Cough treatment

Beechwood creosote has been used as a disinfectant, a laxative, and a cough treatment. In the past, treatments for leprosy, pneumonia, and tuberculosis also involved eating or drinking beechwood creosote. It is rarely used today in the United States by doctors since it has been replaced by better medicines, and it is no longer produced by businesses in the United States. It is still available as an herbal remedy, and is used as an expectorant and a laxative in Japan. The major chemicals in beechwood creosote are phenol, cresols, and guaiacol. 

In this section we select, inevitably rather arbiharily, four herbal cough treatments for which the effectiveness and mechanisms have been studied. With many other herbs there are a few pointers in the literature that the herb may be objectively considered an effective antitussive in humans, but the evidence is so thin as to be unconvincing (Table 1). In some instances, research only on animals or animal preparations has been done. 

Cineole, a monoterpene cyclic ether which is also named eucalyptol, is widely distributed in plants and is found in high concentrations in the essential oil of Eucalyptus polybractea. It is extensively used in cosmetics, for cough treatment, muscular pain, neurosis, rheumatism, asthma, and urinary stones (Wichtel, 2002). Using rat liver microsomes, 1,8-cineole is predominantly converted to 3-hydroxy-l,8-cineole, followed by 2- and then 9-hydroxycineole (Miyazawa et al., 2001b). As seen in Figure 8.7, in human liver microsomes, however, only the 2-hydroxy- and 3-hydroxy products... 

The NF and reagent grades are employed in the pharmaceutical industry which makes use of benzyl alcohol s local anesthetic, antiseptic, and solvent properties (17—20). It also finds use in cough symps and drops ophthalmic solutions bum, dental (21), and insect repeUant solutions and ointments and dermatological aerosol sprays. It is used in nail lacquers and as a color developer in hair dyes by the cosmetics industry (22), and in acne treatment preparations (23). 

ACE inhibitors can be administered with diuretics (qv), cardiac glycosides, -adrenoceptor blockers, and calcium channel blockers. Clinical trials indicate they are generally free from serious side effects. The effectiveness of enalapril, another ACE inhibitor, in preventing patient mortaUty in severe (Class IV) heart failure was investigated. In combination with conventional dmgs such as vasodilators and diuretics, a 40% reduction in mortaUty was observed after six months of treatment using 2.5—40 mg/d of enalapril (141). However, patients complain of cough, and occasionally rash and taste disturbances can occur. 

CociEana, the dried bark of Guana rusbji (Britt.) Rushy, was probably first used by the natives of the BoUvian Andes as an emetic—cathartic. It is often prescribed as an alternative to ipecac in the treatment of cough, and the emetic side effects at high doses suggest a mechanism of action similar to that of ipecac. 

Narcotic Antitussives. Since its isolation in 1832, codeine [76-57-3] (27) has been one of the most widely used and effective compounds for the treatment of cough. Though less potent than morphine [57-27-2] (28), it has become the reference against which most antitussives are measured. 

Dia2epam [439-14-5] (60) and clona2epam [1622-61 -3] (61) suppress cough induced by electrical stimulation of the lower brainstem of cats (90). Clona2epam and dia2epam adrninistered intravenously are about thirty-five times and six times more potent than codeine, respectively. Nevertheless, the compounds have not been widely used as antitussives in humans. Dia2epam is used in the treatment of anxiety, and clona2epam as an anticonvulsant. 

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