antitussives

鎮咳薬、鎮咳剤

関

antitussive、antitussive agent、antitussive drug

WordNet

1. any medicine used to suppress or relieve coughing

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/07/31 22:56:34」(JST)

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Cough syrup redirects here. For the Young the Giant song, see Cough Syrup (song).

Cough medicine often contains cough suppressants or expectorants.

A cough medicine (or linctus, when in syrup form) is a medicinal drug used in an attempt to treat coughing and related conditions. For dry coughs, treatment with cough suppressants (antitussives) may be attempted to suppress the body's urge to cough. However, in productive coughs (coughs that produce phlegm), treatment is instead attempted with expectorants (typically guaifenesin, in most commercial medications) in an attempt to loosen mucus from the respiratory tract.

There is no good evidence for or against the use of these medications in those with a cough. Even though they are used by 10% of American children weekly, they are not recommended in children 6 years of age or younger due to lack of evidence showing effect, and concerns of harm.

Examples

Pharmaceuticals

Dextromethorphan

Dextromethorphan (DXM) may be modestly effective in decreasing cough in adults with viral upper respiratory infections. In children however it has not been found to be effective.

Codeine

Codeine was once viewed as the gold standard in cough suppressants. Some recent placebo-controlled trials have found however that it may be no better than placebo for some etiologies including acute cough in children. It is thus not recommended for children.

Ephedrine

Ephedrine is used in cough medicine, such as Mollipect, in some countries.

Others

Other commercially available cough treatments have not been shown to be effective in viral upper respiratory infections, including in adults: antihistamines, antihistamine-decongestant combinations, Benzonatate, and guaifenesin; and in children: antihistamines, decongestants or combinations of these.

Alternative medicine

Honey may be a minimally effective cough treatment. However a Cochrane review found insufficient evidence to recommend for or against its use. The evidence is a single study of Buckwheat honey given before bedtime which provided better cough relief at night and improved sleep difficulty in children more than no treatment or dextromethorphan based over-the-counter cough medicine. However, honey's use as a cough treatment has been linked on several occasions to infantile botulism and as such should not be used in children less than one year old.

Many alternative treatments are used to treat the common cold. However, a 2007 review states that, "Complementary and alternative therapies (i.e., Echinacea, vitamin C, and zinc) are not recommended for treating common cold symptoms... Vitamin C prophylaxis may modestly reduce the duration and severity of the common cold in the general population and may reduce the incidence of the illness in persons exposed to physical and environmental stresses."

A 2009 review found that the evidence supporting the effectiveness of zinc is mixed with respect to cough, and a 2011 Cochrane review concluded that zinc "administered within 24 hours of onset of symptoms reduces the duration and severity of the common cold in healthy people". A 2003 review concluded: "Clinical trial data support the value of zinc in reducing the duration and severity of symptoms of the common cold when administered within 24 hours of the onset of common cold symptoms." Nasally applied zinc gel may lead to long-term or permanent loss of smell. The FDA therefore discourages its use.

A review of sixteen trials of echinacea was done by the Cochrane Collaboration in 2006 and found mixed results. All three trials that looked at prevention were negative. Comparisons of echinacea as treatment found a significant effect in nine trials, a trend in one, and no difference in six trials. The authors state in their conclusion: "Echinacea preparations tested in clinical trials differ greatly. There is some evidence that preparations based on the aerial parts of Echinacea purpurea might be effective for the early treatment of colds in adults but results are not fully consistent. Beneficial effects of other Echinacea preparations, and for preventative purposes might exist but have not been shown in independently replicated, rigorous randomized trials." A review in 2007 found an overall benefit from echinacea for the common cold however further analysis found problems with the interpretations of this review.

While a number of plants and Chinese herbs have been purported to ease cold symptoms, including ginger, garlic, hyssop, mullein, and others, scientific studies have either not been done or have been found inconclusive.

Toxicity

Main article: Toxic cough syrup

According to the New York Times, at least eight mass poisonings have occurred as a result of counterfeit cough syrup, substituting inexpensive diethylene glycol in place of glycerin. In May 2007, 365 deaths were reported in Panama, which were associated with cough syrup containing diethylene glycol.

Efficacy

The efficacy of cough medication is questionable, particularly in children. A 2008 Cochrane review concluded that "There is no good evidence for or against the effectiveness of OTC medicines in acute cough". In 2001, a meta-analysis indicated that some cough medicines may be no more effective than placebos for acute coughs in adults, including coughs related to upper respiratory tract infections. In 2006, the American College of Chest Physicians published a guideline for whooping cough, a cough that is caused by bacteria and can last for months. The guideline pointed out that available cough medicines are not designed to treat whooping cough or its causative bacterium. Although the efficacy is inconclusive for children over 2 years of age, a number of factors including accidental overdoses and well-documented adverse effects suggested caution in the pediatric prescription of cough syrups and medicines. No over the counter cough medicines have been found to be effective in cases of pneumonia.

