Cough Drugs — Complete Pharmacological Reference

ls -la /home/daytona/workspace/ 2>/dev/null || echo "workspace not found"

mkdir -p /home/daytona/workspace/cough-drugs && cat > /home/daytona/workspace/cough-drugs/build_chart.py << 'PYEOF' import openpyxl from openpyxl.styles import ( PatternFill, Font, Alignment, Border, Side, GradientFill ) from openpyxl.utils import get_column_letter wb = openpyxl.Workbook() # ── Colour palette ────────────────────────────────────────────── HEADER_BG = "1F4E79" # dark navy HEADER_FG = "FFFFFF" CLASS_BG = "2E75B6" # medium blue CLASS_FG = "FFFFFF" ALT1_BG = "DDEEFF" # light blue ALT2_BG = "FFFFFF" WARN_BG = "FFE699" # yellow warning WARN_FG = "7F3F00" TITLE_BG = "0D2E5A" TITLE_FG = "FFFFFF" BORDER_COL = "2E75B6" def thin_border(color=BORDER_COL): s = Side(style="thin", color=color) return Border(left=s, right=s, top=s, bottom=s) def header_fill(hex_color): return PatternFill("solid", fgColor=hex_color) def bold_font(size=10, color="000000", italic=False): return Font(name="Arial", bold=True, size=size, color=color, italic=italic) def norm_font(size=10, color="000000", italic=False): return Font(name="Arial", size=size, color=color, italic=italic) def center_align(wrap=True): return Alignment(horizontal="center", vertical="center", wrap_text=wrap) def left_align(wrap=True): return Alignment(horizontal="left", vertical="center", wrap_text=wrap) # ═══════════════════════════════════════════════════════════════ # SHEET 1 — Master Drug Chart # ═══════════════════════════════════════════════════════════════ ws = wb.active ws.title = "Cough Drugs – Master Chart" # --- Title row --- ws.merge_cells("A1:K1") ws["A1"].value = "COUGH DRUGS — COMPLETE PHARMACOLOGICAL REFERENCE CHART" ws["A1"].font = Font(name="Arial", bold=True, size=14, color=TITLE_FG) ws["A1"].fill = header_fill(TITLE_BG) ws["A1"].alignment = center_align() ws["A1"].border = thin_border() ws.row_dimensions[1].height = 30 # --- Subtitle --- ws.merge_cells("A2:K2") ws["A2"].value = "Sources: Goodman & Gilman's 14e | Katzung's 16e | Murray & Nadel's Respiratory Medicine" ws["A2"].font = norm_font(size=9, color="FFFFFF", italic=True) ws["A2"].fill = header_fill("2E4057") ws["A2"].alignment = center_align() ws.row_dimensions[2].height = 18 # --- Column headers --- headers = [ "Drug Name", "Class / Type", "Mechanism of Action", "Antitussive\nDose & Route", "Duration\nof Action", "Key Indications", "Major ADRs", "Drug Interactions", "Special\nPrecautions", "Availability", "Pediatric\nUse" ] col_widths = [20, 18, 38, 20, 14, 28, 30, 28, 28, 16, 18] for col, (h, w) in enumerate(zip(headers, col_widths), start=1): cell = ws.cell(row=3, column=col, value=h) cell.font = bold_font(size=10, color=HEADER_FG) cell.fill = header_fill(HEADER_BG) cell.alignment = center_align() cell.border = thin_border() ws.column_dimensions[get_column_letter(col)].width = w ws.row_dimensions[3].height = 36 # ── Drug data ───────────────────────────────────────────────── # Each tuple: (Drug, Class, Mechanism, Dose/Route, Duration, # Indications, ADRs, Interactions, Precautions, Availability, Pediatric) drug_data = [ # ─── OPIOID ANTITUSSIVES ─── ("── OPIOID ANTITUSSIVES ──", "", "", "", "", "", "", "", "", "", ""), ( "Codeine", "Opioid antitussive\n(μ-receptor agonist)", "Direct central depression of medullary cough centre; also peripheral opioid effects", "15 