-
Pharmaceutical Biology Dec 2021(KOG) is a traditional mixed herb preparation consisting of CA Meyer (Araliaceae), Wolf (Polyporaceae), (Gaertner) Liboschitz ex Steudel (Orobanchaceae), and honey....
CONTEXT
(KOG) is a traditional mixed herb preparation consisting of CA Meyer (Araliaceae), Wolf (Polyporaceae), (Gaertner) Liboschitz ex Steudel (Orobanchaceae), and honey. Various pharmacological effects of KOG are reported, but the efficacy on respiratory diseases has not been evaluated.
OBJECTIVE
The anti-inflammatory, expectorant, and antitussive properties of KOG were examined using animal models of respiratory diseases.
MATERIALS AND METHODS
KOG (100, 200, and 400 mg/kg) was orally administered to ICR mice ( = 8) once a day for 11 days. Anti-inflammatory effects of vehicle, xylene, KOG and DEXA (1 mg/kg) were determined by monitoring edoema and redness of treated ears, and measuring the relative and absolute weight of each ear. Expectorant properties of vehicle, KOG and AM (250 mg/kg) were evaluated by observing body surface redness, and the amount of mucous secreted by the trachea. The antitussive potential of vehicle, NHOH, KOG and TB (50 mg/kg) was evaluated by monitoring changes in the number of coughs (for 6 min).
RESULTS
KOG (400 mg/kg) treated mice showed 31.29% and 30.72% ( < 0.01) decreases in the relative and absolute weights of each ear relative to xylene control mice, 39.06% increases ( < 0.01) in TLF OD values relative to intact vehicle control mice, and 59.53% decrease ( < 0.01) in coughing compared to NHOH control mice. Dose-dependent changes were observed in all experimental models.
CONCLUSIONS
KOG may be a potential therapeutic agent for the treatment of various respiratory diseases, particularly those caused by environmental toxins.
Topics: Administration, Oral; Animals; Anti-Inflammatory Agents; Antitussive Agents; Cough; Disease Models, Animal; Dose-Response Relationship, Drug; Expectorants; Inflammation; Male; Mice; Mice, Inbred ICR; Phytotherapy; Plant Extracts
PubMed: 33770452
DOI: 10.1080/13880209.2021.1892155 -
Pharmacological Reviews 2014Cough remains a serious unmet clinical problem, both as a symptom of a range of other conditions such as asthma, chronic obstructive pulmonary disease, gastroesophageal... (Review)
Review
Cough remains a serious unmet clinical problem, both as a symptom of a range of other conditions such as asthma, chronic obstructive pulmonary disease, gastroesophageal reflux, and as a problem in its own right in patients with chronic cough of unknown origin. This article reviews our current understanding of the pathogenesis of cough and the hypertussive state characterizing a number of diseases as well as reviewing the evidence for the different classes of antitussive drug currently in clinical use. For completeness, the review also discusses a number of major drug classes often clinically used to treat cough but that are not generally classified as antitussive drugs. We also reviewed a number of drug classes in various stages of development as antitussive drugs. Perhaps surprising for drugs used to treat such a common symptom, there is a paucity of well-controlled clinical studies documenting evidence for the use of many of the drug classes in use today, particularly those available over the counter. Nonetheless, there has been a considerable increase in our understanding of the cough reflex over the last decade that has led to a number of promising new targets for antitussive drugs being identified and thus giving some hope of new drugs being available in the not too distant future for the treatment of this often debilitating symptom.
Topics: Animals; Antitussive Agents; Clinical Trials as Topic; Cough; Drug Discovery; Humans; Molecular Structure; Molecular Targeted Therapy
PubMed: 24671376
DOI: 10.1124/pr.111.005116 -
Pediatrics Dec 2022Adverse events (AE), including death, occur in children with benzonatate use. This study aims to understand recent trends in benzonatate exposure and clinical...
BACKGROUND AND OBJECTIVES
Adverse events (AE), including death, occur in children with benzonatate use. This study aims to understand recent trends in benzonatate exposure and clinical consequences in pediatric patients.
METHODS
This retrospective analysis of data from IQVIA pharmacy drug dispensing, National Poison Data System, National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project, FDA Adverse Event Reporting System, and the medical literature evaluated exposure trends and medication-related AEs with benzonatate. Trends for comparator narcotic and nonnarcotic antitussive medications were analyzed where possible for context.
