Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dextromethorphan-containing cold/cough preparations are frequently prescribed and bought over the counter for use in children. Although generally considered safe, dextromethorphan has been shown to cause CNS side effects, including hyperexcitability, increased muscle tone, and ataxia. Two deaths have been reported with intentional dextromethorphan overdose. A literature review, brief review of pharmacology, and report of two cases of adverse reactions to dextromethorphan-containing preparations are presented.
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PMID:Toxicity with dextromethorphan-containing preparations: a literature review and report of two additional cases. 187 8

Dextromethorphan, a common ingredient in cough syrups, has rarely been described to cause toxicity. The authors describe an unusual case of a known asthmatic presenting with somnolence, who appeared to be in end-stage respiratory failure. Her partial response to routine naloxone, 1 mg, was surprising. However, additional naloxone was required to completely normalize the patient's mental status. The authors suggest naloxone be administered in doses of 0.4 mg or more intravenously in suspected dextromethorphan overdose.
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PMID:Dextromethorphan poisoning reversed by naloxone. 201 93

Dextromethorphan is one of the most widely used non-opioid cough suppressants, representing the active ingredient in several over-the-counter antitussive formulations. It does not possess the CNS pharmacology of other opiates in humans (i.e. analgesia, respiratory depression, abuse liability or psychotomimetic properties), but since the discovery in 1981 of high affinity recognition sites in brain for dextromethorphan a unique neuropharmacological profile has emerged for this relatively innocuous drug. Anticonvulsant and neuroprotective properties have been demonstrated, and treatment with dextromethorphan has been shown to improve the cerebrovascular and functional consequences of global cerebral ischemia. Frank Tortella and colleagues review the CNS pharmacology of dextromethorphan, its possible involvement with NMDA or sigma-receptors, and the potential clinical importance of this old 'new' drug.
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PMID:Dextromethorphan and neuromodulation: old drug coughs up new activities. 215 97

We have carried out a single-dose comparison of three different dextromethorphan cough mixtures in 10 healthy human volunteers. Dextromethorphan was administered in a single dose of 60 mg in random order. The concentrations of dextromethorphan and its main metabolite, dextrorphan, were determined from the plasma samples using high performance liquid chromatography. The concentrations of dextrorphan were 170 times higher than the concentrations of dextromethorphan. No therapeutically significant differences were detected between the three preparations tested, and there were no great differences between the pharmacokinetic profiles of dextromethorphan and dextrorphan. The three test preparations were Resilar and Redol comp. (Remeda Pharmaceutical Co., Finland), and Extuson (Ferrosan Ab, Sweden).
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PMID:Pharmacokinetics of dextromethorphan and dextrorphan: a single dose comparison of three preparations in human volunteers. 367 20

The possible antitussive effects of dextrorphan (the (+) isomer of levorphanol) and phencyclidine (PCP) were compared to well known antitussive properties of dextromethorphan in the post-halothane anesthetized decerebrate cat in which cough was elicited by direct electrical stimulation of the cough center. Dextrorphan, when injected i.a. (0.05-0.32 mg kg-1) or i.v. (1 to 3 mg kg-1), PCP i.a. (0.1-0.32 mg kg-1) or i.v. (1.0 mg kg-1) had no effect on electrically elicited cough. After i.v. administration, dextrorphan caused a variable effect on respiration but did not have any respiratory effect with i.a. administration of the drug. PCP injection i.a. at 0.32 mg kg-1 severely inhibited respiration though coughing could still be elicited. But i.v. administration of 1.0 mg/kg-1 suppressed both cough and respiration for several hours. Dextromethorphan inhibited cough upon both i.a. and i.v. injection. The mean effective i.a. dose was 0.063 mg kg-1. A ten times higher dose was necessary (0.65 mg kg-1) for cough suppression by the i.v. route. It is concluded from the i.a./i.v. ratio that dextromethorphan has specific central antitussive activity not possessed by dextrorphan and PCP.
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PMID:Comparative antitussive effects of dextrorphan, dextromethorphan and phencyclidine. 376 75

The present study had two basic purposes: to observe the effect of methysergide on the cough reflex and to investigate the effect of methysergide on the antitussive effect of dextromethorphan. Male and female cats were anesthetized with pentobarbital-Na. Respiration and cough reflex were measured using a pneumotachograph via a cannula inserted into the trachea. The cough reflex was elicited by electrical stimuli to the superior laryngeal nerve. Methysergide (3 mg) injected into the vertebral artery increased the number of coughs and respiratory frequency. Dextromethorphan in a dose of 3 mg inhibited the cough reflex. Methysergide (1 and 3 mg) reduced the antitussive effect of dextromethorphan in a dose-dependent manner, but did not inhibit the excitatory effect on respiratory frequency. These findings might indicate that the central serotonergic system has an inhibitory role on the cough reflex and may be related to the antitussive mechanisms of dextromethorphan.
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PMID:Effects of methysergide on the cough reflex. 382 Aug 62

