, with no significant difference in efficacy. Common but mild side effects in the lidocaine group included oropharyngeal numbness and bitter taste, and, in the bronchodilator group, tremor and palpitation. Dyspnoea, dizziness, and nausea and vomiting were equally uncommon in both groups. None of these problems caused any of the patients to discontinue their treatments and no allergic reactions were reported. CONCLUSIONS: Both lidocaine and bronchodilator inhalation treatments are equally effective for short term cough suppression in patients with COPD.
Mesh-terms: Administration, Inhalation; Aged; Aged, 80 and over; Antitussive Agents :: administration & dosage; Antitussive Agents :: adverse effects; Bronchodilator Agents :: administration & dosage; Bronchodilator Agents :: adverse effects; Comparative Study; Cough :: complications; Cough :: prevention & control; Female; Humans; Lidocaine :: administration & dosage; Lidocaine :: adverse effects; Male; Middle Aged; Nebulizers and Vaporizers; Prospective Studies; Pulmonary Disease, Chronic Obstructive :: complications; Severity of Illness Index; Terbutaline :: administration & dosage; Terbutaline :: adverse effects; Treatment Outcome;
Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China.
Mesh-terms: Antitussive Agents :: adverse effects; Antitussive Agents :: blood; Codeine :: adverse effects; Codeine :: blood; Cyanosis :: chemically induced; Cyanosis :: therapy; Drug Combinations; Female; Human; Infant, Newborn; Promethazine :: adverse effects; Promethazine :: blood; Respiratory Insufficiency :: chemically induced; Respiratory Insufficiency :: therapy;
Department of Otolaryngology, University of Arkansas for Medical Services, Little Rock 72205, USA.
Pharmacological agents with the most notable effects on voice exert their influences on the vocal tract through the autonomic nervous system. These agents do not have a profound effect on laryngeal function. Their effects are subtle, but they are important in certain groups of patients, such as professional voice users. It is essential to take a thorough history of medications being used, both by prescription and nonprescription, when evaluating patients with voice disorders. It is also important to keep in mind that idiosyncratic variations may occur in response to medications, and careful monitoring is essential when patients with voice disorders are under treatment. The importance of adequate water intake should be emphasized for general hydration and for vocal tract lubrication. Understanding the autonomic nervous system and how it is influenced by pharmacological agents makes evaluating the effect of medicines on the vocal tract simpler.
Mesh-terms: Antihypertensive Agents :: adverse effects; Antihypertensive Agents :: pharmacology; Antitussive Agents :: adverse effects; Antitussive Agents :: pharmacology; Cholinergic Antagonists :: adverse effects; Cholinergic Antagonists :: pharmacology; Gastroesophageal Reflux :: drug therapy; Histamine H1 Antagonists :: adverse effects; Histamine H1 Antagonists :: pharmacology; Hormones :: adverse effects; Hormones :: pharmacology; Human; Psychotropic Drugs :: adverse effects; Psychotropic Drugs :: pharmacology; Sympathomimetics :: adverse effects; Sympathomimetics :: pharmacology; Vitamins :: adverse effects; Vitamins :: pharmacology; Voice :: drug effects; Wetting Agents :: adverse effects; Wetting Agents :: pharmacology;
Mesh-terms: Abnormalities, Drug-Induced; Analgesics :: adverse effects; Antacids :: adverse effects; Antitussive Agents :: adverse effects; Cathartics :: adverse effects; Drugs, Non-Prescription :: adverse effects; Expectorants :: adverse effects; Female; Fetal Diseases :: chemically induced; Fetus :: drug effects; Gestational Age; Histamine H1 Antagonists :: adverse effects; Human; Hypnotics and Sedatives :: adverse effects; Pregnancy; Pregnancy Complications :: drug therapy; Self Medication; Sympathomimetics :: adverse effects; Time Factors; Tranquilizing Agents :: adverse effects;
Department of Emergency Medicine, Cooper Hospital University Medical Center, Camden, New Jersey 08103, USA. Nairn-Sandy@cooperhealth.edu
Mesh-terms: Adrenergic Agents :: adverse effects; Adrenergic Agents :: therapeutic use; Antitussive Agents :: adverse effects; Antitussive Agents :: therapeutic use; Child; Common Cold :: drug therapy; Cough :: drug therapy; Dextromethorphan :: adverse effects; Dextromethorphan :: therapeutic use; Drug Combinations; Drug Therapy :: adverse effects; Ephedrine :: adverse effects; Ephedrine :: therapeutic use; Histamine H1 Antagonists :: adverse effects; Histamine H1 Antagonists :: therapeutic use; Human; Male; Movement Disorders :: etiology; Pyridines :: adverse effects; Pyridines :: therapeutic use;
