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Antitussive therapy: a rational choice. Antitussives Centrally acting antitussives for children

Coughing is a protective reaction of the body that allows the removal of abnormal secretions from the respiratory system. This condition is a symptom of various pathologies. Therefore, only eliminating the provoking factor helps to get rid of the problem. Quite often, antitussives are used to combat the disorder. They should be selected by a doctor depending on the clinical picture of the pathology.

Mechanism of action

Antitussive drugs are used if coughing does not produce secretions or very little of them are released. In the second case, too much is observed. If a person suffers from it for a long time, the person cannot sleep and lead a normal life. Typically, this symptom is characteristic of the following anomalies:

lesions of the lungs and bronchi of various natures;
infectious pathologies;
systemic diseases;
bronchial asthma;
tumor lesions of the lungs.

To cope with the main manifestations of these ailments, you should temporarily turn off the receptors that provoke coughing. This can be achieved in various ways:

Reduce the activity of the cough center in the medulla oblongata due to its effect on opiate receptors. Typically, this method is used when a painful cough occurs against the background of a complete absence of secretions in the bronchi.
Eliminate the reflex directly in the respiratory organs, which also contain the corresponding receptors. This method is usually used in the absence of thick secretion.

When viscous sputum forms, it is permissible to use antitussive drugs only in extreme situations to temporarily improve the patient’s condition. As a rule, they are recommended to be taken before bed. This helps make your vacation better. The effect of such funds lasts 4-6 hours.

Combining such substances with medications to thin sputum is strictly prohibited. This complicates therapy and can cause dangerous consequences.

Classification of medications

The classification of such drugs is based on the method of action on receptors. Thus, there are drugs with central and peripheral effects. Despite certain differences, both types of drugs lead to the same result - they cope with cough. You need to take substances in different situations, since they have different effects.

Central acting agents

According to experts, these are the substances that are considered most effective. They are prescribed for intense coughing that occurs in attacks. Such drugs are divided into 2 large categories – narcotic and non-narcotic. Both groups of drugs affect the cough center in the medulla oblongata, but the effect is carried out through different receptors.

The dosage of drugs for adults and children is selected individually. They should be taken exactly as prescribed by your doctor. This will help avoid the negative side effects that such substances have.

Peripheral drugs

Such drugs affect receptors that are located directly in the respiratory tract. Typically, the drugs produce analgesic and bronchodilator effects. The main purpose of such drugs is to eliminate persistent non-productive coughing or dry cough.

Medicines in this category may include the following components:

Prenoxdiazine– this ingredient has a local anesthetic effect and has a bronchodilator effect.
Levodropropizine– the substance reduces the sensitivity of receptors in the respiratory organs.
Tipepidine– the ingredient helps reduce the sensitivity of receptors in the respiratory system. It also partially affects the respiratory center of the brain.

A special category includes substances that affect cold receptors. Such drugs are combination drugs. They can have a number of effects - antihistamine, bronchodilator, antibacterial, antispasmodic. Such substances contain the following ingredients:

levomenthol;
triprolidine;
biclotymol;
terpinhydrates.

The doctor should tell you which medications should be used. Common cough suppressants for children and adults include the following:

libexin,
helicidin,
left pront.

In this case, it is necessary to take into account the nature of the pathology, the frequency of cough and other factors.

The dosage form is of no small importance. Children are usually prescribed drugs in syrup form, while adults are more suitable for tablets that have a prolonged effect.

Regardless of the method of action on the human body, antitussive drugs are prohibited in case of excessive production of bronchial secretions. Contraindications also include pulmonary hemorrhages, including situations with an increased risk of their occurrence.

Review of effective cough medications

Antitussives should only be prescribed by a doctor. Typically, such drugs are used when a severe and frequent dry cough occurs.

Sinekod

This substance is included in the list of antitussives and acts directly on the cough center. The drug has expectorant characteristics and produces a moderate anti-inflammatory effect. The medicine is prescribed for acute dry cough of various etiologies.

The substance is prohibited for use during pregnancy and breastfeeding. Tablet forms are prohibited for children under 12 years of age. Side effects of the drug include nausea, bowel problems, allergies, and dizziness.

This drug belongs to the category of combined substances. It has antitussive, antimicrobial and expectorant properties. In addition, the herbal remedy perfectly relieves inflammation. The composition contains natural extracts - plantain and mallow. The substance helps relieve dry cough.

Contraindications include hypersensitivity to herbal ingredients and fructose intolerance. You should take the drug with great caution if you have diabetes.

Codelac phyto

This remedy is also a combination remedy. The composition contains codeine and plant extracts - licorice, thyme, thermopsis. The medicine has an expectorant effect.