The antitussive properties of caramiphen edisylate were studied in the decerebrate cat in which cough was elicited by direct electrical stimulation of the cough center. In this preparation dextromethorphan hydrobromide was compared to caramiphen as an antitussive agent. Dextromethorphan was somewhat more potent when given i.v. as well as when given directly into the left vertebral artery (i.a.). Both agents were far more effective when given i.a. than when given i.v. The effective dose ratios of i.v./i.a. were about 12 and 14 for caramiphen and 11 and 7 for dextromethorphan (actual and cumulative doses). These ratios indicate that both agents have a central rather than a peripheral site of antitussive action. Both drugs had antitussive effects in i.a. doses which did not alter arterial blood pressure or respiration greatly. However, after i.v. administration transient changes in both arterial blood pressure and respiration were observed with both agents. It was concluded that the antitussive action of both caramiphen and dextromethorphan is due to a selective effect on the cough center in the brainstem of the cat. On a milligram per kilogram basis, caramiphen required a 3 to 4 times larger dose than dextromethorphan for equieffective antitussive effects.
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PMID:Evidence for a central site of action for the antitussive effects of caramiphen. 398 59

In order to understand the relationship between the cough and respiratory centers in the brain stem, we investigated the effects of antitussive drugs such as codeine, dextromethorphan, eptazocine and fominoben on respiratory movement and the cough reflex. Coughs were induced using electrical stimulation of the central cut end of the right superior laryngeal nerve in lightly anesthetized dogs. The drugs were administered intraarterially into the vertebral artery. Rate (RR), amplitude (RA) and volume (RV) of the respiration and number (NC) and amplitude (AC) of the cough reflex evoked were measured as indices. Codeine produced a decrease in RR, RV and NC at 0.3 mg and, additionally, AC at 1 mg. Dextromethorphan increased RR and RV and rather enhanced NC and AC at 0.3 mg, but the agent reduced NC and AC at 3 mg even if it increased RR and RV. Eptazocine produced decreases in RA, NC and AC at 1 mg, and, additionally, RV at 10 mg. Fominoben increased RR, RA and RV dose-dependently at 0.3-3 mg, although it depressed NC and AC at 3 mg. These findings suggest that the thresholds for the cough responses and respiratory responses to antitussive drugs are different from drug to drug and that the respiratory centers and cough center in the brain stem are affected in a different manner even qualitatively.
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PMID:[Difference in the effects of antitussive drugs on respiration and cough reflex]. 622 55

Dextromethorphan, the most widely used cough suppressant in the U.S.A., was compared with codeine, the traditional European antitussive, in a double-blind, crossover trial using both an objective and subjective assessment of efficacy in sixteen patients with chronic, stable cough. Both preparations, at a dose of 20 mg, were similarly effective in reducing cough frequency. Dextromethorphan lowered cough intensity to a greater degree than codeine (p less than 0.0008) and was considered the better antitussive by the majority of patients (p less than 0.001). In view of its lack of side-effects, its safety even in overdose and its non-narcotic status, the increasing trend in Europe to use dextromethorphan as a substitute for codeine in the treatment of cough is to be welcomed.
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PMID:Dextromethorphan and codeine: objective assessment of antitussive activity in patients with chronic cough. 685 61

1. Dextromethorphan is a widely used antitussive agent which is a non-narcotic codeine analogue. We have investigated whether inhaled administration of dextromethorphan provides antitussive activity in a citric acid induced cough model. 2. Twenty normal subjects underwent repeated cough challenge with 5% citric acid. Subjects were studied on six occasions. Study medication consisted of oral dextromethorphan 30 mg or oral matched placebo or 1, 3 and 30 mg inhaled dextromethorphan or matched inhaled placebo. Cough challenge was administered 10 min after study medication and hourly thereafter up to 250 min. 3. No significant differences were seen between baseline cough responses. Oral dextromethorphan (30 mg) produced a mean percentage reduction in cough of 38% (P < 0.002), which remained significant at 250 min. Inhaled dextromethorphan had no clinically significant effect although activity at later time points was not excluded. The antitussive effect of oral dextromethorphan is confirmed with prolonged inhibition of induced cough. It is possible that dextromethorphan or its active metabolites act centrally to inhibit the cough reflex.
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PMID:The effect of inhaled and oral dextromethorphan on citric acid induced cough in man. 761 66


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