Preparations for the treatment of cough

Cough is a symptom of many diseases, including serious ones. Therefore, with a strong and prolonged respiratory disorder, you should not self-medicate, because this can lead to very disastrous consequences.

After diagnosing the cause of respiratory disorders, one should start therapy aimed at suppressing factors, cough, but in most cases this symptom indicates a progressive viral or bacterial infection in respiratory tract. However, doctors do not always recommend fighting with respiratory attacks, as they help clear the airways and lungs of the toxins that accumulated in them. That is, in the first place, cough is a protective reflex of the body, designed to get rid of foreign objects trapped in the human respiratory system.

In the case of colds, the respiratory disorder is treated with special medications with different effects on the body. Some are aimed at suppressing the cough reflex, and other drugs affect bronchial mucosa and sputum liquefaction.

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What are the most effective medicines for fighting cough? First of all, the choice of a medicine should depend on the form and nature of this symptom. Here are the forms of cough that require treatment:

Dry non-productive, which often causes pain, discomfort and restless sleep.
Productive, with viscous and poorly secreted viscous sputum, which requires liquefaction.
Frequent moist with liquid and well excreted sputum.

Drugs with a strong dry cough

If the cough is dry, unproductive, painful and painful, leading to insomnia and loss of appetite, then the most effective are combined and antitussive drugs. For the treatment of this type of respiratory disorder apply:

Codeine-based drugs that depress the cough reflex, such as Kodelak, Todein, Tercodin.
Means with dextromethorphan, for example Glycodine, which reduce the number of cough reflexes, which soothes irritated airways.
Sinecod - softens reflex attacks and helps to translate them into productive form. It is used by adults mainly in the form of a syrup, and for children it is recommended to use drops.
Eucalyptus oils and inhalants added to boiling water help to mechanically thin the sputum and facilitate its rapid excretion.

Preparations against cough with viscous sputum

With a productive cough, but with a viscous and difficult to separate sputum, the optimal choice will be mucolytic agents that dilute sputum and promote its rapid elimination. Among them the most common are:

Bromhexine - tablets and syrup, which contribute not only to liquefaction of sputum, but also to the effective excretion of this fluid from the lungs.
Fluimucil is a drug in granules and in a liquid form that promotes productive cough. It is used both for direct use inside and for inhalations.
Ambroxol is one of the modern mucolytics with combined action. It helps to improve the consistency of fluid in the lungs and effectively removes it. This drug is from a cold and cough.

When using mucolytics, it should be remembered that in no case can they be used together with antitussive drugs, since their actions contradict one another.

Expectorants with wet cough

As you know, this form of respiratory disorder does not require special treatment, there is only the need for additional stimulation of expectoration. If you have frequent respiratory attacks with enough liquid sputum, then you will be helped by expectorants and antitussives:

Gedelix - syrup and drops, which are allowed even to children. This drug is based on a natural component - an extract of ivy leaves, which has long been known as a good cough drug.
Mukaltin is an extract of the medicinal althea, which attracts not only its effectiveness, but also the prevalence. In addition, the price of this cough drug makes it the most popular and affordable.
If you are looking for inexpensive cough medicine, then the licorice root syrup is for you. This agent effectively removes sputum, reduces the number of seizures and softens the irritated throat.

Precautions when taking medications

Some recommendations that will help you decide on the most effective drug for cough:

Starting from the above, it will be much easier for you to choose the most effective cough drug, but remember that self-medication does not lead to good.
Even in the pharmacy you do not get the necessary advice.
At the first sign of respiratory illnesses, you need to see a doctor so that he or she can determine which drugs you should take with a cough.
Determine the composition to avoid the possibility of allergic reactions.

Do not neglect the recommendations described above, contact your doctor in good time and be healthy!

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Drugs and medications for cough

Very often people who suffer from bronchospasm can hear the question: "What medicines should I drink from a cough, Advise? "However, one should never rush to advise such patients, especially relying on their own experience or advertising. After all, professional medical treatment of bronchospasm has a fairly multidirectional vector. It depends on many different factors. After all, drugs and drugs for coughing are chosen taking into account:

Causes of its occurrence.
Stages of development of the disease.
The nature of an unpleasant symptom.
The age of the patient, the individual characteristics of his body.

In addition, many even the same drugs and drugs have a different form of release - tablets, syrups, medicines, sprays, various suspensions powders, and cough-stabs. What to apply more effectively in each case can be determined only by the doctor.

What Helps Cough: Antiviral Drugs and Medications

The acute form of bronchospasm is very often caused by SARS and other viral infections that get into the respiratory tract. In this case, quickly from cough will help get rid of medicinal treatment aimed at suppressing these pathogenic microorganisms.

The effectiveness of antiviral drugs and drugs in the treatment of reflex respiratory tract spasms is observed if they begin to be used in the first 3-4 days of its occurrence. If the disease lasts longer, it is useless to take the pharmaceutical.

During the treatment of cough medicines, which destroy viruses, it should be consumed about 10 days. These include:

Arbidol.
Amizon.
Amiksin.
Remantadin et al.

In general, preparations are issued in the form of tablets, syrups and suspensions, but antiviral injections with strong cough are also sometimes prescribed. It is only the doctor who has the right to determine which means to use.

Use of antibacterial drugs and drugs in the treatment of cough

If the cause of the bronchospasm is different bacteria, then it becomes advisable to treat the disease with antibiotics. The doctor decides that giving such cough preparations is also appropriate if the etiology of the symptom is not clear, and the patient's condition worsens.

