The use of antitussive drugs for dry cough. Dry cough tablets for adults: a list of inexpensive and effective drugs Drugs that depress the cough center

»» №2 1999 PROFESSOR G.A. SAMSYGINA, HEAD OF THE DEPARTMENT OF CHILDREN'S DISEASES N1, RUSSIAN STATE MEDICAL UNIVERSITY

Cough is a well-known, but very complex reflex in its mechanism, aimed at restoring airway patency. Cough is one of the most common manifestations of respiratory tract diseases. And in this regard, it is usually considered as a phenomenon that any person who does not have special knowledge (parents, relative or acquaintance), a pharmacy pharmacist and, of course, a doctor can handle. This opinion is erroneous and even harmful, since it is often based on incorrectly chosen antitussive therapy.

This is especially true in pediatrics, since both the child's body itself and diseases at this age have their own characteristics. In addition, not only the mechanisms, but also the causes of cough in children can differ significantly from those in adults. Therefore, the use of drugs taken in adult therapeutic practice, especially combined antitussive drugs, may not only not help a coughing child, but even worsen his condition. Unfortunately, even doctors know a relatively small range of drugs and often do not have complete information about the mechanisms of their pharmacological action. The rational choice and use of antitussive therapy in pediatrics requires knowledge of at least two main points: the causes of cough and the features of the mechanism of formation of the cough reflex in childhood and knowledge of the mechanisms of action of the antitussive drugs used. As noted above, the main function of cough is to remove secretions from the airways to improve their patency and restore mucociliary transport of bronchial secretions (mucociliary clearance).

There are many causes of cough in children:

• Infectious and inflammatory process in the upper respiratory tract (acute respiratory viral infections angina, pharyngitis, sinusitis, exacerbation of tonsillitis, laryngitis)
• Infectious and inflammatory process in the lower respiratory tract (laryngotracheitis, tracheitis, bronchitis, pneumonia)
• Irritative inflammation of the mucous membranes of the respiratory tract
• Allergic inflammation of the mucous membranes of the respiratory tract
• Bronchospasm
• Airway obstruction by viscous bronchial secretions, aspirated foreign bodies, fluids, endogenous and exogenous formations, etc.
• Edema of the lung parenchyma
• Other factors

Most often, coughing is one of the symptoms of an infectious process.

Violation of mucociliary clearance in children can also be due to several reasons. This is hyperplasia of the bronchial mucosa under the influence of infectious, allergic or other inflammation; swelling of the mucous membrane of the bronchial tree; increased secretion of mucus; increase in the viscosity of the secret; reduced formation of surfactant; bronchospasm; bronchial dyskinesia, that is, a decrease in their caliber on exhalation by more than 25% compared to the caliber on inspiration; finally, impaired mucociliary clearance may be caused by a combination of two or more of these factors.

Clinical manifestations range from a severe, agonizing cough accompanied by vomiting, restlessness, and/or pain syndrome, disturbing the sleep and well-being of the child, to a constant cough imperceptible to the patient himself, which has almost no effect on his behavior. In the latter case, the child usually does not need special antitussive treatment, but finding out the cause of the cough is necessary.

Cough treatment is indicated only in cases where it disturbs the well-being and condition of the patient. In this case, you should always start by eliminating its cause.

The need for the treatment of the actual cough, that is, the appointment of the so-called antitussive therapy, arises mainly when the child has an unproductive, dry, obsessive cough. Its peculiarity is that it does not lead to the evacuation of secretions accumulated in the respiratory tract and / or does not release the receptors of the mucous membrane of the respiratory tract from irritating effects, for example, during irritative, infectious or allergic inflammation. It should be emphasized once again that in children, especially young children, an unproductive cough is more often due to increased viscosity of bronchial secretions, a violation of the "sliding" of sputum along the bronchial tree, insufficient activity of the ciliated epithelium of the bronchi and contraction of bronchioles. Therefore, the purpose of prescribing antitussive therapy in such cases is to thin the sputum, reduce its adhesiveness and thereby increase the effectiveness of coughing.

Thus, the effectiveness of antitussive therapy is essentially to increase the cough, provided that it is transferred from dry, unproductive to wet, productive. This ultimately leads to his disappearance.

Treatment of a productive cough, which consists in suppressing the cough reflex, is carried out in children only in special situations: when the cough is very intense and exhausts the baby, is accompanied by vomiting, disturbs the child’s sleep, or when there is a high risk of developing aspiration (for example, in children with severe CNS pathology ).

Thus, for the correct choice of antitussive treatment, it is necessary: ​​firstly, to establish a diagnosis of the disease that caused the child to cough, and secondly, to assess its productivity, duration and intensity, and the degree of influence on the patient's condition. Based on anamnestic, physical and, if necessary, additional laboratory and instrumental data, it is advisable to assess the nature of bronchial secretions (mucous or purulent, the degree of viscosity, "mobility", quantity, etc.) and the presence or absence of bronchospasm.

Therefore, in addressing questions about the need and rational choice antitussive treatment for a child, the participation of a pediatrician is simply necessary. Furthermore, right choice antitussive therapy is always based on a good knowledge of the mechanisms of action of drugs with antitussive effect.

Among them are:

• actually antitussive drugs (central and peripheral action);
• drugs with an indirect antitussive effect (bronchodilator, anti-inflammatory, antiallergic, decongestant, and others);
• combination drugs.

Antitussive drugs are usually divided into two main groups: central action and peripheral (afferent, efferent and combined). Among the latter, preparations of plant and synthetic origin are distinguished.

Centrally acting antitussives suppress the function of the cough center of the medulla oblongata or other nerve centers of the brain associated with it. These include drugs with narcotic effect(codeine, dionine, morphine, dextromethorphan) and drugs that have a non-narcotic antitussive effect in combination with analgesic, sedative and, as a rule, a weak antispasmodic effect. These are glaucine hydrochloride (glauvent), libexin, sinekod, tusuprex and others. This also includes broncholithin - a combined antitussive drug, including glaucine hydrochloride, ephedrine, sage essential oil and citric acid.

Drugs of narcotic action are used in pediatrics extremely rarely, in a hospital setting and for special indications: mainly for oncological diseases of the respiratory tract (opium drugs, dextromethorphan) to suppress the cough reflex during bronchography, bronchoscopy and other surgical interventions on the respiratory tract.

