Decongestants & Antitussives

Decongestants and antitussives are the cold-remedy drugs that relieve congestion or suppress a dry cough, and each has a specific way of going wrong. Decongestants such as pseudoephedrine, phenylephrine and oxymetazoline are sympathomimetics that vasoconstrict, so they can raise blood pressure and pulse and cause insomnia and nervousness. They are never given with an MAOI or within two weeks of stopping one, because of hypertensive crisis, and are used with caution or avoided in hypertension, coronary disease, hyperthyroidism, diabetes, angle-closure glaucoma and BPH. Topical nasal sprays used more than three days cause rebound congestion. Antitussives suppress a dry, nonproductive cough; a productive cough should clear. Dextromethorphan is a non-opioid that carries serotonin syndrome risk with MAOIs and SSRIs. Codeine is an opioid, so watch for respiratory depression and teach no alcohol. Benzonatate must be swallowed whole, never chewed, dissolved or crushed, and accidental ingestion can be fatal in children. Teach the client to report a cough lasting over seven days and to check combination labels for acetaminophen.