There are cases in which the treatment of reflex respiratory tract spasms with antibacterial drugs is mandatory. It:

Children age up to 6 months.
Body temperature reaching up to 39 degrees.
Strong intoxication.
Increasing respiratory failure.
Inflammation of the nasopharynx, having a purulent character.

Cough treatment is inexpensive and effective for the use of drugs based on antibiotics from several groups:

Aminopenicillins.
Macrolides.
Fluoroquinolones.

First and foremost, cough preparations are prescribed (their list is wide enough), made on the basis of penicillin. However, there are patients who are not suitable for these reasons for individual reasons. In this case, the medications of other groups are used in the treatment.

Drugs used in anti-inflammatory therapy

Sufficiently powerful drugs used in the treatment of bronchospasm, caused by bronchitis, pneumonia, bronchial asthma, COPD, are corticosteroids. Anti-inflammatory for cough can be used both inhalation and oral.

Effective drugs such as:

Bechotid.
Beclometh.

What helps cough: antiallergic drugs

Attacks of bronchospasm in adults and children can appear due to hypersensitivity of the organism to various substances. Treatment of a symptom that has arisen against the background of allergies is facilitated by the exclusion of contact with the stimulus. If this is not enough, then antihistamines against the further development of the disease begin.

Basically, in the treatment of drugs prescribed in the form of tablets. Anti-allergic cough syringes (adults and children) are used if the bronchospasm manifests itself very strongly. In this case, the doctor decides on the expediency of obtaining a more powerful and quick effect from the drug.

What is good for cough: symptomatic treatment with various medications

There are groups of drugs that very effectively help to remove the intensity of bronchospasm. However, despite all the efficacy, symptomatic treatment is absolutely ineffective for dealing with the very cause that causes the appearance of a symptom. Therefore, this method can not be used as an independent one.

Most often for the symptomatic treatment of an unpleasant phenomenon, the following medications for cough are recommended (their composition is quite different):

Expectorants.
Antitussive.

The first group - drugs that dilute sputum and help to get mucus out of the respiratory system - are prescribed for the treatment of a wet symptom almost always. These include drugs such as:

Funds made on the basis of the althea.
Thermopsol.
Ambroxol.
Lazolvan.
Bromhexine.
Varied breasts, etc.

The second group - drugs that relieve the intensity of the symptom - are prescribed only with dry sharp spastic exhalations. This includes drugs:

Peripheral action.
Integrated.

The huge choice of diverse drugs completely excludes self-treatment. After all, a person who has no special education, can never correctly determine the cause of bronchospasm, and, therefore, it is correct to choose which injections of cough, and maybe tablets or suspensions, it is necessary for effective treatment. Only timely consultation with a doctor and a clear fulfillment of his prescriptions will help get rid of reflex respiratory tract spasms and their causes.

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How to choose a cough medicine?

What are the cough tablets?

Effective drugs for cough therapy in adults, adolescents and children is an actual topic to date and this is related to common cases of self-medication and a huge choice of drugs in the form of syrups, tablets, potions, drops, suspensions, sprays, inhalers, infusions and tinctures. In this case, patients often consult a pharmacist and pharmacist who can not assess the nature of the cough, determine the diagnosis and severity disease, the possibility of a complicated course of nosological form, which can be determined only by a qualified specialist - therapist, pediatrician or family doctor. If necessary, additional instrumental methods of examination are prescribed.

The correct treatment of a cough is not to suppress the cough reflex, which is a protective reaction of the body to irritation of the respiratory tract due to the development in them inflammatory process and with sputum production (wet cough) or with minimal mucus presence (dry unproductive cough), and also in case of inhalation of any irritant factor:

small particles of dust;
foreign objects;
various infectious agents - pathogenic microorganisms, viruses, fungi;
allergens.

In some cases, cough, especially in childhood, can occur in diseases that are not associated with pathological processes directly in the respiratory system, but has a central (neurogenic) nature - with neuroses, the syndrome of hyperactivity, psychopathy. Also cough is an additional symptom in diseases of other organs or systems: allergic diseases, heart and vascular diseases, digestive organs.

Therefore, in each specific case, a diagnosis and careful selection of strictly defined and maximized effective cough tablets for complex therapy of the underlying disease with elimination or relief of a specific type of cough.

Pathogenesis of cough

Mucous membranes of the trachea, bronchi and alveoli normally produce mucus.

But with inflammatory processes that occur during seasonal infections, colds, cough is one of the symptoms, acutely occurring pathological processes that accompanied by an increase in temperature, lethargy, weakness, runny nose and general malaise, in connection with the development of the inflammatory process in the epithelial cells of the larynx, trachea, pharynx, bronchi or alveoli. At the same time, hyperemia with persistent edema and production of mucous exudate develops, aimed at evacuating viruses and pathogenic microorganisms from the upper and lower respiratory tract.

Another cause of coughing is bronchospasm.

Inflammation of the alveoli, pleura, or lung tissue with pneumonia and pleurisy is accompanied by frequent dry, and irritating cough, but the diagnosis of these diseases is carried out only in the conditions of a medical institution.

Types of cough and treatment tactics

Cough, depending on the amount of sputum in the respiratory tract is divided into wet and dry.

In this case, treatment of each type of cough has its own characteristics and determines the choice of cough medicine.

Tablets from dry cough, in most cases suppress the cough reflex (blocking the cough center or the receptors of the tracheobronchial tree), so their

It is unacceptable to use for the treatment of a damp cough, as a result of which evacuation of sputum and bronchial clearance are completely blocked by a constantly developing secret.