Non-narcotic drugs are used more widely, but, unfortunately, often incorrectly and unreasonably. The indication for their appointment is the urgent need for cough suppression. In pediatrics, such a need, although it occurs, is rare. In young children, it occurs with whooping cough and in cases of very intense productive cough with excessively abundant and liquid bronchial secretions (bronchorrhea), when there is a real threat of aspiration.

It should be noted that bronchospasm is also rare in young children. Usually, the obstructive syndrome, and especially pronounced, at this age is caused by hyperplasia and infectious-inflammatory edema of the bronchial mucosa, impaired motility of the bronchioles, decreased secretion mobility due to its increased viscosity and low level of surfactant. Therefore, centrally acting antitussives simply do not have a point of application. Moreover, by suppressing the cough reflex, they slow down the release of secretions from the airways, worsen the aerodynamics of the respiratory tract and the processes of oxygenation of the lungs.

In the older age period, these drugs may be useful in cases of cough associated with moderate bronchospasm. At the same time, they are used alone or as an addition to bronchodilators and drugs that suppress allergic or irritative inflammation.

The group of antitussive non-narcotic drugs of central action is also indicated for cough associated with irritation of the mucous membranes of the upper (epiglottic) respiratory tract due to infectious or irritative inflammation. In these cases, the result of their appointment is usually enhanced when combined with peripheral drugs with an enveloping effect. Broncholitin can serve as a partial example of such a combined effect. But its use is justified only in the absence of pronounced changes in the mucosa of the lower parts of the bronchial tree, since the ephedrine included in it “dries out” the bronchial mucosa, increases the viscosity of the bronchial secretion and aggravates the violation of mucociliary transport, and, accordingly, increases the unproductiveness of cough in the presence of bronchitis and pneumonia. In addition, ephedrine has a stimulating effect on the central nervous system, disturbs the child's sleep and contributes to an increase in unproductive cough and shortness of breath.

Peripheral antitussives affect either the afferent or efferent components of the cough reflex, or have a combined effect. Drugs with an afferent effect act as mild analgesics or anesthetics on the mucous membrane of the respiratory tract and reduce the reflex stimulation of the cough reflex. In addition, they change the formation and viscosity of the secret, relax the smooth muscles of the bronchi. Preparations with an efferent action increase the mobility of the secret, as if improving its "sliding" along the mucosa, reduce the viscosity of the mucus, or increase the effectiveness and strength of the cough mechanism itself.

One of the effective afferent antitussive drugs of peripheral action is moisturizing the mucous membranes. This is primarily the use of aerosols and steam inhalations, which reduce mucosal irritation and reduce the viscosity of bronchial secretions. Water vapor inhalation alone or with the addition of medications (sodium chloride or benzoate, sodium bicarbonate, ammonium chloride, plant extracts such as eucalyptus) is the simplest, most affordable and common method of moisturizing. Along with this, a plentiful drink can be used (including medicinal teas, when efferent and afferent mechanisms of action are combined), and in severe cases (in a hospital setting), intravenous fluid infusions.

Enveloping agents also refer to peripheral afferent antitussives. These drugs are mainly used for coughs that occur when the mucous membrane of the upper supraglottic sections of the respiratory tract is irritated. Their action is based on the creation of a protective layer for the mucous membrane of the nasopharynx and oropharynx. Usually they are oral lozenges or syrups and teas containing plant extracts (eucalyptus, acacia, licorice, wild cherries, etc.), glycerin, honey and other components. Local anesthetics (benzocaine, cyclain, tetracaine) are also afferent agents, but are used only in a hospital according to indications, in particular for afferent inhibition of the cough reflex during bronchoscopy or bronchography.

Efferent drugs include expectorants. These are plant extracts (marshmallow, anise, ninesil, wild rosemary, oregano, ipecac, coltsfoot, plantain, sundew, licorice, pine buds, violet, thyme, thermopsis, etc.), terpinhydrate, iodides.

The mechanism of action of these drugs is based on the removal of bronchial secretions from the respiratory tract by reducing its viscosity with an increase in volume. Most of the expectorant drugs increase the secretion of mucus due to reflex irritation of the glands of the bronchial mucosa. Some, for example, iodides and a number of herbal preparations (thyme, sundew, thermopsis, ipecac, etc.) also have a direct effect on secretory bronchial cells and are released into the lumen of the bronchial tree, while increasing the secretion of mucus and increasing its volume. They partly activate the motor function of the bronchioles and the ciliated epithelium of the bronchial mucosa. Along with this thermopsis, ipecac also enhance the activity of the vomiting and respiratory centers of the medulla oblongata.

Plant extracts are included in syrups, drops and cough tablets, are components of breast fees.

EXPECTORANT DRUGS OF PLANT ORIGIN

Ingredients: extracts of marshmallow, anise, wild rosemary, ninesil, oregano, ipecac, coltsfoot, sundew, plantain, licorice, pine buds, violet, thyme, thermopsis.

Dosage forms:

• decoctions, infusions, teas
• tablets (cough tablets based on thermopsis and sodium hydrochloride, mukaltin based on marshmallow extract, glycyram based on the ammonium salt of glycyrrhized acid isolated from licorice, bronchicum lozenges)
• syrups (bronchicum based on honey, thyme, rosehip, pimpinella root, primrose and grindelia, eucabal based on plantain and thyme)
• drops (bronchicum based on thyme, soapwort, quebracho bark and menthol, eucabal based on sundew and thyme).

It should be noted that plant origin medicinal product does not yet mean its complete safety for a child, especially an early age. So, preparations of ipecac contribute to a significant increase in the volume of bronchial secretions, enhance the gag reflex. Enhances vomiting and cough reflexes herb thermopsis. Therefore, in children of the first months of life, in children with CNS damage, they should not be used: they can cause aspiration, asphyxia, atelectasis, or increase vomiting associated with coughing. Anise, licorice and oregano have a rather pronounced laxative effect and are not recommended if a sick child has diarrhea.

A significant increase in sputum volume is also noted with the use of iodides (potassium iodide, sodium iodide, iodized glycerol). The use of these drugs in pediatrics should also be limited, since the expectorant effect of iodides is observed only when they are administered in doses close to intolerable, which is always dangerous in pediatric practice. In addition, they have an unpleasant taste (an exception is iodized glycerol, but its effect is extremely insignificant).