RESULTS
During the study period, pediatric benzonatate prescription utilization increased but remained low compared with pediatric utilization of dextromethorphan-containing prescription antitussive medications. Among the 4689 pediatric benzonatate exposure cases reported to US poison control centers from 2010 to 2018, 3727 cases (80%) were for single-substance exposures. Of these, 3590 cases (77%) were unintentional exposures and most involved children 0 to 5 years old (2718 cases, 83%). Cases involving intentional benzonatate exposure increased among children 10 to 16 years old with a more pronounced increase for multiple-substance exposures. Most benzonatate cases involving misuse or abuse were for children 10 to 16 years old (59 cases, 61%). The proportion of cases with serious adverse effects was low. There were few cases annually of serious AEs with benzonatate in children.
CONCLUSIONS
There were rising patterns of unintentional ingestion of benzonatate in children 0 to 5 years old and intentional benzonatate ingestion in children 10 to 16 years old. Rational prescribing and improved provider and caregiver awareness of benzonatate toxic effects may reduce risks associated with benzonatate exposure.
Topics: Child; Humans; United States; Infant, Newborn; Infant; Child, Preschool; Adolescent; Antitussive Agents; Retrospective Studies; Poison Control Centers; Butylamines
PubMed: 36377394
DOI: 10.1542/peds.2022-057779 -
The Journal of International Medical... Dec 2017Objectives Sceptridium ternatum is an expectorant in traditional Chinese medicine and is prescribed for the treatment of asthma. The study aim was to screen Sceptridium...
Objectives Sceptridium ternatum is an expectorant in traditional Chinese medicine and is prescribed for the treatment of asthma. The study aim was to screen Sceptridium ternatum for ingredients with antitussive and antiasthmatic effects and to study their associated mechanisms. Methods Cough in mice was induced using ammonia. Cough latency and the number of coughs within 3 minutes were determined. Airway responsiveness was assessed using ovalbumin as a sensitizer and characteristic asthma indicators were measured. Results Chloroform and ethyl acetate extracts significantly reduced the number of coughs within 3 minutes, tidal volume, and the percentage of eosinophilic granulocytes, lymphocytes and neutrophils. All extracts decreased airway responsiveness in asthmatic mice compared with the untreated group. Petroleum ether, chloroform and n-butanol extracts lowered the Penh values of asthmatic mice. Petroleum ether and ethyl acetate extracts greatly reduced interleukin-4 expression and the interleukin-4/interferon gamma ratio. Compared with the model group, all extracts reduced mRNA expression of the cysteinyl leukotriene receptor-1 (CysLT). Conclusions Chloroform extract and ethyl acetate extract displayed obvious antitussive effects and reduced airway inflammation. Thus, these two extracts contain the effective ingredients of Sceptridium ternatum. The active mechanism was ascribed to inhibition of mRNA expression of the CysLT receptor in mice with bronchial asthma.
Topics: Animals; Anti-Asthmatic Agents; Antitussive Agents; Chromatography, High Pressure Liquid; Cough; DNA, Complementary; Drug Evaluation, Preclinical; Drugs, Chinese Herbal; Female; Interferon-gamma; Interleukin-4; Mice, Inbred BALB C; Mice, Inbred C57BL; Plant Extracts; RNA, Messenger; Receptors, Leukotriene; Tandem Mass Spectrometry
PubMed: 29251256
DOI: 10.1177/0300060517722876 -
Purinergic Signalling Sep 2022Chronic cough is the most common complaint in respiratory clinics. Most of them have identifiable causes and some may respond to common disease-modifying therapies.... (Review)
Review
Chronic cough is the most common complaint in respiratory clinics. Most of them have identifiable causes and some may respond to common disease-modifying therapies. However, there are many patients whose cough lacks effective aetiologically targeted treatments or remains unexplained after thorough assessments, which have been described as refractory chronic cough. Current treatments for refractory chronic cough are limited and often accompanied by intolerable side effects such as sedation. In recent years, various in-depth researches into the pathogenesis of chronic cough have led to an explosion in the development of drugs for the treatment of refractory chronic cough. There has been considerable progress in the underlying mechanisms of chronic cough targeting ATP, and ongoing or completed clinical studies have confirmed the promising antitussive efficacy of P2X3 antagonists for refractory cough. Herein, we review the foundation on which ATP target was developed as potential antitussive medications and provide an update on current clinical progresses.