mg PO q4–6h\n(antitussive dose; lower than analgesic dose)", "4–6 hours", "Acute & chronic cough; mild-to-moderate pain", "Sedation, constipation, nausea, respiratory depression (high dose), physical dependence", "MAOIs (avoid); CNS depressants (additive); CYP2D6 inhibitors alter metabolism", "CYP2D6 polymorphism: ultra-rapid metabolisers risk toxicity; use caution in hepatic impairment; addictive potential", "Widely available; OTC in some countries; Rx in USA", "⚠ Avoid in children — CYP2D6 variability; use reconsidered for all ages" ), ( "Morphine\n(inc. Slow-Release)", "Strong opioid\n(μ-receptor agonist)", "Central medullary cough suppression; anxiolytic; analgesic", "Slow-release morphine PO (palliative / refractory cough); dose titrated", "SR: 12–24 h\nIR: 4–6 h", "Palliative cough (terminal cancer); severe refractory chronic cough", "Physical dependence, sedation, respiratory depression, constipation, nausea, histamine release (wheeze)", "CNS depressants, MAOIs, benzodiazepines, alcohol (additive depression)", "Reserved for terminal/palliative care or refractory chronic cough only; risk of dependence", "Rx only; Schedule II (USA)", "⚠ Avoid in children except palliative" ), ( "Diamorphine\n(Heroin)", "Strong opioid", "Same as morphine; central antitussive + analgesic", "Palliative doses only", "Short", "Palliative cough / pain in terminal cancer (UK)", "Physical dependence, respiratory depression, sedation", "CNS depressants, MAOIs", "NOT available in USA; UK palliative use only", "UK only (palliative)", "⚠ Not for children" ), # ─── NON-OPIOID ANTITUSSIVES ─── ("── NON-OPIOID / OPIOID-RELATED ANTITUSSIVES ──", "", "", "", "", "", "", "", "", "", ""), ( "Dextromethorphan\n(DXM)", "Non-narcotic antitussive\n(opioid-related structure; NO μ-receptor binding)", "Central elevation of cough threshold (non-opioid); inhibits neuronal serotonin reuptake; at high doses: NMDA receptor antagonism", "10–20 mg PO q4h OR 30 mg q6–8h; max 120 mg/day\nER: 60 mg bid", "5–6 hours\n(ER: 12 h)", "Acute & chronic cough (adults); OTC cold/cough preparations", "Therapeutic dose: few ADRs; no constipation\nHigh dose: dizziness, nausea, vomiting, headache, hallucinations, euphoria, dissociation, motor impairment", "⚠ MAOIs — CONTRAINDICATED (serotonin syndrome → death)\nCaution with SSRIs/SNRIs", "No analgesic / addictive properties; abuse potential at high doses ('robo-tripping'); does NOT inhibit ciliary activity", "OTC widely; many combination products", "🚫 FDA-BANNED < 6 years old; not effective in children" ), ( "Pholcodine", "Opioid-related structure (non-opioid mechanism)", "Central cough suppression; does NOT act at opioid receptors", "5–10 mg PO once or twice daily (long t½)", "12–24 hours", "Dry, irritating cough", "Generally well tolerated; mild sedation", "Caution with MAOIs", "Long half-life allows once/twice daily dosing", "Outside USA (UK, Europe, Australia)", "Caution in children; check local guidelines" ), ( "Levopropoxyphene", "Stereoisomer of dextropropoxyphene (non-opioid)", "Central antitussive; mechanism not fully defined; devoid of opioid effects", "50–100 mg PO q4h", "~4 hours", "Cough suppression", "Sedation", "Caution with CNS depressants", "No analgesic / opioid properties", "NOT available in USA", "Not established" ), ( "Noscapine", "Opium alkaloid antitussive (non-addictive)", "Central cough