Also, do not use tablets from wet cough, dilute sputum and promote both its formation, and an easier expectoration in the occurrence of dry cough, which is associated with irritation of the mucous membrane of the respiratory tract by a catarrhal inflammatory process or irritation with chemical or physical agents. If they are not effective, they can stimulate the secretion when the cells are not ready for it, so there is aggravation of edema and inflammation of the bronchi and trachea.

It is important to remember that cough is only a symptom of the disease and the main point of therapy is the definition and elimination of the cause of the pathological process.

Causes of cough in children and adults

To date, the main causes of coughing are:

1. Diseases of the respiratory system

Catarrhal and infectious diseases of the bronchopulmonary system of viral and bacterial etiology (considered the largest and most important group of pathologies that are accompanied by a cough):
- diseases of the upper respiratory tract (nasopharyngitis, laryngitis, pharyngitis, laryngotracheitis, tonsillitis, sinusitis);
- pathological processes in the lower respiratory tract (tracheitis, tracheobronchitis, bronchiolitis, bronchitis, bronchopneumonia and pneumonia, pleurisy, alveolitis, lung abscess);
Specific infectious and inflammatory processes (tuberculosis and mycosis of the lungs, chlamydial pneumonia), 3) Diseases of infectious-allergic and allergic genesis (bronchial asthma, angioedema larynx);
Congenital pathology of bronchi and lungs (bronchial hypoplasia, congenital bronchiectasis);
Children's infectious diseases (whooping cough, measles, scarlet fever);
Benign and malignant neoplasms of the respiratory tract (lung sarcoma, bronchogenic carcinoma, pleural tumors);
Irritation of mucous respiratory tract by aggressive chemical substances (poisoning with petrol vapors, acetone, carbon monoxide);
Foreign bodies in the respiratory tract;
Interstitial lung diseases.

2. Diseases of the heart and blood vessels

heart defects (congenital and acquired);
angina pectoris;
heart failure;
inflammatory diseases of the heart (myocarditis, pericarditis).

3. Diseases of the digestive tract

gastroesophageal reflux;

4. Diseases of the nervous system

neurogenic dysfunction of the pharynx musculature;
neuroses;
Parkinson's disease;
organic pathology of the brain (post-stroke complications, brain tumors).

5. Other reasons

a smoker's cough;
cough, as a side effect when taking certain medicines (inhibitors of renin-angiotensin).

Effective elimination of the cause of the occurrence of cough, is the basis for the therapy of cough, directed at the etiologic factor.

Classification of drugs that eliminate and relieve cough

The modern classification of medical devices that affect cough is extensive, but to date the drugs are positively affecting the occurrence of cough reflex, its productivity and intensity in pharmacology and medicine are divided into three main groups:

drugs that directly exert a retarding effect on the cough center of the central nervous system (in the brain) and on the nerve endings of cough receptors with complete or partial suppression of cough;
drugs affecting smooth muscle and bronchial mucosa;
drugs affecting the state of bronchial secretions.

Dry cough pills

Dry cough occurs as a complex reflex protective reaction of the body, which occurs with constant irritation of the respiratory tract by any infectious or other foreign agents with simultaneous presence of catarrhal inflammation and edema of the mucous membrane of the respiratory tract with minimal production of sputum, mainly in the development of viral or bacterial infections.

Dry cough is irritating and unproductive, and most often occurs with catarrhal inflammation of the mucous membranes of the upper respiratory tract - larynx, nasopharynx and / or the initial part of the trachea, as well as their combined lesions - laryngopharyngitis, laryngotracheitis and pharyngotracheitis. Also, a frequent dry and irritating cough can occur in children with infectious diseases - measles, paracut, parotitis, whooping cough and scarlet fever.

Dry cough can be a symptom of pleurisy, bronchoadenitis, the presence of a foreign body of bronchial tubes, as well as a symptom of diseases of other systems: psychogenic cough with neuroses or irritating cough with endocrinopathies and diseases of the digestive system (gastroesophageal reflux).

In this type of cough, in a number of cases, antitussive drugs that depress the cough reflex are prescribed. It is important to remember that this type of medication is used only for the purpose of the doctor at any age, but in young children (up to a year), premature and weakened babies, in the presence of perinatal pathology of the central nervous system, these drugs can oppress not only the cough reflex, but also respiratory center. Therefore, in pediatric practice, these drugs are prescribed only under the constant supervision of a specialist in the case of severe dry cough, significantly disturbing the well-being and sleep of the child, causing regurgitation and vomiting - in whooping cough, parakoklishe and in the complex therapy of obstructive bronchitis and bronchopneumonia.

These drugs are divided:

preparations of central action;
peripheral action;
combined medicines.

Counter-cough medicines of central action

A group of drugs affecting the center-center cough center is used to eliminate coughing and is used to treat diseases with no sputum. It includes mainly medicines for the treatment of dry cough:

1. With narcotic effect (Morphine chloride, Codeine, Demorphan, Hydrocodone, Codipron, and Ethylmorphine hydrochloride).

2. Without a narcotic effect (Tusuprex, Glavent, Sedotussin, Sinekod, Pakseladin, Butamirat).

Narcotic antitussive medicines

These drugs are released in the pharmacy network only when presenting a prescription.

With caution the drugs of this group are prescribed for acute pain in the abdomen of an unknown genesis, convulsions (in the anamnesis), arrhythmia, alcoholism, bouts of asthma, suicidal tendencies, neuroses and emotional lability. And also with intracranial hypertension and brain injuries of prostatic hyperplasia, renal and / or hepatic insufficiency, hypothyroidism, severe inflammatory bowel disease, and with urethral strictures channel. Very rarely drugs of this group are assigned to weakened patients, in any period of pregnancy and during lactation, and also elderly patients and children due to a large number of adverse reactions, the possibility of overdose and poisoning.