Contraindications include asthma, children under 2 years of age, pregnancy and feeding. The substance is also prohibited for use in case of respiratory failure and intolerance to certain ingredients. Adverse reactions include allergies, headaches, and stool disorders. With prolonged use there is a risk of addiction to codeine.

Codeine

The product successfully copes with cough reflexes. Thanks to a single use of the substance, it is possible to get rid of attacks of dry cough for 5-6 hours. The drug inhibits the activity of the respiratory center, so it is prescribed quite rarely.

In addition, the substance reduces the rate of ventilation of the lungs and provokes other consequences - the development of dependence, drowsiness, constipation. When combined with alcoholic beverages, psychotropic substances and sleeping pills, it can lead to dangerous complications. The medicine should not be used by children under 2 years of age and pregnant women.

Glaucine

The substance is produced in various dosage forms - tablets, syrup, dragees. Thanks to the use of the product, it is possible to quickly make a non-productive cough moist. The drug is inexpensive, but can cause low blood pressure, allergies, weakness, and dizziness.

The substance is prohibited for use by people who have low blood pressure, a history of myocardial infarction and a tendency to allergic reactions.

Levopront

This is a fairly cheap, but at the same time very effective drug that can be used by adults and children. The substance is prescribed in the form of drops and syrup with a pleasant taste.

Sometimes a substance causes unwanted side effects. They manifest themselves in the form of stool disturbances, nausea, and drowsiness. There is also a risk of skin rashes, heartburn, and weakness. The substance cannot be used during pregnancy and lactation. Contraindications also include kidney failure.

The substance successfully copes with dry cough, helps reduce the symptoms of bronchospasm and has a local analgesic effect. The drug helps eliminate dry cough for 4 hours.

The medicine is used for viral infections, asthma, pneumonia. However, it can lead to undesirable consequences, which manifest themselves in the form of nausea, dry mouth, digestive disorders, and allergies.

Bronholitin

This drug has a combined effect and is considered one of the most popular remedies. The active components of the drug include ephedrine and glaucine. Thanks to their action, it is possible to make a dry cough less painful and painful. Due to the use of the drug, the symptoms of inflammation and bronchospasm are reduced, and the patient’s condition is significantly improved.

Contraindications to the use of antitussives

Despite the high effectiveness of antitussive drugs, they have many contraindications. Therefore, it is strictly forbidden to use them without consulting a doctor. Common restrictions on the use of such drugs include the following:

Age– Antitussive medications are usually not prescribed to children under 2 years of age.
Pregnancy– It is very harmful to take such drugs at the initial stage and in the last trimester.
Lactation– the ingredients of the products can penetrate into the milk, causing harm to the baby’s body.
Complex obstructive pulmonary lesions that are characterized by bleeding. Contraindications also include bronchial asthma.
Respiratory failure– in this case, due to various reasons, the volume of breathing decreases.

Do not use antitussive substances if you have allergic reactions to the components of the drugs. Combination medications are especially dangerous in this regard, as they contain quite a few ingredients.

Before starting treatment, the patient must notify the doctor about the presence of systemic pathologies. Of no small importance are drugs whose use is planned to be combined with antitussives. The effectiveness of therapy depends on the correct choice of medication and compliance with medical recommendations.

The medications described are highly effective and allow you to cope with a painful cough. However, such drugs cause many adverse reactions and have many contraindications. Therefore, self-medication is strictly prohibited.

Cough blocking drugs are medications that suppress coughing by acting directly on the centers and receptors in the brain responsible for this reflex. Medicines of this type do not eliminate the main cause of the disease: their task is to suppress a painful, non-productive cough without expectoration.

Coughing is one of the body’s reflexes, which acts as a protective reaction of the body to the entry of foreign objects into the respiratory system or to the accumulation of mucus in them.

The cough center of the brain controls the process of this reflex. It receives information from conductors that are located in different areas: near the ears and nose, vocal cords, near the pericardium, in the areas of the larynx and pleura, as well as in the area of separation of the large bronchi and trachea.

For reference. The described spheres are united by the vagus nerve: it receives impulses from these receptors and then transmits them to a special part of the brain, which is called the cough center.

The location of this section is the medulla oblongata.

This department, receiving the necessary data, transmits impulses to the nerve fibers that control the muscles of the abdominal press, diaphragm and chest. When they contract, a reflex reaction appears - coughing.

To suppress the reaction, antitussive drugs are often prescribed to suppress the cough center.

Characteristics and names of antitussives

Antitussive drugs act either directly on the cough center or on receptors, helping to reduce their sensitivity. Such tablets or syrups do not affect the cause of the disease: their task is to relieve symptoms. This is especially true for non-productive coughs.