suppression; exact mechanism unclear; also bronchodilatory properties", "15–30 mg PO q6–8h", "4–8 hours", "Dry cough; also studied in oncology", "Nausea, dizziness; low abuse potential", "Mild interactions; caution with anticoagulants", "Not available in USA", "Outside USA", "Limited data" ), # ─── PERIPHERAL ANTITUSSIVES ─── ("── PERIPHERAL ANTITUSSIVES ──", "", "", "", "", "", "", "", "", "", ""), ( "Levodropropizine", "Peripheral antitussive (non-opioid)", "Peripheral inhibition of sensory cough receptors (C-fibres) in airways; no central CNS effects", "60 mg PO tid", "6–8 hours", "Cough with favourable safety profile vs. central agents; daytime use", "Rare: fatigue, GI upset; no sedation or dependence", "Minimal interactions", "Preferred when central side effects need to be avoided; favourable benefit/risk vs. dextromethorphan", "Europe, Asia; not USA", "Used in children in some countries" ), ( "Benzonatate", "Local anaesthetic-type peripheral antitussive", "Anaesthetises stretch receptors (pulmonary mechanoreceptors) in respiratory tract → reduces afferent cough signals", "100–200 mg PO tid; max 600 mg/day", "3–8 hours", "Cough when opioids/DXM undesirable; symptomatic relief", "Sedation, dizziness, GI upset; if capsule chewed → oropharyngeal anaesthesia, bronchospasm, cardiac arrest risk", "CNS depressants (additive sedation)", "Capsules must be swallowed WHOLE — never chewed or crushed (risk of cardiovascular collapse)", "USA (Rx); marketed as Tessalon", "⚠ Not recommended < 10 years" ), # ─── NEUROMODULATORS ─── ("── NEUROMODULATORS (Chronic / Refractory Cough) ──", "", "", "", "", "", "", "", "", "", ""), ( "Gabapentin", "Neuromodulator\n(α2δ calcium channel ligand)", "Modulates voltage-gated Ca²⁺ channels; reduces presynaptic transmitter release; reduces postsynaptic excitability; may affect GABA signalling and NMDA receptors", "300 mg tid, titrated (typical range 1200–2400 mg/day)", "Ongoing (daily dosing)", "Refractory / idiopathic chronic cough; neuropathic cough", "Dizziness, somnolence, ataxia, cognitive blunting", "Additive CNS depression with opioids, benzodiazepines; caution with alcohol", "Renal dose adjustment required; withdraw gradually; evidence from RCTs in chronic cough", "Rx only", "Off-label; limited paediatric cough data" ), ( "Pregabalin", "Neuromodulator\n(α2δ calcium channel ligand)", "Similar to gabapentin; inhibits voltage-gated Ca²⁺ channels; reduces neural sensitisation", "75–150 mg bid (combined with speech therapy)", "Ongoing", "Refractory chronic cough (esp. combined with speech pathology therapy)", "Dizziness, somnolence, weight gain, peripheral oedema", "CNS depressants; opioids (respiratory depression risk)", "Renal dose adjustment; withdraw gradually; RCT evidence in refractory cough with speech therapy", "Rx only", "Off-label" ), ( "Amitriptyline", "Tricyclic antidepressant\n(neuromodulator)", "Central antinociception; modulates presynaptic NMDA receptors → reduced transmitter release; inhibits serotonin & noradrenaline reuptake", "10–25 mg PO nocte (low dose)", "Ongoing (daily)", "Chronic cough post-URTI; idiopathic chronic cough; superior to codeine/guaifenesin in RCT", "Sedation, anticholinergic effects (dry mouth, urinary retention, constipation), QTc prolongation", "MAOIs (contraindicated); SSRIs (serotonin syndrome); QTc-prolonging drugs", "ECG monitoring; use with caution