Hmmm....

[usernamenumber]

For some reason this had never occurred to me before, but...

• Expectorant (n): An agent that increases bronchial secretions and facilitates their expulsion through coughing.
  
• Cough Suppressant (n): An agent that suppresses coughs (see also: "Duh").
  

Given this, should I be a bit worried that my Robitussin CF claims to be both an expectorant and a cough suppressant??? Shouldn't this be giving me pneumonia or something?

Sorry for all the random postage lately, but this illness has, for some reason, had really strange effects on my sleeping habits. For example, waking up at 5:30 am with an uncontrollable urge to look up the definition of expectorant.


P.S. Today's PVP inspired me to make a new icon. Horray for Bull!

P.P.S. Oh, and on a related note: Squeeeeeel!! =:)

P.P.P.S. Night court premiered over 21 years ago ('84-'92). I feel so freaking OLD.

Comments

[m-shell.livejournal.com]

i, for one, enjoy the random postage. ^_^

[usernamenumber.livejournal.com]

Why, thank you. Then I shall continue to spew forth (cough suppressants notwithstanding).

Sorry. Couldn't help myself.

But seriously, you're Ms. Med School now, right? So what's up with the apparent contradiction on my medicine? Since I have, in fact, not coughed much since I started taking it, it occurs to me that the junk in my lungs doesn't really have anywhere to go. So aren't I actually postponing my recovery with this?

[m-shell.livejournal.com]

this is probably hard to believe, but as a post-second-year med student (which means i'm done with the formal classroom education part) i have never had a single lecture/resource session/case/learning issue on treatment for colds. i know. it's ridiculous.

that said, i'm going to use my research sk33lz to find you an answer! (to be cont.)

mechanism of action for robitussin® CF (dextromethorphan, guaifenesin, and pseudoephedrine)

[m-shell.livejournal.com]

Description: Dextromethorphan, guaifenesin, and pseudoephedrine are used together in oral preparations to treat cough and congestion due to colds, acute respiratory infections, acute and chronic bronchitis, and hay fever. Dextromethorphan is a centrally acting cough suppressant. Guaifenesin loosens and thins phlegm and bronchial secretions to ease expectoration. Although guaifenesin may be used as an expectorant in both productive and non-productive coughs, it is especially useful in the treatment of dry, non-productive coughs, which tend to injure the respiratory mucous membranes. Pseudoephedrine is a sympathomimetic amine that is used as a decongestant. It shrinks nasal mucous membranes, reduces tissue hyperemia and edema, and increases nasal airway patency.

Mechanism of Action:

•Dextromethorphan: Dextromethorphan is a non-competitive antagonist of N-methyl-D-aspartate (NMDA) receptors in the brain and spinal cord. It is the d-isomer of levorphanol but has none of the analgesic, respiratory depressive, or sedative effects associated with opiate agonists. Dextromethorphan has similar antitussive effects as codeine. Dextromethorphan acts on the cough center in the medulla to raise the threshold for coughing by decreasing the excitability of the cough center. Naloxone, an opiate-antagonist, does not block the antitussive effects of dextromethorphan.

•Guaifenesin: Guaifenesin is an expectorant which increases the output of phlegm (sputum) and bronchial secretions by reducing mucous adhesiveness and surface tension. The increased flow of less viscous secretions promotes ciliary action and changes a dry, unproductive cough to one that is more productive and less frequent. By reducing the viscosity and adhesiveness of secretions, guaifenesin increases the efficacy of the mucociliary mechanism in removing accumulated secretions from the upper and lower airway. The expectorant effect can reduce cough frequency. Guaifenesin can also be beneficial for irritating, nonproductive coughs and for conditions in which thick mucous secretions are produced.