It should be noted that the use of other antitussive and expectorants simultaneously with narcotic antitussives is prohibited.

The most common drugs in this group are Codeine and codeine-containing drugs and Ethylmorphine.

Codeine

Codeine is an alkaloid of opium and is formed synthetically by methylation of morphine. Its therapeutic effect is based on suppressing the redistribution of the cough center of the brain.

Codeine is part of the combination of medications that are used as symptomatic agents for the treatment of an obsessive, painful and debilitating cough:

1) in combination with expectorant drugs and terpinhydrate

Terpinkod;
Codterpine;
Kodarin;

2) with sodium hydrocarbonate, a herb of thermopsis and a root of licorice

Codesan;
Kodelak;

3) in combination with anti-inflammatory drugs (ibuprofen, naproxen, metamizole, paracetamol and analgin, and) with the inclusion of some preparations of phenobarbital with its soothing action

Sedalgin;
Pentalgin;
Solpadein;
Nurofen Plus.

Ethylmorphine

Ethylmorphine is a central antitussive drug that promotes stimulation of opioid receptors neurons of the brain and a decrease in the excitability of the cough center and providing analgesic and soothing act. It is available in the form of tablets.

Indication for use Ethylmorphine is an unproductive, painful cough that is accompanied by a pain syndrome with pulmonary tuberculosis, pleurisy, neoplasms of the bronchopulmonary system.

Contraindication to the use of this drug is respiratory depression against the background of various infectious and inflammatory processes of the lungs (bronchopneumonia, bronchiectasis, pulmonary emphysema and other COPD), especially in the elderly, as well as increased sensitivity to drug. The most frequent adverse reactions are persistent headaches, insomnia, permanent constipation (especially in the elderly and senile age, in weakened patients) and the development of drug dependencies.

Non-narcotic antitussive medications

To date, the pharmacy network has a very large selection of non-narcotic antitussive drugs, which can be considered true cough tablets. Typical representatives of this group are Libexin, Paxeladin, Glaucin, Sedotussin, Tusuprex, Sinekod and other preparations.

The mechanism of action of these drugs:

oppressive effect on the nerve endings of cough receptors with complete or partial suppression of cough and mediated inhibition of the cough center;
interruption or weakening of signals going to the brain (medulla oblongata) from the affected mucosa of the trachea and bronchi.

Some of these substances are part of a combination of drugs, mainly Glaucin, which is an antitussive component many medicines containing also other soothing, expectorant or anti-inflammatory components (Stoptussin, Broncholitin).

Medicinal preparations of non-narcotic effect for today by patients and in some cases also by doctors are widely used, but, to Unfortunately, it is often unreasonable and wrong, because the indication for their purpose is the need to suppress frequent, irritating cough. In pediatrics, such cases are rare - mainly with whooping cough or in cases of intense productive cough with intense production sputum with the formation of abundant and liquid bronchial secretion (bronchorrhea), when there is a real threat of aspiration of bronchial contents.

In patients in the older age group (children over 12 years, adolescents, adults), these drugs are prescribed in cases of cough, combined with moderate bronchospasm. At the same time they are used both independently and as an addition to bronchodilator drugs, suppressing catarrhal or allergic inflammation.

The most commonly prescribed drugs in this group are Butamyrate, Libexin, Bithiodine, Paxeladine.

Butamate

This antitussive drug effectively inhibits the excitability of the cough center, while providing moderate anti-inflammatory, expectorant action and a weak bronchodilator effect, reducing irritation of the trachea and bronchi and potentiating antitussive action without depressing influence on the respiratory center.

Butamirate tablets are used for symptomatic treatment of inflammatory diseases of the bronchopulmonary system in adults and children and over 12 years of age who are accompanied by a frequent unproductive and severe irritating cough that has an obsessive character. Butamirate is the main component of medicines Sinekod, Kodelak-Neo, Omnitus.

Bithiodine

Antitussive drug, the therapeutic effect of which is due to active influence on the receptors of the mucous membrane of the bronchopulmonary system and to a lesser extent on the cough center of the central nervous system. Its active ingredient is Tipedidine, which is close to codeine by force of action, but does not cause drug dependence even with prolonged use.

Paxeladin

This drug refers to antitussive drugs that do not have a chemical affinity for either opioids or their derivatives, or antihistamines. Its active ingredient is oxeladine citrate, which acts selectively at the level of the cough nerve centers. Pakseladin is released in prolonged-action capsules and in syrup. Like all non-narcotic antitussives, it is prescribed for the symptomatic treatment of frequent dry cough in most cases spastic or reflex. It is not used to treat productive cough - it is difficult to get rid of phlegm and aggravation of inflammatory processes, conditions are created for the development of complications (bronchopneumonia, pleurisy). Also, do not apply Paxeladin simultaneously with expectorant and mucolytic drugs - in this case, activates viscous products sputum, which provokes the development of bronchospasm, peristalsis of small and medium bronchi and obliteration of the lumen of the bronchi, which aggravates cough.
It is not recommended to use capsules before the age of 15 years.