The most effective antitussive drugs with efferent peripheral action are mucolytics. They well dilute the bronchial secret by changing the structure of the mucus. These include proteolytic enzymes (deoxyribonuclease), acetylcysteine ​​(ACC, carbocysteine, N-acetylcysteine ​​(fluimucil), bromhexine (bisolvan), ambroxol (ambrohexal, lasolvan), dornase (pulmozyme), etc. sputum, they practically do not increase its volume.The liquefying effect of proteolytic enzymes is based on breaking the peptide bonds of bronchial secretion protein molecules.Acetylcysteine, carbocysteine ​​and N-acetylcysteine, bromhexine and ambroxol break the integrity of the disulfide bonds of acid mucopolysaccharides of the sputum gel, thereby diluting it.Bromhexine and Ambroxol also has the ability to stimulate the production of endogenous pulmonary surfactant (antatelectatic factor), which ensures the stability of alveolar cells during respiration, protects them from external adverse factors, improves the “sliding” of bronchopulmonary secretion along the epithelium of the bronchial mucosa. Its gliding facilitates the release of sputum from the respiratory tract.

MAIN INDICATIONS FOR THE CHOICE OF ANTICOUGH DRUGS IN CHILDREN

Drugs (according to the mechanism of action)	Main indications for use	Restrictions on the appointment and contraindications
Central action (libeksin, broncholitin)	Dry, obsessive cough, accompanied by pain (dry pleurisy, whooping cough, etc.)	Productive cough. Early age of the child. Productive cough in children with CNS lesions. Infection of the lower parts of the DP. Pulmonary edema. Foreign bodies. Aspiration
Moisturizers	Unproductive nature of cough	Dry pleurisy. Foreign bodies DP. Aspiration of liquids. Pulmonary edema
Enveloping	Unproductive cough with ARI, tonsillitis, exacerbation of tonsillitis, pharyngitis, etc.	Not
Local anesthetics	Carrying out medical manipulations on the respiratory tract	All other situations
Expectorants	Diseases of the upper respiratory tract. Infectious and inflammatory diseases of the lower respiratory tract in children older than 3 years, cough associated with bronchospasm (in combination with bronchodilators and anti-inflammatory drugs)	Productive cough. Early age of the child. High risk of developing aspiration. Bronchorea of ​​any etiology. Pulmonary edema
Mucolytics	Cough due to difficulty in passing viscid, thick sputum from the respiratory tract	Bronchospasm
Preparations based on guaifenesin (coldrex-broncho, tussin, robitussin - cough mixture)	The same	Age up to 3 years
Antihistamines	Allergic edema of the nasal and oropharyngeal mucosa, bronchorrhea	All other situations
Combined drugs (Loraine, Hexapneumine)	Acute respiratory (respiratory-viral) infection with high fever and cough due to irritation of the mucous membrane of the upper parts of the DP, severe rhinitis, etc.	Unproductive cough in infectious and non-infectious diseases of the lower parts of the DP. Bronchospasm. Pulmonary edema. Foreign bodies. Aspiration
Combined drugs (trisolvan, solutan)	Bronchospasm	All other situations

Acetylcysteine, bromhexine and ambroxol can be widely used in pediatrics in the treatment of cough caused by diseases of the lower respiratory tract (tracheitis, laryngotracheitis, bronchitis, pneumonia, etc.), especially in children of the first five years of life, in whom increased viscosity of bronchial secretions is the main pathogenic factor in the formation of cough. The tendency to insufficiency of surfactant synthesis justifies the use of drugs such as ambroxol in neonatological practice and in children during the first weeks of life.

But one of the disadvantages of acetylcysteines (ACC, carbocysteine ​​and fluimucil) and, in part, bromhexine is their ability to increase bronchospasm. Therefore, the use of these drugs in acute period bronchial asthma is not shown.

Acetylcysteine, bromhexine and ambroxol have proven themselves well in chronic bronchitis, bronchiectasis, cystic fibrosis, and other fermentopathies, which are characterized by increased viscosity and often purulent or mucopurulent sputum. But in this situation, mucolytics such as proteolytic enzymes and dornase have advantages, as they more effectively dilute purulent sputum.

Currently, the drug guaifenesin is widely used. It is included in such products as coldrex broncho, robitussin - cough mixture, tussin (a combination drug that includes caramel, glycerin, citric acid, sodium benzoate, corn syrup along with guaifenesin) and a number of other widely advertised over-the-counter antitussives. The dose of guaifenesin is usually 100 to 200 mg taken every 4 hours. Guaifenesin may be used in children over 3 years of age. In its action, guaifenesin occupies an intermediate position between expectorant and mucolytic drugs. Unlike the expectorants described above, the action of guaifenesin is based on a decrease in surface tension and adhesion of sputum to the bronchial mucosa and a decrease in its viscosity due to the depolymerization of acid mucopolysaccharides of mucus. But the ability to increase the secretion of mucus (albeit less viscous) brings guaifenesin closer to expectorants. side effects guaifenesin has not been noted, but there are no reliable data on its effectiveness.

The use of drugs with mediated antitussive action in pediatrics has very limited indications. For example, antihistamines it is not recommended to use in the treatment of cough in children, especially young children, since their "drying" effect on the bronchial mucosa enhances an unproductive cough caused by the already viscous nature of the secret. For the same reasons, decongestants (decongestants) used for acute rhinitis and cough in adults are not used in children.

Bronchodilators (eufillin, theophylline) are indicated if cough is associated with bronchospasm. The use of atropine is generally undesirable in both children and adults - it thickens sputum, making it more viscous and difficult to remove.

I would like to focus on the use combined cough medicines. This group of drugs, usually over-the-counter or prescribed by doctors, contains two or more ingredients. A number of combination drugs include a centrally acting antitussive, antihistamine, expectorant and decongestant (broncholithin, stoptussin, sinecod, hexapneumine, lorain). Often they also include a bronchodilator (solutan, trisolvin) and / or an antipyretic component, antibacterial agents (hexapneumine, lorain). Such drugs relieve coughing with bronchospasm, manifestations of a respiratory viral (for example, rhinitis), or bacterial infection, but they should also be prescribed according to the relevant indications (see table). Often such drugs are not indicated or even contraindicated in young children, especially in the first months of life.

In addition, in combination drugs, in particular those prescribed by doctors, opposite in their action can be combined. medications, such as antihistamines and expectorants (Zvyagintseva powder and its variants). Many prescriptions contain suboptimal or low concentrations of drugs, which reduces their effectiveness. But, of course, there are quite justified combinations of drugs.

