The Treatment of Cough (11)Drugs that May Increase the Threshold or Latency of the Cough Center
An extensive number of narcotic and nonnarcotic agents have been studied and can be classified in this section. On the basis of numerous studies on artificially induced cough in animals and healthy subjects, as well as clinical trials on pathologic cough in patients, we believe that it is reasonable to assume that all narcotics of the phenanthrene alkaloid group (eg, morphine and codeine) are effective antitussives. Codeine, the prototypical agent in this group, clearly works; it is the standard to which other central antitussives are compared. Codeine and nonnarcotic agents that have been adequately evaluated in clinical studies appear in Table 3. buy yasmin online
According to our criteria, the following nonnarcotic agents have been shown to be effective antitussive agents: dextromethorphan, glaucine, diphenhydramine, caramiphen,’ viminol p-hydroxyben-zoate, and levodropropizine. On the other hand, ethyl dibunate, pholcodine, and brospamin have been shown to be ineffective. To date, the data of the efficacy of levopropoxyphene appear conflicting. While Chernish et al found it to be effective in a subjective study, Woolf and Rosenberg observed the drug to be ineffective in an objective study usii)g cough counting.

Table 3—Effects of Antitussive Drugs that May Increase the Latency or Threshold of the Cough Center

Drug Reference Study Design Resultf Dosing Scheduled Patients
Narcotics
Codeinel Aylward et al Cough counts E 30-60 mg; PO; 1 dose 8 B
Mathys et al Cough counts Subjective E 20 mg; PO; bid; 3 days 4 TB; 4 CA; 1 PF; 7 OB
Nonnarcotics
Dextromethorphan Aylward et al Cough counts E 60 mg; PO; 1 dose 8 B
Cass and Frederik Subjective E 10-20 mg; PO; qid; 10 days 121 B
Mathys et al Cough counts Subjective E 20 mg; PO; bid; 3 days 4TB;4CA;1PF;7 0B
Glaucine Ruhle et al Cough counts E 30 mg; PO; 1 dose 24 B
Gastpar et al Subjective E 30 mg; PO; tid; 7 days 130 URI
Dierckx et al Cough counts E 30 mg; PO; 1 dose 38 (B; CA; P; A)
Diphenhydramine Lilienfield et al Cough counts Subjective EI 25-50 mg; PO; q 4 h; 16 h 14 B; 1 S
Caramiphen Cass and Frederik Subjective E 10 mg; PO; qid; 10 days 121 B
Thomas et al Cough counts Subjective EE 20 mg; PO; tid; 2 days 25 (B; TB)
Viminol Sabot et al Cough counts E 70-140 mg; PO; 1 dose 24 B
Frigerio et al Cough counts E 60 mg; PO; 1 dose 31 B
Ethyl dibunate Sevelius and Colmore Cough counts I 50 mg; PO; tid; 3 days 12 B
Pholcodine Edwards et al Cough counts I 15 mg; PO; bid; 5 days 24 B
Brospamin Beumer et al Cough counts I 10 mg; PO; 1 dose 18 (B; CA; P)
Levopropoxyphenel Chernish et al Subjective E 100 mg; PO; qid; 7 days 19 (B; A)
Woolf and Rosenberg Cough counts I 100 mg; PO; q 4-5 h; 2 days 10 B
Levodropropizine
Allegra and Bossi Cough counts Subjective E 60 mg; PO; tid; 3 days 80 (B; A)