Cough Syrup via PEG Tube

Nurses General Nursing

Updated:   Published

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 help control the cough? Also, when given PO, you don't want to give water after the cough syrup; does the water flush given after PEG tube administration impact its effectiveness?

I've asked my fellow nurses who work night shift with me and no one seems to know. I'm counting on the expertise here to help me understand. Thank you!

Specializes in Emergency & Trauma/Adult ICU.
BabyLady said:
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.

1
Up Vote Up Vote ×
Altra said:
?????

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.

1
Up Vote Up Vote ×
Specializes in Professional Development Specialist.
Altra said:
?????

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.

1
Up Vote Up Vote ×
Specializes in geriatrics.

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.

1
Up Vote Up Vote ×

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.

1
Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.
MisMatch said:
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.

1
Up Vote Up Vote ×
DizzyLizzyNurse said:
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.

1
Up Vote Up Vote ×
Specializes in NICU, Post-partum.
Altra said:
?????

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.

It is actually an opiate.

1
Up Vote Up Vote ×
BluegrassRN said:
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.

Correct me if I'm wrong, but I'm assuming the Mucinex you're referring to are the granules, since the pills are extended-release. How well do the granules go through a peg tube?

1
Up Vote Up Vote ×
Plagueis said:
Correct me if I'm wrong, but I'm assuming the Mucinex you're referring to are the granules, since the pills are extended-release. How well do the granules go through a peg tube?

I was using mucinex synonymously with guaifenesin. I just didn't want to type out (and probably misspell) guaifenesin. I've never personally had to crush guaifenesin, because I always request pharmacy switch to the liquid form, so that I can just pour it down the peg tube.

1
Up Vote Up Vote ×
Specializes in Med/Surg, Ortho, ASC.
OldNurseEducator said:
If the cough syrup were an expectornat, it would matter. :confused:

Why would that matter?

1
Up Vote Up Vote ×
Specializes in Peds Medical Floor.
michelle126 said:
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.

Yeah or a cough drop.

1
Up Vote Up Vote ×
+ Add a Comment