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Dextromethorphan, or DXM, a common active ingredient found in many over-the-counter cough suppressant cold medicines, is used as a recreational drug and entheogen for its dissociative effects. It has almost no psychoactive effects at medically recommended doses. However, dextromethorphan has powerful dissociative properties when administered in doses well above those considered therapeutic for cough suppression. Recreational use of DXM is sometimes referred to in slang form as "robo-tripping", whose prefix derives from the Robitussin brand name, or "Triple Cs", which derives from the Coricidin brand whose tablets are printed with "CC+C" for "Coricidin Cough and Cold". However, this brand presents additional danger when used at recreational doses due to the presence of chlorpheniramine.
Paracetamol is a non-opioid analgesic and antipyretic agent used to treat fever and mild to moderate pain. It is a widely used over the counter medication and common brand names include Tylenol and Panadol.
Tylenol is a brand of medication, advertised for reducing pain, reducing fever, and relieving the symptoms of allergies, cold, cough, headache, and influenza. The active ingredient of its original flagship product is paracetamol, an analgesic and antipyretic. Like the words paracetamol and acetaminophen, the brand name Tylenol is derived from a chemical name for the compound, N-acetyl-para-aminophenol (APAP). The brand name is owned by McNeil Consumer Healthcare, a subsidiary of Kenvue.
The common cold or the cold is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx. Signs and symptoms may appear fewer than two days after exposure to the virus. These may include coughing, sore throat, runny nose, sneezing, headache, and fever. People usually recover in seven to ten days, but some symptoms may last up to three weeks. Occasionally, those with other health problems may develop pneumonia.
Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid prescription. In many countries, OTC drugs are selected by a regulatory agency to ensure that they contain ingredients that are safe and effective when used without a physician's care. OTC drugs are usually regulated according to their active pharmaceutical ingredient (API) rather than final products. By regulating APIs instead of specific drug formulations, governments allow manufacturers the freedom to formulate ingredients, or combinations of ingredients, into proprietary mixtures.
Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including analgesics, antihistamines and decongestants, among many others. It also includes drugs which are marketed as cough suppressants or antitussives, but their effectiveness in reducing cough symptoms is unclear or minimal.
Vicks NyQuil is a brand of over-the-counter medication manufactured by Procter & Gamble intended for the relief of various symptoms of the common cold. All medications within the NyQuil imprint contain sedating antihistamines, hypnotics, and/or alcohol, and are intended to be taken before sleep. Its daytime counterpart is antihistamine-free DayQuil, formulated to avoid drowsiness. NyQuil is also used as a sleep aid. NyQuil was first marketed in the United States in 1966.
Promethazine, sold under the brand name Phenergan among others, is a first-generation antihistamine, antipsychotic, sedative, and antiemetic used to treat allergies, insomnia, and nausea. It may also help with some symptoms associated with the common cold and may also be used for sedating people who are agitated or anxious, an effect that has led to some recreational use. Promethazine is taken by mouth (oral), as a rectal suppository, or by injection into a muscle (IM).
Dihydrocodeine is a semi-synthetic opioid analgesic prescribed for pain or severe dyspnea, or as an antitussive, either alone or compounded with paracetamol (acetaminophen) or aspirin. It was developed in Germany in 1908 and first marketed in 1911.
Dextropropoxyphene is an analgesic in the opioid category, patented in 1955 and manufactured by Eli Lilly and Company. It is an optical isomer of levopropoxyphene. It is intended to treat mild pain and also has antitussive and local anaesthetic effects. The drug has been taken off the market in Europe and the US due to concerns of fatal overdoses and heart arrhythmias. It is still available in Australia, albeit with restrictions after an application by its manufacturer to review its proposed banning. Its onset of analgesia is said to be 20–30 minutes and peak effects are seen about 1.5–2.0 hours after oral administration.
Codeine/paracetamol, also called codeine/acetaminophen and co-codamol, is a compound analgesic, comprising codeine phosphate and paracetamol (acetaminophen). Codeine/paracetamol is used for the relief of mild to moderate pain when paracetamol or non-steroidal anti-inflammatory drugs alone do not sufficiently relieve symptoms.
Vicks is an American brand of over-the-counter medications owned by the American companies Procter & Gamble and Helen of Troy Limited. Vicks manufactures NyQuil and its sister medication, DayQuil as well as other medications in the "Quil" line. Vicks also produces the Formula 44 brand of cough medicines, cough drops, Vicks VapoRub, and a number of inhaled breathing treatments. For much of its history, Vicks products were manufactured by the family-owned company Richardson-Vicks, Inc., based in Greensboro, North Carolina. Richardson-Vicks, Inc., was eventually sold to Procter & Gamble in 1985. Procter & Gamble divested the Vicks VapoSteam U.S. liquid inhalant business and sold it to Helen of Troy in 2015.