•Pseudoephedrine: Pseudoephedrine acts directly on both alpha- and, to a lesser degree, beta-adrenergic receptors. Like ephedrine, pseudoephedrine also has an indirect effect of releasing norepinephrine from its storage sites. By acting directly on alpha-adrenergic receptors in the mucosa of the respiratory tract, pseudoephedrine produces vasoconstriction, which shrinks swollen nasal mucous membranes; reduces tissue hyperemia, edema, and nasal congestion; and increases nasal airway patency. Also, drainage of sinus secretions is increased, and obstructed eustachian ostia may be opened. Pseudoephedrine can relax bronchial smooth muscle by stimulating beta2-adrenergic receptors; however, bronchodilation has not been consistently demonstrated upon oral administration.

Re: mechanism of action for robitussin® CF (dextromethorphan, guaifenesin, and pseudoephedrine)

[m-shell.livejournal.com]

so the way i read that as saying that the guaifenesin makes the phlegm thinner and easier to get out, so even if the dextromethorphan makes you cough less, it still comes out. and the pseudoephedrine shrinks your mucous membranes, so you feel less cloggy.

basically, if your problem is a nonproductive cough with think/hard-to-cough-up mucus, then robitussin® CF should help make the cough less often but more productive. if, however, you feel like your cough is productve and you wish it would happen more often so that the gunk comes out, you might want to look into an expectorant-only product without the dextromethorphan.

Re: mechanism of action for robitussin® CF (dextromethorphan, guaifenesin, and pseudoephedrine)

[usernamenumber.livejournal.com]

Wonderful. Thanks for the effort and the advice. =:)

Re: mechanism of action for robitussin® CF (dextromethorphan, guaifenesin, and pseudoephedrine)

[heiligekuh.livejournal.com]

When Jodi and I start to get a cold, we skip the CF and just chug straight guifenesin. It keeps us coughing and (feels like) that prevents the gunk from setteling in our chest. Thus we never get to the huge body-wracking coughing fits. If that fails and we do wind up with a full boown chest cold, then it's back to the suppressant and guifenesin combined, just for comfort and survival.

*Not a medical student, just frequently borderline sick.

Re: mechanism of action for robitussin® CF (dextromethorphan, guaifenesin, and pseudoephedrine)

[usernamenumber.livejournal.com]

I think I'm going to stick with the CF for now because there's fortunatley another instructor at the office today who can cover for most of my class and I figure lots of coughing (especially mine, which makes me sound like I've been chain smoking since birth) would neither help my voice in the timeframe it would need to be helped in nor enhance the classroom experience much for the students.

On that note, though, am I right in assuming that the reason I can't talk is that the bronchial gunk is gumming up my vocal chords (so if I'd gotten something that just let me cough all night I might actually be better this morning), or is it something else?

Oh. I just realized that I never actually said this explicitly: My voice is _gone_. I really lucked out by having another instructor in the area.

[abazureonna.livejournal.com]

"Shouldn't this be giving me pneumonia or something?"

hahahahahahahahahaha!

that'd be bad, but funny. not funny that you have pneumonia, that part would be bad. but it'd be funny that robitussin was manufacturing and marketing a pneumonia syrup and selling it as cold medicine.

laryngitis

[m-shell.livejournal.com]

according to harrison's:
"Acute laryngitis is a common syndrome caused predominantly by the same viruses responsible for many other URIs. In fact, most cases of acute laryngitis occur in the setting of a viral URI."

also:
"Laryngitis is characterized by hoarseness and can also be associated with reduced vocal pitch or aphonia. As acute laryngitis is caused predominantly by respiratory viruses, these symptoms usually occur in association with other symptoms and signs of URI, including rhinorrhea, nasal congestion, cough, and sore throat. Direct laryngoscopy often reveals diffuse laryngeal erythema and edema, along with vascular engorgement of the vocal folds."

so basically, i think the loss of voice is due to inflammation and swelling of your larynx and vocal folds, not the mucus per se. but both are caused by the same infectious agent.

^_^

[andmydog.livejournal.com]

P.P.P.S. Night court premiered over 21 years ago ('84-'92). I feel so freaking OLD.

I miss Bull. And Roz. And Dan Fielding.