Medicinal and folk strong expectorant. Mucolytic agents What is a mucolytic cough suppressant

Cough is a symptom familiar to every person. We first encounter it in early childhood, cough often and thickly in kindergartens and continue to do this in elementary school. We drink a lot of tasty and not very expectorants in syrups, tablets and drops. Gradually the cough goes away, only to remind itself again after a while. Do we know why we cough? Do we know how to treat a cough correctly? And on what basis do we choose expectorants?

The modern pharmaceutical market sometimes amazes us with the variety of cough medications. A completely confused person can spend a long time looking at shop windows filled with expectorant variety. And take the first package you come across to finally dispel the pharmacy obsession.

Let's try to put all the expectorants on their shelves and clearly understand when, how much, and, most importantly, what exactly should be taken for a cough.

Before you continue reading: If you are looking for an effective method of getting rid of constant colds and diseases of the nose, throat, lungs, then be sure to look into section of the site "Book" after reading this article. This information is based on the author’s personal experience and has helped many people, we hope it will help you too. NOT advertising! So, now back to the article.

Main causes of cough

But before we do therapy, we need to understand why we cough. After all, sometimes a symptom requires medical intervention and urgent measures, and self-medication is dangerous.

So, coughing is a completely normal, physiological process that helps clear our airways of excessive secretions, foreign particles and, of course, germs. Frequent cough is almost always a symptom of the disease. It is completely wrong to believe that a cough is necessarily a cold. Reasons for such symptoms include:

• infections.
  Of course, in most cases, cough is the result of respiratory infections: ARVI, influenza, pneumonia, whooping cough, tuberculosis. Typically, an acute cough lasting less than three weeks is caused by a common cold;
• reactive respiratory diseases.
  Such pathologies include bronchial asthma, chronic obstructive pulmonary disease and chronic bronchitis, including smoker's bronchitis;
• gastroesophageal reflux.
  The backflow of hydrochloric acid into the esophagus is most often the cause of a cough of unknown origin;
• contaminated air;
• foreign body;
• taking antihypertensive drugs that block ACE (Enalapril, Ramipril and others);
• psychogenic factor;
• other factors, including tumors and severe respiratory disease.

Self-medication of cough: be careful!

You can treat a cough yourself by taking expectorants only in cases of infectious diseases. However, one cannot lose vigilance even with a seemingly innocent cough that accompanies ARVI.

Sometimes dangerous symptoms noticed in time save a life, so don’t relax and monitor your condition. Let's list the manifestations that require contacting a specialist.

If, against the background of a “cold” cough, there is a sharp deterioration- a severe fever has begun, weakness, sweating, and purulent thick sputum have appeared - call a doctor immediately!

If your cough has been bothering you for more than three weeks, urgently go to your local therapist!

If there are streaks of blood in your cough, you need immediate consultation with a pulmonologist!

We will return to cough, which can be treated on our own, and will deal with a detailed description of expectorants.

Why are expectorants needed?

If we say that coughing is a physiological reflex, then why are expectorants needed? Let's figure it out.

In a healthy person, the glands of the trachea and bronchi produce tracheobronchial secretion. It helps our respiratory tract cope with bacteria and viruses, and is also involved in the removal of small particles coming from the air. We don’t even notice how we swallow about 100 ml of this mucus per day.

If an infection has entered the body, the volume of tracheobronchial secretion can increase to 1.5 liters per day. Such sputum is an excellent substrate for the further prosperity of pathogenic microorganisms. The body tries with all its might to get rid of the pathological secretion, and a cough begins.

However, thick, difficult-to-clear mucus does not want to leave the respiratory tract. Liquefying viscous secretions is the main function of expectorants used to treat wet coughs.

Expectorants and antitussives: what is the difference?

If expectorants primarily help to dilute mucus and facilitate its removal, then antitussives act exactly the opposite. Most antitussives have a central effect and block the cough reflex. Antitussive drugs are prescribed only for dry, so-called “barking” cough, the main symptom of which is the complete absence of bronchial secretions.

Therefore, when treating a cough, it is important not to confuse the cards and not take medications for dry and wet coughs at the same time. Remember that expectorants based on ambroxol, carbocysteine ​​and acetylcysteine ​​should absolutely not be combined with centrally acting antitussives.

Classification of expectorants

There is no clear classification of expectorant drugs. Nevertheless, in pharmaceutical practice it is customary to distinguish:

• drugs that have an irritating effect: products based on medicinal plants;
• carriers of sulfhydryl groups: acetylcysteine, carbocysteine;
• vasicine derivatives: bromhexine, ambroxol;
• combined expectorants.

Expectorants: pharmacological action

Drugs that stimulate expectoration have many names. Secretolytics, expectorants, expectorants - all these terms combine the same drugs. The mechanism of action of expectorants may be different.

