Is opiate action in cough due to sedation?

Dickinson, Rebecca S.; Morjaria, Jaymin B.; Wright, Caroline E.; Morice, Alyn H.

Abstract

Opiates have been used for cough suppression for centuries. It is unclear whether this antitussive action is due to their known sedative effects. We aimed to assess correlation between cough suppression and opiate usage. Methods: We performed a post hoc analysis of two published trials with three opioids. In study one, patients with chronic cough were treated with 4 weeks of modified release morphine sulphate (5 mg twice daily) or placebo in a double-blinded placebo-controlled fashion. Cough suppression was assessed subjectively by the Leicester Cough Questionnaire and objectively by citric acid aerosol (CAA) induced cough challenge. In study 2, normal volunteers were given single doses of placebo, codeine 30 mg or dextromethorphan 50 mg and cough suppression assessed using the CAA-induced cough challenge. Sedation was contemporaneously assessed by direct questioning. Results: There were 14 episodes of patient-reported sedation; 2 with modified release morphine sulphate, 9 with codeine and 3 with dextromethorphan. There was no correlation between change in the Leicester Cough Questionnaire or the CAA-induced cough challenge and reported sedation. This observational study suggests that sedation is unlikely to underlie the antitussive properties of these opioids. Eliciting the mechanism of these medications in cough may be a target for future tailored drug development. © 2014, SAGE Publications. All rights reserved.

Citation

Dickinson, R. S., Morjaria, J. B., Wright, C. E., & Morice, A. H. (2014). Is opiate action in cough due to sedation?. Therapeutic Advances in Chronic Disease, 5(5), 200-205. https://doi.org/10.1177/2040622314543220

• Journal Article Type: Article
• Acceptance Date: Jul 23, 2014
• Online Publication Date: Jul 23, 2014
• Publication Date: Sep 1, 2014
• Deposit Date: May 16, 2022
• Journal: Therapeutic Advances in Chronic Disease
• Print ISSN: 2040-6223
• Electronic ISSN: 2040-6231
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: 5
• Pages: 200-205
• DOI: https://doi.org/10.1177/2040622314543220
• Keywords: Antitussive; Codeine phosphate; Cough therapies dextromethorphan; Morphine sulphate (MST); Sedation
• Public URL: https://hull-repository.worktribe.com/output/3610102