Updated: 1/17/2019

Expectorants

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Topic
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Questions
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Evidence
4 4
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Overview
  • Guaifenesin (Robitussin)
    • removes excess sputum
    • does not suppress cough reflex
    • must use large doses
  • N-acetylcysteine
    • mucolytic
      • cleaves disulfide bridges between mucus glycoproteins 
      • loosens mucus plugs in CF patients
    • also used as an antidote for acetaminophen overdose
  • Dextromethorphan  
    • over the counter cough suppressant
    • side effect of constipation
    • overdose can lead to hallucinations
 

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Questions (4)
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(M1.PL.15.75) After receiving a positive newborn screening result, a 2-week-old male infant is brought to the pediatrician for a diagnostic sweat test. The results demonstrated chloride levels of 65 mmol/L (nl < 29 mmol/L). Subsequent DNA sequencing revealed a 3 base pair deletion in a transmembrane cAMP-activated ion channel known to result in protein instability and early degradation. The physician discusses with the parents that the infant will develop respiratory infections due to improper mucus clearance and reviews various mucolytic agents, such as one that cleaves disulfide bonds between mucus glycoproteins thereby loosening the mucus plug. This mucolytic can also be used as a treatment for which of the following overdoses? Tested Concept

QID: 106837
1

Opioids

7%

(8/118)

2

Acetaminophen

64%

(76/118)

3

Cyanide

11%

(13/118)

4

Benzodiazepines

2%

(2/118)

5

Salicylates

12%

(14/118)

M 1 D

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(M1.PL.13.9) A 5-year-old Caucasian boy presents with a productive cough that yields thick sputum. His past medical history is significant for three prior pulmonary infections, two of which cultured S. aureus and one that was positive for Pseudomonas. Chest radiograph today is shown in Figure A. Which of the following pharmacologic agents act most directly to counteract the defective physiologic process in these patients? Tested Concept

QID: 100812
FIGURES:
1

Ipratroprium

7%

(5/67)

2

Beclomethasone

15%

(10/67)

3

Albuterol

7%

(5/67)

4

Zileuton

10%

(7/67)

5

N-acetylcysteine

58%

(39/67)

M 3 E

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Evidence (4)
Topic COMMENTS (2)
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