Cough syrup

[John Connellan]

I'm taking cough syrup at the moment and I'm just curious:

Does anybody know why it comes in syrup form? Most drugs/medicines nowadays are in pill/tablet form for easy transportation straight to the stomach. I used to think it was because the syrup acts locally around the opening to the trachea. Syrup is thick and may cling to the walls of the oesophagus. I now think this is not the case at all and that it enters the general bloodstream just like any other drug. Why syrup then? Would it not be easier to take a pill? Less messy? Easier to measure exactly?

Or perhaps it is still taken as syrup as a kind of psychological thing - maybe most people believe syrups to act locally down their throat?

Any suggestions?

 

[Ragnarok]

Ive often thought the same thing. Why syrup? You cough through the trachea, yet it coats the esophagus. My best guess is that the 'coating action' the cough syrup claims to have, is a marketing gimmick used to lure the people ignorant of this usless trait. I hope a pharmasist or doctor could clarify this.

 

[John Connellan]

Why syrup? You cough through the trachea, yet it coats the esophagus.

Well i thought that, because it is not practical for any syrup to line the trachea, it clings outside the opening of the trachea near the larynx.
I now believe this to be false and that they all the syrup finds its way to the stomach where active components get absorbed into the bloodstream.

 

[Ragnarok]

in other words, a quick dissolving tablet would have the same effect? Hmmm, and which one costs more?

 

[John Connellan]

So you might think syrup is less expensive than tablets and thus would be better to produce for those drugs where exact measurements mightn't be too important? Hmm, you could be right

 

[cpt.scruffy]

Ive often thought the same thing. Why syrup? You cough through the trachea, yet it coats the esophagus. My best guess is that the 'coating action' the cough syrup claims to have, is a marketing gimmick used to lure the people ignorant of this usless trait. I hope a pharmasist or doctor could clarify this.

it's the route of drug administration man.
for example, a lot of cough syrups use the opiod drug dextromethorphan (dxm), which through cough syrup, enters through absorption in the small intestine. the drug enters the system, and as an opioid drug supresses the cough.

they're symptomatic drugs, in that they stop the action of reacting in the case of the cough.

 

[cpt.scruffy]

So you might think syrup is less expensive than tablets and thus would be better to produce for those drugs where exact measurements mightn't be too important? Hmm, you could be right

they DO have cough supression tablets, too.

 

[Ragnarok]

so, in other words, it comes in syrup form to speed up the digestion, absorbtion, and administration process throughout the body... oooooohhhh it all becomes so clear now,....

 

[Billy T]

Quite a few (drugs are or soon will be)* delivered as fine (a few microns) powders directly into the lungs. I own stock in a couple of he companies that are (or have)* developed them. So far all are working on more seriour diseases than a cough.

One company I own is Nectar,
www.nektar.com/wt/page/dry_powder_devices,
Their insulin powder drug has been approved for nearly a year now by FDA as it is just as good (and from a patient complyance POV, much better than conventional injections of insulin) Pfizer is doing the marketing and now in a slow careful education phase - no need to rush as it will be at least three years before anyone else gets FDA approval.

I also own some discovery labs,
www.discoverylabs.com
Their lead drug, Surfaxin, is a better synthetic replacement for the animal derived drugs used to treat respiratory problems and a aerosol version is in development. Surfaxin was near final FDA approval but one of the three official "stability test" samples failed. (Many dozens not among the three official samples, are without any stability problem - This very bad luck case caused the stock to lose about 80% of its value in one day and I bought the next week)
A few percent of all babiess have Respiratory Distress Syndrome and about a third of those who survive develop Broncho Pulmonary Dysplasia (They frequently need to breath thru tubes, have long hospital says, with cost averaging $250,000 each with best current treatments available. In a couple of late stage clinical trials, Surfaxin’s re-intubation rates were significantly lower than animal-derived surfactants (34.2% vs. 43.9%, respectively; p = .005). If an when, the aerosol version gets FDA approval there will be no need to stick the "tubulation " into these babies.

The stock appears to be on its way back up now. I expect approximately a 600% gain when FDA approves Surfaxin and several times that if and when the aerosol version is approved, but look into them yourself and make your own decisions. Do not trust anything like this you read from anyone, even your broker, - most often they are just "pumping the stock" for their own gain at your expense.

There are two others with large economic potential / promise in this “direct into the lungs” field, but I will not tell who they are until after I decide to buy. - They are still very early stage - too early even for me. (In developing drugs, there are many possible "slips between cup and lip" as the saying goes and these two have not yet passed my "acceptable risk" requirements, but both look like they will soon.)
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*You probably do not think of it as a drug delivered this way, but nicotine has been delivered at great profit this way for couple hundred years. (cigarettes) Too bad there was no FDA when it was introduced.

 

[Ragnarok]

One company I own is Nectar,
www.nektar.com/wt/page/dry_powder_devices,
Their insulin powder drug has been approved for nearly a year now by FDA as it is just as good (and from a patient complyance POV, much better than conventional injections of insulin) Pfizer is doing the marketing and now in a slow careful education phase - no need to rush as it will be at least three years before anyone else gets FDA approval.

I have heard of this, in fact it was discussed as a new method of emergency ditribution of insulin into the blood for inmates in prison. I work as an officer in the sheriffs dep. where i live, and at the correctional compound we run we have approximately 3,000 inmates at a time. Of those 3,000, about 400 have diabeties related illnesses. This is a way to keep inmates alive that have 'crashed' and need help imediately. Of coarse its just newly being discussed, and probably wont come into play for awhile.