Cough suppressants are prescribed for dry cough caused by the following diseases:

tracheitis;

The following medications of this type are distinguished:

Antitussive tablets to suppress the reflex have the following actions:

thinning of mucus when coughing without expelling it;
activation of the ciliated epithelium;
antiviral effect;
stimulation of muscle contraction of the bronchi.

List of drugs

The category of antitussive medications includes the following:

Pay attention! Antitussive drugs can cause side effects such as addiction to the drug, drowsiness, decreased blood pressure, and nausea.

Prohibitions for use and precautions

Taking medications that block the cough center or the nerve endings that transmit impulses to it, contraindicated for:

severe dysfunctions of the respiratory system;
intolerance by the body to the active elements of the drug;
periods of gestation and breastfeeding;
asthma.

For children

Children are prescribed only those medications that are as safe as possible for their health. These include the following.

Cough is a protective reflex. This is a kind of forced exhalation, accompanied by sound. In the process of coughing, the respiratory tract is cleared of dust, mucus and irritating particles.

The likelihood of contracting a disease accompanied by tickling increases for children aged 2-5 years. During this period, children have more contact with the outside world, exchanging bacteria and viruses. Treatment of children's cough should be prescribed only by a doctor after examination. It is quite difficult to choose the right medications on your own.

All medications for cough treatment are divided into two types:

expectorants;
antitussives.

The latter are grouped according to the principle of operation into three types: central, peripheral and combined action.

Non-narcotic drugs of central action

Medicines that have a non-narcotic central effect work selectively. They suppress the cough reflex, but do not have a detrimental effect on the respiratory center.

Medicines are often supplemented with other properties: anti-inflammatory, bronchodilator and expectorant. Active components of drugs with non-narcotic central action: glaucine, butamirate, ledin, pentoxyverine.

Narcotics of central action

Centrally acting narcotic drugs increase the cough threshold. At the same time, they affect the respiratory center, suppressing it.

Such drugs are rarely prescribed to children because they have a lot of side effects.. The active ingredients of the drugs are: codeine, dextrometrophan, ethylmorphine.

Peripheral drugs

The peripheral action of medications is directed to the mucous membrane of the respiratory tract. The medications have an anesthetic effect, which suppresses irritation and relieves coughing.

The advantage of such drugs is that they eliminate spasms, relax muscles and have anti-inflammatory activity. The active ingredients of the drugs are: levodopropizine, prenoxdiazine, bithiodine, benpropyrine.

Combination drugs

Combined medications, along with an antitussive effect, have an enveloping, local anesthetic, and softening effect. Medicines contain several active components that complement each other.

Indications for use

Antitussive drugs for children are prescribed taking into account the age of the child, the clinical picture of the disease and based on the results of laboratory diagnostics.

The main indication for the use of these medications is dry cough. It can occur due to irritation of the larynx by viral or bacterial infections (tonsillitis, pharyngitis, laryngitis). Such medications are also used for dry coughs of other origins: allergic or psychosomatic.

Antitussive medications show high effectiveness against whooping cough.
They are used after surgical or diagnostic interventions.
Drugs are prescribed for children after bronchoscopy.
They can be recommended for the complex treatment of pneumonia, bronchitis, and chest trauma.

The pharmacological market offers consumers a variety of products. They are available in the form of suspensions, drops, tablets, and inhalants. For young children, it is advisable to recommend liquid substances.

Older children can be given tablets or capsules for convenience. When choosing a medicine, you need to carefully read the instructions for use. The annotation indicates age restrictions, additional contraindications and quantities for use.

Children under one year old

Antitussives for young children and infants are recommended for cautious use. In some cases, it is difficult even for a doctor to understand the nature of the baby’s cough.

A feature of the respiratory system of children in the first 6 months of life is that they have a weak cough reflex, which leads to the accumulation of sputum in the bronchi and difficulty breathing.

Sinekod in the form of drops is used in children from 2 months. Up to a year, the medicine is prescribed in a dosage of 10 drops with a break of 6 hours. The medication may cause nausea and vomiting in the child.
Panatus syrup is used after 6 months. Children are prescribed a dosage of 2.5 ml in 4 divided doses. The medication should be used only as prescribed by a doctor.
Stoptussin drops are prescribed to children of the first year of life. Prohibited for use in infants whose weight does not reach 7 kg. The medicine is given 4 times a day, 8-9 drops. It is important to pay attention to the manufacturer when purchasing this medicine. The Czech remedy is not suitable for children of the first year of life.

A common side effect of treatment for young children is an allergic reaction. If parents notice unusual warning signs, discontinue the medication and seek medical attention.

How to recognize an allergic cough in a child and how it differs from any other -.