in elderly; low doses used for cough vs antidepressant doses", "Rx only; generic", "⚠ Not recommended in children for cough" ), # ─── EXPECTORANTS ─── ("── EXPECTORANTS ──", "", "", "", "", "", "", "", "", "", ""), ( "Guaifenesin", "Expectorant", "Increases volume of respiratory secretions; reduces mucus viscosity → facilitates mucociliary clearance and expectoration", "200–400 mg PO q4h; ER: 600–1200 mg q12h; max 2400 mg/day", "4 h (IR)\n12 h (ER)", "Productive cough; cough with congestion; combined with antitussives (e.g., DXM/guaifenesin)", "Nausea, vomiting at high doses; generally well tolerated", "No significant interactions", "Evidence for efficacy is limited; adequate hydration enhances effect", "OTC widely (USA & global)", "✓ Generally considered safe > 2 years (check formulation)" ), # ─── MUCOLYTICS ─── ("── MUCOLYTICS ──", "", "", "", "", "", "", "", "", "", ""), ( "Acetylcysteine\n(N-acetylcysteine, NAC)", "Mucolytic", "Breaks disulfide bonds in mucus glycoproteins → reduces sputum viscosity; also antioxidant", "200 mg PO tid OR 600 mg PO daily (effervescent)", "Ongoing", "Chronic bronchitis; COPD; reduction of exacerbation frequency", "Nausea, vomiting, stomatitis; bronchospasm (inhaled); rash", "Activated charcoal (reduces absorption); nitroglycerin (enhances effect)", "Small reduction in bronchitis exacerbations; modest improvement in cough and sputum; also antidote for paracetamol overdose", "OTC & Rx", "✓ Used in paediatric pulmonology" ), ( "Carbocysteine\n(Carbomethylcysteine)", "Mucolytic", "Alters mucus glycoprotein structure; reduces sputum viscosity; regulates mucus secretion", "750 mg PO tid initially, then 375 mg PO qid", "Ongoing", "Chronic bronchitis; COPD; bronchiectasis", "GI upset; rash", "Minimal significant interactions", "Evidence comparable to acetylcysteine", "Rx in most countries", "Paediatric syrup formulations available" ), ( "Bromhexine", "Mucolytic / Expectorant", "Depolymerises mucopolysaccharide fibres; reduces sputum viscosity; stimulates secretion of low-viscosity mucus", "8–16 mg PO tid", "Ongoing", "Chronic bronchitis; conditions with excessive/viscous mucus", "GI disturbance; rash; mild elevation of transaminases", "No significant interactions", "Active metabolite: ambroxol", "Global OTC/Rx", "✓ Paediatric formulations available" ), ( "Ambroxol", "Active metabolite of Bromhexine\n(Mucolytic)", "Stimulates surfactant production; increases serous secretion; reduces mucus viscosity", "30 mg PO tid (standard); 75 mg PO daily (SR)", "Ongoing", "Chronic bronchitis; COPD; also local anaesthetic effect at high doses", "GI disturbance; rare hypersensitivity", "No significant interactions", "Also has mild antitussive and local anaesthetic properties at high doses", "Global OTC/Rx", "✓ Widely used in paediatrics" ), ( "Methylcysteine", "Mucolytic", "Reduces sputum viscosity via mucoprotein depolymerisation", "200 mg PO tid–qid", "Ongoing", "Chronic bronchitis; conditions with viscous mucus", "GI disturbance", "Minimal", "Less commonly used vs. acetylcysteine or carbocysteine", "Select countries", "Limited data" ), # ─── AROMATIC / DEMULCENTS ─── ("── AROMATIC AGENTS & DEMULCENTS ──", "", "", "", "", "", "", "", "", "", ""), ( "Menthol", "Aromatic agent (TRPM8 agonist)", "Activates cold-sensitive TRP receptor TRPM8 in airways; inhibits capsaicin-induced cough; decongestant effect