oxide powder. It is used as an emollient with slightly astringent properties, and because of its opaqueness it is ideal for protecting sensitive skin from the sun.
EXPECTORANTS AND ANTITUSSIVES
Expectorants, more accurately known as bronchomucotropic agents, are drugs used to assist in the removal of secretions or exudate from the trachea, bronchi, or lungs. They act by liquifying viscid mucus or mucopurulent exudates, i.e., they are decongestants. Therefore, they are used in the treatment of coughs to help expel these exudates and secretions. Antitussives are agents that specifically inhibit or suppress the act of coughing. They should not be used to suppress productive coughing. Expectorants and antitussives are most commonly used in the symptomatic treatment of the common cold or bronchitis. Other cold and allergy relief preparations are discussed later in this chapter.
Guaifenesin (Robitussin)
ACTION AND USE.— Guaifenesin is an expectorant. It may be useful in the symptomatic relief of dry, nonproductive coughs and in the presence of mucous in the respiratory tract.
USUAL DOSE.— 5 to 20 ml every 4 to 6 hours.
Dextromethorphan (DM)
ACTION AND USE.— This is a synthetic non-narcotic derivative of codeine that acts as an antitussive. It is used to control nonproductive coughs by soothing minor throat and bronchial irritations.
USUAL DOSE.— 5 to 15 ml (10 to 30 mg) every 6 to 8 hours. It is frequently combined with Guaifenesin (Robitussin).
Benzonatate (Tessalon Perles)
ACTION AND USE.— Benzonatate is an antitussive. It anesthetizes the stretch receptors located in the respiratory passages and lungs, reducing the cough reflex at its source. It is used for the symptomatic relief of nonproductive coughs.
USUAL DOSE.— One perle three times daily as needed, up to 600 mg a day.
Terpin Hydrate Elixir with Codeine (ETH with Codeine)
ACTION AND USE.— Codeine is a narcotic antitussive. The terpin hydrate is used primarily as a vehicle for the codeine but has a mild expectorant effect. This product contains 40 percent alcohol which serves as the main bronchomucotropic agent.
USUAL DOSE.— 5 ml every 3 to 4 hours.
ANTISEPTICS, DISINFECTANTS, AND GERMICIDES
These drugs are primarily intended for the prevention of infections by destroying bacteria or preventing their growth. The differences among them are based primarily on degree of activity and how they are used; antiseptics suppress the growth of microorganisms and are used topically; germicides kill susceptible organisms; and disinfectants are agents used on inanimate objects and are primarily germicidal in their action. All of these agents are for external use only unless otherwise indicated.
Phenol (Carbolic Acid)
Historically one of the first antiseptic agents used, phenol is the standard by which all other antiseptic, disinfectant, and germicidal agents are measured in their effectiveness. Because of its highly caustic nature, it must be handled with care. The effect of phenol is coincident with the concentration; high concentrations are germicidal and can cause tissue destruction; lower concentration are antiseptic. Phenol is inactivated by alcohol. Because more effective and less damaging agents have been developed, phenol is no longer used extensively. Never use phenol to disinfect rubber, cloth, or plastic.
Povidone-Iodine (Betadine)
ACTION AND USE.— Numerous iodine and iodine complex agents are available for use in disinfection. The most common of these is povidone-iodine (Betadine). It is used externally to destroy bacteria, fungi, viruses, protozoa, and yeasts. It is relatively nontoxic, nonirritating, and nonsensitizing to the skin. When used as an antiseptic, the complex breaks down on contact with skin or mucous membranes to release free iodine which is slowly absorbed. It is most commonly used as a preoperative skin antiseptic.