From 1 to 4 years

Antitussive drugs for children with a dry cough can be used the same as for younger children. It is only necessary to increase the dosage according to the age of the small patient. Also, after a year, additional compounds may be prescribed. After 3 years, the list of permitted medications expands further.

Sinekod drops are used from a year on 15 pieces up to 4 times a day. The syrup is approved for use from 3 years of age and is given three times a day, 5 ml.
Codelac Neo in syrup form is prescribed to children over 3 years of age. A single dosage is 5 ml. The daily volume should not exceed 15 ml.
Panatus syrup has been used since one year in a volume of 5 ml three times a day. It is better to give medicine to your child before meals.
Broncholitin syrup prescribed to children from 3 years of age in a single dose of 5 ml. It is important to note that this medicine contains ethanol. In addition to the antitussive effect, it has an expectorant effect.
Glycodin syrup is an old and proven remedy. Can be used for up to 3 years only as prescribed by a doctor.

Using large doses of medication that exceed those recommended by the instructions may cause nausea and vomiting. If your health worsens or there is no effect, you should consult a doctor to clarify the diagnosis.

What can you do after 5 years?

Many medications have an age limit of up to 6 years. Antitussives for children with dry cough, described earlier, can be used at 5 years of age. To correctly determine the single and daily dose, you must carefully read the instructions.

Doctors allow children over 5 years old to give drops, syrups or tablets.

Sinekod syrup is prescribed in 10 ml doses three times a day. Drops are used 25 pieces three times.
Codelac NEO is prescribed to children from 6 years old, 10 ml in the morning, evening and lunch. After 12 years, it is necessary to increase the single dose to 15 ml.
Panatus tablets are suitable for children from 6 years of age. Take one capsule in the morning and evening.
Alex Plus in lozenges is prescribed 1 dose up to 4 times a day. For children over 7 years old, the single dose can be increased to 2 lozenges.
Libexin tablets can only be used as prescribed by a doctor. A single dose varies from a quarter to half a pill, depending on the child’s body weight.
Sedotussin is used for children over 4 years of age, 15 mg of active ingredient. The medicine is available in the form of syrup and rectal suppositories.
Codelac based on codeine is used for children in an individual dosage prescribed by a doctor. This medication can only be purchased with a special prescription.
Tuseprex tablets are used for children over 15 years of age. A single dose of the drug is 10 mg, and a daily dose is 40.
Rengalin is taken one tablet separately from food. The medicine has unproven effectiveness.
Falimint is a tablet for topical use. Taken as needed, but no more than 10 per day.

Children 4-5 years old should not be given medications in tablet form simply because they will not be able to take the medication without first crushing it.

Herbal remedies

Many parents prefer to replace synthetic drugs with herbal remedies.

Gerbion syrup is actively used to treat dry cough. It does not affect the respiratory center and does not increase the cough threshold. Has a pronounced anti-inflammatory and calming effect.

Herbs are also very popular in the treatment of dry cough in children. Decoctions prepared from them are used for gargling and drinking.

The following have an antitussive effect:

plantain;
ginger;
chamomile;
sage;
breast fees;
licorice.

The effectiveness of non-standard treatment will be higher if it is started earlier. It is almost impossible to achieve an antitussive effect in case of prolonged or chronic cough with herbal preparations.

The use of herbs, despite their supposed safety, should also be agreed with a doctor. Many formulations are allergens and are not suitable for children under 3-5 years of age.

Prescribed treatment with antitussive medications cannot be replaced with traditional recipes.

Contraindications

It is forbidden to give children narcotic antitussives on their own. Such drugs can cause respiratory depression, which can have unpleasant consequences.

Antitussive medications for children with a wet cough are strictly prohibited. The main purpose of medications is to stop the cough reflex and alleviate the child’s condition.

If the cough is caused by the accumulation of phlegm in the bronchi, then the thick mucus must be thinned and then removed. By giving the child an antitussive, parents muffle the manifestations of the disease. As a result, complications may arise.

Antitussives are also contraindicated for children who are hypersensitive to a particular type of medication. Ignoring this condition leads to the development of an allergic reaction of varying intensity.

When prescribing a medicine for dry cough to a small patient, the doctor always gives individual recommendations and advice. Children should be offered antitussive formulations half an hour before meals.

Compliance with this condition will allow you to obtain the maximum therapeutic effect. The exception is for drugs that have an individual pattern of use.

Correct environmental conditions should also be maintained. The air in the room should be cool and humid.

Following the doctor's advice and strictly observing the rules for using medications will help cure a child's dry cough in the shortest possible time and at minimal cost.