in nose", "Topical / inhalation; variable concentrations in OTC preparations", "Short (1–2 h)", "Symptomatic relief of nasal congestion & cough; short-term", "Rare sensitivity/skin irritation", "Minimal", "Inhibits capsaicin-induced cough in normal volunteers", "OTC widely", "✓ Generally safe; avoid in infants (near face)" ), ( "Eucalyptus Oil", "Aromatic agent", "Decongestant effects in nasal mucosa; mild antimicrobial; local soothing", "Inhalation / topical; OTC preparation", "Short", "Nasal congestion; symptomatic cough relief", "Contact sensitisation; GI irritation if ingested", "Minimal", "Short-term relief only", "OTC widely", "⚠ Avoid in infants (neurotoxic in large amounts)" ), ( "Demulcents\n(Honey, Glycerol, Syrup-based)", "Demulcent / soothing agent", "Form protective layer over inflamed pharyngeal/bronchial mucosa; reduce local irritation", "Honey: 2.5–5 mL PO; proprietary syrups as directed", "Short", "Soothing of throat irritation; nocturnal cough in children (honey)", "Honey: risk of botulism in infants", "None significant", "Evidence: honey superior to placebo for nocturnal cough in children (RCT evidence)", "OTC widely", "🚫 Honey CONTRAINDICATED < 1 year (infant botulism)" ), ] # ─── Write data rows ─────────────────────────────────────────── row_num = 4 for i, row in enumerate(drug_data): is_section = row[0].startswith("──") and row[1] == "" for col, val in enumerate(row, start=1): cell = ws.cell(row=row_num, column=col, value=val) cell.border = thin_border() if is_section: cell.fill = header_fill(CLASS_BG) cell.font = bold_font(size=10, color=CLASS_FG) cell.alignment = center_align() if col == 1 else left_align() if col == 1: ws.merge_cells(start_row=row_num, start_column=1, end_row=row_num, end_column=11) break else: bg = ALT1_BG if i % 2 == 0 else ALT2_BG # Highlight warnings if val and ("⚠" in str(val) or "🚫" in str(val) or "CONTRAINDICATED" in str(val) or "BANNED" in str(val)): cell.fill = PatternFill("solid", fgColor=WARN_BG) cell.font = norm_font(size=9, color=WARN_FG, italic=False) else: cell.fill = PatternFill("solid", fgColor=bg) cell.font = bold_font(size=9) if col == 1 else norm_font(size=9) cell.alignment = center_align() if col in (4, 5, 10, 11) else left_align() ws.row_dimensions[row_num].height = 60 if not is_section else 22 row_num += 1 # Freeze panes ws.freeze_panes = "A4" # ═══════════════════════════════════════════════════════════════ # SHEET 2 — Drug Interaction & Contraindication Quick Reference # ═══════════════════════════════════════════════════════════════ ws2 = wb.create_sheet("Interactions & Contraindications") ws2.merge_cells("A1:F1") ws2["A1"].value = "COUGH DRUG — INTERACTIONS & CONTRAINDICATIONS QUICK REFERENCE" ws2["A1"].font = Font(name="Arial", bold=True, size=13, color=TITLE_FG) ws2["A1"].fill = header_fill(TITLE_BG) ws2["A1"].alignment = center_align() ws2["A1"].border = thin_border() ws2.row_dimensions[1].height = 28 hdrs2 = ["Drug", "Interacting Drug / Class", "Severity", "Effect / Risk", "Clinical Action", "Mechanism"] col_w2 = [20, 25, 14, 35, 28, 30] for col, (h, w) in enumerate(zip(hdrs2, col_w2), 1): c = ws2.cell(row=2, column=col, value=h) c.font = bold_font(10, HEADER_FG) c.fill = header_fill(HEADER_BG) c.alignment = center_align() c.border = thin_border() ws2.column_dimensions[get_column_letter(col)].width = w ws2.row_dimensions[2].height = 22 