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MEDICAL GASES FOR THE TREATMENT OF ACUTE AND CHRONIC COUGH

IP.com Disclosure Number: IPCOM000201136D
Publication Date: 2010-Nov-09
Document File: 3 page(s) / 57K

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MEDICAL GASES FOR THE TREATMENT OF ACUTE AND CHRONIC COUGH

 

Cough is the most common symptom for which medical advice is sought. Consequently, antitussive drugs are amongst the most widely used medications worldwide and generate estimated sales of $4 billion per year. However, no new class of drugs have been introduced into the market for many years, despite a recent study suggesting that over-the-counter antitussive drugs, as well as central cough suppressants such as codeine, possess little clinically relevant efficacy, and they have not been shown to be more effective than placebo in adequately performed clinical trials. Better cough suppressants, in terms of efficacy, safety and tolerability, are desperately needed 1-2.

What is desired is a highly effective, well tolerable and safe cough, attributed to a variety of underlying disorders, suppressant therapy by gases.

Most currently available cough suppressants have not demonstrated antitussive efficacy in adequately performed clinical trials of acute cough. This includes non-prescription (OTC) products as well as central cough suppressants such as codeine[3] D.C. Bolser, Cough suppressant and pharmacologic protussive therapy. In: Diagnosis and management of cough: ACCP evidence-based clinical practice guidelines, Chest 129 (2006), pp. 238S–249S. Full Text via CrossRef. Furthermore, currently available antitussives, such as the opioids, are not consistently effective, or achieve therapeutic effect at the expense of unpleasant or intolerable side effects. Safer and more effective cough suppressants are hence needed 1.  Table 1 lists the antitussive agents currently available to practitioners.

 

Table 1. Drugs with proven or potential antitussive effect currently available to clinicians 1.

Agents approved as antitussives

Centrally acting

Narcotic opioids

Codeine, hydrocodone, morphine

Non-narcotic opioids

Dextromethorphan

Older-generation antihistamines

Peripherally acting

Benzonatate

Levodropropizine

Moguisteine

Guaifenesin (?)

Drugs approved for other indications; not approved as antitussives

Centrally acting

Amitriptyline

Baclofen

Peripherally acting

Tiotropium

Non-pharmaceutical agents with possible antitussive activity

Theobromine

 

Emerging neurobiological similarities between chronic pain states and chronic cough states provide evidence that cough is regulated much like the sensation of pain, providing strong evidence that NMDA antagonists might be highly effective at limiting cough, analogous to the beneficial effects of antagonizing NMDA receptors in pain 3-5.

However, the FDA approved, clinical available NMDA antagonists have, at therapeutic doses, potent side effects limiting their therapeutic use.

Medical gases such as nitrous oxide (N2O) and...