Indications and features of non-narcotic antitussive drugs

A group of non-narcotic antitussive medicines of central action is shown mainly with a cough that is associated with marked irritation of mucous epiglotti (upper) respiratory tracts arising from infectious and / or catarrhal inflammation. In this case, the positive result is usually enhanced when they are used together with preparations of peripheral antitussive action with enveloping effect. An example of such a combined action is Broncholitin. But the effectiveness of its use is justified only in the absence of pronounced inflammatory changes in the mucosa in the lower parts of the bronchopulmonary system, in connection with the fact that the ephedrine entering into it "dries" the bronchial mucosa, increasing the viscosity of the bronchial secretion, increasing the inefficiency of coughing in bronchitis and pneumonia. Ephedrine also has an exciting effect on the central nervous system, so the use of this drug in children unjustified and dangerous - it can disrupt the child's sleep, contributing to increased dyspnoea and unproductive cough.

It is important to remember that the use of this group of drugs as self-medication can do more harm than good, cause complications in the form of bronchial obstruction, increasing the viscosity of bronchial secretions and promote the progression of inflammatory processes, edema and lowering of the pathological process in lower departments.

Group of peripheral drugs

The peripheral group includes pharmacological preparations from dry cough acting on nerve receptors and endings that are located in the tracheobronchial tree - Libexin, Levopront and Helicidin.

Libexin

Libexin is considered an effective antitussive drug, which additionally has a local anesthetic, bronchodilator and spasmolytic effects and has a moderate expectorant and anti-inflammatory effect with minimal decrease in respiratory activity center. The basic form of Libexin is round flat tablets of almost white color with a dividing stripe into four equal parts on one side and engraving "LIBEXIN" on the other, containing 100 mg of active ingredient - prenoxdiazin hydrochloride.

This drug is currently considered a drug of choice in the treatment of laryngitis, tracheitis, pharyngitis and less frequent bronchitis, which are accompanied by a dry, unproductive cough. Also as one of the components in the complex therapy of pleurisy and pneumonia, which are accompanied by pain and obstructive syndromes, and with congenital diseases of bronchopulmonary system, cystic fibrosis and other chronic lung diseases: tuberculosis, pneumoconiosis, emphysema in children and adults as a symptomatic remedy with compulsive irritating coughing.

With caution this drug is prescribed for ulcerative lesions of the gastrointestinal tract, as well as in the presence of a history of gastric bleeding, liver or kidney failure, glomerulonephritis, cystitis, allergic form of bronchial asthma with a tendency to stand bronchial obstruction.

Libexin is contraindicated for individual intolerance, pregnancy (especially in the first trimester), lactation and in early childhood.

Levoprint

This drug is prescribed for frequent dry cough to children and adults. It is released as a syrup and drops for oral administration.

Absolute contraindications to its reception are:

pregnancy in any period;
lactation period;
liver failure;
decreased mucociliary function of the bronchi;
hypersensitivity to the components of the drug.

Levoproton can cause side effects in the form of increased fatigue, diarrhea, drowsiness, dizziness, tachycardia, heartburn, nausea, vomiting and allergic reactions. With long-term use of this drug, mental disorders, the development of sopor and coma, possible, especially with overdoses in childhood and the elderly.

Group of antitussive drugs combined action

These drugs have simultaneously reducing the cough reflex effect and expectorant, moderate anti-inflammatory and mild bronchodilator actions in connection with their constituent several components - Stopptussin, Butamirate, Libexin-Muko, Tussin plus, Bronholitin, Protiazin, Hexapneumine.

All drugs of this group are widely used for the treatment of dry and unproductive cough, but it is important to remember that

They are contraindicated in the presence of productive wet cough or other conditions that are accompanied by abundant sputum discharge, as well as with the likelihood of developing pulmonary hemorrhages.

Therefore, the choice of an antitussive drug should be performed by a physician on the basis of an anamnesis, clinical examination of the patient and, if necessary, additional methods (laboratory or instrumental).

Indications and features of antitussive drugs

A group of "true" antitussive drugs of central and peripheral action is shown mainly with a cough that is associated with marked irritation of mucous epiglotti (upper) respiratory tracts arising from infectious and / or catarrhal inflammation. In this case, a positive result is usually enhanced when they are used together with drugs that have anti-inflammatory and enveloping effects in addition. An example of such a combined action is Broncholitin. But the effectiveness of its use is justified only in the absence of pronounced inflammatory changes in the mucosa in the lower parts of the bronchopulmonary system, in connection with the fact that the ephedrine entering into it "dries" the bronchial mucosa, increasing the viscosity of the bronchial secretion, increasing the inefficiency of coughing in bronchitis and pneumonia. Ephedrine also has an exciting effect on the central nervous system, so the use of this drug in children unjustified and dangerous - it can disrupt the child's sleep, contributing to increased dyspnoea and unproductive cough.

It is important to remember that the use of this group of drugs as self-medication can do more harm than good, cause complications in the form of bronchial obstruction, increase the viscosity of the bronchial secretion and promote the progression of inflammatory processes, edema and lowering of the pathological process in the lower parts of the bronchopulmonary system.

Cough preparations of local action

This group of antitussive drugs includes drugs that depress the cough reflex as a result of anesthesia of the mucous membranes respiratory tract, in connection with which the irritating effect of various agents, both infectious and non-infectious (chemical and physical factors). These drugs also reduce the viscosity of phlegm and relax the bronchi.

To local anesthetics include tablets Libexin, Tusuprex and resorption tablets Falimint.

Tusuprex

Tablets Tusuprex is often used for symptomatic cough therapy in children from the year, adolescents and adults patients, but in pediatric practice they are used only according to the doctor's prescription (due to the complexity of dosing in young children age). Also, this drug should not be used against the background of the development of bronchospasm (with obstructive bronchitis and bronchial asthma), in the presence of confirmed bronchiectasis and for any disease that is accompanied by a difficult separation phlegm.