interactions = [ ("Dextromethorphan", "MAO Inhibitors (phenelzine, tranylcypromine, selegiline)", "CONTRAINDICATED 🔴", "Serotonin syndrome; CNS depression; DEATH reported", "NEVER co-administer; allow 14 days washout after MAOI", "Serotonin reuptake inhibition by DXM + MAOI → serotonin excess"), ("Dextromethorphan", "SSRIs / SNRIs (fluoxetine, paroxetine)", "Caution 🟡", "Serotonin syndrome risk; elevated DXM levels (CYP2D6 inhibition)", "Monitor; use lowest effective dose; consider alternative", "CYP2D6 inhibition increases DXM plasma levels; additive serotonergic effect"), ("Codeine", "MAO Inhibitors", "CONTRAINDICATED 🔴", "Serotonergic toxicity, respiratory depression", "NEVER co-administer", "Serotonergic + CNS depressant synergy"), ("Codeine", "CYP2D6 inhibitors (fluoxetine, paroxetine, bupropion)", "Major 🟠", "Reduced conversion of codeine to morphine → reduced analgesia; OR toxicity in ultra-rapid metabolisers", "Avoid or choose alternative analgesic/antitussive", "CYP2D6 converts codeine → morphine (active)"), ("Codeine", "CNS depressants (benzodiazepines, alcohol, antihistamines)", "Major 🟠", "Additive CNS and respiratory depression; overdose risk", "Avoid combination; if necessary, reduce doses and monitor closely", "Additive CNS depression"), ("Morphine", "CNS depressants / alcohol", "Major 🟠", "Enhanced sedation and respiratory depression", "Avoid; if unavoidable, reduce doses and monitor", "Additive CNS depression"), ("Morphine", "MAO Inhibitors", "CONTRAINDICATED 🔴", "Severe CNS toxicity, respiratory depression, hyperpyrexia", "NEVER co-administer; 14-day washout", "Serotonergic + CNS mechanisms"), ("Amitriptyline", "MAO Inhibitors", "CONTRAINDICATED 🔴", "Hypertensive crisis; serotonin syndrome; seizures", "NEVER co-administer", "Serotonin/noradrenaline excess"), ("Amitriptyline", "QTc-prolonging drugs (azithromycin, haloperidol, methadone)", "Major 🟠", "Additive QTc prolongation → Torsades de Pointes; sudden death", "ECG monitoring; avoid combinations where possible", "Additive cardiac ion channel blockade"), ("Amitriptyline", "SSRIs / SNRIs", "Major 🟠", "Serotonin syndrome", "Monitor; avoid high-dose combinations", "Serotonin excess"), ("Gabapentin / Pregabalin", "Opioids", "Major 🟠", "Respiratory depression; sedation; increased overdose mortality", "Minimise concurrent use; if unavoidable, use lowest doses + close monitoring", "Additive CNS/respiratory depression"), ("Gabapentin / Pregabalin", "Alcohol / CNS depressants", "Moderate 🟡", "Enhanced sedation; impaired coordination", "Advise patients to avoid alcohol", "Additive CNS depression"), ("Benzonatate", "CNS depressants", "Moderate 🟡", "Additive sedation", "Caution; counsel patients", "Additive CNS depression"), ("Benzonatate", "SWALLOWED AS CHEWED CAPSULE", "CRITICAL ⚫", "Oropharyngeal anaesthesia → choking; systemic absorption → ventricular arrhythmia, cardiac arrest", "Must always swallow whole; patient education critical", "Local anaesthetic systemic toxicity"), ("Acetylcysteine", "Activated charcoal", "Moderate 🟡", "Reduced GI absorption of NAC (relevant in overdose protocols)", "In paracetamol overdose: IV NAC preferred", "Adsorption of NAC to activated charcoal"), ("Honey (demulcent)", "N/A – Age contraindication", "CONTRAINDICATED 🔴 < 1 year", "Infant botulism (Clostridium botulinum spores)", "NEVER give honey to infants < 12 months", "GI