 

[Billy T]

...Of coarse its just newly being discussed, and probably wont come into play for awhile.

It is for sale now. many drug stores have it. but it is a perscription item. Pfizer is mainly educating the doctors now not yet trying hard to make them perscribe etc.

I never thought about it before but how do you handle "informed consent" - perhaps that is a "right" a prisoner loses?

I looked in to artificial blood about a year ago. IMHO, none of the public stock companies are approaching this problem correctly, but one still private one, lead by a doctor, is. I have some experience with medical things and physics. I would have tried to do exactly what the public compaines had done (make it less viscous, carry more oxygen etc. but now believe this is wrong approach.)
One of the leaders is Northfield Laboratories. - They just announced a week or so ago the prelimary results, which did meet the "not worse" requirement (with the stastical margins help and some failure to follow plans adjustments) but a greater percentage of the extreme shock patients treated with their product died than with the standard saline volume replacement. - Stock took terrible one day hit. (forget but at least 50% drop) and has not turned around yet last time I looked.

I am very glad I read the papers of the private doctor leading his approach and came to think what is the obvious way to make artifical blood even better than real blood is completely wrong, so did not buy NL.

NL had a waver of "informed consent" for this just completed large trial. US Army (or is it Navy?) wants to make big battle field trial, but FDA is requiring "informed consent" for it, so probably that is the end of it.

Many years ago, while at APL, which works for the US Navy, two naval medical officers came to APL and as I was one of the few doing a lot of work with doctors at the JHU hospital, they were sent to talk with me on the artifical blood need and problem. Thank god, I was already too busy and told them so and that I knew nothing about it, was a physicist and they need a chemical physiologist etc. If I had started into that area I am sure I would have done what NL has done, only less well. - I.e. I would have assumed more oxygen carrying capacity, lower viscosity, etc are "best objectives" for the program. - This even though I always believed "mother nature" / evolution has found the near optimal solution to most problems. Duplication of blood's properties is what the doctor of the private company in this area had as his goal. -I wish I could buy some stock in him and his product. - It is a few years from serious large humman trial* and NL results will make it hard to do them without getting "informed consent" - One more reason, when the revolution comes, to begin by killing all the lawyers.

Tell me about prisoners and informed consent. I know they due a lot of voluntary testing, but what about when they can not give "informed consent" and are in some critical medical condition - must be a tricky legal problem.
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*I do not remember just now, but think he is at the "draining cats" stage only now.

 

[Ragnarok]

Well, fortunately i do not have to deal with this problem. Informed consent deals only with community care facilities. A community care facility is defined as...

(a) a facility, or part of a facility, for the care, protection, rehabilitation or accommodation of mentally dysfunctional persons; or

(b) a prescribed psychiatric institution or a prescribed part of a psychiatric institution;

but does not include a correctional centre.

So we are exempt. But i was refering to the regular use of this product after it had been proven an efective means to administer insulin to a paitient by an emergency medical technition, or in other senarios, a certified officer. (you see we were having problems with the diabetic inmates crashing because they are not allowed K.O.P. medicines, or keep on person medicines due to the fact that they abuse that privilage by selling thier meds to other inmates for a quick 'high'.) And it took a long time to securly move the inmate from the housing unit, to the clinical facility on the compound. Our compound was not well planned out, due to the rappid growth of the inmate population, a situation which will be rectified by the year 2009. Keep in mind, we are a Correctional facility, and not a prison. A correctional facility is like a very large jail, where the inmates await trial and sentencing. They usually stay at most for 4 years, at least 2 days, and then are relaesed or sent to a prison. Did i mention i love my job?

 

[John Connellan]

they DO have cough supression tablets, too.

So then do u have any idea why syrup is the most common form of administration (as per the title question?)

 

[John Connellan]

so, in other words, it comes in syrup form to speed up the digestion, absorbtion, and administration process throughout the body... oooooohhhh it all becomes so clear now,....

Surely there are other more important drugs out there which would find better use with syrup administration then?! The urgency to suppress a cough would not, as most would agree, be as great as the urgency to suppress a toothache.

Why then do we still take Aspirin in tablet form?!

 

[Billy T]

...Why then do we still take Aspirin in tablet form?!

When I was young it did come in premeasured powder packets and that was their claim - faster acting.

 

[invert_nexus]

the urgency to suppress a toothache.

Why then do we still take Aspirin in tablet form?!

Put the aspirin directly on the tooth..
Problem being that most people are too big of pussies to be able to stand the taste of aspirin.

 

[John Connellan]

I don't know if this counts but I DO like the taste of Dispirin!

 

[Fraggle Rocker]

Cough syrup contains a local anesthetic that does indeed act on the tissue in the throat. Cough drops do the same thing and work the same way as they dissolve in your saliva.

I have occasionally had something "go down the wrong pipe" and coughed it back up before I choked on it. In many cases it was something with a rough texture but even smooth objects cause trauma to the throat tissue that doesn't get much of that kind of action. Or try a chili pepper seed. I will cough for hours while waiting for that tissue to heal, and of course it doesn't heal very fast because coughing irritates it.

I tried taking a cough drop and before it was even completely dissolved my throat was anesthetized and I stopped coughing. Generally by the time it wears off the trauma is sufficiently healed for the coughing spell not to resume, but if not a second cough drop does the job.

This works way too fast to be the result of something being absorbed through the stomach walls.

Admittedly cough syrup contains other ingredients that work on the problem from a different angle. Opium is a general anesthetic. Still cough syrup usually has at least a partial immediate effect and this can't be attributed to anything except a local anesthetic.