If the main complaint is the cough itself, it is always better to use one drug and in full dose, but one that acts on the component of the cough reflex specific to this patient. For example, to relieve cough associated with acute upper respiratory tract infections, tablets or syrups with enveloping peripheral action or their combination (in older children and adolescents) with centrally acting non-narcotic drugs such as libexin are indicated. In acute laryngitis, tracheitis, bronchitis and pneumonia, it is most effective to use airway humidification to enhance bronchial secretion and thin viscous sputum. If it is ineffective, expectorants and / or mucolytics are added to the treatment.

Mucolytics are the drugs of choice in the presence of viscous, mucopurulent or purulent sputum and in children with reduced surfactant synthesis (early age, prematurity, prolonged bronchitis, pneumonia, cystic fibrosis, alpha1-antitrypsin deficiency).

When coughing in a patient with symptoms of bronchospasm, it is advisable to prescribe bronchodilators, antiallergic and anti-inflammatory drugs along with moisturizing and expectorant drugs, but centrally acting antitussive drugs and mucolytics such as acetylcysteine ​​are not indicated.

In young children, in children with a pronounced gag reflex, in children with a high risk of aspiration, expectorants that increase the volume of secretions and increase the gag and cough reflexes are contraindicated. And for the purposeful suppression of an unproductive cough, for example, with whooping cough, on the contrary, it is possible to use antitussive non-narcotic drugs of central action.

Literature

1. Artamonov R.G. The state of the bronchi in protracted and chronic segmental and lobar pneumonia in children of the first years of life. Abstract diss. cand. honey. Sciences, M., 1958.
2. Ignatieva E.P., Makarova O.V., Ponikav V.E. Modern expectorants. In the world of drugs, N 1, 1998, p. 10-13.
3. Mashkovsky M.D. Medicines. M., Medicine, 1993.
4. Rachinsky S.V. et al. bronchitis in children. L., Medicine, 1978, p. 211.
5. Tatochenko V.K. et al. Acute diseases respiratory system in children. M., Medicine, 1981, p. 206.
6. Guide to medicine. Diagnostics and therapy. M., 1997, v.1, p. 407-410.
7. Reference Vidal. Medicines in Russia. M., 1999.
8. Anmmon H.P. Incrisde the glucose by ACC during hyperglycern Arsne, 1992, 42, 642-645.
9. Bianchi M. el al. Ambroxol inhibits interleucin 1 and tumor necrosis factor production in human mononuclear cell. Agents and Actions, vol. 31, 3/4.
10. Ziment I. Acetilcysteine: a drug with in interest in past end a future. Respiration, 1986, 50 suppl 1; 20-30.

The drugs of this group suppress cough - a protective mechanism for removing contents from the bronchi. The use of antitussive drugs is advisable when the cough is ineffective (unproductive) or even contributes to the retrograde movement of the secret deep into the lungs (chronic bronchitis, emphysema, cystic fibrosis, and also with reflex cough).

According to the predominant component of the mechanism of action, two groups of antitussives are distinguished:

1. Means of the central type of action - narcotic analgesics (codeine, morphine, ethylmorphine hydrochloride - dionine).

2. Means of a peripheral type of action (libexin, tusuprex, glaucine hydrochloride - glauvent).

CODEINE (Codeinum) - a drug of the central type of action, an opium alkaloid, a derivative of phenanthrene. It has a pronounced antitussive effect, a weak analgesic effect, causes drug dependence.

Codeine is available as a base, as well as codeine phosphate. Codeine is part of a number of combined preparations: ankylosing spondylitis, Codterpin tablets, panadeine, solpadeine (Sterling Health SV), etc.

Ankylosing spondylitis' medicine contains an infusion of adonis, sodium bromide and codeine.

Codterpine includes codeine and an expectorant (terpinhydrate or sodium bicarbonate).

Morphine - narcotic analgesic, opium alkaloid, phenanthrene group. Stronger than codeine in antitussive effect, but rarely used in this regard, as it depresses the respiratory center and causes drug addiction. They are used only for health reasons, when the cough becomes life-threatening for the patient (heart attack or lung injury, surgery on the chest organs, festering tuberculoma, etc.).

Antitussive drugs with predominantly peripheral action include the following drugs:

LIBEXIN (Libexinum; tablets 0, 1) is a synthetic drug prescribed one tablet 3-4 times a day. The drug acts mainly peripherally, but there is also a central component.

The mechanism of action of libexin is associated with:

With a slight anesthetic effect on the mucous membrane of the upper respiratory tract and facilitating the separation of sputum,

With mild bronchodilator effect.

The drug does not affect the central nervous system. According to the antitussive effect, it is inferior to codeine, but does not cause the development of drug dependence. Effective for tracheitis, bronchitis, influenza, pleurisy, pneumonia, bronchial asthma, emphysema.

Side effects include excessive anesthesia of the mucous membranes.

A similar drug is GLAUTSIN, an alkaloid of the yellow plant (Glaucium flavum). The drug is available in tablets of 0, 1. The action is to inhibit the cough center, a sedative effect on the central nervous system. Glaucine also relieves bronchial smooth muscle spasm in bronchitis. The drug is prescribed to suppress cough in tracheitis, pharyngitis, acute bronchitis, whooping cough. When used, respiratory depression, delayed separation of secretions from the bronchi and expectoration of sputum are noted. A moderate decrease in blood pressure is possible, since the drug has an alpha-adrenergic blocking effect. Therefore, glaucine is not prescribed to people suffering from hypotension and people with myocardial infarction.

TUSUPREKS (Tusuprex; tab. 0.01 and 0.02; syrup 0.01 per 1 ml) is a drug that mainly acts on the cough center without inhibiting the respiratory center. It is used to stop coughing attacks in diseases of the lungs and upper respiratory tract.

FALIMINT (Falimint; dragee at 0.025) - has a weak local anesthetic effect and a good disinfectant effect on the mucous membrane of the oral cavity and nasopharynx, reducing, in case of inflammation, irritation of the mucous membranes, the occurrence of reflexes from them, including cough reflexes.

All these drugs are prescribed for dry unproductive cough. With dryness of the bronchial mucosa, with a viscous and thick secretion of the bronchial glands, coughing can be reduced by increasing the secretion of the glands of the bronchial mucosa, as well as diluting the secretion, and for this purpose expectorants are prescribed.

Antitussive drugs in children's practice Dry, hacking cough accompanies almost everyone and characterizes First stage interactions of the microorganism with the epithelium of the upper respiratory tract. Once infectious process gain strength, that is infectious agent overcomes the mucous barrier and reaches the secreting glands, sputum appears, marking the qualitative transition of a dry cough into a wet one.

