Dextromethorphan

When ATH:
R05DA09

Pharmacological action

Antitussive. Inhibiting the excitability of the cough center, suppresses the cough of any origin. There is no habituation effect, It has no analgesic and hypnotic action. The onset of action is observed after dextromethorphan 10-30 minutes after ingestion, duration: 5-6 no – adults and 6-9 no – children.

Pharmacokinetics

After oral administration, dextromethorphan is completely absorbed from the gastrointestinal tract. C_max dextromethorphan plasma achieved through 2 no. Dextromethorphan biotransformed in the liver. To 45% dextromethorphan excreted by the kidneys, while there is considerable individual variation in the excretion of certain metabolites.

Testimony

Dry cough (various etiologies).

Dosage regimen

Adults and children over 12 years appoint 15 mg 4 times / day, older children 6 years – by 7.5 mg 4 time / day.

Side effect

Drowsiness, nausea, dizziness.

Symptoms: excitation, dizziness, decrease in blood pressure, tachycardia, hypertonus muscles, ataxia.

Treatment: IVL, symptomatic drugs. In case of overdose can occur (depending on the number of) drowsiness, or, conversely, excitation, incoordination, psyche,hallucinations.

Peredozirovke antidote - naloxone, It can be used in overdose 100 or more times.

Contraindications

Bronchial asthma, bronchitis, concomitant use of mucolytics.

Pregnancy and lactation

When pregnancy (especially in the I trimester) and lactation (breast-feeding) dextromethorphan administered with caution, Only in those cases, when the expected therapeutic benefit to the mother outweighs the potential risk to the fetus or child.

Cautions

With care prescribe dextromethorphan in the human liver.

Symptoms of overdose are agitation, dizziness, respiratory depression, disturbance of consciousness, decrease in blood pressure, tachycardia, hypertonus muscles, ataxia. Treatment: IVL, symptomatic agents.

Drug Interactions

MAO inhibitors (including furazolidone, procarbazine, selegiline) while the application may cause adrenergic crisis, collapse, whom, dizziness, excitation, increased blood pressure, hyperpyrexia, intracranial hemorrhage, lethargy, nausea, spasms, tremor. In combination with tricyclic antidepressants (amitriptyline etc.) serotonin syndrome may appeal and possible subsequent death. Amiodarone, fluoxetine, quinidine, inhibiting the cytochrome P450 system, can increase the concentration of drug in the blood. Tobacco smoke can lead to increased secretion of glands for background inhibition of the cough reflex.

Certain inhibitors of CYP450, Taki how quinidine, increase, but mainly lengthen its action.