Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: (Phenergan with Codeine: This brand no longer is available in the
U.S.)
DRUG CLASS AND MECHANISM:Promethazine is in a class of drugs called
phenothiazines which also includes chlorpromazine (Thorazine) and
trifluoperazine (Stelazine); however, unlike the other drugs in this class,
promethazine is not used as an anti-psychotic but rather as an anti-histamine,
sedative, antiemetic (anti-nausea), and cough suppressant.
Cells in the body
release histamine during several types of allergic reactions. When histamine
binds to its receptors on other cells, it stimulates changes within the cells
that lead to release of other chemicals that cause sneezing, itching, and
increased mucus production. Antihistamines such as promethazine compete with
histamine for one of the receptors for histamine (the H1 receptor) on cells;
however, when antihistamines bind to the receptors they do not stimulate the
cells. Instead, they prevent histamine from binding and stimulating the cells.
Promethazine also blocks the action of acetylcholine, a neurotransmitter that
nerves use to communicate with one another, on its receptors (anticholinergic
effect), and this may explain its benefit in reducing the
nausea of motion
sickness. It is used as a sedative because it causes drowsiness as a side
effect. The cough suppressant effects may be due to is anticholinergic effects.
Codeine is a weak narcotic pain-reliever and cough suppressant similar to
morphine and hydrocodone. In fact, a small amount of codeine is converted to
morphine in the body. The precise mechanism of action of codeine is not known;
however, like morphine, codeine binds to narcotic receptors in the brain (opioid
receptors) that are important for transmitting the sensation of pain throughout
the body and brain. Codeine increases tolerance to pain and decreases
discomfort, but the pain still is apparent to the patient. In addition to
reducing pain, codeine also causes sedation (drowsiness) and depresses
breathing. The FDA approved promethazine and codeine in January 1952.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Syrup: 6.25mg of promethazine and 10mg of codeine per
teaspoonful.
STORAGE: Promethazine and codeine should be stored at room temperature, 15-25
C (59-77 F) in a tightly closed container protected from light.
PRESCRIBED FOR: Promethazine and codeine is used for the treatment of cough
and cold symptoms,
DOSING: The usual adult dose is one teaspoonful every 4 to 6 hours as needed.
The maximum dose is two tablespoons daily.
DRUG INTERACTIONS: Excessive sedation may occur when promethazine and codeine
is combined with other medications that cause sedation. Such drugs include
ethanol, barbiturates, anti-anxiety medications, sedatives, other
phenothiazines, and narcotic pain medications.
Promethazine should not be taken with any of the
monoamine oxidase (MAO)
inhibitor class of antidepressants, for example, isocarboxazid (Marplan),
phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane),
because of the increased risk of extrapyramidal symptoms (EPS) - uncontrollable
movement disorders.
Excessive anti-cholinergic effects (described below) can occur when
promethazine is used with other antihistamines, for example, diphenhydramine
(Benadryl), some phenothiazines, for example, thioridazine (Mellaril), some
tricyclic antidepressants, for example, amitriptyline (Elavil,
Endep), clozapine
(Clozaril), cyclobenzaprine (Flexeril), and disopyramide (Norpace).
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
Chronic cough is a cough that persists. Chronic cough is not a
disease in itself; rather it is a symptom of an underlying condition. Chronic
cough is a common
problem and the reason for many doctor visits.
What are causes of chronic cough?
Some common causes of chronic cough include
asthma,
allergic rhinitis, sinus
problems (for example sinus
infection), and esophageal reflux of stomach contents. In rare occasions, chronic
cough may be the result of aspiration of foreign objects into the lungs (usually
in children). It is very important to see a doctor who may order a chest
X-ray if a chronic cough is present. The following are common causes of
chronic coughing.
Cigarette smoking
actually is the most common cause of chronic cough.
Asthma is a disease of airways, resulting in difficulty breathing or
wheezing often characterized by abnormal breathing...
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