Depending on which microorganism caused the damage to the respiratory tract, sputum may be mucous or purulent. An excruciating cough, up to respiratory arrest, causes a pathogen that creates an epicenter of irritation in the brain stem.

Based on the mechanism of cough, the antitussives used should either block cough receptors (on the mucous membrane of the respiratory tract or those in the medulla oblongata), or promote the discharge of secreted sputum.

It should be recalled that antitussives are only symptomatic therapy, which, ideally, should be supported by drugs designed to destroy the pathogen. So, all antitussive drugs are divided into two main groups:

1. Drugs used for dry cough.
2. Medicines used for wet cough.

In the first group, almost all drugs belong to drugs with a central mechanism of action, with the exception of libexin. Their action is based on the blockade of nerve impulses of the cough center. Ten years ago, microdoses of codeine were widely used for this purpose, added to prefabricated mixtures such as codelac and complex tablet preparations - codeine.

Medications used to suppress cough

Along with dose-dependent suppression of the cough center, such drugs thinned sputum and contributed to its excretion. But due to the increase in the percentage of the drug-addicted population, who bought up all pharmacy preparations containing opium alkaloids (in this case, codeine), a decree was issued banning the free sale of codeine-containing preparations from pharmacies. To replace it, a new line of drugs was developed, with the same mechanism of action, but not related to narcotic substances:

1. "Tusuprex". In the pharmacy market, it competed for the effectiveness of the action in parallel with codeine-containing drugs, but did not become a leader due to the cost. Available only in tablets. Reception is allowed from two years, at a dosage of 5 mg 3 times a day.

2. A fairly old drug - "glaucine", also with a central mechanism of action. But in addition to suppressing the cough center, it causes a peripheral block of vascular receptors, which may be accompanied by a sharp drop in blood pressure in the vessels. Children are prescribed in the form of syrup, at a dosage of 10 mg 2-3 times a day. Recommended for use over 2 years of age.

3. A relatively new drug, also with a central mechanism of action, has become “sinekod”. The release of the drug in drops and syrup allows the use of the drug in babies from the age of two months. Up to a year, the remedy is prescribed 10 drops up to 4 times a day, from a year to three years the dosage reaches 15 drops per dose, and from three years a syrup is allowed for use, used up to the age of six, 5 ml 3 times a day.

Recently, its cheap analogue containing the same active principle (butamirate) - "omnitus", produced by pharmaceutical companies in Serbia and Russia, began to compete with "sinekod" for the sales market. It can be found in tablet form and as a syrup. The form of the drug is prescribed depending on the age of the child. Syrup is allowed when the child reaches three years, and tablets - six years.

4. "Libeksin". A fairly old drug with a peripheral mechanism of action, that is, the action of "libexin" resembles the effect of local anesthetics, it blocks the receptor field of the respiratory mucosa. The instructions for taking the drug in children do not indicate the age and do not indicate the exact dosages, only a general formulation that allows the drug to be taken in the form of ¼ or ½ of the minimum adult dosage, without further instructions.

Here, in fact, is the whole range of medicines used for dry cough. Unfortunately, in whooping cough and parapertussis, none of the described drugs is able to give a pronounced therapeutic effect, which codeine-containing drugs had.

When the cough becomes productive, that is, a large amount of sputum is formed, there is no point in suppressing it. In this case, it is important to promote sputum discharge by all means. For these purposes, a group of expectorants is used, conditionally divided into two subgroups, based on the nature of the active principle of the drugs.

Medications that improve sputum discharge

I group, which is based on synthesized chemicals. It includes:

1. "Bromhexine" - the pioneer of this group of drugs, which is essentially a chemical analogue of the plant alkaloid vasicin. In the body, "bromhexine is converted into the active substance - ambroxol.

Bromhexine is available in both liquid and solid form. The drug in tablets is given to children from three years old at a dosage of 4 mg three times a day. After 6 years, the dosage of "Bromhexine" reaches 8 mg three times a day. In the form of Bromhexine syrup, it is prescribed to children under two years old, 2 ml of syrup three times a day, up to six years old - 4 ml each and over six years old - 8 ml syrup each.

Directly "ambroxol" itself and its analogues - "lazolvan", "ambrobene", "ambrohexal", "bronchorus". Preparations are produced in several forms: in tablets, syrups, and inhalation solutions.

For inhalation, an aqueous solution of ambroxol is more often used. Up to two years, 7.5 mg of the drug is used once, from the age of two - 15 mg 1-2 times a day.

In the form of syrup "Ambroxol" is taken orally in children under two years old in the amount of 7.5 mg twice a day, up to five years old - 7.5 mg three times a day, over 5 years old "Ambroxol" is prescribed 15 mg three times a day . Tablets are allowed to be taken from 6 years old, 15 mg 2-3 times a day.

Three directions were found in the mechanism of action of this subgroup of drugs:

- Stimulation of the production of bronchial and alveolar surfactant and a change in the physicochemical properties of mucus produced by the mucous glands. All this together leads to a secretolytic effect, that is, the mucus becomes more liquid.
- Stimulates and coordinates the movement of cilia located on the epithelium that lines the mucous membrane of the respiratory tract - a secretory effect.
- It has a weak antitussive effect, with an unidentified point of action.

From side effects, in addition to allergic phenomena, the phenomena of dyspepsia are possible.

2. "Acetylcysteine" is good to use in the presence of very thick, difficult to separate sputum, as it has a pronounced mucolytic effect. Able to suppress the production of non-specific protective factors of the mucous membrane of the respiratory tract. It has antioxidant protection, as it carries sulfur ions, which restore the activity of an intracellular enzyme that inactivates toxic oxygen species. The analogue of "acetylcysteine" is "fluimucil".

"Acetylcysteine" (analogue - "ACC") is available in the form of a soluble dosed powder, syrup. All forms are approved for use from the age of two, 100 mg each active substance 2 to 4 times a day.

In addition to the listed options, there is an inhaled form of acetylcysteine, released as part of an antibiotic of the levomycetin group - “fluimucil + IT antibiotic”.

It is important to know that for the effectiveness of the use of this drug, it is better to use a compressor nebulizer to prevent destruction antibacterial agent. In children, in the form of inhalations, the drug is used from the age of two with a fixed dosage of 125 mg 1-3 times a day.

3. "Carbocysteine". Analogues - "fluditec", "fluifort". Used for difficult to separate sputum. Unlike acetylcysteine, it does not suppress the protective properties of the respiratory mucosa. As bonus properties, "carbocysteine" normalizes the activity of the mucous glands, restores the secretion of immunoglobulin A and the activity of the ciliated epithelium of the respiratory tract.