Falimint

Tablets for resorption of the Falimint are indicated in the presence of an unproductive irritant cough that is caused by pronounced catarrh of the upper respiratory tract (pharynx, larynx and upper parts trachea). This drug has in its composition a local anesthetic component and therefore reduces the intensity of dry cough.

Falimint does not apply:

in children under 4 years;
during pregnancy and lactation;
hypersensitivity to the components of the drug;
with intolerance to fructose.

Drugs affecting the state of bronchial secretions

Separately, a group of drugs with mucolytic and / or expectorant action is distinguished. These tablets and syrups, which are used in wet productive cough and are divided into the following subspecies of drugs:

1. Expectorants:

a) having predominantly reflex action:

Terpinhydrate, Thermopsis, Sodium benzoate, Lycorin;
the roots of Licorice, Devyasil, Istad and Althea;
essential oils.

b) stimulating gastropulmonary and / or vomiting reflex:

Gwaiphenazine, Ipecacuan, Sodium Citrate, Ammonium Chloride.

c) resorptive action with increased bronchial secretion:

Sodium iodide, Sodium bicarbonate, Ammonium chloride, Potassium iodide.

2. Mucolytic agents:

a) direct action, which quickly destroy the polymer bonds of bronchial mucus:

Mukaltin;
The mukonist;
Mukobene;
Exomuk;
Acetylcysteine, Fluimutsil, Carbocysteine group (Mukopron, Bronkatar, Mukodin, Fluvik, Mistabron, Mucosol;
preparations with infusions of leaves of plantain, mother-and-stepmother, licorice;
enzymatic preparations that reduce the viscosity of sputum - Chymotrypsin, DNAase, Trypsin, Ribonuclease, Streptokinase, DNAase, Pulmozyme;

b) Indirect action (mucoregulators):

Ambroxol (Ambrobene, Ambrosan, Ambroghexal, Khalixol, Medovent, Lazolvan, Ambrollanazolvan);
Bromhexine (Fulpen, Flegamine, Broxin, Bisolvon);
Carboxymethylcysteine, Sobregorod, Sodium Ethanesulfate, Letostein, Sodium bicarbonate;
changing the productivity of bronchial glands - anticholinergic and antihistamines.

3. Anti-inflammatory drugs with bronchodilator and / or expectorant effect:

Suprima-bronho, Sinupret, Pulmotin, Glytsiram, Ascoril, Gelomirtol, Gedelix, Evkabal and Prospan.

Features of the use of expectorant drugs

At the basis of the mechanism of action of expectorants are - increased secretion of sputum by bronchial glands, dilution of secretion by reflex by way of and as a result of this easier departure of mucous or mucopurulent sputum from the lower parts of the bronchopulmonary system to its higher departments. These drugs actively irritate the receptors of the mucous membranes of the stomach and, inducing vomiting center, which is localized in the medulla oblongata and, in connection with this, significantly increase sputum excretion bronchi.

Expectorants are prescribed for diseases that are accompanied by a decrease in sputum production or vice versa, an abundance of thick, viscous, difficult-to-separate mucus that accumulates in the bronchi (with bronchitis and bronchial asthma), larynx (with laryngitis), in the trachea (with tracheitis), in the alveoli and small bronchioles (with bronchopneumonia and cystic fibrosis).

The use of expectorants for the treatment of respiratory diseases can not be combined with antitussive drugs of central and peripheral action that oppress the cough center or inhibit cough reflex. In this case, a large number of sputum accumulates in the lower respiratory tract, which often leads to their obliteration and development of severe infectious and inflammatory diseases (obstructive bronchitis, bronchopneumonia, pleurisy).

There are two groups of expectorant drugs that differ in the mechanism of their therapeutic action:

means of reflex action;
medicines with direct effect.

And

preparations of vegetable origin;
synthetic drugs.

Popular expectorants of plant origin

Basically, almost all expectorants with a reflex action mechanism are represented medicinal plants and their extracts, which intensify and accelerate the excretion of sputum from the organs bronchopulmonary system. This group of medicines is extensive and in most cases they are represented by herbal medicines.

Expectorants have medicinal plants:

licorice;
thermopsis;
anise;
marshmallows;
plantain;
elecampane;
ledum;
oregano;
thyme;
mother and stepmother;
ipecacuanha;
thyme;
violet;
pine buds, etc.

Herbal extracts of these herbs are included in various breast pills, tablets, powders and syrups for the treatment of moist productive cough in children and adults.

Pills for cough with thermopsis

In most cases (and this is actually so), this drug is considered to be the best drug for treating wet cough.

Tablets from cough with thermopsis and sodium bicarbonate are very popular earlier and effective at the present time. Their balanced composition is a herb of thermopsis, which enhances sputum secretion while simultaneously reducing its viscosity and sodium bicarbonate, an emollient and gently tearing bonds in sputum molecules - effectively dilute sputum, promoting its rapid evacuation from the upper and lower divisions of the respiratory tract.

In these tablets there are no artificial additives, synthetic components, and in comparison with expensive medicinal preparations in efficiency they do not concede.

But for the purpose of this drug there are absolute contraindications:

individual intolerance to the components of the drug;
erosive and ulcerative pathological processes of the stomach and other parts of the digestive system;
pregnancy.

Thermopsis is today considered to be an excellent remedy for treating wet cough in children. But it is important to remember that it is not used for infants for the therapy of bronchitis or bronchopneumonia with a large amount of sputum, while the child can not effectively cough, and thermopsis additionally activates the increase in mucus secretion by bronchial glands, which quickly leads to the development of respiratory insufficiency. Also, the herb of thermopsis has an emetic effect and the babies show frequent regurgitation and vomiting, which leads to dysfunctions of the digestive system, the development of lethargy, reduced weight gain and overall weakening of the body the kid.

