is an NMDA receptor antagonist used to treat cases of dry cough. Dextromethorphan Medicine is a levorphanol derivative and codeine analog commonly used as a cough suppressant and also a drug of abuse. Although similar in structure to other opioids, it has minimal interaction with opioid receptors.
Dextromethorphan Medicine Uses.
Dextromethorphan is indicated in combination with brompheniramine and pseudoephedrine in the treatment of coughs and upper respiratory symptoms associated with allergies or the common cold. Dextromethorphan is also used in combination with guaifenesin as an over-the-counter product to relieve a cough. Dextromethorphan Medicine in combination with quinidine is indicated in the treatment of pseudobulbar affect.
Pharmacodynamics
Dextromethorphan Medicine is an opioid-like molecule indicated in combination with other medication in the treatment of coughs and pseudobulbar affect. It has a moderate therapeutic window, as intoxication can occur at higher doses. Dextromethorphan has a moderate duration of action. Patients should be counselled regarding the risk of intoxication.
Mechanism of Action
Dextromethorphan Medicine is an agonist of NMDA and sigma-1 receptors. It is also an antagonist of α3/β4 nicotinic receptors. However, the mechanism by which dextromethorphan’s receptor agonism and antagonism translates to a clinical effect is not well understood.
Absorption
A 30mg oral dose of dextromethorphan reaches a Cmax of 2.9 ng/mL, with a Tmax of 2.86 h, and an AUC of 17.8 ng*h/mL.
Volume of distribution
The volume of distribution of Dextromethorphan Medicine is 5-6.7L/kg.
Protein binding
Dextromethorphan is 60-70% protein bound in serum.
Metabolism
Dextromethorphan Medicine can be N-demethylated to 3-methoxymorphinan by CYP3A4, CYP2D6, and CYP2C9 or O-demethylated to dextrorphan by CYP2D6 and CYP2C9. Dextrorphan is N-demethylated by CYP3A4 and CYP2D6, while 3-methoxymorphinan is O-demethylated by CYP2D6. Both are metabolized to form 3-hydroxymorphinan. Dextrorphan and 3-hydroxymorphinan are both O-glucuronidated or O-sulfated.
Half-life
Dextromethorphan Medicine has a half life of 3-30 hours.
Clearance and Route of elimination
Not Available
Toxicity
A Dextromethorphan Medicine overdose may present as nausea, vomiting, stupor, coma, respiratory depression, seizures, tachycardia, hyperexcitability, toxic psychosis, ataxia, nystagmus, dystonia, blurred vision, changes in muscle reflexes, and serotonin syndrome. Overdose should be managed through symptomatic and supportive measures.
Food Interactions
Take with or without food. The absorption is unaffected by food.
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