Lemsip is a brand of cold and flu remedies in the United Kingdom, Republic of Ireland, Australia, and New Zealand. It is manufactured by the British company Reckitt.
Doxylamine, sold under the brand name Unisom among others, is an antihistamine medication which is used in the treatment of insomnia and allergies. It is also used to treat morning sickness in pregnant women in combination with pyridoxine (vitamin B6). Doxylamine is available over-the-counter, and is used in nighttime cold medicines, such as NyQuil, as well as in pain medications containing acetaminophen and codeine, to help with sleep. The medication is taken by mouth.
Dextromethorphan (DXM) is a cough suppressant used in many cough and cold medicines. It affects NMDA, and sigma-1 receptors in the brain, all of which have been implicated in the pathophysiology of depression. In 2022, the FDA approved a formulation of it combined with bupropion named Auvelity to serve as a rapid acting antidepressant in patients with major depressive disorder.
Benylin is a brand name owned by Kenvue for a range of cough, cold and flu medications. Some Benylin products also contain codeine, which is used to treat pain, cough and diarrhea.
Hydrocodone/paracetamol is the combination of the pain medications hydrocodone and paracetamol (acetaminophen). It is used to treat moderate to severe pain. It is taken by mouth. Recreational use is common in the United States.
Codeine is an opiate and prodrug of morphine mainly used to treat pain, coughing, and diarrhea. It is also commonly used as a recreational drug. It is found naturally in the sap of the opium poppy, Papaver somniferum. It is typically used to treat mild to moderate degrees of pain. Greater benefit may occur when combined with paracetamol (acetaminophen) or a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen. Evidence does not support its use for acute cough suppression in children or adults. In Europe, it is not recommended as a cough medicine in those under 12 years of age. It is generally taken by mouth. It typically starts working after half an hour, with maximum effect at two hours. Its effects last for about four to six hours. Codeine exhibits abuse potential similar to other opioid medications, including a risk of habituation and overdose.
Paracetamol poisoning, also known as acetaminophen poisoning, is caused by excessive use of the medication paracetamol (acetaminophen). Most people have few or non-specific symptoms in the first 24 hours following overdose. These symptoms include feeling tired, abdominal pain, or nausea. This is typically followed by absence of symptoms for a couple of days, after which yellowish skin, blood clotting problems, and confusion occurs as a result of liver failure. Additional complications may include kidney failure, pancreatitis, low blood sugar, and lactic acidosis. If death does not occur, people tend to recover fully over a couple of weeks. Without treatment, death from toxicity occurs 4 to 18 days later.
References
- ↑ Vicks DayQuil
- ↑ Yin HS; et al. (2013). "Use of active ingredient information for low socioeconomic status parents' decision-making regarding cough and cold medications: role of health literacy". Academic Pediatrics. 13 (3): 229–35. doi:10.1016/j.acap.2013.01.004. PMC 3747773 . PMID 23680341.
- ↑ Burnett I; et al. (2006). "Onset of analgesia of a paracetamol tablet containing sodium bicarbonate: a double-blind, placebo-controlled study in adult patients with acute sore throat". Clinical Therapeutics. 28 (9): 1273–1278. doi:10.1016/j.clinthera.2006.09.009. PMID 17062300.
- ↑ Mizoguchi H; et al. (2007). "Efficacy of a single evening dose of syrup containing paracetamol, dextromethorphan hydrobromide, doxylamine succinate and ephedrine sulfate in subjects with multiple common cold symptoms". International Journal of Clinical Pharmacology and Therapeutics. 45 (4): 230–6. doi:10.5414/cpp45230. PMID 17474541.
- ↑ Smith SM; et al. (2012). Smith, Susan M. (ed.). "Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory setting". Cochrane Database of Systematic Reviews. 8 (8): CD001831. doi:10.1002/14651858.CD001831.pub4. PMID 22895922.
- ↑ Bryner JK; et al. (2006). "Dextromethorphan abuse in adolescence: an increasing trend". Archives of Pediatrics and Adolescent Medicine. 160 (12): 1217–22. doi:10.1001/archpedi.160.12.1217. PMC 2257867 . PMID 17146018.
- ↑ Schilling A; et al. (2010). "Acetaminophen: Old drug, new warnings". Cleveland Clinic Journal of Medicine. 77 (1): 19–27. doi: 10.3949/ccjm.77a.09084 . PMID 20048026. S2CID 17368757.
- ↑ FDA. "Acetaminophen Overdose and Liver Injury - Background and Options for Reducing Injury" (PDF). Food and Drug Administration .
- ↑ Gillman PK (2005). "Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity". British Journal of Anaesthesia. 95 (4): 434–41. doi: 10.1093/bja/aei210 . PMID 16051647.