Cough treatment, antitussives

Cough is a complex reflex reaction of the airways, the main function of which is to restore their normal patency.
The occurrence of a cough can be caused by irritation of the cough receptors of the nose, ears, posterior wall of the pharynx, trachea, bronchi, pleura, diaphragm, pericardium, esophagus. External and internal factors (foreign bodies, cold and dry air, aeropollutants, tobacco smoke, nasal mucus, sputum, inflammation of the mucous membranes of the respiratory tract, etc.) excite cough receptors, which are divided into irritant, quickly responding to mechanical, thermal, chemical irritants, and C-receptors, predominantly stimulated by inflammatory mediators (prostaglandins, kinins, substance P, etc.). The resulting impulse is transmitted through the afferent fibers of the vagus nerve to the cough center located in the medulla oblongata. The reflex arc is closed by the efferent fibers of the vagus, phrenic and spinal nerves going to the muscles of the chest, diaphragm and abdominals, the contraction of which leads to the closure of the glottis, followed by its opening and expulsion at high air speed, which is manifested by a cough.
In addition, cough can be caused or suppressed voluntarily, since the formation of the cough reflex is under the control of the cerebral cortex.
Cough is classified by nature (non-productive, or dry, and productive, or wet cough), by intensity (coughing, mild and severe cough), by duration (episodic, paroxysmal and persistent cough), by course (acute - up to 3 weeks, prolonged - more than 3 weeks and chronic - 3 months or more).
In some cases, cough loses its physiological purpose and not only does not contribute to the resolution of the pathological process in the respiratory system, but also leads to the development of complications.
The reflex arc of the cough reflex includes receptors, the cough center, afferent and efferent nerve fibers, and the executive link - the respiratory muscles. Cough is most effectively suppressed at two levels - the receptor level and the level of the cough center. In this regard, antitussive drugs are divided into 2 groups: central and peripheral action. In turn, centrally acting drugs can be divided into narcotic and non-narcotic drugs.

Mechanism of action and pharmacological effects Centrally acting narcotic antitussives
These include morphine-like compounds such as codeine, ethylmorphine and dextromethorphan, which suppress the function of the cough center of the medulla oblongata. The most well-known narcotic antitussive drug is codeine, which is a natural narcotic analgesic from the group of opiate receptor agonists. Medicines from the codeine group are very effective, but have significant drawbacks. Their antitussive effect is not selective; they simultaneously depress the respiratory center. Dextromethorphan is a synthetic antitussive drug, similar in chemical structure and activity to opiates ( codeine); has a central effect, increasing the cough threshold.

Non-narcotic antitussive drugs of central action
These include oxeladine, butamirate, glaucine, pentoxyverine, ledin and pholcodine, which have a selective central effect. They partially suppress the cough center without exerting a pronounced inhibitory effect on the respiratory center. Not inferior in potency to codeine, they do not cause addiction or addiction, do not depress breathing and do not affect intestinal motility (do not cause constipation). Some antitussive drugs have additional effects that improve their effect. Thus, oxeladine, butamirate and ledin are characterized by some bronchodilator action. Butamirate also has expectorant and anti-inflammatory effects.

Non-narcotic antitussive drugs of peripheral action
This group of drugs includes prenoxdiazine, levodopropizine, benpropyrine and bithiodine, which affect the afferent component of the cough reflex, acting on the mucous membrane of the respiratory tract as an anesthetic and reducing reflex stimulation of the cough reflex. In addition, they have a local anti-inflammatory effect and help relax the smooth muscles of the bronchi.

Enveloping drugs also refer to peripheral antitussive drugs of afferent action. Their action is based on creating a protective layer on the mucous membrane of the nasopharynx and oropharynx. They are oral tablets or syrups and teas containing plant extracts of eucalyptus, acacia, licorice, wild cherry, linden, etc., glycerin, honey, etc.
One of the ways to influence the afferent part of the reflex arc is also the use of aerosols and steam inhalations to moisturize the mucous membranes of the respiratory tract. Steam inhalation, alone or with the addition of sodium chloride or herbal decoctions or extracts, is the most accessible method of hydration. Along with inhalations, drinking plenty of fluids can be used.
Antitussive drugs with local anesthetic activity reduce the feeling of soreness and irritation in the throat, reduce sensitivity to various irritating factors, weakening the cough reflex. The drugs are used in the form of medicines for resorption in the oral cavity.
Local anesthetics (benzocaine, cycline, tetracaine) are also drugs with afferent action, but are used only in a hospital setting for special indications.

