preloder

Benzonatate


Benzonatate is a non-narcotic cough

medicine

. It works by numbing the throat and

lungs

, making the cough reflex less active.

Benzonatate

may also be used for purposes not listed in this medication guide.
Dosing
Adult dosing:
Cough:
  • 100 or

    200 mg

    orally 3 times daily as needed
  • Maximum

    dose

    is 600 mg/day
  • Maximum single

    dose

    is

    200 mg


  • Pediatric dosing:
    Cough:
    10 years or older:
  • 100 or

    200 mg

    orally 3 times daily as needed
  • Maximum

    dose

    is 600 mg/day
  • Maximum single

    dose

    is

    200 mg


  • Indications
    FDA-Labeled Indications:
  • Cough
  • Mechanism of Action
    Systemic:
  • Suppresses cough through a peripheral action, anesthetizing the stretch or cough receptors of vagal afferent fibers, which are located in the respiratory passages,

    lungs

    , and pleura; also, may suppress transmission of the cough reflex by a central mechanism, at the level of the medulla.
  • Local anesthetic activity when applied topically to the mucosa.

  • Adverse Effect
    Serious:
    Immunologic:
  • Hypersensitivity

    reaction

  • Neurologic:
  • Visual

    hallucinations

  • Contraindication
  • Hypersensitivity

    to benzonatate or related compounds
  • Precaution
    Immunologic:
  • Severe

    hypersensitivity

    reactions (e.g., bronchospasm, laryngospasm, cardiovascular collapse) have been reported.

  • Neurologic:
  • Adverse CNS effects have been reported during use.

  • Psychiatric:
  • Bizarre behavior, including mental confusion and visual

    hallucinations

    , has been reported during concurrent use with other drugs.
  • Pregnancy Category
  • C (FDA)
  • Breast Feeding
  • Infant risk cannot be ruled out.
  • Monitoring
  • Symptomatic improvement
  • How to Take or Administration
    Oral:
  • Swallow capsules whole; do not break, chew, crush, or dissolve; if capsules are chewed or dissolved in the mouth, oropharyngeal anesthesia may occur and could lead to choking.
  • Do not administer 2 doses at one time.
  • Dosage Form
    Oral Capsule, Liquid Filled:
  • 100 mg

  • 150 mg
  • 200 mg

  • Treatment
    Management of Mild to Moderate

    Toxicity

    :

  • The majority of benzonatate exposures require only supportive care. If patients present soon after exposure, activated charcoal may be considered; however, as the drug is rapidly absorbed and there is a risk of

    seizures

    after exposure, one should only give charcoal, if the patient is alert, can protect the airway, and the exposure has just recently occurred. The majority of these exposures will have mild symptoms only (i.e.,

    local anesthesia

    to the oropharynx) and require only observation to ensure patients do not choke or go on to have severe

    toxicity

    . For those experiencing a

    hypersensitivity

    reaction to benzonatate or the compounds related to it formulation,

    treatment

    should be stand decontamination (such as washing with soap and water) and other standard medications used to

    treat

    allergic reactions (e.g.,

    antihistamines

    and steroids).

  • Management of Severe

    Toxicity

    :

  • Patients with CNS depression, recurrent

    seizures

    or hemodynamic instability require early intubation.

    Treat

    QRS widening or

    ventricular

    dysrhythmias

    initially with sodium bicarbonate, 1 to 2 mEq/kg initial doses. Monitor arterial blood gases and serial ECG; maintain pH Between 7.45 to 7.55. Follow ACLS protocol for

    ventricular

    dysrhythmias

    not responsive to bicarbonate. Consider intravenous lipid therapy early for patients with

    ventricular

    dysrhythmias

    or hypotension.

    Treat

    seizures

    with benzodiazepines, if

    seizures

    persist or recur add propofol or barbiturates.

  • Dermal Exposure:
  • Wash with soap and water. If a patient experiences a

    hypersensitivity

    reaction,

    treat

    with

    antihistamines

    and steroids.

  • Ocular Exposure:
  • Irrigate with water.
  • Toxicology

    Toxicity

    :

  • Mild

    toxicity

    may occur with a single ingestion of a

    100 mg

    capsule, especially in pediatric patients less than 6 years old. More severe outcomes, including death, have been associated with doses ranging from 200 mg to the thousands of milligrams, most often in

    children

    less than 6 years old.

  • Adult:
  • An adult survived an ingestion of 3600 mg after experiencing

    seizures

    and unstable

    ventricular

    tachycardia.

  • Children

    :

  • Death has been reported in an 18-month-old child who ingested 2 to 10 capsules of benzonatate. An adolescent developed

    seizures

    and cardiac arrest but was resuscitated after ingesting at least 2000 mg benzonatate.

  • Patient Counselling or Clinical Teaching
  • This drug may cause nausea, dizziness, headache, sedation, or somnolence.
  • Tell patient that capsule should be swallowed whole. Oropharyngeal anesthesia may occur if capsules are chewed or dissolved in the mouth.












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