Also, if the dose of Thermopsis is exceeded, its emetic effect is manifested, which can cause nausea at the beginning of treatment at any age (especially in children).

Mukaltin

Another effective herbal preparation for the treatment of wet cough is Muciltin tablets from cough, which are created on the basis of the extract of the drug althea. It has a pronounced anti-inflammatory and expectorant effect, which is due to reflex stimulation ciliary epithelium of the respiratory tract and an increase in peristalsis of the bronchi and bronchioles with activation of secretion bronchial glands.

Muciltine tablets also contain sodium bicarbonate.

Currently, this drug is recognized as one of the most effective expectorant drugs that are used to treat productive wet cough in children and adults.

Doctor Mom

Dr. Mom is a complex herbal preparation that is used in the treatment of diseases accompanied by a damp productive or cough with viscous sputum. It consists of active plant substances that have expectorant, softening, secretory, anti-inflammatory, moderate bronchodilator and mucolytic effects.

At the heart of pastilles and syrup are dry extracts from leaves, roots, seeds, bark, flowers of medicinal plants: aloe, elecampane, basil, ginger, licorice, turmeric, pepper cubebe, terminalee beleriki and nightshade Indian.

Additional positive characteristics of this drug is its good tolerability, even with prolonged use.

With caution, this medicine should be taken by pregnant women and with lactation and only with the appointment of a doctor and with constant monitoring.

Also, Dr. Mom is not assigned simultaneously with medications that suppress the cough reflex. A good effect is the use of this plant expectorant in combination with mucolytic drugs (Ambroxol, Lazolvan and Bromhexin).

At the beginning of treatment or with prolonged or uncontrolled use of the drug, nausea may occur before vomiting or frequent regurgitation in young children, which is due to the presence in the formulation of an extract of licorice, which has a weak emetic effect.

Expectorants of artificial origin

At the basis of the mechanism of action of expectorant antitussive drugs of direct action is the enhancement elimination of bronchial secretion as a result of exposure to sputum and stimulation of bronchial peristalsis. This group of medicines is represented by artificial medicinal preparations - iodized salts of potassium and sodium, Benzoate sodium, sodium hydrochloride, terpinhydrate, ammonium chloride, potassium bromide and essential oils - eucalyptus fir, aniseed. They are quite effective and are mainly used for inhalations.

In the pharmacy network, you can buy a combination of drugs for the treatment of wet cough, which have in their composition as plant substances, and artificial components - Moist-anise drops and Pertussin, which contains the extract of thyme and bromide potassium.

Mucolytic drugs

The action of mucolytic drugs is aimed at diluting the thick and viscous secretion bronchial glands without increasing sputum secretion to facilitate their evacuation from the lower and upper respiratory tract.

Mucolytic tablets today are considered one of the main components in the therapy of wet cough. They also restore the mucous membranes of the bronchi and the elasticity of the lungs.

To this group of drugs are - Ambroxol, ATSTS, Bromheksin, Carboccithin. When combined with various plant expectorants with mucolytics, the effectiveness of both increases sharply. Also mucolytics potentiate the action of antibacterial drugs, increasing their effectiveness, Therefore, they are widely used in complex therapy of pneumonia, bronchiolitis, obstructive bronchitis and pleurisy.

Ambroxol and Bromhexin activate the formation of pulmonary surfactant, which ensures the normal functioning of the alveoli of the lungs, preventing their collapse and adhesion, therefore they are widely used in pediatric practice for the treatment of bronchopulmonary pathology in young children, premature babies and toddlers with intrauterine hypotrophy.

Their negative side is the ability to cause bronchospasm, which is considered a contraindication to the use of these drugs during periods of exacerbation of bronchial asthma.

The main groups of mucolytic drugs

In medicine and pharmacology mucolytics are divided into several groups:

1) drugs that are developed based on proteolytic enzymes - chymotrypsin, trypsin and mesna. But this group of medicines is used only in extreme cases, always in a hospital and under the supervision of the attending physician;
2) drugs based on acetylcysteine - ATSTS, Mukobene, Fluimutsil, Exemuk, Mukomist and others.

The mechanism of action of these drugs is based on dilution of thick and viscous sputum as a result of rupture of large molecules of mucus to small in connection with this facilitates the process of coughing and evacuation of sputum from the respiratory tract. Also, acetylcysteine drugs have a protective effect on the inflamed cells of the bronchopulmonary system.
Preparations of this group can not be taken simultaneously with antitussive drugs, which leads to stagnation of sputum in the bronchi and alveoli, oppression of the cough and the development of complications (bronchopneumonia, respiratory failure, and with the layering of aggressive microflora - abscesses of the lungs and purulent pleurisy).
3) drugs based on carbocisteine (mucoregulators) - Bronkatar, Carbocysteine, Drill, Mukodin, Fluvik, Mukoprint.