Pharmacokinetics
Most drugs are well absorbed after oral administration. The maximum concentration in the blood plasma of codeine is achieved after 1 hour, butamirate citrate - after 1.5 hours. In the latter case, it is 6.4 μg/ml, protein binding is 95%. Both drugs undergo biotransformation in the liver and are almost completely excreted in the urine in the form of metabolites and unchanged. T1/2 of codeine - 3-4 hours, butamirate citrate - 6 hours. The pharmacokinetics of most other drugs and their components have not been studied.

Tactics for choosing medications for cough
If the reason for prescribing medications is the cough itself, it is better to use medications that act on the specific cause of the cough for this case. Antitussive drugs are symptomatic therapy. To relieve cough associated with acute respiratory infections, moisturizing inhalations and drugs with enveloping peripheral action or their combination with non-narcotic drugs of central action such as prenoxdiazine are indicated. In the presence of sputum, it is advisable to prescribe expectorants or mucolytics. When a patient coughs with symptoms of bronchospasm, along with hydration, it is advisable to prescribe bronchodilators and anti-inflammatory drugs, however, narcotic antitussive drugs and mucolytics, with the exception of bromhexine and ambroxol, are contraindicated. For targeted suppression of non-productive cough caused by irritation of the mucous membrane of the respiratory tract (for example, with whooping cough), in children it is possible to use antitussive non-narcotic drugs of central action.

Place in therapy
Antitussive drugs are used to suppress frequent dry coughs that disturb the patient's condition. For coughs associated with irritation of the upper respiratory tract, the use of antitussive drugs with local anesthetic activity is indicated. They are drugs for symptomatic therapy in the treatment of inflammatory processes in the pharynx (sore throat, pharyngitis) and larynx (laryngitis). Actually, local anesthetics are used for afferent inhibition of the cough reflex during bronchoscopy or bronchography.

Contraindications and precautions
Prescribing antitussive drugs to a patient with a wet cough leads to stagnation of sputum in the respiratory tract, which worsens bronchial obstruction and can contribute to the development of pneumonia. Narcotic antitussives may cause respiratory depression.

Literature

Belousov Yu.B., Moiseev V.S., Lepakhin V.K. Clinical pharmacology and pharmacotherapy. M., 1997; 530.
Danilyak I.G. Cough: Etiology, pathophysiology, diagnosis, treatment. Pulmonology. 2001; 3:33-7.
Clinical pharmacology. Ed. V.G. Kukesa. M., 1991.
Lekmanov A. Cough: if treated, then with what? Materials of the VII Russian National Congress "Man and Medicine". Educational news. 2001; 19.
Rational pharmacotherapy of respiratory diseases: Hand. for practicing doctors / A.G. Chuchalin, S.N. Avdeev, V.V. Arkhipov, S.L. Babak et al.; Under the general editorship. A.G.Chuchalina. - M.: Litterra, 2004. - 874 p. - (Rational pharmacotherapy: Series of manuals for practicing physicians; T.5).
Samsygina G.A. Antitussive drugs in pediatrics. Consilium medi- sit. 2001; 2: 18-22.
Chuchalin A.G., Abrosimov V.N. Cough. Ryazan, 2000.

Cough is a defense reaction of the human body. It helps cleanse the mucous membranes of the respiratory tract from sputum, dust, and pathogenic microorganisms.

There are two types of cough: wet and dry. The first is accompanied by the discharge of mucus. The microorganisms contained in it are removed from the respiratory tract, making the recovery period easier and faster. In the second type, there is no discharge of mucus. Most often it does not bring relief, debilitating attacks. It also contributes to severe irritation of the respiratory tract, causing chest pain, and sometimes even damage to mucosal tissue.

Dry cough in adults

Signs that usually accompany the pathological condition:

runny nose;
nausea, vomiting;
enlarged lymph nodes;
body aches;
increase in temperature;
drowsiness;
hoarse voice;
loss of appetite;
change in stool character;
periodontal disease;
frequent urination;
swelling;
tachycardia;
sensation of a “lump” when swallowing;
dyspnea.

Any cough that lasts more than 2 weeks and is accompanied by acute symptoms becomes a reason to consult a pulmonologist. The specialist will conduct a series of tests that will allow you to make the correct diagnosis. Pharmaceutical companies produce a variety of medicines sold in different forms (syrups, cough tablets, drops, mixtures). Only a doctor should select the appropriate medicine.

Features of dry cough

There are 3 types of non-productive cough:

Deaf. A possible sign of the formation of a lung tumor or the initial stage of tuberculosis.
Barking. It becomes a consequence of a viral disease that damages the vocal cords.
Nasadny. It is most often diagnosed in children with whooping cough.

Depending on the duration, it may be:

acute - up to 3 weeks;
chronic - more than 2 months.

In 10-40% of cases of visiting a doctor, the occurrence of a dry barking cough is the patient’s only complaint.