Topics: Adenosine Triphosphate; Antitussive Agents; Chronic Disease; Cough; Graft vs Host Disease; Humans; Treatment Outcome
PubMed: 35727480
DOI: 10.1007/s11302-022-09877-z -
Clinical Neuropharmacology 2020Among opioid-dependent patients on maintenance therapy, concomitant drug abuse is a serious problem. Dextromethorphan, an over-the-counter antitussive agent that can be...
BACKGROUND
Among opioid-dependent patients on maintenance therapy, concomitant drug abuse is a serious problem. Dextromethorphan, an over-the-counter antitussive agent that can be purchased without prescription, is a drug with a high potential for misuse, especially when consumed in high doses.The objective of this study was to investigate possible abuse of dextromethorphan among substituted opioid-dependent patients and comparison of subjective and objective findings.Due to its ability to increase serotonin levels, opioid-dependent patients may be particularly susceptible to dextromethorphan misuse. Dextromethorphan misuse may have side effects, including psychiatric symptoms and serotonin syndrome, and may induce assault, suicide, or homicide.
METHODS
A total of 104 opioid-dependent patients in maintenance treatment were included in this cross-sectional study conducted in the outpatient department of the Psychiatric Hospital, University of Zurich. Study participants were divided into 2 groups based on laboratory results: dextromethorphan abusers (n = 12) and nonabusers (n = 92). The objective use and concentrations of dextromethorphan was detected using 3-month hair toxicology analysis.Statistical analysis was performed by using χ test, Student t test, Mann-Whitney U test, and Barnard exact test.
RESULTS
Dextromethorphan was abused by 12 (11.5%) patients, 11 (91.7%) of whom did not report concomitant abuse of dextromethorphan but were identified through hair analysis. In general, there were significant differences among patients abusing dextromethorphan compared with nondextromethorphan consumers in terms of trauma due to sexual maltreatment/violence, multiple traumas, or harmful use of hallucinogenic drugs.
CONCLUSIONS
Further studies are necessary to examine dextromethorphan and its impact on patients with psychiatric comorbidities and psychiatric medication. According to literature, there is a significant drug interaction risk due to the impact of dextromethorphan misuse on serotonin syndrome and psychiatric symptoms.1-3 We recommend active inquiry into and testing for concomitant drug abuse among substituted opioid-dependent patients to reduce the risk of drug interactions and side effects in this especially vulnerable group of patients.
Topics: Adult; Cross-Sectional Studies; Dextromethorphan; Female; Hair; Hallucinogens; Humans; Male; Mental Disorders; Middle Aged; Opiate Substitution Treatment; Opioid-Related Disorders; Outpatients; Sexual Behavior; Substance Abuse Detection; Substance-Related Disorders; Violence; Wounds and Injuries
PubMed: 32947422
DOI: 10.1097/WNF.0000000000000403 -
Yonsei Medical Journal May 2015This study aims to investigate the additive effect of the Hedera helix (HH) and Rhizoma coptidis (RC) extracts mixture on antitussive and expectorant activities in...
PURPOSE
This study aims to investigate the additive effect of the Hedera helix (HH) and Rhizoma coptidis (RC) extracts mixture on antitussive and expectorant activities in animals.
MATERIALS AND METHODS
The expectorant assay was performed with phenol red secretion in mice trachea. Mice or guinea pigs were randomly divided into groups of 8 each, including negative and positive control groups. After gastric administration of the test extracts in mice, 2.5% phenol red solution (0.2 mL) was intraperitoneally injected. Trachea was dissected and optical density of tracheal secretion was measured. After gastric administration of the test extracts in guinea pigs, the antitussive activities were assessed using a citric acid-induced cough measurement.
RESULTS
The extracts of HH and RC significantly increased tracheal secretion and inhibited cough. The mixture of HH and RC extracts in a 1:1 concentration at a dose of 200 mg/kg showed a more potent effect on phenol red secretion (25.25±3.14) and cough inhibition (61.25±5.36) than the individual use of each extracts [phenol red secretion; HH 13.39±4.22 (p=0.000), RC 20.78±2.50 (p=0.010), cough inhibition; HH 9.89±4.14 (p=0.010), RC 30.25±7.69 (p=0.000)]. A 3:1 ratio mixture of HH to RC demonstrated an optimal expectorant effect (p<0.001), and this mixture showed expectorant and antitussive effects in a dose-dependent manner.
