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INTRODUCTION

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guaifenesin (gwye-fen-e-sin)

Alfen Jr, Altarussin, Benylin-E, Breonesin, Calmylin Expectorant, Diabetic Tussin, Ganidin NR, Guiatuss, Hytuss, Hytuss-2X, Mucinex, Naldecon Senior EX, Organidin NR, Resyl, Robitussin, Scot-tussin Expectorant, Siltussin SA, Siltussin DAS

Classification

Therapeutic: allergy, cold, and cough remedies, expectorant

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Indications
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Coughs associated with viral upper respiratory tract infections.

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Action
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Reduces viscosity of tenacious secretions by increasing respiratory tract fluid. Therapeutic Effects: Mobilization and subsequent expectoration of mucus.

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Adverse Reactions/Side Effects
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CNS: dizziness, headache. GI: nausea, diarrhea, stomach pain, vomiting. Derm: rashes, urticaria.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Assess the quantity and consistency of sputum to help document whether this drug is successful in reducing the viscosity of respiratory secretions.

  • Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician, and caution the patient and family/caregivers to guard against falls and trauma.

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Interventions
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  • When implementing airway clearance techniques or other pulmonary interventions, attempt to intervene when the drug has produced expectorant effects. Effects typically begin 30 min after oral administration.

  • Design and implement breathing exercises to maximize ventilation and help prevent infections caused by pulmonary congestion.

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Patient/Client-Related Instruction
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  • Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged headache, skin reactions (rash, welts), or GI problems (diarrhea, nausea, vomiting, stomach pain).

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Pharmacokinetics
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Absorption: Well absorbed after oral administration.

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Distribution: Unknown.

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Metabolism and Excretion: Renally excreted as metabolites.

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Half-life: Unknown.

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TIME/ACTION PROFILE (expectorant action)

ROUTE ONSET PEAK DURATION
PO 30 min unknown 4–6 hr
PO-ER unknown unknown 12 hr

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity; Some products contain alcohol and should be avoided in patients with known intolerance; Some products contain aspartame and should be avoided in patients with phenylketonuria.

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Use Cautiously in: Cough lasting >1 wk or accompanied by fever, rash, or headache; Pregnancy (although safety has not been established, guaifenesin has been used without adverse effects); Patients receiving disulfiram (liquid products may contain alcohol); Diabetic patients (some products may contain sugar); Children (check age limitations on specific dose forms).

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Interactions
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Drug-Drug: None significant.

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Route/Dosage
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PO (Adults): 200–400 mg q 4 hr or 600–1200 mg q 12 hr as extended-release product (not to exceed 2400 mg/day).

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PO (Children 6–12 yr): 100–200 mg q 4 hr or 600 mg q 12 hr as extended-release product (not to exceed 1200 mg/day).

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