An interesting property of "fluifort" is its prolonged action, which lasts up to 8 days after a single dose.

In children, "carbocysteine" can be used in the form of a syrup. From one month to two years, the amount of the drug is calculated from the ratio of 5 mg / kg of the child's weight 3 times a day, up to five years - 2.5-5 ml of syrup 4 times a day, over five years - 10 ml three times a day.

"Fluifort" in children under one year is not used. Children under five years of age are prescribed in the amount of 2.5 ml of the drug, after five years - 5 ml of syrup twice a day.

Herbal extracts used for wet cough

II group of medicines, using all kinds of plant extracts as the active substance.

First on this list is thyme extract with proven anti-inflammatory and expectorant effects.

Thyme alcoholic extract contains Pertussin syrup, which has been known since Soviet times. In addition to thyme, the syrup is enriched with the presence of potassium bromide, which, due to bromine, has a general calming effect, thus reducing the excitability of the cough center. It is prescribed from three years in a dosage of 2.5 ml, after five years - 5 ml three times at regular intervals.

Syrup and tablets "codelac broncho" in ancient times contained codeine in their composition. To date, their composition has changed. Instead of codeine, thyme extract was introduced into the composition of the syrup, in connection with which the syrup began to be called “codelac broncho with thyme” (there is a syrup without thyme). In addition to thyme, the syrup contains ambroxol and synthesized active substance licorice root - glycyrrhizinate, which, through its action on the adrenal glands, suppresses inflammation. Used from the age of two.

Cheap and quite effective for wet cough tablets "mukaltin" contain soda, marshmallow herb extract. In the instructions for the drug, in contraindications, there is no child age, but there is also no exact dosage and its dependence on the age or weight of the child. In such cases, they usually resort to dividing the tablet into half or a quarter, depending on the age of the child, and drink three times a day.

Syrup "bronchicum" contains an alcohol extract of thyme herb. Approved for use in children from 6 months.

Elixir "bronchicum", in addition to thyme extract, contains an extract of primrose roots.

Multicomponent preparation with complex action

Of all the other drugs with a complex action, one can note "ascoril", which is available both in tablets and in syrup. In its composition, "ascoril" contains:

1. Bromhexine.
2. Salbutamol.
3. Guaifenesin.

Due to the composition, the drug has mucolytic, mucomotor, bronchodilatory and weak antitussive effects. It is better to use it in case of severe lung pathology, for example, with obstructive, bronchiolitis or bronchial asthma. Children are prescribed in the form of syrup, from the age of three, 5 ml, 2-3 times a day.

Mustard plasters as a means of increasing blood flow

To enhance the effect of antitussive drugs, at home, they often use the imposition of mustard plasters. Considering that the mechanism of their action refers to a locally irritating effect, it is necessary to remember a few rules for their use in young children:

1. apply on a thin gauze layer soaked in heated vegetable oil.
2. You can only lay out mustard plasters on your back with the reverse side (the mustard layer should not come into contact with the skin).
3. The smaller the age group of the baby, the smaller the percentage of the skin surface should be under mustard plasters, for example, a six-month-old child needs only one mustard plaster in a transverse overlay on the back.
4. After the mustard compress is installed, the warm-up session should not be more than 10-15 minutes. You should focus on a slight reddening of the skin under the mustard plaster.

Subject to all precautions, mustard plasters can also be used in babies who have not reached the age of one.

Conclusion

In addition to these drugs, today's pharmaceutical market is full of other complex products, consisting of all kinds of combinations of plants, often with the addition of synthesized medicines. What is important to remember when choosing a cough medicine:

1. medicinal product must be used strictly for its intended purpose. With a wet cough, it is contraindicated to use drugs that suppress the cough reflex.
2. In childhood, it is better to give preference to monopreparations, to avoid complex composition and alcohol solutions.

Many diseases are very often accompanied by cough, which is considered a protective physiological reaction of the body in response to the irritating effect of chemical, physical or organic factors on the mucous membrane of the respiratory tract. The body, with the help of coughing, tries to clear and free the airways as much as possible from foreign bodies or sputum, which is produced in response to the inflammatory process, in a word, from everything that should not be normal in the respiratory system.

In this regard, the question of suppressing the cough reflex should not arise in principle. Indeed, in the absence of the ability to cough, the respiratory tract will overflow with constantly produced sputum and become impassable to air. But it is still necessary to eliminate the cough when it acquires an excruciating painful character, being absolutely unproductive, or to alleviate it, making it more effective for releasing the bronchi from the secret.

In each case, you have to select certain "cough pills". By the way, this name is absolutely incorrect in medical terms. It sounds as ridiculous as the phrase "pills for the head." But due to the fact that such a concept has taken root among the people, in this article we will use such phrases for the convenience of our readers in order to talk in an accessible way about the principles of choosing and using cough medicines.

This topic is very important, because often sick people try to self-medicate without going to a doctor, but to pharmacists who work in a pharmacy, where entire display cases are filled with various antitussive drugs in the form of tablets, drops, inhalers, sprays, syrups, potions, infusions , tinctures, suspensions, etc., the number of which simply dazzles the eyes. As a result, a sick person relies on the advice of a pharmacist, who is forbidden to advise anything at all. After all, which cough pills to choose, only a specialist doctor has the right to advise.

>>Recommended: if you are interested in effective methods of getting rid of chronic rhinitis, pharyngitis, tonsillitis, bronchitis and persistent colds, then be sure to check out this website page after reading this article. The information is based on personal experience the author and helped many people, we hope it will help you. Now back to the article.<<

Why is the list of cough medicines so long?

The answer to this question is quite simple - cough cough discord. It arises due to many causes and various diseases, which is why it is necessary to select strictly defined, most effective cough remedies to treat the corresponding ailment, eliminate or alleviate a certain type of cough.

The respiratory tract, or rather, the mucous membranes of the bronchi, constantly produce a certain amount of mucus, regardless of whether the person is sick or healthy. But with the development of the pathological process, the amount of sputum or mucus increases dramatically, and their excess is removed only by coughing. But even without sputum production, any irritation of the respiratory mucosa leads to a cough, only a very unproductive one.

As a result, the cough is usually divided into dry or wet (wet). The treatment of each type of cough has its own characteristics and determines which cough medicines should be selected.

Dry cough preparations that generally suppress the cough reflex should not be used to treat wet cough, otherwise the bronchial lumen will be completely clogged with constantly produced sputum.