Irritant medications

Thus, some drugs promote irritation of receptors in the gastric mucosa, resulting in reflex stimulation of the bronchial glands and increased production of bronchial secretions. The sputum is liquefied and gradually eliminated. Expectorant irritants include most medicinal herbs: marshmallow root, thermopsis herb, terpin hydrate,

With acute respiratory infections, we often encounter such an unpleasant phenomenon as coughing. It can be exhausting and annoying, makes breathing difficult and significantly reduces the quality of life. It is very important for the doctor to determine what type of cough the patient has: dry or wet. The first type is considered unproductive and is characterized by difficulty in expelling sputum. is called productive and shortens the patient’s recovery time. Having discovered a dry type of cough in a patient, doctors often prescribe drugs that liquefy the viscous mucous secretion that forms in the respiratory organs. Due to the increased density of this mucus, the patient experiences difficulty with expectoration or expectoration.

What types of mucolytics are there?

To help a patient with a dry cough, the doctor usually prescribes mucolytics.

The list of drugs included in this group is quite extensive. Based on the way they affect the human body, these drugs can be divided into three groups:

• Mucoregulating substances. They influence the volume of mucous secretion released. This group includes glucocorticosteroids, M-anticholinergics and carbocysteine.
• Mucokinetics are drugs that significantly improve mucus discharge. These include ambroxol, bromhexine, etc.
• Directly mucolytics. These substances help to liquefy mucous secretions by reducing its viscosity. Mucolytics include proteolytic enzymes, acetylcysteine, etc.

Various mucus liquefaction mechanisms

If we consider the mechanism by which the molecules of acidic mucopolysaccharides of human mucous secretions can be destroyed with the help of drugs, then two main paths can be distinguished - the enzymatic method and the non-enzymatic path. In the first case, enzymes destroy protein bonds, and in the other, disulfide bridges in sputum molecules.

Classification according to the main active ingredient

All these drugs are combined under the international or ATS code R05CB “Mucolytics”. The list of main active ingredients also provides a certain letter and numerical designation:

• R05CB01 - acetylcysteine.
• R05CB02 - bromhexine.
• R05CB03 - carbocisteine.
• R05CB06 - ambroxol.
• R05CB10 - preparations with a combined composition.
• R05CB13 - Dornase alfa (deoxyribonuclease).

Only the attending physician decides which mucolytic drugs to prescribe to a particular patient.

He makes this appointment only after a thorough examination and guided by the results of relevant tests. Let's take a closer look at how each active substance included by pharmacists in group R05CB works.

Mucolytics with acetylcysteine

Acetylcysteine ​​effectively helps thin mucus, and therefore was included in the mucolytics group. The list of drugs with this active ingredient includes about two dozen names of drugs in various forms. Acetylcysteine ​​is characterized by the following mechanisms of action:

• It has reactive sulfhydryl groups in its molecule, which have a destructive effect on the disulfide compounds of mucopolysaccharides, due to which the mucus is characterized by increased viscosity. As a result, sputum thins out and is removed from the body more easily.
• This substance helps to reduce activity and reduces the number of pathogenic bacteria that are on the mucous membrane of the respiratory organs.
• It has antioxidant properties. Sulfhydryl groups react with free radicals and oxygen metabolites and remove them from the body. Thus, acetylcysteine ​​has an anti-inflammatory effect and rids the body of toxic substances, significantly alleviating the patient’s condition.

Among the drugs containing acetylcysteine ​​as an active substance, the following can be noted:

• "Mukobene" - tablets; 100, 200 or 600 mg.
• "Mukomist" - solution in ampoules, 20% for topical use and inhalation.
• "Mukonex" in the form of granules, 0.1 g for making syrup.
• "Fluimucil" in the form of granules, 100 and 200 mg; tablets for producing an effervescent drink, 600 mg.
• "ACC" in the form of tablets for the preparation of an effervescent drink - 100, 200, 600 mg; solution for injection 300 mg/3 ml in ampoules; granules for oral solution, 100, 200 mg.
• "Acetylcysteine" in powder form, 200 mg; solution for injection, 10%; solution for inhalation, 20%;
• "Acestin" - tablets for internal use, 100, 200, 600 mg; tablets for producing an effervescent drink, 200 and 600 mg.

Acetylcysteine ​​and drugs containing it are contraindicated in children under 2 years of age (and some under 6 years of age), pregnant and lactating women, and people with gastrointestinal ulcers in the acute stage. Side effects may occur in the form of headache, stomatitis, drowsiness and tinnitus; gastrointestinal disorders, allergies, and tachycardia are less common. Acetylcysteine ​​should not be taken together with antitussive medications. It also enhances the effect of nitroglycerin and inhibits the absorption of antibiotics.

