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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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Coughs associated with viral upper respiratory tract infections.
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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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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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Absorption: Well absorbed after oral administration.
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Metabolism and Excretion: Renally excreted as metabolites.
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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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Drug-Drug: None significant.
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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 ...