tract of infants permits germination of botulinum spores"), ] SEVERITY_COLORS = { "CONTRAINDICATED": "FF0000", "Major": "FF8C00", "Moderate": "FFC000", "Caution": "FFD966", "CRITICAL": "000000", } for i, row in enumerate(interactions): rn = i + 3 for col, val in enumerate(row, 1): c = ws2.cell(row=rn, column=col, value=val) c.border = thin_border() c.alignment = left_align() bg = ALT1_BG if i % 2 == 0 else ALT2_BG sev = row[2] if "CONTRAINDICATED" in sev or "CRITICAL" in sev: c.fill = PatternFill("solid", fgColor="FFD7D7") c.font = norm_font(9, "7F0000") elif "Major" in sev: c.fill = PatternFill("solid", fgColor="FFE7CC") c.font = norm_font(9, "7F3F00") elif "Moderate" in sev or "Caution" in sev: c.fill = PatternFill("solid", fgColor="FFFACC") c.font = norm_font(9, "7F5F00") else: c.fill = PatternFill("solid", fgColor=bg) c.font = norm_font(9) ws2.row_dimensions[rn].height = 50 ws2.freeze_panes = "A3" # ═══════════════════════════════════════════════════════════════ # SHEET 3 — Indication-Based Selection Guide # ═══════════════════════════════════════════════════════════════ ws3 = wb.create_sheet("Indication Selection Guide") ws3.merge_cells("A1:E1") ws3["A1"].value = "COUGH DRUG — INDICATION-BASED SELECTION GUIDE" ws3["A1"].font = Font(name="Arial", bold=True, size=13, color=TITLE_FG) ws3["A1"].fill = header_fill(TITLE_BG) ws3["A1"].alignment = center_align() ws3["A1"].border = thin_border() ws3.row_dimensions[1].height = 28 hdrs3 = ["Clinical Scenario / Cause of Cough", "First-Line Drug(s)", "Second-Line / Alternative", "Avoid", "Notes"] wids3 = [35, 30, 30, 25, 40] for col, (h, w) in enumerate(zip(hdrs3, wids3), 1): c = ws3.cell(row=2, column=col, value=h) c.font = bold_font(10, HEADER_FG) c.fill = header_fill(HEADER_BG) c.alignment = center_align() c.border = thin_border() ws3.column_dimensions[get_column_letter(col)].width = w ws3.row_dimensions[2].height = 22 scenarios = [ ("Acute viral URTI cough (adults)", "Dextromethorphan 30 mg q6–8h\nGuaifenesin (expectorant)", "Codeine 15 mg q4–6h", "Antibiotics (viral aetiology)", "Conservative management; hydration; honey/demulcent for throat"), ("Acute viral URTI cough (children 6–12 yr)", "Honey 2.5–5 mL ± saline nasal rinse", "No pharmacological antitussive recommended", "Dextromethorphan < 6 yr (FDA-banned)\nCodeine (all children)", "Non-pharmacological first; DXM not proven effective in children"), ("Infants < 1 year", "Saline drops; humidification", "Paediatric review", "Honey (botulism risk)\nDXM\nCodeine", "No OTC cough drugs in infants"), ("ACE inhibitor–induced cough", "Discontinue ACE inhibitor\nSwitch to ARB (e.g., losartan)", "—", "Antitussives (treat symptom not cause)", "Cough resolves within weeks of ACE inhibitor discontinuation"), ("Asthma / Cough-variant asthma", "Inhaled corticosteroids\nBronchodilators (SABA)", "Leukotriene antagonists (montelukast)", "Opioid antitussives (may worsen bronchospasm)", "Treat underlying asthma; cough resolves with asthma control"), ("Allergic rhinitis / Postnasal drip", "Topical nasal corticosteroids\nAntihistamines (cetirizine, loratadine)", "Topical nasal anticholinergics (ipratropium)\n± antibiotics if sinusitis confirmed", "—", "First-generation antihistamines (sedating) also reduce secretions"), ("GERD-associated cough", "PPI (omeprazole, lansoprazole)\nLifestyle modifications", "H₂ antagonist (ranitidine → replaced