One hundred and thirty out-patients, affected by acute and chronic cough caused by upper respiratory tract inflammation, took part in two clinical studies aimed at evaluating the efficacy and tolerability of glaucine , a new antitussive agent. The first study involved 90 patients in a double-blind comparative trial of glaucine and codeine: both treatments were administered as a syrup at a dosage of 30 mg 3-times daily for 7 days. The cough suppressant effect of the two treatments was checked by the physician and the patient using a 4-point scale (from absent to severe), and by the patient using a visual analogue scale. Mean scores of the physician's evaluation decreased from 3. to 1.10 after codeine and from 3. to .47 after glaucine (p less than .001 between treatments). Mean values of the patients' visual analogue scales decreased from 83 mm to 17 mm after codeine, and from 85 mm to 7 mm after glaucine (p less than .001 between treatments). Constipation and nausea were reported by 9 patients on codeine and by no patient on glaucine (p less than .01). One patient on codeine was withdrawn from the study after 3 days because of vomiting, constipation and nausea. The second study was an open trial in 40 patients who received glaucine capsules at a dosage of 30 mg 3-times daily for 28 days. The antitussive effect of the treatment was evaluated on the basis of the same criteria as in the first study. The mean score of the physician's evaluation decreased from 3. to .15 (p less than .001); the mean value of the patients' visual analogue scales decreased from 93 mm to 1 mm (p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
Mesh-terms: Adolescent; Adult; Aged; Antitussive Agents :: adverse effects; Antitussive Agents :: therapeutic use; Aporphines :: adverse effects; Aporphines :: therapeutic use; Bronchitis :: drug therapy; Chronic Disease; Clinical Trials; Codeine :: adverse effects; Codeine :: therapeutic use; Cough :: drug therapy; Double-Blind Method; Female; Human; Male; Middle Aged; Random Allocation;
The matched pair system of the Finnish Register of Congenital Malformations was used to search for association between defects of the central nervous system (CNS), and maternal diseases and/or drug consumption during pregnancy. The study material consisted of 710 cases with CNS defects and their controls. Significant associations were found for the following conditions: influenza, threatened abortion, depressive state, toxemia of pregnancy, diabetic mothers, and for the consumption of the following drugs: salicylates, pyrazolones/anilines, euphoristic analgesics, sympathomimetics, barbiturates, and cough medicines. 259 cases with polydactyly and their controls were also compared, with a view to demonstrating what biases might be introduced by the case-control method. After utilizing the possibilities of this design for examining the above mentioned significant associations, the factors to be seriously considered were reduced to the following ones: influenza, depressive state, toxemia of pregnancy, diabetic mothers and cough medicines.
Mesh-terms: Abnormalities :: etiology; Abnormalities, Drug-Induced; Abnormalities, Multiple :: etiology; Antitussive Agents :: adverse effects; Central Nervous System :: abnormalities; Depression :: complications; Female; Fingers :: abnormalities; Finland; Human; Influenza :: complications; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious; Pregnancy Toxemias :: complications; Pregnancy Trimester, First; Pregnancy in Diabetics :: complications;
Department of Internal Medicine, Clinical Immunology and Allergology University Hospital, 29 av de Lattre de Tassigny 54035 Nancy, France.
Mesh-terms: Administration, Oral; Adult; Angioneurotic Edema :: chemically induced; Antitussive Agents :: administration & dosage; Antitussive Agents :: adverse effects; Codeine :: administration & dosage; Codeine :: adverse effects; Codeine :: analogs & derivatives; Drug Hypersensitivity :: diagnosis; Drug Hypersensitivity :: etiology; Female; Humans; Laryngeal Diseases :: chemically induced; Morpholines :: administration & dosage; Morpholines :: adverse effects; Pharyngitis :: drug therapy; Skin Tests;
