药品详情：
【氢溴酸右美沙芬dextromethorphan 简述】
本品又名安咳锭、镇咳锭、治咳锭、去咳锭、可扶康锭、咳德锭等，是一种止咳类药品。
【氢溴酸右美沙芬dextromethorphan 适应症】
本品主要用于干咳，适用于感冒、急性或慢性支气管炎、支气管哮喘、咽喉炎、肺结核以及其他上呼吸道感染时的咳嗽。
【氢溴酸右美沙芬dextromethorphan 规格】
本品为胶囊、片剂、口服液等多种规格。
【氢溴酸右美沙芬dextromethorphan 服用方法】
患者应完全遵循主治医师或说明书上的指示服用，不可服用超过每日允许的推荐量。
【氢溴酸右美沙芬dextromethorphan 注意事项】
1.与单胺氧化酶抑制剂并用时，可致高烧、昏迷，甚至死亡。
2.不得与抗抑郁药并用。
3.不宜与乙醇及其他中枢神经系统抑制药物并用，因可增强对中枢的抑制作用。
【氢溴酸右美沙芬dextromethorphan 不良反应】
偶有头晕、轻度嗜睡、口干、便秘等副作用，孕妇及痰多病人慎用，妊娠3个月内妇女及有精神病史者禁用。勿过量服用，24小时内应不超过8片（120mg）。
Dextromethorphan
Dextromethorphan (DXM or DM) is a medication most often used as a cough suppressant in over-the-counter cold and coughmedicines. It is sold in syrup, tablet, spray, and lozenge forms.
It is in the morphinan class of medications with sedative, dissociative, and stimulant properties (at lower doses). In its pure form, dextromethorphan occurs as a white powder.[3]
DXM is also used recreationally. When exceeding approved dosages, dextromethorphan acts as a dissociative anesthetic. It has multiple mechanisms of action, including actions as a nonselective serotonin reuptake inhibitor[4] and a sigma-1 receptor agonist.[5][6] DXM and its major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anesthetics such as ketamine and phencyclidine.
It was patented in 1949 and approved for medical use in 1953.[7]
Medical uses
Cough suppression
The primary use of dextromethorphan is as a cough suppressant, for the temporary relief of cough caused by minor throat and bronchial irritation (such as commonly accompanies the flu and common cold), as well as those resulting from inhaled particle irritants.[8] However, controlled studies have found the symptomatic effectiveness of dextromethorphan similar to placebo.[9]
Neuropsychiatric disorders
In 2010, the FDA approved the combination drug dextromethorphan/quinidine for the treatment of pseudobulbar affect (uncontrollable laughing/crying). Dextromethorphan is the actual therapeutic agent in the combination; quinidinemerely serves to inhibit the enzymatic degradation of dextromethorphan and thereby increase its circulating concentrations via inhibition of CYP2D6.[10]
In 2013, a randomized clinical trial was conducted at Tabriz University of Medical Sciences in Tabriz, Iran, that indicated dextromethorphan may help reduce the overall discomfort and duration of withdrawal symptoms associated with Opioid use disorder. When combined with Clonidine, dextromethorphan reduced the overall time needed for withdrawal symptoms to peak by 24 hours while also reducing the severity of the symptoms compared to Clonidine alone.[11]
In 2016, the ASA released a promising study with the combination of dextromethorphan with pregabalin, acetaminophen, and naproxen which showed a decrease in postoperative pain intensity (preemptive analgesia).[12]
Contraindications
Because dextromethorphan can trigger a histamine release (allergic reaction), atopic children, who are especially susceptible to allergic reactions, should be administered dextromethorphan only if absolutely necessary, and only under the strict supervision of a healthcare professional.[13]
Adverse effects
Adverse effects of dextromethorphan in overdose at doses 3 to 10 times the recommended therapeutic dose:[17][not in citation given]
euphoria
increased energy
increased confidence
mild nausea
restlessness
insomnia
talking fast
feelings of increased strength
dilated pupils
glassy eyes
dizziness
At doses 15 to 75 times the recommended therapeutic dose:[17][not in citation given]
hallucinations
dissociation
vomiting
blurred vision
double vision
bloodshot eyes
dilated pupils
sweating
fever
bruxia (teeth grinding)
hypotension
hypertension
tachycardia
shallow respiration
diarrhea
urinary retention
muscle spasms
sedation
euphoria
paresthesia
blackouts
sight loss
inability to focus eyes
skin rash
severe itchieness
注：药品如有新包装,以新包装为准。以上资讯来源于网络或由高等医药院校的学生志愿者翻译（如有错漏，请帮忙指正）,仅供医护人员内部讨论,不作任何用药依据,具体用药指引,请咨询主治医师。
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