Reasons for appearance

The problem usually occurs due to external conditions or infection.

Main development factors:

smoking;
neuralgia;
sinusitis;
sinusitis;
aortic aneurysm;
lupus erythematosus;
dust, allergens;
dry indoor air;
pleurisy;
whooping cough and measles;
gastric reflux;
chlamydia, mycoplasmosis;
laryngitis;
tracheitis;
helminthic infestation.

The main reason for the problem is that the respiratory organs are not able to get rid of the irritating factor on their own. If the process lasts for a long time, a person may experience deformation of the walls of the bronchial tubes, which will become a provoking factor for the development of asthma, lung abscess, and pneumonia. Therefore, it is better to treat a dry cough immediately after its appearance, following all the advice of a specialist.

Types of medicines for dry cough

Dry cough tablets are a separate pharmaceutical group of medications designed to mitigate and eliminate the pathological process. The choice of treatment tactics should be entrusted to the doctor, who, after performing diagnostic procedures, will determine the possible cause of the problem and select the best medications.

Therapy drugs are divided into three options:

Antitussives (Omnitus, Libexin, Terpinkod). Drugs in this group successfully block seizures. The mechanism of action is aimed at suppressing a certain part of the brain responsible for the formation of the cough reflex. Prescribed only for coughs with no sputum. The list of medications is very long. They are divided into two subspecies:

Drugs with narcotic influence. They dull a special center in the central nervous system and block a dry cough. Their danger lies in the risk of addiction and drug dependence. Indications for use are severe headaches, as well as paroxysmal cough without mucus secretion.
Medicines without narcotic influence. They are not addictive or dependent. They create an antitussive effect, lower blood pressure, and relieve spasms from the bronchi.

Mucolytic (Ambroxol, Bromhexine, Lazolvan). These remedies are very effective. Mucolytics anesthetize, block cough receptors in the central nervous system, and relieve bronchospasms.

Combined (Stoptussin, Codelac, Halixol, Lorraine, Bronchicum). The ingredients in their composition have expectorant, bronchodilator, and mild anti-inflammatory effects.

Patients suffering from smoker's dry cough need to give up the bad habit at least for the period of illness, as it increases the unpleasant symptoms. It is also necessary to use medications that help expand the airways.

Antitussive tablets

Terpincode.

It has a noticeable anti-inflammatory effect, reduces the number of attacks, as well as their severity. Restores irritated larynx, improves expectoration, reducing the thickness and viscosity of sputum.

The medicine is effective for bronchitis, tracheitis, pneumonia and other colds of the respiratory system.

Do not use for gastric ulcers, diarrhea, lactose deficiency, bronchial asthma and hypersensitivity to the composition of the drug. Prohibited for children under 12 years of age.

Prescribe 1 tablet about 3 times a day, for a course of up to 5 days.

Omnitus.

Stops the problem by acting on a specific area of the central nervous system. Does not inhibit respiratory function, does not lead to gastrointestinal irritation. Has an anti-inflammatory effect.

Indicated for cough of any etiology.

Omnitus is not prescribed for allergies, pregnancy and lactation. The age limit is also up to 6 years.

Apply 1-2 pieces 2-3 times a day for about 4-5 days.

Libexin.

The drug blocks the cough reflex, relieves spasm of the bronchi, and has a slight anesthetic effect.

Indicated for lesions of the upper and lower respiratory tract.

Libexin should not be used if you are hypersensitive to the components of the drug or have lactose intolerance. The medicine is also prohibited for pathologies accompanied by strong sputum production.

Prescribe 1 tablet 3 times. per day. The doctor selects the required period of treatment.

Mucolytic drugs

Ambroxol.

Causes a noticeable expectorant effect. It cleanses the bronchi well, thinning mucus and improving its secretion.

Indications for the use of Ambroxol are infectious diseases of the respiratory system, as well as cystic fibrosis.

Contraindicated during pregnancy, with ulcerative lesions of the gastrointestinal tract, convulsions of any origin, or allergies to Ambroxol.

It must be taken according to a certain scheme:

3 days, 1 piece three times a day;
then the dosage can be reduced to 2 pieces per 24 hours;
the entire therapeutic course lasts from 5 days to 2 weeks.

The duration of treatment depends on: the course of the pathological process; the stage at which therapy was prescribed; concomitant diseases - and is determined by the doctor.

Bromhexine.

It has a noticeable mucolytic effect, thinning the mucus that accumulates in the trachea, bronchi, nasopharynx and larynx.

Bromhexine is contraindicated in early pregnancy, in case of personal intolerance to the ingredients of the drug, renal or liver failure

Bromhexine is prescribed, according to the instructions, 1-2 pieces three times within 24 hours. The duration of use varies depending on the severity of the symptoms of the disease.