Mucolytics with bromhexine

Medicines containing this substance as an active component are quite often prescribed for coughs and are positioned as mucolytics. The list of drugs is limited to five pharmaceutical products. Once in the human body, bromhexine acts as follows:

• reduces the viscosity of bronchial secretions by depolarizing mucus polysaccharides;
• stimulates the cells of the bronchial mucosa, which secrete neutral polysaccharides;
• promotes the formation of surfactant;
• produces an expectorant effect;
• inhibits the cough reflex.

Mucolytic drugs, the list of which is given below, contain bromhexine as the main active ingredient.

These include:

• "Solvin" - solution for internal use, 4 mg/5 ml; tablets for oral use, 8 mg.
• "Bromhexine" in the form of a solution, 4 mg/5 ml; syrup, 4 mg/5 ml; tablets, 8 mg.

Mucolytic drugs containing bromhexine are contraindicated in persons with individual intolerance to this component, as well as in children under 6 years of age. They can cause digestive disorders, headaches, increased sweating, skin rashes and bronchospasm. Pregnant and lactating women are prescribed medications containing bromhexine extremely rarely.

Preparations with carbocisteine

This medicinal substance is also included in the “Mucolytics” group. The list of drugs with carbocisteine ​​includes about ten items, but they all have the same pharmaceutical effect:

• reduce the content of neutral glycopeptides and increase the production of acidic glycopeptides, normalizing their proportion;
• reduce viscosity and regulate the elasticity of sputum;
• regenerate the mucous membrane of the respiratory organs and restore its normal structure;
• increase the local specific resistance factor lgA;
• normalize the release of sulfigryl groups;
• activate the activity of the ciliated epithelium of the bronchi.

Quite often, patients are prescribed just such mucolytics.

The list of medicines and drugs containing carbocysteine ​​is given below:

• "Libexin Muco" in the form of syrup, 50 mg/ml.
• "Mukodin" in capsule form, 125 mg; syrup for children 125 mg/5 ml and 250 mg/5 ml.
• "Carbocisteine" in the form of syrup 250 mg/5 ml and 125 mg/5 ml (for children); capsules, 375 mg.
• "Fluifort" in the form of granules for suspension, 2.7 mg; syrup, 90 mg/l; syrup 2% (for children) and 5%.

Carbocysteine ​​mucolytics, drugs and preparations described above cannot be taken if you are allergic to the main component, as well as with peptic ulcers, impaired normal functioning of the kidneys, acute glomerulonephritis, cystitis, pregnancy and breastfeeding. Drugs in capsule form are contraindicated for children under 12 years of age, and in syrup form for children under 2 years of age. Mucolytic cough preparations based on carbocisteine ​​can cause digestive disorders and allergic manifestations.

Medicines with ambroxol

These drugs are the most popular among patients. Ambroxol has the following effects on the human body:

• reduces the viscosity and adhesion of sputum;
• facilitates the removal of mucus from the respiratory tract;
• activates the work of serous cells of the glandular tissue of the bronchial mucosa;
• stimulates the production of enzymes that destroy the structure of sputum polysaccharides;
• actively promotes surfactant production;
• stimulates the work of bronchial cilia and prevents them from sticking together.

Due to the presence of these factors of action of ambrocol, it was included in the “Mucolytics” group.

The list of medications containing this component is very extensive. Here are the most common drugs containing ambroxol:

• "Lazolvan" - lozenges, 20 mg; lozenges, 15 mg; solution, 7.5 mg/ml; syrup 15 and 30 mg/5 ml; tablets, 30 mg.
• "Halixol" - in the form of syrup, 30 mg/10 ml and tablets, 30 mg.
• "Medox" - in the form of syrup, 15 mg/5 ml and tablets, 30 mg.
• "Deflegmin" - in the form of drops for oral administration, 0.75% and tablets, 30 mg;
• "Suprima-coff" - in tablet form, 30 mg.
• "Mukobron" - in the form of tablets, 30 mg.
• "Bronkhovern Drops" - solution for internal use, 7.5 mg/ml.
• "Ambrobene" - in capsule form, 75 mg; solution for injection, 7.5 mg/ml; syrup, 15 mg/5 ml; tablets, 30 mg.
• "Ambrohexal" - in the form of capsules, 75 mg; solution for inhalation and oral administration, 7.5 mg/ml; syrup 3 and 6 mg/ml and tablets, 30 mg.
• "Ambroxol" - in the form of syrup, 3 and 6 mg/ml; tablets, 30 mg and capsules, 75 mg.
• "Ambrolap" - in the form of capsules, 75 mg; syrup, 15 mg/5 ml; tablets, 30 mg; solution for internal use and for inhalation, 7.5 mg/ml.
• "Ambrosan" - in tablet form, 30 mg.
• "Ambrosol" - in the form of syrup 0.3 and 0.6 g/100 ml.
• "Remebrox" - in the form of syrup 30 mg/5 ml.
• "Ambrotard 75" - in the form of capsules, 75 mg.
• "Flavamed" - in the form of an oral solution, 15 mg/5 ml and tablets, 30 mg.
• "Bronchoval" - tablets, 30 mg; syrup, 15 mg/5 ml.

