Cough Syrup via PEG Tube - page 2

by MisMatch

14,200 Views | 23 Comments

I am a fairly new LPN working in LTC. Several residents who are NPO have orders for cough syrup to be given via PEG tube for coughs. The cause of the cough varies with each resident. How does cough syrup given via PEG tube... Read More


  1. 2
    cough syrup doesnt work by coating the throat. it works by absorbing it systemically, so NG or PEG or swallowing it doesnt make a difference. You should know the mechanism of action for every drug you are giving, look it up in a good drug book. You can still expectorate with an NG or peg in place also. Doesnt matter . Cough syrup is very thick and clogs up tubes! Definitely give water afterward.
    BluegrassRN and DizzyLizzyNurse like this.
  2. 0
    Quote from Altra
    Some scary stuff being posted here ...

    OP, get your drug guide and look up "guaifenisin", "dextromethorphan" or whatever the active ingredient is in the cough suppressant that you are administering. You'll have your answer.
    That is what I was thinking.....I was taught in NS to give water with the cough syrup, r/t aiding in loosening secretions and that it acted centrally, no locally.....for that you want a lozenge..
  3. 0
    Quote from BabyLady
    If it has codeine in it, which many of them do, you can give them water with it because it is a cough surpressant.
    ?????

    There are 3 concepts here:

    1. The pharmacologic mechanism of action of the cough suppressant.
    2. Whether the route of administration affects the mechanism of action.
    3. And ... codeine, a morphine-derivative analgesic. It is not a cough suppressant.
  4. 5
    Quote from Altra
    ?????
    codeine, a morphine-derivative analgesic. It is not a cough suppressant.
    It is used as an anti-tussive. As was Morphine back in the day.
  5. 1
    Quote from Altra
    ?????

    And ... codeine, a morphine-derivative analgesic. It is not a cough suppressant.
    Actually it is. Robitussin AC is guafenesin and codeine. In pharm we were taught codeine suppresses the cough center in the brain.

    Route of administration of either guafenesin or guafenesin and codeine doesn't matter, nether does water administration. Maybe I could see not taking water with a cough drop, which sometimes contain a mild topical anesthetic (ie benzocaine) which can numb the throat a bit.

    ETA- Yes, for your own sake and your patients please flush with water after! Otherwise the sticky mess created will be a huge issue later.
    DizzyLizzyNurse likes this.
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    Thank you all for the information. Most of the residents get either guaifenesin or guaifenesin with dextromethorphan. I understand how the dextromethorphan can work systemically when given via PEG tube. I am still not sure how the guaifenesin alone does anything; my drug book shows it being given PO only.
  7. 2
    Po is the same as per PEG tube with such meds. You are not getting any absorption in the mouth...the absorption occurs lower in the GI tract. Mucinex po will have the same effects (and has the same route of absorption) as mucinex via a PEG tube.
    OgopogoLPN and Altra like this.
  8. 0
    Quote from MisMatch
    Thank you all for the information. Most of the residents get either guaifenesin or guaifenesin with dextromethorphan. I understand how the dextromethorphan can work systemically when given via PEG tube. I am still not sure how the guaifenesin alone does anything; my drug book shows it being given PO only.
    Guaifenisin is an expectorant, absorbed through the GI tract. P.O. administration is the same as via PEG tube, except in the case of something topical (like Nystatin) that needs to work in the oral cavity.

    Simply put: whether a patient swallows a med which then travels to the stomach & subsequent GI tract, or gets a med via PEG or other NG or enteral access which travels to the stomach & subsequent GI tract ... it is the same route of administration.
  9. 1
    Quote from DizzyLizzyNurse
    I never understood why you can't give someone water to drink with cough syrup. I couldn't take it without a drink of water. It's always worked for me and the residents I give it to.

    OMGee me too. It kills me when there are residents that look at me like I'm stoopid.

    Now...if you were taking honey or something to coat your throat and prevent coughing....thats another story.
    DizzyLizzyNurse likes this.
  10. 0
    Quote from Altra
    ?????

    3. And ... codeine, a morphine-derivative analgesic. It is not a cough suppressant.
    Actually, it is. Like the other member stated, it supresses the cough center in the brain.

    http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000565

    It is actually an opiate.


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