5.8 Antitussives

Open Resources for Nursing (Open RN)

Dextromethorphan is an example of an antitussive (see Figure 5.10[1]).

Photo showing various packages of Robitussin medications
Figure 5.10  Robitussin DM is an OTC medication that contains dextromethorphan and guaifenesin

Mechanism of Action

Dextromethorphan suppresses a cough by depressing the cough center in the medulla oblongata or the cough receptors in the throat, trachea, or lungs, effectively elevating the threshold for coughing.

Indication for Use

Antitussives are used for a dry, hacking, nonproductive cough that interferes with rest and sleep.

Nursing Considerations Across the Lifespan

This medication is not safe for children under the age of 4 years.

Adverse/Side Effects

The most common side effects include nausea and drowsiness. Some patients may experience a rash or difficulty breathing. High doses may cause hallucinations and disassociation, and the drug has been reported to be used as a recreational drug.[2]

Patient Teaching & Education: Patients should take care to avoid irritants that stimulate their cough.  Additionally, antitussive medications can cause drowsiness, and patients should avoid taking them with other CNS depressants or alcohol.[3]

Now let’s take a closer look at the medication grid on dextromethorphan in Table 5.8.[4], [5], [6]

Table 5.8 Dextromethorphan Medication Grid

Administration Considerations
Therapeutic Effects
Adverse/Side Effects
Antitussive dextromethorphan Take as directed

Administer undiluted

No alcohol due to CNS depression

Use with caution in patients with respiratory disease and with  those taking monoamine oxidase inhibitors  (MAOIs)

Temporarily relieves coughing due to minor throat and bronchial irritation as may occur with the common cold CNS: sedation and dizziness

Mild gastrointestinal effects

  1. "Robitussin Cough Cold Flu Congestion decongestant Relief Medicine" by Mike Mozart is licensed under CC BY 2.0
  2. Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer.
  3. uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral
  4. This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0.
  5. Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer.
  6. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain.


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Nursing Pharmacology Copyright © 2020 by Open Resources for Nursing (Open RN) is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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