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Antihistamines, Decongestants, and Expectorants during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Dextromethorphan is commonly used as an antitussive. The frequency of congenital anomalies was not increased among 300 infants born to women who tool dextromethorphan during the first trimester (Heinonen et al., 1977).
Ethnomedicinal and Pharmacological Importance of Glycyrrhiza glabra L
Published in Mahendra Rai, Shandesh Bhattarai, Chistiane M. Feitosa, Wild Plants, 2020
Ashish K. Bhattarai, Sanjaya M. Dixit
Licorice has been used as an antitussive and expectorant herbal medicine for a long time. Cough is produced in different medical conditions, such as common cold, bronchitis, and other respiratory illnesses. Expectorants help to bring up mucus and other materials from the lung, bronchi, and trachea. The activities of 14 major compounds and crude extracts of licorice, using the classical ammonia-induced cough model and phenol red secretion model in mice was evaluated. Liquiritinapioside, liquiritin, and liquiritigenin at 50 mg/kg (i.g.) could significantly decrease cough frequency by 30–78% (p < .01). The compounds Liquiritinapioside, liquiritin, and liquiritigenin showed potent expectorant activities after 3 days of treatment (p < .05). The water and ethanol extracts of licorice, which contain abundant Liquiritinapioside and liquiritin, could decrease cough frequency at 200 mg/kg by 25–59% (p < .05). The result indicates liquiritinapioside and liquiritin are the major antitussive and expectorant compounds of licorice. Their antitussive effects depend on both peripheral and central mechanisms (Kuang et al. 2018). Glycyrrhizin is responsible for demulcent action of licorice. Liquiritinapioside, an active compound present in the methanolic extract of licorice, is found to inhibit capsaicin-induced cough (Kamei et al. 2003).
Scientific Rationale for the Use of Single Herb Remedies in Ayurveda
Published in D. Suresh Kumar, Ayurveda in the New Millennium, 2020
S. Ajayan, R. Ajith Kumar, Nirmal Narayanan
Considering the use of V. negundo in Ayurveda to treat respiratory disorders, Haq et al. (2012) carried out an investigation on its cough-relieving potential. The antitussive effect of the butanol extract of V. negundo on sulfur dioxide-induced cough was studied in mice. The safety profile of the extract was examined by observing acute neurotoxicity, median lethal dose and behavior. The extract dose-dependently inhibited the cough provoked by sulfur dioxide gas and exhibited maximum protection after 60 minutes of administration. At 1000 mg kg (−1), the extract caused maximum cough-suppressive effects. The LD50 value of V. negundo was found to be greater than 5000 mg kg (−1). Toxicity tests showed no signs of neural impairment and acute behavioral toxicity at antitussive doses. The extract was well tolerated at higher doses. This study demonstrated the antitussive effect of V. negundo devoid of toxicity.
Anti-inflammatory, expectorant, and antitussive properties of Kyeongok-go in ICR mice
Published in Pharmaceutical Biology, 2021
Jin-Ryul Hu, Chul-Jong Jung, Seong-Min Ku, Dae-Hwa Jung, Khawaja Muhammad Imran Bashir, Sae-Kwang Ku, Jae-Suk Choi
Linctus (a cough medication in syrup form) is used to treat cough and its related symptoms. For dry cough, treatments with antitussives or cough suppressants are used to suppress the body's urge to cough. Whereas, in productive coughs (producing phlegm), expectorants are used to loosen mucus from the respiratory tract (Smith et al. 2008; Dicpinigaitis 2012). Animal models including mice can be used to verify the antitussive effects of drugs by detecting and counting the number of coughs produced by tussive stimulus, like NH4OH given to animals, and by comparing the number of coughs induced in response to the administration of tussive, as an effective and simple experimental approach (Zhang et al. 2009; Wang et al. 2012). In this study, the antitussive effects of KOG were tested using the NH4OH exposure coughing mouse model. ASA is directly related to the gas exchange capacity of lung, the higher the ASA, the higher the gas exchange capacity (Davey et al. 2002; Choi et al. 2005; Ku et al. 2012).
Looking ahead to novel therapies for chronic cough. Part 1 – peripheral sensory nerve targeted treatments
Published in Expert Review of Respiratory Medicine, 2020
Elzbieta M. Grabczak, Marta Dabrowska, Surinder S Birring, Rafal Krenke
Although P2X3 antagonists reduce cough in a dose dependent manner, there are still patients who do not significantly benefit from the treatment. This also refers to other new anti-cough agents. Thus, it seems doubtful that gefapixant will be equally effective in all types of RCC irrespective to underlying pulmonary diseases, e.g. COPD or interstitial lung diseases. In other words, winning one battle by developing and launching P2X3 antagonist does not mean winning the whole war with RCC. Importantly, the varying success rate of different antitussives suggests that various mechanism may be responsible for cough in different patients. In this context the hypothesis of cough endotypes seems to be very attractive. Should it be possible to better characterize different cough phenotypes/endotypes by their specific markers and mechanisms, we could probably match the most efficient (personalized) therapy to improve the outcome. Some large international projects (e.g. NEUROCOUGH) may be essential for the search for practical biomarkers such as cough tussive challenge, cytokines or neurokines which may help to better characterize subgroups of RCC patients for future targeted therapies. Search for phenotypic or endotypic features may include: cough characteristic and intensity, coexisting diseases (e.g. IPF, COPD or laryngeal neuropathy), and should include practical biomarkers that could predict treatment response, analogous to e.g. blood or sputum eosinophilia or FeNO as predictors of response to inhaled corticosteroid treatment in asthma or COPD.
Pharmacokinetics and pharmacodynamics of dextromethorphan: clinical and forensic aspects
Published in Drug Metabolism Reviews, 2020
Ana Rita Silva, Ricardo Jorge Dinis-Oliveira
Therefore, DXM is chemically an opium alkaloid derivative but since it does not act pharmacologically at opioid receptors, it is not an opioid and does not have analgesic, euphoriant, and respiratory depression effects, such as codeine and morphine (Bem and Peck 1992; Jasinski 2000; Pechnick and Poland 2004). In other words, DXM and DXO, both dextrorotatory enantiomers, are non-opioid opium alkaloid derivatives. Racemethorphan is the racemic mixture composed by the two enantiomers DXM and levomethorphan (Wong and Sunshine 1996). Racemorphan or morphanol refers to the racemic mixture of DXO and levorphanol, both with pharmacological and toxicological effects similar to their correspondent methyl ether derivatives (Aumatell and Wells 1993). This enantiomeric behavior is characteristic of other opioids. Indeed, dextrorotatory opioids have very different pharmacological profiles than their levorotatory isomers. Unlike the levorotatory opioids, dextrorotatory generally have little or no affinity to the mu (MOR; µ), delta (DOR; δ), or kappa (KOR; Κ) opioid receptors, and thus do not carry the same abuse and addiction potential as their levorotatory enantiomers (Sromek et al. 2014). Dextrorotatory enantiomers typically act as weak to moderate noncompetitive NMDA receptor antagonists and have affinity to the σ1 and α3β4 nicotinic receptors (Glick et al. 2001). Both dextrorotatory and levorotatory opioids have antitussive properties.