They normalize not only the qualitative composition of the sputum (liquefying it and easing the cough), but also increase the activity of cells that produce bronchial secretion and the work of cilia of bronchial epithelium and bronchioles. And also have an anti-inflammatory effect and stimulate local immunity in connection with the increase in the production of protective immune complexes (group A immunoglobulins).
The most modern preparations of this group are Fluviert, its distinctive feature is a longer lasting effect.
4) mucolytics with expectorant effect - derivatives of Ambroxol and Bromhexine

The mechanism of action of these drugs is based on stimulation of secretion by alveoli of liquid sputum and liquefaction and already accumulated mucus, stimulate the formation of immunoglobulin and lysozyme in a bronchial secretion and have an expectorant effect.
But the pronounced effect of these drugs does not come immediately, but only on the fourth - the sixth day from the beginning of treatment.
Bromhexine preparations include - Flexin, Bronchosan, Flegamin, Bromoxin, Fulpen, Solvin.
Drugs of this group also can not be used simultaneously with antitussive drugs in connection with possible accumulation of excess sputum as a result of cough suppression and the absence of evacuation of the accumulated secretion from the bronchi and alveoli. In addition, when this group of drugs is prescribed, the use of a vibratory (drainage) massage and postural drainage (the patient's acceptance of certain body positions that improve the outflow phlegm).
Ambroxol preparations are active metabolites of Bromhexine with an improved chemical structure, so these medicinal means have a complex effect on the respiratory tract - mucolytic, anti-inflammatory and expectorant. Since 2012 Ambroxol is on the list of the most important and vital medicines. But Ambroxol preparations also can not be taken simultaneously with antitussive drugs.

The main drugs are Ambrobene, Lazolvan, Ambrohexal, Khaliksol, Bronhoverne, Dephlegmine, Ambrolan.

Good tablets against coughing

Definitions of "good pills for cough" from both medical and pharmaceutical point of view does not exist. Cough is only a symptom, the complete elimination of which or even its reduction can do more harm than good. With the development of bronchopulmonary pathology in both children and adults, treatment is aimed at eliminating the cause of the pathological process - cupping bronchospasm, the elimination of inflammation, the removal of a foreign body from the trachea and bronchi or the treatment of other systems and organs - neuroses, psychopathies (with neurotic character of coughing).

Therefore, the choice of the drug for cough treatment is individual and is made after a patient's examination, careful collection of anamnesis and diagnosis.

Tablets for children cough

The right choice of medicines for cough therapy in children is determined by the main factors - the cause of cough, the mechanism of action of antitussive drugs, features of a cough reflex in a child, and the full spectrum of all these factors can be assessed only by a specialist who will assign the baby the correct one in each case treatment.

Inhibition of cough reflex in a child, the use of several antitussive drugs from different groups simultaneously, increasing dosages, multiplicities and the duration of taking the drug can lead to many negative consequences, the development and progression of hazardous to health and even life complications.

Tablets for coughing during pregnancy

Pregnancy in most cases is an absolute contraindication to taking many antitussive medicines, especially narcotic antitussives, many complex medicines, in connection with their pronounced negative impact on the embryo, followed by the development of fetopathies and other violations of the correct laying of organs and systems of the future child.

Relatively contraindicated medicinal products for treating cough are:

insufficiently studied drugs, in which application the risk of a dangerous effect on the baby's body is possible;
medicines, with the possible risk of development in the future mother of side effects.

Also on any period of pregnancy, some medicinal plants and medicinal funds that have them in its composition - juniper, nettle, oregano, mother-and-stepmother, St. John's Wort and others. The negative effect of medicinal herbs on the fetus is sometimes many times more active than synthetic drugs - they have a fetopathological and teratogenic effect on the fetus, change the hormonal background of the pregnant, can stimulate the contraction of the myometrium and cause miscarriages, especially in the early terms.

Therefore, even at the planning stage, and even more so in the early stages of pregnancy, it is necessary to take with caution any medicinal and / or homeopathic medicines and herbs.

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Choice of drugs for the treatment of dry cough

Cough is a reflex response of the body to irritation of the mucous membrane of the respiratory tract. To remove the attack of dry cough, use special medications.

Types and causes of cough

Distinguish wet (productive) and dry cough. The main symptom of wet cough is the abundant sputum secretion, which is produced by the trachea and bronchi. Along with phlegm, microorganisms and their toxins are excreted from the body. Dry cough is not accompanied by secretions, it can have an infectious and non-infectious nature. To relieve an attack of dry cough, you need to take drugs that affect the "cough" center, located in the medulla oblongata.

For the correct choice of treatment for dry cough, it is very important to determine its cause. When non-infectious, it develops as a result of various kinds of irritation (dust, smoking, surgery, excitement, allergy, side effect of certain drugs). Dry cough can cause respiratory tract infections, bronchial asthma, chronic bronchitis, postnasal rhinorrhea (persistent discharge of watery mucus from the nose), gastrointestinal reflux (throwing stomach contents into the esophagus), foreign bodies, taking certain medications (eg, ACE inhibitors), left ventricular cardiac failure.

How to choose a drug for dry cough

The choice of a medicament for the removal of an irritating attack of dry cough is carried out according to individual indications taking into account possible concomitant diseases. High effectiveness in stopping such attacks is provided by a non-narcotic drug based on citrate butramate. The drug reduces the excitability of the "cough" center (it has a central effect). It suppresses persistent cough, facilitates and improves breathing, is well tolerated, has a variety of forms of release. The drug does not depress respiration, as it acts selectively on the cough center. Preparations based on butramate citrate are allowed for use in young children from two months.

To cure dry cough will help effective drugs of peripheral action. They reduce seizures, affecting receptors and reducing their excitability. These medicines include: "Alex plus "Bronchicum "Falimint "Paxeladin" and others. For the treatment of dry cough appoint a combination of drugs that have a calming, analgesic, antispasmodic effect. To accelerate the transition of dry cough to wet, you can buy drugs with a mukoreguliruyuschim effect, for example, "Fljuditik" (France). The drug promotes the formation of sputum, has an antiviral, anti-inflammatory effect. Often it is recommended in the complex treatment of whooping cough.

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Preparations for the treatment of cough