Lazolvan.

The main active substance ambroxol increases the content of mucus in the bronchi and removes it from there. Lazolvan also affects the formation of surfactant in the lungs, which promotes the expansion of alveoli.

Indications for use are bronchitis, pneumonia, COPD, bronchial asthma.

Taking Lazolvan is prohibited in the first 12 weeks of pregnancy if you are allergic to the components of the medication. The specialist prescribes the medicine with caution during lactation, as well as in patients with liver and kidney damage.

Combined products

Stoptussin.

Stoptussin is a combined drug that has an expectorant effect. The main components of the medicine are butamirate and guaifenesin. The first has an analgesic effect on the membranes of the bronchi, and the second thins the mucus, making it less thick and facilitating its better discharge.

Stoptussin is prescribed for dry coughs of various origins.

Do not use if you have a personal intolerance to the ingredients in the medicine. Also, the drug is not prescribed to children under 12 years of age, pregnant women (in the first three months) and lactating women. The dose of the medicine must be calculated taking into account the weight:

up to 50 kg - 0.5 tablets 4 times every 24 hours;
51-70 kg - 1 piece 3 times a day;
71-90 kg - 1.5 tablets three times a day;
from 90 kg - 1.5 pieces 4 times a day.

Halixol.

This is an expectorant, the main substance of which is ambroxol, which thins sputum. It reduces its viscosity and adhesive properties.

Halixol is prescribed for various respiratory diseases. This could be asthma, pneumonia, COPD, bronchitis.

The remedy is not recommended if you have an ulcer, in the first three months of pregnancy, or if you are allergic to the components of the medicine. It is prescribed with caution to persons with insufficient bronchial motility or with sputum that is not very viscous, because stagnation of mucus in the bronchi may occur. Since Halixol contains sweeteners, patients with diabetes should take it only after consulting a doctor.

Prescribe 1 tablet three times a day for two days. Then they continue the course, also 1 piece, but twice a day.

Lorraine.

A combined product whose effect is determined by the ingredients it contains. Paracetamol has anti-inflammatory, analgesic and antipyretic effects. Phenylephrine - constricts the arterioles, reducing swelling of the nasal mucosa and the amount of mucus discharge. Chlorphenamine works as an antihistamine.

The use of the drug is prohibited in case of individual sensitivity to the ingredients of the product, diseases of the blood, liver and kidneys, high blood pressure, thyrotoxicosis, glaucoma, prostate adenoma, diabetes mellitus, nephritis.

Lorraine is taken for a week, 2 pieces up to 6 times a day.

Bronchicum.

The product effectively stimulates the thinning of mucus and facilitates its discharge. Relieves swelling of the bronchial mucosa, significantly softening coughing attacks.

Prescribed for bronchitis, acute respiratory viral infections, acute respiratory infections, and influenza.

Do not use for kidney and liver diseases, problems with the absorption of fructose, during pregnancy, lactation, as well as in case of an allergic reaction to one or more components of Bronchicum.

All tablets for dry cough for adults are quite affordable and effective if used correctly. Which of them are suitable and will help quickly, only the doctor should decide. You should carefully follow the instructions for use of the drugs, avoid taking antitussive and mucolytic tablets at the same time. It is not recommended to use drugs for longer than the period recommended by the instructions or the doctor. If there is no therapeutic effect from the use of the drug, it is better to stop using it and, after consulting a doctor, change the tablets.

Attacks of the cough reflex can be caused by various reasons. Therefore, competent diagnosis and properly selected treatment are very important. Therapeutic procedures for dry cough should be aimed at alleviating symptoms and eliminating the disease that provoked cough attacks.

Sometimes the onset of a pathological process is a consequence of irritation of the pleura or larynx. The cough is very painful, there is a danger of complications: pneumothorax or subcutaneous emphysema - conditions when air penetrates into the pleural cavity or under the skin.

In addition to the basic medication treatment with the need to take pills, you need to drink enough fluids and control the humidity in the rooms. Mucolytic and expectorant drugs are used to liquefy and remove mucus. Mucolytics break the molecular bonds between the elements of mucus, reducing its viscosity. Expectorants increase the production of mucus in the bronchi. All of them are relatively inexpensive, but they do the job well. Dry cough therapy is performed on these principles.

Any illness can be prevented if the necessary preventive measures are taken in a timely manner. Personal hygiene, a balanced diet, avoiding drafts, hardening, sufficient physical activity - all this will help prevent many diseases that provoke a dry cough. And if it occurs, only careful diagnosis and timely treatment with well-chosen drugs will help you quickly get rid of a debilitating cough and avoid complications.