CONCLUSION
This study provides evidence for antitussive and expectorant effect of a 3:1 mixture of HH and RC, which may be a useful therapeutic option for respiratory diseases.
Topics: Animals; Antitussive Agents; Behavior, Addictive; Coptis chinensis; Cough; Drugs, Chinese Herbal; Ethanol; Expectorants; Guinea Pigs; Hedera; Male; Mice; Phytotherapy; Plant Extracts; Plant Roots; Trachea
PubMed: 25837191
DOI: 10.3349/ymj.2015.56.3.819 -
Respiratory Medicine Feb 2017Idiopathic pulmonary fibrosis (IPF) is a progressive disease of dysregulated wound healing leading to unremitting scarring and loss of lung function. The predominant... (Review)
Review
Idiopathic pulmonary fibrosis (IPF) is a progressive disease of dysregulated wound healing leading to unremitting scarring and loss of lung function. The predominant symptoms are dyspnea on exertion and a persistent dry cough. For patients with IPF, cough is more than just bothersome; it has a significant negative impact on quality of life and is a marker of disease severity and progression. The etiology of cough in IPF is unclear but may be due to architectural distortion of the lungs, increased sensitivity of the cough reflex, airway inflammation, or changes in mucus production and clearance. There also may be an overlap between IPF cough and cough due to other common etiologies such as asthma, gastroesophageal reflux disease, upper airway cough syndrome, and medications. There are no approved therapies to specifically treat IPF cough, and recently approved medications for IPF have not been evaluated in cough. Few clinical trials have focused on treatments for IPF cough. To date, there is only one randomized, placebo control therapeutic study for IPF cough with thalidomide, which significantly reduced IPF cough and improved quality of life. Two additional cohort studies report that interferon-α and prednisolone also decrease IPF cough. However, no medication is approved to treat IPF cough. Currently, the mainstay of therapy for IPF cough is standard cough suppressants, which have limited efficacy and often intolerable side effects. Future studies are needed to determine an effective therapy to alleviate this particularly debilitating symptom and improve overall quality of life for patients suffering with IPF.
Topics: Antitussive Agents; Comorbidity; Cough; Gastroesophageal Reflux; Humans; Idiopathic Pulmonary Fibrosis; Interferon-alpha; Quality of Life; Thalidomide
PubMed: 28137504
DOI: 10.1016/j.rmed.2016.12.016 -
Journal of Pharmacy & Pharmaceutical... 2021Codeine continues to be widely used as an analgesic, antidiarrhoeal and antitussive agent. Its analgesic effect depends on its biotransformation to morphine, a strong...
Codeine continues to be widely used as an analgesic, antidiarrhoeal and antitussive agent. Its analgesic effect depends on its biotransformation to morphine, a strong opioid. The highly variable biotransformation of codeine to morphine, catalysed by CYP2D6, underlies the pronounced interindividual variability of its analgesic response. Randomized controlled trials have demonstrated that codeine administered alone has the poorest analgesic effect among all commonly used analgesics in acute postoperative pain. Moreover, it is highly unlikely that the low dose of codeine contributes to the pain-relieving effect of the non-opioid component in combination analgesic products. In addition, there is a lack of reliable clinical evidence to support the use of codeine as an antitussive in acute or chronic cough. Codeine use, through its active metabolite morphine, has the potential to lead to abuse and dependence. The World Health Organization (WHO) removed codeine from the essential medicines list for children in 2011. Based on the available information in the scientific literature on the efficacy and safety of codeine, the WHO should seriously consider removing it also from the list of essential medicines for adults, which would be a strong signal for all health professionals to prescribe and dispense codeine with the utmost caution.
Topics: Adult; Analgesics, Opioid; Antitussive Agents; Child; Codeine; Drugs, Essential; Humans; Opioid-Related Disorders; Randomized Controlled Trials as Topic; World Health Organization
PubMed: 34192509
DOI: 10.18433/jpps31639 -
Canadian Family Physician Medecin de... Feb 2008
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Antitussive Agents; Bronchitis; Humans; Prognosis
PubMed: 18272643
DOI: No ID Found