Conversely, it makes no sense to use wet cough tablets that thin sputum and contribute to its formation and easier expectoration if a dry cough occurs associated with irritation of the bronchial or tracheal mucosa by an inflammatory process or exposure to some chemical or physical factors.

In addition to all that has been said, it is necessary in the treatment of cough to always proceed from the fact that not how to choose and what remedies to drink for coughing in order to simply get rid of it, but how to cure the cause that provokes its occurrence. Otherwise, the treatment will be ineffective and untenable.

But you should always remember that a dry cough most often turns into a wet one. In this regard, it is necessary to change the entire treatment regimen in a timely manner in order to maintain airway patency to ensure normal free breathing.

Causes of cough that affect the choice of medicine

Cough does not always occur due to diseases of the respiratory tract, sometimes the cause lies in the pathology of the central nervous system, the cough center of the brain. The list of diseases leading to the occurrence of cough is very extensive, so we bring to your attention the main causes - diseases:

1. Infectious diseases of a viral and bacterial nature are the largest and main group of diseases accompanied by a cough. This group includes laryngitis, tonsillitis, sinusitis, pharyngitis, tracheitis, bronchitis, bronchiolitis, bronchopneumonia, pneumonia, bronchiectasis, pleurisy, lung abscesses, COPD, tuberculosis and mycosis of the lungs, etc.

2. Diseases of an allergic or infectious-allergic nature, for example, bronchial asthma, laryngeal edema.

3. Children's infectious diseases, for example, whooping cough.

4. Benign and malignant tumors of the respiratory tract, bronchogenic cancer.

5. Irritation of the respiratory tract by chemical aggressive substances - vapors of gasoline, paint, acetone, carbon monoxide.

From this large list, it is difficult for a person ignorant in medicine to understand which antitussive medications to choose so that the treatment is effective, and the cough is productive, easier and faster.

Basic principles for the treatment of dry cough

At the very beginning of the development of the inflammatory process in the respiratory tract, as well as in many other diseases not associated with the pathology of the respiratory system, coughing can be very severe, painful, hacking. Dry cough without sputum formation occurs against the background of irritation of the mucous membrane of the respiratory tract, which can have a wide variety of genesis, for example, inflammatory, allergic, infectious and non-infectious.

In this case, coughing does not bring any benefit, but only exhausts an already exhausted sick person. The only way to eliminate such a cough is the use of antitussive drugs that suppress the activity of the cough center or act on the receptors of the bronchial mucosa.

At this stage of treatment, narcotic and non-narcotic drugs, for example, Codelac tablets, which are based on Codeine, will be very effective. Codeine-containing drugs are very effective, but they are sold in a free pharmacy network, but only on special prescriptions from doctors, because they can cause drug addiction.

But instead of them, the pharmacological industry offers no less effective, but safer, not affecting the respiratory center, quite affordable drugs, which do not contain narcotic substances. These include a fairly large list of non-narcotic cough medicines - Libexin, Tusuprex, Paxeladin, Glaucin, etc.

These drugs work mainly through the peripheral route, desensitizing receptors in the bronchial mucosa, although they may also affect the cough center. Bronchial receptors are very sensitive, they instantly react to irritation and send signals to the medulla oblongata, where the cough center is immediately activated and a cough reflex occurs. These drugs are not addictive, do not lead to drug dependence, so they can also be used for cough treatment for children.

Combination medicines for dry cough are also becoming very popular, for example, Bronholitin, which, in addition to the antitussive substance Glaucine, also contains the well-known Ephedrine, as well as Basil oil. The list of tablets, medicines, cough syrups in this category is very large, and certain principles must be followed for the use of these medicines.

It is forbidden to use these very effective and good tablets for the treatment of any kind of cough, if it becomes wet, otherwise the blockade of the cough will lead to impaired lung clearance, sputum removal, and this is a direct path to the development of pneumonia, impaired lung ventilation. You should know the general contraindications for the use of drugs in this group:

1. If there is hypersensitivity to the active and auxiliary components of the drug;

2. Not prescribed for pregnant and lactating women;

4. Identified respiratory failure 2-3 tbsp.;

5. In history - aggravated form of bronchial asthma.

Which is better to choose and how to take tablets for the treatment of dry cough?

Of course, there is no single answer to this question, because the choice of medicine is always selected according to an individual scheme. In addition, when choosing a medicine, you need to pay attention to the form of release of the drug. For example, it is better for young children to buy not tablets, but a syrup for the treatment of dry cough.

A form such as effervescent or absorbable tablets in the treatment of cough is absorbed much faster, their effect comes very soon, but they are also not suitable for babies.

In addition, effervescent tablets, as an antitussive, should not be taken by those who have an increased acidity of gastric juice, hyperacid gastritis, and peptic ulcer.

1. Libexin

If a dry cough occurs at the onset of a cold, flu, acute or exacerbation of chronic bronchitis, as well as in patients suffering from heart failure, it is recommended to use Libexin. These cheap cough medicines are quite comparable in their effectiveness to codeine-containing drugs.

The drug reduces the sensitivity of cough receptors, affects the cough reflex, but does not have a depressing effect on the respiratory center. In addition, Libeksin has a mild anti-inflammatory and bronchodilator action.

If this drug is sold under the name Libexin muco, then this means that it contains a mucolytic - Carbocysteine, which reduces the viscosity of sputum. Libeksin can be prescribed to young children, but with caution.

According to the instructions, the Libexin tablet preparation is used according to the scheme, which involves taking it up to 4 times a day at a dose corresponding to the age of the patient - from ¼ to 2 tablets at a time, without chewing the tablets, because they cause anesthesia of the oral mucosa. The duration of action of this drug is quite short - 3-4 hours.

This rather simple cough medicine may have another trade name, Glauvent. The drug has a central effect directly on the cough center, but it does not apply to narcotic drugs, does not cause respiratory depression and intestinal motility, addiction to it.

Glaucine can be prescribed to children from 4 years of age, but is not prescribed to people who have had a myocardial infarction who have been diagnosed with arterial hypotension, because it can cause a decrease in blood pressure. A pronounced antitussive effect occurs after 30 minutes and lasts almost 8 hours, which is why it is enough to apply it 2-3 times a day.

3. Bitiodin

Among the drugs of peripheral action, Bitiodin, a common and simple cough pill, can be called very effective, which is quite comparable in strength to Codeine, but at the same time does not cause addiction as narcotic antitussives and has very few side effects. This feature allows it to be used in the treatment of cough in children.

