Dextromethorphan

Generic Names: dextromethorphan, dextromethorphan hydrobromide Brand Names/Trade Names: Tussionex™, Polistirex™ Extended Release suspension, Robitussin™ DM Manufacturer: Covidien Pharmaceuticals (a division of Malinckrodt), 15 Hampshire Street, Mansfield, MA 02048; Wyeth Healthcare, P.O. Box 26609, Richmond, VA 23261-6609 Drug Class: antitussive, N-methyl-d-aspartate (NMDA) receptor antagonist Chemical Structure: see Figure 78.1 Chemical Name: 3-methoxy-17-methyl-9(alpha),13(alpha),14(alpha)-morphinan hydrobromide monohydrate Chemical Formula: C18H25NO·HBr ·H2O; molecular Wt 271; dextromethorphan is the d isomer of levophenol; it occurs as white crystals, is sparingly soluble in water, and freely soluble in alcohol Introduction Dexromethorphan is a synthetically produced substance that is chemically related to codeine and morphine. It is not classified as an opioid, is non-habituating, and is not associated with respiratory depression. The FDA approved this drug as a cough suppressant in 1954 and it has gradually replaced codeine as the most widely used cough suppressant in the USA. Dextromethorphan is currently an ingredient in more than 140 over-the-counter cough and cold medications. It is marketed alone or in combination with other drugs such as analgesics (e.g. acetaminophen), antihistamine (e.g. chlorpheniramine), decongestants (e.g. pseudo-ephedrine) and/or expectorants (e.g. guaifenesin). Experimental evidence suggests that dextromethorphan is a low-affinity NMDA receptor antagonist and may provide relief of somatic and neuropathic pain.

Duke Scholars

Author Muhammad Farooq Anwar Anesthesiology, Pain Management