Expectorant Drugs
TERMS
□ guaifenesin (Robitussin, others)
□ acetylcysteine (Mucomyst)
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Expectorants stimulate the flow of respiratory tract secretions, which makes the cough more effective. Mucolytics work directly on mucus to make it more watery, which makes the cough more productive.
Efficacy of expectorants is questionable, but they are popular over-the-counter (OTC) drugs that are found in cold and cough preparations. Guaifenesin (Robitussin) is a widely used and popular expectorant. Expectorants can be given as a single agent or in combination with other drugs.
Table 35-1 Expectorant Drugs | |||||||||
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EXPECTORANT DRUGS CLIENT TEACHING
Avoid concurrent use of OTCs and herbal remedies without consulting with physician.
Dispose of tissues and secretions properly.
Cough effectively by sitting up, taking several slow deep breaths before coughing.
Encourage fluid intake to help liquefy secretions, unless contraindicated.
Report fever, cough, headache, or other symptoms lasting longer than 1 week to health care provider.
Encourage fluid intake to help liquefy secretions, unless contraindicated.Guaifenesin (Robitussin)
Liquid product may contain alcohol and sugar, and recovering alcoholics and diabetic clients should avoid use.
Liquid product may contain alcohol and sugar, and recovering alcoholics and diabetic clients should avoid use.Acetylcysteine (Mucomyst)
Has a characteristic rotten egg odor due to release of hydrogen sulfide
Use good oral hygiene during therapy.
Use good oral hygiene during therapy.
ACTIONExpectorants
Mucolytics
Decreases viscosity of pulmonary secretions. Splits links in the respiratory mucoprotein molecules into smaller, more soluble, and less viscous strands.2
In acetaminophen (Tylenol) overdose, it alters hepatic metabolism to decrease liver injury.
USEAll Expectorants
Relief of coughs associated with viral upper respiratory tract infections
Mucolytics
Adjunct treatment of thick tenacious mucus in cystic fibrosis and bronchiopulmonary disease
Antidote for acetaminophen (Tylenol) toxicity
Dornase alfa (Pulmozyine) used for management of cystic fibrosis
ADVERSE EFFECTS AND SIDE EFFECTSExpectorants
Pregnancy category C
GI: GI upset, nausea, and vomiting
Mucolytics
Pregnancy category B
CNS: Dizziness, drowsiness
GI: Nausea, stomatitis, hepatoxicity, unpleasant odor (sulfur in drug may smell like rotten eggs)
Resp: Bronchospasm, hemoptysis, rhinorrhea
Dornase Alfa (Pulmozyme)
Resp: cough pharnyngitis, wheezes
Other: conjunctivitis, chest pain
INTERACTIONSExpectorants (Guaifenesin [Robitussin])
None significant
Mucolytics
Acetylcysteine (Mucomyst) contains hydrogen sulfide and will discolor iron, copper, and harden rubber.
CONTRAINDICATIONSAll Expectorants and Mucolytics
Hypersensitivity
Expectorants
Some guaifenesin-containing products contain alcohol and should be avoided by recovering alcoholics.