by famotidine)", "Antitussives alone (treat underlying GERD)", "Cough may take weeks to respond to acid suppression"), ("Chronic bronchitis / COPD", "Smoking cessation (primary)\nMucolytics (NAC, carbocysteine)\nBronchodilators", "Bromhexine; Ambroxol", "Central antitussives (suppress protective cough)", "Mucolytics reduce exacerbation frequency modestly"), ("Chronic idiopathic / refractory cough (adults)", "Gabapentin 300–600 mg bid-tid\nSpeech & language therapy", "Pregabalin + speech therapy\nAmitriptyline 10–25 mg nocte\nSlow-release morphine", "High-dose opioids long-term (dependence)", "Neuromodulators address neuropathic sensitisation underlying refractory cough"), ("Post-infectious (post-URTI) prolonged cough", "Amitriptyline 10–25 mg PO nocte", "Gabapentin\nCodeine short-term", "Long-term codeine", "RCT: Amitriptyline > codeine/guaifenesin for complete response in post-viral cough"), ("Palliative / terminal cancer cough", "Slow-release morphine (titrated)\nDiamorphine (UK only)", "Strong opioids + anxiolytics", "—", "Opioids also relieve anxiety and pain; treat as part of symptom burden"), ("Productive cough (mucus clearance)", "Guaifenesin\nAcetylcysteine\nBromhexine / Ambroxol", "Carbocysteine", "Pure antitussives (suppress productive cough)", "Maintain hydration; postural drainage in bronchiectasis"), ("Pertussis (whooping cough)", "Macrolide antibiotic (azithromycin)\n± supportive care", "Co-trimoxazole", "Antitussives (little benefit once paroxysmal phase begins)", "Antibiotic shortens infectivity; cough may persist weeks despite treatment"), ("Nocturnal cough in children", "Honey 2.5 mL PO at bedtime (> 1 yr)", "Elevated head of bed; saline rinse", "OTC antitussives", "RCT: Honey > placebo for nocturnal cough in children"), ] for i, row in enumerate(scenarios): rn = i + 3 for col, val in enumerate(row, 1): c = ws3.cell(row=rn, column=col, value=val) c.border = thin_border() c.alignment = left_align() bg = ALT1_BG if i % 2 == 0 else ALT2_BG c.fill = PatternFill("solid", fgColor=bg) c.font = bold_font(9) if col == 1 else norm_font(9) ws3.row_dimensions[rn].height = 55 ws3.freeze_panes = "A3" # ── Save ────────────────────────────────────────────────────── path = "/home/daytona/workspace/cough-drugs/Cough_Drugs_Reference_Chart.xlsx" wb.save(path) print(f"Saved: {path}") PYEOF echo "Script written."

cd /home/daytona/workspace/cough-drugs && python build_chart.py

# Fix: shorten sheet name + write to /tmp first then copy sed -i 's/ws.title = "Cough Drugs – Master Chart"/ws.title = "Master Drug Chart"/' /home/daytona/workspace/cough-drugs/build_chart.py sed -i 's|path = "/home/daytona/workspace/cough-drugs/Cough_Drugs_Reference_Chart.xlsx"|path = "/tmp/Cough_Drugs_Reference_Chart.xlsx"|' /home/daytona/workspace/cough-drugs/build_chart.py cd /home/daytona/workspace/cough-drugs && python build_chart.py && cp /tmp/Cough_Drugs_Reference_Chart.xlsx /home/daytona/workspace/cough-drugs/ && echo "Done"

python3 -c " import openpyxl, io wb = openpyxl.Workbook() ws = wb.active ws.title = 'Test' ws['A1'] = 'hello' buf = io.BytesIO() wb.save(buf) print('BytesIO save works, size=', len(buf.getvalue())) with open('/home/daytona/workspace/cough-drugs/test.xlsx','wb') as f: f.write(buf.getvalue()) print('file write works') "

~/cough-drugs/build_chart2.py

python3 /home/daytona/workspace/cough-drugs/build_chart2.py