See also

• Cough drop

References

External links

• Cough medicines not helpful - from CNN.com

UpToDate Contents

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• 1. 成人における亜急性および慢性咳嗽の治療 treatment of subacute and chronic cough in adults
• 2. The common cold in children: Management and prevention
• 3. 成人における感冒：治療および予防 the common cold in adults treatment and prevention
• 4. 緩和ケア：咳嗽、上気道性喘鳴、および喀血の概要 palliative care overview of cough stridor and hemoptysis
• 5. クループ：薬剤および補助治療 croup pharmacologic and supportive interventions

English Journal

• Noscapine recirculates enterohepatically and induces self-clearance.

• Mukkavilli R1, Gundala SR2, Yang C2, Jadhav GR3, Vangala S3, Reid MD4, Aneja R5.
• European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.Eur J Pharm Sci.2015 Sep 18;77:90-9. doi: 10.1016/j.ejps.2015.05.026. Epub 2015 May 28.
• Noscapine (Nos), an antitussive benzylisoquinoline opium alkaloid, is a non-toxic tubulin-binding agent currently in Phase II clinical trials for cancer chemotherapy. While preclinical studies have established its tumor-inhibitory properties in various cancers, poor absorptivity and rapid first-pass
• PMID 26026989

• Ethnomedicinal, Phytochemical and Pharmacological Profile of Anthriscus sylvestris as an Alternative Source for Anticancer Lignans.

• Olaru OT1, Niţulescu GM2, Orțan A3, Dinu-Pîrvu CE4.
• Molecules (Basel, Switzerland).Molecules.2015 Aug 17;20(8):15003-22. doi: 10.3390/molecules200815003.
• Anthriscus sylvestris (L.) Hoffm. is a wild herbaceous plant common in most temperate regions. It has been used traditionally to treat headaches, as a tonic, as antitussive, antipyretic, analgesic and diuretic. The plant contains deoxypodophyllotoxin, which is proven to have antitumor and anti-proli
• PMID 26287153

• Enhanced Cough Reflex in a Model of Bleomycin-Induced Lung Fibrosis in Guinea Pigs.

• Fernández-Blanco JA1, Aguilera M1, Domenech A2, Tarrasón G1, Prats N1, Miralpeix M1, De Alba J3.
• Clinical science (London, England : 1979).Clin Sci (Lond).2015 Aug 14. pii: CS20150302. [Epub ahead of print]
• Fibrotic lung diseases, such as idiopathic pulmonary fibrosis, are associated with spontaneous dry cough and hypersensitivity to tussive agents. Understanding the pathophysiology driving enhanced cough may help defining better therapies for patients. We hypothesised that lung fibrosis induced by int
• PMID 26275723

Japanese Journal

• Multiple Pharmacological Actions of Centrally Acting Antitussives : Do They Target G Protein-Coupled Inwardly Rectifying K⁺ (GIRK) Channels?

• Journal of pharmacological sciences 120(3), 146-151, 2012-11-20
• NAID 10031147561

• Centrally acting antitussives inhibit the dopamine D_2 receptor-mediated GIRK current in VTA neurons

• J Pharmacol Sci 118(Suppl 1), 225P, 2012
• NAID 50008384780

• 中枢性鎮咳薬の脳単一ニューロンレベルでの作用—メカニズムの解明に向けて

• 日本気管食道科学会会報 63(2), 95-95, 2012
• NAID 130004915884

Related Links

• Cough medicine - Wikipedia, the free encyclopedia

A cough medicine (or linctus, when in syrup form) is a medicinal drug used in an attempt to treat coughing and related conditions. For dry coughs, treatment with cough suppressants (antitussives) may be attempted to suppress the body's urge ...

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★リンクテーブル★

リンク元	「鎮咳薬」「antitussive drug」「antitussive agent」
関連記事	「antitussive」

「鎮咳薬」

　　[★]

英

antitussive, antitussives

関

分類

中枢性鎮咳薬

• コデイン、ジヒドロコデイン、デキストロメトルファン、ジメモルファン
• エプラジノン

末梢性鎮咳薬

• ベンゾナテート

「antitussive drug」

　　[★]

• 鎮咳薬、鎮咳剤

関

antitussive、antitussive agent、antitussives

「antitussive agent」

　　[★]

• 鎮咳薬

関

antitussive、antitussive drug、antitussives

「antitussive」

　　[★]

• adj.

• 鎮咳の、鎮咳性の

• n.

• 鎮咳薬、鎮咳剤

関

antitussive agent、antitussive drug、antitussives