Depending on the form of release of the drug, there are contraindications to taking medications based on ambroxol. Such mucolytic drugs for children under 2 years of age are suitable only if the dosage of the active substance does not exceed 3 mg/ml; as a rule, these are syrups or solutions. Tablets should not be taken by patients under 6 years of age, capsules by those under 14 years of age. Also, if the patient has an individual intolerance to ambroxol, these mucolytics cannot be prescribed. Side effects of the drug include digestive disorders, increased secretion of mucus from the nose, difficulty urinating, and allergic reactions. During pregnancy, as a rule, ambroxol is not prescribed in the first trimester, and in later stages - only on the recommendation of a doctor.

Mucolytics with a combined composition

These drugs contain several different active substances that thin the sputum, so they were included in the “Mucolytics” typology. For dry cough, the list of drugs prescribed by a doctor from the list described earlier in the article can be supplemented with the following drugs:

Ribonuclease for the treatment of dry cough

The mucolytics usually prescribed by doctors for dry coughs, the list of which was presented earlier, can be classified as traditional and time-tested drugs. A completely new and modern way of getting rid of viscous sputum in the respiratory organs is the use of ribonuclease or dornase alpha. This substance is a genetically engineered product, an analogue of a natural human enzyme, which is responsible for the cleavage of extracellular DNA.

If a patient has cystic fibrosis, which is characterized by an aggravated infectious process, accumulation of purulent secretion with high viscosity is observed. As a result, patients' respiratory function is impaired. The purulent secretion contains large quantities of extracellular DNA. These particles are released from disintegrating white blood cells produced as a response to infection and are highly viscous. Ribonuclease hydrolytically breaks down the DNA of sputum and, as a result, the mucus liquefies.

Dornase alfa is part of the drug "Pulmozym", which is available in the form of a solution for inhalation. Active substance content - 2.5 mg/2.5 ml. This drug is successfully used for cystic fibrosis, as well as chronic pulmonary diseases: bronchiectasis, COPD, congenital defects in children, pneumonia, immunodeficiency-related respiratory diseases.

Pulmozym has few contraindications. The drug should not be prescribed to pregnant and lactating women, as well as children under 5 years of age. Side effects during treatment with this drug occur rarely and can manifest themselves in the form of acute lymphocytic leukemia, aplastic anemia, epilepsy, migraine, conjunctivitis, imbalance, tachycardia, cardiac arrest, bradycardia, pneumonia, bronchospasm, digestive disorders, allergic dermatitis, Quincke's edema, disorders pregnancy and childbirth, chest pain, weakness.

Get treatment promptly and correctly

This article addressed the question: “Which drugs are mucolytics?” A list of the most common drugs in this group has been named.

It is worth specially noting that the prescription of the drug, its dosage, as well as recommendations for the duration of the course of treatment and the possibility of replacing the drug with an analogue are issues that are within the competence of only a medical specialist after a thorough diagnosis of the patient. Self-medication in this situation can not only be unproductive, but can also lead to unpredictable consequences: from side effects of drugs to the development of chronic diseases. Therefore, if you have symptoms of the disease, do not delay your visit to the doctor. Be healthy!

For acute respiratory viral infections, bronchitis and a wet cough with poorly separated sputum, it is recommended to use drugs that either thin the sputum - mucolytic drugs, or facilitate its separation - cough expectorants. These include both herbal products and synthetic drugs.

Many of us prefer to limit the intake of medications not obtained from natural remedies, however, we should always remember that any medicinal plant, no matter what positive properties it has, just like synthetic drugs, has side effects and has a number of contraindications.

Since the composition of all medicinal plants is very complex and rich, in addition to useful and medicinal, herbs and herbs contain a lot of other, sometimes toxic, harmful substances. Moreover, these days, the majority of the population suffers from various types of allergies, and any drug, even the most expensive, effective and safe, can cause an inadequate reaction in the body.

An important condition for a quick recovery and good sputum discharge is plenty of warm drinks. Prepare alkaline mineral water (for example, Borjomi) and hot milk. This drink promotes the removal of sputum no worse than pharmaceuticals.

Classification of drugs that relieve cough and promote rapid recovery

All cough relief products are divided into antitussives, expectorants and mucolytics.

• Antitussives, as well as combination drugs - are indicated for dry, unproductive cough that disrupts sleep and appetite (see article).
• Expectorants- indicated for productive cough, when the sputum is not thick or viscous.
• Mucolytic agents- indicated for a productive cough, but with thick, difficult to separate, viscous sputum.

Any cough medications should be prescribed only by your doctor. Antitussives cannot be used for treatment simultaneously with mucolytic drugs, however, there are combination drugs that have a weak antitussive and expectorant effect.

Expectorants - drugs that stimulate expectoration, are also divided into:

• Reflex action- these drugs have an irritating effect on the gastric mucosa, and this in turn stimulates the vomiting center, but vomiting does not occur, and the production of mucus in the respiratory tract increases. The peristalsis of the smooth muscles of the bronchi and the activity of the epithelium, which removes mucus from small to large bronchioles and into the trachea, also increases. The result of such irritation is easier expectoration of mucus and removal of phlegm from the bronchi. These are mainly herbal preparations - thermopsis, wild rosemary, coltsfoot, marshmallow, plantain, thyme, etc.

• Direct resorptive action- after these cough expectorants are absorbed into the gastrointestinal tract, they cause irritation of the bronchial mucosa, thereby increasing the secretion of liquid sputum.
• Mucolytic agents- drugs that thin sputum:
  • Mucolytic agents that affect the elasticity and viscosity of bronchial mucus (ACC, etc.)
  • Mucolytic agents that accelerate the removal of sputum (bromhexine, ambroxol)
  • Mucolytic drugs that reduce mucus formation (Libexin Muco, M-anticholinergics, glucocorticoids).

Reflex cough expectorants

The use of infusions from thermopsis herb should be treated very carefully. In children, the slightest overdose may cause vomiting. Moreover, cytisine (an alkaloid) included in its composition in large doses can cause short-term stimulation of breathing in children, which is then replaced by respiratory depression.

Stoptussin phyto syrup (130 rubles) Ingredients: plantain, thyme, thyme. This is a herbal medicine with anti-inflammatory and expectorant effects. Contraindicated: during pregnancy and breastfeeding, children under 1 year. Patients with kidney and liver diseases, brain injuries should take with caution. Application: after meals, 1-5 years, 1 teaspoon 3 times a day, 5-10 years, 1-2 teaspoons. 10-15 years 2-3 tsp, adults 1 tbsp. l. 3-5 r/day. Usually the course of treatment is no more than 1 week; it is possible to continue therapy according to indications.

Coldrex broncho (syrup 110-250 rubles) Coldrex Broncho syrup has the smell of anise and licorice, the main substance uses guaifenesin, and also includes dextrose, macrogol, sodium cyclamate and benzoate, red pepper tincture, star anise seed oil, racemic camphor, levomenthol. Contraindicated: children under 3 years old, with gastric ulcers, hypersensitivity. Application: children from 3-12 years old are prescribed a single dose of 5 ml every 3 hours, adults 10 ml every 3 hours. Side effects: abdominal pain, vomiting, nausea, vomiting, diarrhea, urticaria, rash.

Gedelix (240-350 rubles) This herbal remedy is ivy leaf extract. It has an expectorant, mucolytic, antispasmodic effect. In the form of syrup and drops for oral administration. Contraindicated: children under 2 years of age, bronchial asthma, laryngospasm, hypersensitivity, including to peppermint oil. Application: children from 2-4 years old 16 drops. 3 r/day, 4-10 years 21 caps. adults 31 caps.. Side effects: nausea, vomiting, pain in the epigastric region.

overslept Ivy extract, syrup 320-550 rub. Contraindications: for glucose-galactose malabsorption, sucrase/isomaltase deficiency, fructose intolerance. Application: children 1-6 years old - 1 tsp 3 times a day, older - 2 tsp, adults - 2-3 tsp. The course of treatment is 1 week. Side effects: nausea, vomiting, diarrhea, allergies.

Herbion ivy Dry extract of ivy leaves in syrup 360 rub. Application: 15-50 ml. 2-3 times a day. Contraindications: severe cardiovascular diseases, thyroid dysfunction, hypersensitivity.

Thyme (thyme extract) Thyme herb (40 rubles) Thyme essential oil (90 rubles) It is also a cough expectorant of plant origin and has an analgesic and antimicrobial effect. Contraindications and side effects are similar to those of plantain leaf. Usage: 1 tbsp. pour a spoon or 15 sachets into a glass of water and boil in a water bath for 15 minutes, cool, filter, bring to 200 ml. Take 1 tbsp after meals. l. 3 times a day for a course of 14-21 days.

These are liquid extracts of thyme, which are mucolytic and expectorant cough remedies for bronchitis, pneumonia, for diseases with paroxysmal cough, and difficult to separate sputum. Bronchicum S syrup and lozenges After meals, children 6-12 months old - 0.5 teaspoon 2 times a day, 2-6 years old - 1 teaspoon. 2 r/day, 6-12 years old - 1 tsp. 3 r/day, adults 2 tsp. 3 r/day. Lozenges should be dissolved, children 6-12 years old - 1 paste. 3 r/day, adults 1-2 pastes. 3 r/day. Bronchicum TP (primrose with thyme) Children 1-4 years old - 0.5 tsp. 3 times a day, 5-12 years - 1 tsp. 4 r/day, adults 1 tsp. 6 r/day. Bronchicum should be taken at regular intervals throughout the day. Pertussin (thyme + potassium bromide) After meals, children 3-6 years old, 0.5 teaspoon, 6-12 years old, 1-2 teaspoons, over 12 years old, a dessert spoon, adults, a tablespoon 3 times a day, course 10-14 days. Tussamag drops and syrup (thyme extract) Children 1-5 years old take 2-3 times a day, 10-25 drops, which can be taken either diluted or undiluted. Children over 5 years old: 20-50 drops, adults: 40-60 drops 4 times a day. The syrup should be taken after meals for children 1-5 years old 3 times a day, 1 teaspoon, over 5 years old 1-2 teaspoons, adults 2-3 teaspoons. 4 r/day.

Gelomirtol (170-250 rubles) This is a cough expectorant for chronic and acute bronchitis, of plant origin. Dosage: Children under 10 years old: 120 mg 5 times a day for acute inflammation, 3 times a day for chronic inflammation. For adults, half an hour before meals for acute bronchitis, 300 mg 4 times a day, for chronic bronchitis, 2 times a day for chronic bronchitis. For chronic bronchitis, an additional 300 mg is taken before bedtime to improve morning mucus discharge. Side effects:, allergic reactions, abdominal pain, increased mobility of stones in the gall bladder and kidneys.

Direct resorptive cough expectorants

Active ingredients such as ammonium chloride, sodium bicarbonate, potassium and sodium iodides increase the secretion of liquid sputum, essential oils of anise fruits, medicinal herbs - wild rosemary, oregano, etc. have the same effect.

Mucolytic cough suppressants for bronchitis

Mucolytic agents help to liquefy viscous sputum, improving the process of its removal, eliminating the breeding ground for pathogenic microorganisms.

Acetylcysteine A mucolytic agent, reduces the severity of the inflammatory process, reduces the frequency of exacerbations in chronic bronchitis. Indicated for otitis media, obstructive, acute bronchitis, pneumonia. Contraindicated: during pregnancy, children under 2 years of age, with pulmonary hemorrhage, with caution in case of bronchial asthma (may increase bronchospasm), renal and liver failure, diseases of the adrenal glands. Application: The duration of therapy for acute colds should not exceed 7 days; for chronic bronchitis, longer use is possible. Acetylcysteine ​​preparations are best taken after meals, it should be taken into account that there is always additional fluid intake increases expectorant effect. Children 2-5 years old, 100 mg 2-3 times a day, from 6-14 years old, 3 times a day, 100 mg, adults, 200 mg 3 times a day or 600 mg once a day. Side effects:, headache, vomiting, heartburn, decreased blood pressure, bronchospasm, development of pulmonary hemorrhage, urticaria, skin rash.

Mucolytic agent, has an expectorant and weak antitussive effect. The effect occurs within 2-5 days after the start of therapy. Contraindicated: for children under 6 years of age for tablets, for hypersensitivity, in the 1st trimester of pregnancy, during lactation. Application: children from 6 years old 8 mg 3 times a day, from 2-6 years (in syrup, mixture) 2 mg 3 times a day, adults 8-16 mg 4 times a day. Treatment can be carried out in the form of 2 times a day, the solution is diluted with saline or distilled water 1/1, heated to body temperature, the dosage for children 2-10 years old is 2 mg, over 10 years old - 4 mg, for adults - 8 mg. Side effects: vomiting, nausea, allergic reactions, headache, dizziness.

Combined drugs Joset, Ascoril, Cashnol Used only according to strict indications. As prescribed by a doctor in the presence of obstructive syndrome. Joset syrup price 190-280 rub. Cashnol syrup 130 rub. Ascoril tablet. 200-400 rubles, syrup 340 rubles. Ingredients: Bromhexine, Guaifenesin, Salbutamol. Indicated: for bronchial asthma, COPD, pneumonia, emphysema, tuberculosis, chronic bronchitis, tracheobronchitis. Contraindications: children under 3 years of age, pregnancy and lactation, tachyarrhythmia, thyrotoxicosis, diabetes mellitus, gastric and duodenal ulcers, liver and kidney failure, aortic stenosis. Do not take together with non-selective β-adrenergic receptor blockers, antitussives, MAO inhibitors. Dosage: children strictly as prescribed by the doctor, 3-6 years old, 5 ml 3 times a day, from 6-12 years old, 5-10 ml. 3 r/day, over 12 years old and adults 10 ml. 3 r/day. Side effects: increased nervous excitability, headache, convulsions, dizziness, drowsiness, sleep disturbance (see), vomiting, nausea, diarrhea, exacerbation of stomach ulcers, decreased blood pressure, tachycardia, pink urine color, rash, urticaria, paradoxical bronchospasm. Special instructions: Do not drink alkaline drinks.

Ambroxol This mucolytic, expectorant medicine, Lazolvan, is considered one of the most effective mucolytic drugs today. Indications: for COPD, pneumonia, acute and chronic bronchitis, bronchial asthma, and other diseases of the respiratory tract, accompanied by viscous sputum. Contraindicated: in the 1st trim of pregnancy, in the 2nd and 3rd trims with caution, in patients with chronic liver and kidney diseases. Application: Take 30 mg tablets after meals. 3 r/day for adults. Children are recommended to take it in the form of syrup up to 2 years, 0.5 tsp. 2 times a day, 2-6 years - 0.5 tsp. 3 times/day, 6-12 years 1 tsp each 3 r/day, adults 2 tsp. 3 times a day, the course of therapy is usually no more than 5 days. The syrup should be taken with meals with plenty of liquid. Side effects: heartburn, vomiting, diarrhea, allergic reactions, skin rash.

Carbocisteine expectorant mucolytic agent, increases the viscosity of sputum, improves the elasticity of bronchial secretions. Contraindications: pregnancy, up to 2 years (for children's forms), children under 15 years of age (for adult forms - Libexin Muco, Bronchobos capsules, Fluifort tablets), stomach ulcer, chronic glomerulphritis, cystitis. Application: 15 ml or 1 measuring cup 3 times a day, separately from meals. The course of treatment cannot be carried out for more than 8 days Side effects: gastrointestinal bleeding, nausea, vomiting, urticaria, skin itching, weakness, dizziness.

List of drugs

Almost all colds and inflammatory diseases of a bacterial or viral nature are accompanied. Depending on the nature of the pathology and the physiological state of the lungs and bronchi, the cough may occur with sputum (wet) or not be accompanied by discharge ().

Modern pharmaceutical companies offer many products to help cope with coughs of various etiologies and prevent its unpleasant consequences.

What are expectorants and mucolytics used for?

considered the most dangerous for the body. A sharp contraction of the bronchi without secretion of the product leads to various pathological conditions. In the absence of sputum production, the cough reflex causes a lot of suffering. Moisturizing the respiratory mucosa is vital for the body, since this secretion helps the internal organs protect themselves from the negative effects of pathogenic microorganisms and dangerous factors of the external and internal environment.

With a large amount of secreted sputum, it can also be life-threatening, since the production of mucus by the bronchi more than is necessary according to the physiological norm leads to blockage of the airways and serious difficulty breathing in the future. Accumulating in the bronchi, sputum can gradually thicken and harden, accumulating harmful substances and provoking the risk of developing a more serious condition for the patient.

It is in the mechanism of action on the lungs and bronchi that the main difference between expectorants and mucolytic drugs lies.

Expectorants promote active secretion of sputum. They act on the cough center of the brain and help the bronchi contract more intensely, removing phlegm out.

Mucolytic agents are used in cases where, during the course of an illness, too much sputum is released and at the same time it has an extremely dangerous, viscous and thick consistency. Mucolytics are needed to break down the molecular bonds inside the sputum, making it more liquid and accessible to natural elimination from the body.

After the mucus becomes easily separated and its passage through the respiratory tract does not cause difficulties, doctors recommend either switching from mucolytics to expectorants, or immediately prescribing a combination drug that can have several therapeutic effects on the human respiratory system.

Types of expectorants

Expectorants are also called “secretomotor”, since they are the ones that can start the process of mucus secretion and ease the internal condition of the human respiratory organs.

Depending on the mechanism of action of expectorant drugs, experts divide such drugs into two groups:

1. reflex drugs;
2. direct acting drugs.

Reflex-action drugs actively affect the receptors responsible for the secretion of secreted sputum. This occurs due to preliminary irritation of the stomach receptors and an active effect on the cough center of the medulla oblongata. This mechanism of action helps to enhance the severity of the cough reflex and accelerate the synthesis of liquid bronchial secretions.

To drugs of reflex action include the following medicines:

note

It can provoke a large number of side effects and allergic reactions, so pharmaceuticals containing sodium benzoate are used with caution, under the supervision of a physician.

• Essential oils : terpene and eucalyptus. The most well-known preparations containing a large number of such oils are Eucabal, Doctor Mom, as well as herbal cough medicines with a high percentage of essential oil raw materials. These active substances have an expectorant and anti-inflammatory effect, acting both on the receptors responsible for the production of mucus and directly on the epithelium lining the surface of the respiratory organs.

Direct acting expectorants contribute to strengthening the direct liquid component of sputum, significantly facilitating its separation. The main side effect of these active substances is increased snot secretion and lacrimation, since the drug can affect the viscosity of any physiological fluids of the body. Such drugs are considered classic or even outdated, and therefore are used quite rarely: sodium and potassium iodides, ammonia, anise essential oil.

The exceptions are oregano and wild rosemary, which are part of popular antitussive preparations, and are also contained in combined cough medicines: Doctor Mom, Bronchofit, etc.

Types of mucolytic agents

Mucolytic agents are classified mainly by their composition, since their mechanism of action is very similar: diluting the composition of sputum, changing its composition to something more easily separated from the surface of the bronchi and lungs, and gradually removing excess secretions from the body.

Among mucolytics, experts especially highlight the following drugs:

To achieve the fastest effect, medical specialists recommend using mucolytic agents as inhalations, in special dosage forms for direct inhalation. This will significantly facilitate absorption processes and will not waste unnecessary time on the release of active metabolites directly in the body.

Despite the fact that almost all cough medications are available without a doctor’s prescription, before use it is advisable to consult with a specialist to select the most effective pharmacological agent in each specific clinical case.

If desired, the use of chemical medications can be combined with popular and herbal antitussives. However, you need to remember that herbs may also be incompatible with the active pharmacological components of the medication you are taking. Before use, you should carefully read the instructions not only to become familiar with the mechanism of action and side effects, but also to find out exactly how to take this medicine and what additional therapeutic measures it combines well with.

Medicines classified as mucolytic have secretolytic properties, helping to liquefy mucus, speed up its elimination and facilitate breathing. Mucolytic agents are prescribed for diseases accompanied by the formation of thick mucus (bronchitis, pneumonia, tracheitis) and for ENT diseases (sinusitis, sinusitis, rhinitis).

Mucolytic action - what is it?

The peculiarity of such funds is to improve the discharge of sputum without increasing its volume. These drugs are divided into three groups based on their principle of action:

• affecting the viscosity of mucus;
• activating the removal of sputum;
• reducing mucus formation.

Mucolytic agents for dry cough

An important stage in the treatment of cough is its transition from dry to wet. This is achieved by taking mucolytics, which make sputum less viscous and thin it. Let us briefly describe the most effective medications.

Acelcysteine

Available in the form of tablets and granules for dissolution in water, as well as in the form of a solution for injection. Its high effectiveness is explained by its triple action: antitoxic, mucolytic and antioxidant. The drug helps remove phlegm and reduces inflammation. The action of the medicine is based on the property of depolyzing mucoproteins, reducing viscosity and pus.

Ambroxol

Its properties are similar to Bromhexine, however, it has a more pronounced expectorant effect. The drug activates the formation of pulmonary surfactant and stimulates expectoration.

Carbocisteine

This remedy should also be classified as a mucolytic cough medicine, which not only promotes the removal of mucus, but also restores the functioning of secretory cells. The medicine is available in the form of syrup and capsules.

Mucolytic drugs for the nose

Mucolytics are also prescribed to prevent the accumulation of mucus in nasal diseases. They are prescribed in combination with antimicrobial agents and home treatments.

The following mucolytic drugs for sinusitis are distinguished:

• Fludex;
• Mucodin;
• Fluimucil.

Mucolytic herbal medicines

Many people prefer to limit their intake of medications produced without the use of natural ingredients. However, we must remember that herbal preparations, like chemical ones, have their contraindications and side effects.

Mukaltin

The main product is polysaccharide components, which are extracted from the marshmallow plant. The root of the plant contains aspargine, betaine, starch, and mucus, which relieves inflammation.

Linkas

It is another mucolytic herbal remedy. It is sold in the form of syrup, which contains hyssop, marshmallow, violet, etc.

Bronchicum

Sold in the form of an elixir, syrup and lozenges. The drug has a combined effect on the body, providing anti-inflammatory, bronchodilator and expectorant effects. The main elements of the product are primrose root and thyme herb. The medicine improves the condition of dry and wet cough, helps make it productive, facilitating the removal of mucus from the lungs.

Gelomirtol

Helps cope with both the first signs of a cold and the progressive disease. The drug activates self-cleaning mechanisms, getting rid of germs and thinning mucus.