Dry cough is called by many the most difficult in terms of discomfort. It is characterized by the complete absence of sputum and severe irritation of the mucosa during coughing. In addition to constant breathing difficulties, such a cough causes chest pains, throbbing headaches, a sore throat, and much more. That is why doctors advise using antitussive drugs for dry cough. Unlike other drugs, they contribute to the inhibition of the reflex responsible for coughing.

Often a dry cough causes more problems for the patient than a wet one.

In pharmacies you can find a lot of medicines with this effect. It is not so easy to select them, because they differ not only in the composition and origin of the components, but also in the effect they have on the body. Some are recommended for severe paroxysmal coughs, while others help to gently eliminate the cough that occurs under certain conditions.

How antitussives work

All antitussives are designed to treat conditions in which, during attempts to cough up sputum, sputum is not secreted, or is secreted, but in very small quantities. In the latter case, the symptoms are due to excessive density and viscosity of sputum. Dry cough, which worries patients for a long time, does not allow them to sleep normally and lead a normal life, occurs with the following diseases:

• lung infections (flu, whooping cough and others);

Dry cough can occur with inflammation of the lungs or bronchi

• inflammation of various etiologies in the lungs and bronchi;
• pleural pathology;
• systemic and allergic diseases (asthma);
• tumor processes in the lungs.

It is often possible to eliminate the main symptoms of these pathologies by temporarily “turning off” the receptors that provoke coughing as such. You can do this in two ways:

1. By suppressing the cough center in the medulla oblongata due to the effect on opiate receptors. Most often, it is resorted to in case of a painful cough with a complete absence of sputum in the bronchi.

The use of antitussive drugs can reduce the sensitivity of receptors that cause a sharp cough

1. By suppressing the cough reflex directly in the respiratory organs, where specific receptors are also located. This method is used mainly in the absence of thick sputum.

In the presence of thick sputum, antitussives are used only as a last resort to temporarily improve the patient's condition. Usually they are recommended to drink at night, so that the rest is better. They work within 4-6 hours.

It is strictly contraindicated to use such drugs with a dry cough in conjunction with sputum thinners. This can negatively affect the treatment, increasing its duration.

Do not use antitussive drugs uncontrollably, especially together with mucolytics and other sputum-thinning drugs

Classification of drugs against dry cough

According to the method of action on individual receptors, a classification of antitussive drugs has been formed. The first group includes drugs of central action, and the second - peripheral. Such, despite some difference in the area of ​​​​impact, lead to one result - the cessation of coughing. It is recommended to take them in different cases, as they have different strengths and can have serious contraindications and side effects.

Centrally acting drugs

According to doctors, centrally acting drugs are more effective in eliminating the cough itself. They are prescribed for severe paroxysmal cough in adults and children. The classification divides them into two broad groups: narcotic and non-narcotic. They act on the cough center in the medulla oblongata, but through different receptors.

Dry cough often causes pain in the lungs, so it requires specific treatment.

You can learn about the features of such drugs from the table:

The dosage of centrally acting drugs for coughing for a child and an adult is calculated individually. They must be taken in strict accordance with the scheme proposed by the doctor - this will help to avoid undesirable effects, which such drugs have a lot of.

Any medicine of central action is prescribed by a doctor. In pharmacies, they can only be purchased with a prescription, as they are considered potentially hazardous to human health.

The dosage of medicines should always be prescribed only by a doctor.

Peripherally acting drugs

Peripheral cough medicines act directly on receptors in the airways. Most of them have a local anesthetic and bronchodilator effect. Unlike agents with the ability to influence the center of respiration, they are less effective. Therefore, their main purpose is to eliminate systematic unproductive coughing or straining dry cough.

The main components of such drugs are:

• prenoxdiazine - a substance with a local anesthetic and bronchodilator effect;
• levodropropizine - a compound that reduces the sensitivity of receptors in the respiratory tract;

Prenoxdiazine is an effective remedy often prescribed for dry cough

• tipepidine - a substance that reduces the sensitivity of receptors in the respiratory tract and partially in the respiratory center of the brain.

In a separate group, agents that affect the so-called cold receptors are allocated. For the most part, these are combined drugs with antihistamine, mucokinetic, antispasmodic, antibacterial and bronchodilator effects, which include:

• triprolidine;
• terpinhydrates;
• levomenthol;

Glycodin is effective for dry cough, it contains terpinhydrate and levomenthol

• biclotymol.

Which drugs with peripheral action are best taken in a particular case, the doctor decides. Most often, children and adults are prescribed Libeksin, Levopront or Helicidin. This takes into account exactly how the disease proceeds, the nature and frequency of coughing, the conditions under which it occurs. The dosage is also determined by the doctor.

The dosage form can also influence the choice of remedy. So, children are more likely to be prescribed drugs in the form of a syrup or mixture, while it is more convenient for adults to use prolonged-release tablets.

For children of preschool and primary school age, antitussive drugs are given more often in the form of syrups.

Regardless of the method of exposure to the body, any drug with an antitussive effect is contraindicated in case of hyperproductivity of the bronchial secretion, with pulmonary bleeding, including at an increased risk of their occurrence.

Contraindications to the use of antitussives

Antitussives, despite their benefits in certain diseases, have a lot of contraindications. That is why experts do not recommend using them without consulting a doctor, even if they are available without a prescription.

The most significant contraindications that apply to all categories of drugs with the ability to inhibit the cough reflex are:

• age - such drugs are strictly contraindicated for children under the age of 2 years;
• pregnancy, especially the first and last trimester, when vital organs and systems are formed in the fetus;
• lactation period, since the components of the drugs can penetrate into the milk and then enter the baby's body;
• severe obstructive pulmonary disease, accompanied by bleeding, as well as asthma;
• respiratory failure, in which the volume of breathing is reduced due to various reasons.

Do not use cough medicines for allergies without consulting a doctor

You should not use antitussive drugs and with allergies (intolerance or hypersensitivity) to individual components of the funds, including additional ones. In this regard, combined agents are considered more dangerous, since they contain an order of magnitude more components, each of which can provoke problems.

Before prescribing a medicine, an adult patient or a parent of a baby suffering from a cough should inform the doctor about all the underlying diseases, as well as about the drugs that are planned to be taken in conjunction with antitussives.

With the right approach to the choice of the drug, the accuracy of compliance with the therapeutic regimen depends on the effectiveness of the treatment. In this regard, a lot depends on the patient, his responsibility and ability to follow the recommendations given by the doctor.

How to properly treat a dry cough, you will learn from the following video: