For what purpose are antitussive drugs used? Antitussive drugs. The body's reaction can occur when exposed to various stimuli, namely

»» No. 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 in its mechanism, reflex 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 can be dealt with by any person who does not have special knowledge (parents, relatives or friends), a pharmacy pharmacist and, of course, a doctor. This opinion is erroneous and even harmful, since incorrectly chosen antitussive therapy is often based on it.

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 may differ significantly from those in adults. Therefore, the use of drugs used 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 presupposes knowledge of at least two main points: the causes of cough and the peculiarities 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, tonsillitis, 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
• Obstruction of the airways with viscous bronchial secretions, aspirated foreign bodies, fluids, endogenous and exogenous formations, etc.
• Edema of the pulmonary parenchyma
• Other factors

Impaired 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 secretion viscosity; decreased surfactant formation; bronchospasm; bronchial dyskinesia, that is, a decrease in their caliber during exhalation by more than 25% compared to the caliber during inhalation; Finally, impaired mucociliary clearance may be caused by a combination of two or more of these factors.

Clinical manifestations vary from a severe, painful cough, accompanied by vomiting, anxiety and/or pain that disrupts the child’s sleep and well-being, to a constant cough that is invisible to the patient and 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.

Treatment of cough is indicated only in cases where it interferes with the patient’s well-being and condition. However, you should always start by eliminating its cause.

The need to treat the cough itself, that is, to prescribe so-called antitussive therapy, arises mainly when the child has a non-productive, 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 relieve the receptors of the respiratory tract mucosa from irritating effects, for example, during irritative, infectious or allergic inflammation. It should be emphasized once again that in children, especially young children, nonproductive cough is often caused by increased viscosity of bronchial secretions, impaired “sliding” of sputum along the bronchial tree, insufficient activity of the ciliated epithelium of the bronchi and contraction of the bronchioles. Therefore, the purpose of prescribing antitussive therapy in such cases is to dilute sputum, reduce its adhesiveness and thereby increase the effectiveness of cough.

Thus, the effectiveness of antitussive therapy essentially lies in strengthening the cough, provided it is transferred from dry, unproductive to wet, productive. This ultimately leads to its disappearance.

Treatment of productive cough, which consists of 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, disrupts the child’s sleep, or when there is a high risk of developing aspiration (for example, in children with severe central nervous system pathology ).

Thus, for the correct choice of antitussive treatment it is necessary: ​​firstly, to establish a diagnosis of the disease that caused the child’s cough, and secondly, to evaluate 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 the bronchial secretion (mucous or purulent, degree of viscosity, “mobility,” quantity, etc.) and the presence or absence of bronchospasm.

Consequently, in resolving questions about the need and rational choice of antitussive treatment for a child, the participation of a pediatrician is simply necessary. Moreover, the correct choice of antitussive therapy is always based on a good knowledge of the mechanisms of action of drugs with an antitussive effect.

Among them are:

• antitussives themselves (central and peripheral action);
• drugs with an indirect antitussive effect (bronchodilators, anti-inflammatory, antiallergic, decongestants and others);
• combination drugs.

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 a narcotic effect (codeine, dionine, morphine, dextromethorphan) and drugs that have a non-narcotic antitussive effect in combination with an analgesic, sedative and, as a rule, weak antispasmodic effect. These are glaucine hydrochloride (Glauvent), libexin, Sinecode, Tusuprex and others. This also includes broncholitin, a combined antitussive drug that includes glaucine hydrochloride, ephedrine, sage essential oil and citric acid.

Narcotic drugs are used extremely rarely in pediatrics, in hospital settings and for special indications: mainly for oncological diseases of the respiratory tract (opiates, 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 use is the urgent need to suppress cough. In pediatrics, although such a need occurs, it 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. Typically, obstructive syndrome, and especially pronounced, at this age is caused by hyperplasia and infectious-inflammatory edema of the bronchial mucosa, impaired motility of bronchioles, decreased mobility of the secretion 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 older adults, these drugs may be useful in cases of cough associated with moderate bronchospasm. At the same time, they are used independently or as an addition to bronchodilators and drugs that suppress allergic or irritative inflammation.

A group of centrally acting non-narcotic antitussives is also indicated for coughs associated with irritation of the mucous membranes of the upper (supraglottic) respiratory tract due to infectious or irritative inflammation. In these cases, the result of their administration is usually enhanced when combined with peripherally acting drugs with an enveloping effect. A partial example of such a combined effect is broncholithin. But its use is justified only in the absence of pronounced changes in the mucous membrane of the lower sections of the bronchial tree, since the ephedrine included in it “dries out” the bronchial mucosa, increases the viscosity of bronchial secretions and aggravates the disturbance of mucociliary transport, and, accordingly, increases the unproductiveness of cough in the presence of bronchitis and pneumonia. In addition, ephedrine has an stimulating effect on the central nervous system, disrupts the child's sleep and increases unproductive cough and shortness of breath.

Peripheral antitussives influence 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 reflex stimulation of the cough reflex. In addition, they change the formation and viscosity of secretions and relax the smooth muscles of the bronchi. Drugs with efferent action increase the mobility of the secretion, as if improving its “sliding” along the mucous membrane, reduce the viscosity of mucus or increase the efficiency and strength of the cough mechanism itself.

One of the effective afferent antitussives of peripheral action is moisturizing the mucous membranes. This is primarily the use of aerosols and steam inhalations, which reduce irritation of the mucous membrane and reduce the viscosity of bronchial secretions. Inhalation of water vapor alone or with the addition of medications (sodium chloride or benzoate, sodium bicarbonate, ammonium chloride, plant extracts such as eucalyptus) is the simplest, most accessible and common method of hydration. Along with this, heavy drinking can be used (including medicinal teas, when efferent and afferent mechanisms of action are combined), and in severe cases (in a hospital setting) intravenous infusions of fluids.

Enveloping agents also belong to the peripheral antitussive agents of afferent action. These drugs are mainly used for coughs that occur due to irritation of the mucous membrane of the upper supraglottic parts of the respiratory tract. Their action is based on creating a protective layer for the mucous membrane of the nasopharynx and oropharynx. They are usually in the form of oral tablets or syrups and teas containing plant extracts (eucalyptus, acacia, licorice, wild cherry, etc.), glycerin, honey and other components. Local anesthetics (benzocaine, cycline, tetracaine) are also agents of afferent action, but are used only in a hospital setting 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.), terpin hydrate, 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 expectorants increase mucus secretion 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, thereby increasing the secretion of mucus and increasing its volume. They partially activate the motor function of the bronchioles and ciliated epithelium of the bronchial mucosa. Along with this, thermopsis and 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, and are components of chest preparations.

EXPECTORANTS OF PLANT ORIGIN

Ingredients: extracts of marshmallow, anise, wild rosemary, deyasil, 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, mucaltin based on marshmallow extract, glycyram based on the ammonium salt of glycyrrhizated acid isolated from licorice, bronchicum lozenges)
• syrups (bronchicum based on honey, thyme, rose hips, 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).

A significant increase in sputum volume is also observed 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 prescribed in doses close to intolerable, which is always dangerous in pediatric practice. In addition, they have an unpleasant taste (the exception is iodized glycerol, but its effect is extremely insignificant).

The most effective antitussive drugs with efferent peripheral action are mucolytics. They dilute bronchial secretions well by changing the structure of mucus. These include proteolytic enzymes (deoxyribonuclease), acetylcysteine ​​(ACC, carbocysteine, N-acetylcysteine ​​(fluimucil), bromhexine (bisolvan), ambroxol (ambrohexal, lasolvan), dornase (pulmozyme), etc. A feature of mucolytics is that, thinning sputum, they practically do not increase its volume. The liquefying effect of proteolytic enzymes is based on the rupture of peptide bonds of bronchial secretion protein molecules. Acetylcysteine, carbocysteine ​​and N-acetylcysteine, bromhexine and ambroxol disrupt the integrity of the disulfide bonds of acidic mucopolysaccharides of the sputum gel, thereby liquefying it. Bromhexine and Ambroxol also has the ability to stimulate the production of endogenous pulmonary surfactant (anti-atelectatic factor). The latter ensures the stability of alveolar cells during breathing, protects them from the effects of external adverse factors, improves the "sliding" of bronchopulmonary secretions along the epithelium of the bronchial mucosa. Reducing the viscosity of mucus and improving its sliding facilitates secretion of mucus from the respiratory tract.

MAIN INDICATIONS FOR THE CHOICE OF ANTI-COUGH DRUGS IN CHILDREN

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 pathogenetic factor in the formation of cough. The tendency to insufficient surfactant synthesis justifies the use of drugs such as ambroxol in neonatological practice and in children in the first weeks of life.

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

Acetylcysteine, bromhexine and ambroxol have proven themselves well in chronic bronchitis, bronchiectasis, cystic fibrosis, and other enzymopathies, 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, since they dilute purulent sputum more effectively.

Currently, the drug guaifenesin is widely used. It is included in such products as Coldrex-Broncho, Robitussin - a cough medicine, Tussin (a combination drug that, along with guaifenesin, includes caramel, glycerin, citric acid, sodium benzoate, corn syrup) and a number of other widely advertised over-the-counter antitussives. The dose of guaifenesin is usually 100 to 200 mg per dose every 4 hours. Guaifenesin can be used in children over 3 years of age. In its action, guaifenesin occupies an intermediate position between expectorants and mucolytic drugs. Unlike the expectorants described above, the effect of guaifenesin is based on reducing the surface tension and adhesion of mucus to the bronchial mucosa and reducing its viscosity due to the depolymerization of acidic mucopolysaccharides of mucus. But the ability to increase mucus secretion (albeit less viscous) makes guaifenesin similar to expectorants. No side effects have been noted with guaifenesin, but there is no reliable data on its effectiveness.

The use of drugs with an indirect antitussive effect in pediatrics has very limited indications. For example, antihistamines are not recommended for use in the treatment of cough in children, especially young children, since their “drying” effect on the bronchial mucosa increases the unproductive cough caused by the already viscous nature of the secretion. For the same reasons, decongestants (decongestants) used for acute rhinitis and cough in adults are not used in children.

Bronchodilators (aminophylline, 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 particularly focus on the use combination cough medications. This group of medications, usually available over-the-counter or prescribed by doctors, contains two or more ingredients. A number of combination drugs include a centrally acting antitussive drug, an antihistamine, an expectorant and a decongestant (broncholitin, stoptussin, sinekod, hexapneumin, Lorraine). Often they also include a bronchodilator (solutan, trisolvin) and/or an antipyretic component, antibacterial agents (hexapneumin, Lorraine). Such drugs relieve cough during bronchospasm, manifestations of respiratory viral (for example, rhinitis) or bacterial infection, but they should be prescribed according to the appropriate indications (see table). Often such drugs are not indicated or even contraindicated for young children, especially the first months of life.

In addition, combination drugs, in particular those prescribed by doctors, can combine medications that have opposite effects, for example, 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 also completely justified combinations of drugs.

If the main complaint is the cough itself, it is always better to use one drug in full dose, but one that acts on the patient-specific component of the cough reflex. For example, to relieve cough associated with acute infection of the upper respiratory tract, tablets or syrups with an enveloping peripheral effect or their combination (in older children and adolescents) with non-narcotic drugs of central action such as libexin are indicated. In acute laryngitis, tracheitis, bronchitis and pneumonia, the use of airway humidification is most effective to enhance bronchial secretion and dilute viscous sputum. If it is ineffective, expectorants and/or mucolytics are added to 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, long-term bronchitis, pneumonia, cystic fibrosis, alpha1-antitrypsin deficiency).

When a patient coughs with symptoms of bronchospasm, it is advisable to prescribe bronchodilators, antiallergic and anti-inflammatory drugs, along with moisturizing and expectorants, but centrally acting antitussives 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, expectorant drugs that increase the volume of secretions and enhance the gag and cough reflexes are contraindicated. And for the targeted suppression of a non-productive 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. Condition of the bronchi in prolonged and chronic segmental and lobar pneumonia in children of the first years of life. Author's abstract. diss. Ph.D. 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 respiratory diseases in children. M., Medicine, 1981, p. 206.
6. Guide to medicine. Diagnostics and therapy. M., 1997, vol. 1, p. 407-410.
7. Vidal reference book. Medicines in Russia. M., 1999.
8. Anmmon N.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. Acetylcysteine: a drug with interest in the past end a future. Respiration, 1986, 50 suppl 1; 20-30.

Antitussive drugs for dry cough in children and adults.

Cough is a specific reaction of the human body to an irritating factor.

Requires special attention and intensive care.

What and how to treat the disease?

What drugs are most effective in this case?

Only a therapist can give competent answers to these questions.

But general information can be obtained from our article.

Dry cough: causes

The body’s reaction can occur when exposed to various irritants, namely:

• and inflammatory processes in the bronchi;
• tuberculosis;
• pleurisy;
• mediastinum;
• tumors in the lungs.

The main task of a doctor when a patient comes to him is to determine the nature of the cough and its origin, in order to correctly prescribe medications that help mitigate the body’s reaction.

Classification of antitussive drugs for dry cough

They are divided depending on the following characteristics:

1. release forms;
2. manufacturing company;
3. composition of the drug: natural or synthetic;
4. way of influencing the body system.

Drugs of this type can be presented in various forms:

• regular chewing gum;
• medicinal teas;
• pills;
• powders;
• drops;
• herbal infusions;
• lollipops;
• sweet syrups.

When medications should not be taken

In some cases, taking medications is prohibited:

• with hypersensitivity to the ingredients of the drug;
• lactation period;
• bearing a child;
• children under 2 years old;
• asthma;
• respiratory failure.

How do medications work when symptoms appear?

1. Mucolytic. The action of the drug is aimed at transforming and removing it from the body. For this purpose, medicinal herbs and other pharmaceutical preparations are often used: Ambroxol, Mucaltin, Solunat and ACC.
2. Combined. Medicines affect the body in many ways. They not only prevent the development of the inflammatory process, but also block spasms in the bronchi, and make the symptom productive in terms of removing irritants from the body. Some of the most popular products are Codelac-phyto and Doctor Mom.
3. Narcotic. When the reflex appears, it is suppressed by inhibition of the functional system of the brain. Such drugs are used only as prescribed by a doctor, as they can lead to the body becoming accustomed to the active substance. They are mainly prescribed for the treatment of whooping cough and pleurisy. These drugs include: Codeine, Ethylformine, Dimemorphan.
4. Non-narcotic. The reflex is blocked without getting used to the active substance. Therapists prescribe such drugs for advanced cases of influenza and colds. This category includes: Prenoxyndisione, Glaucine, Oxeladin and Butamirate.

Antitussive medications for dry cough: prescriptions from therapists

• Dextromethorphan. It perfectly blocks cough reflexes, but it has side effects: dizziness, drowsiness and nausea. In this regard, before taking the medicine you should consult a specialist. Children over 12 years of age and adults, according to the instructions, take Dextromethorphan 15 mg 4 times daily.
• Codeine. The best therapy when the disease bothers you so much that you cannot breathe calmly. This drug blocks cough for the whole day. But when driving a car and drinking alcohol, taking Codeine is strictly prohibited. The dosage of the medicine per day for an adult is 0.2 g, only 0.01-0.03 g can be taken at a time.
• Butamirat– bronchospasmolytic drug. Used to suppress symptoms in the postoperative or preoperative period. It is used as therapy for coughs caused by any irritants. The recommended dosage for an adult is 1 capsule 2 times a day, for children over 12 years old, 1 tablet daily. The medicine is drunk without chewing before eating.
• Glauvent – an inexpensive but effective medicine that causes a productive cough and cures it completely. Excellent at blocking spasms. Does not cause narcotic effect or addiction. Prescribed as therapy for and. Dosage: 3 times a day, 0.5 grams.
• Glauvent, Demorphan and Sinekod. Block by acting on the main center. Drugs in this group are effective, but they are dispensed from pharmacies only with a doctor’s prescription, so it is not always possible to purchase them. Medicines are taken as prescribed by a therapist, who will tell you in detail how to properly use this or that drug to treat dry bronchitis. It is not recommended to prescribe medications on your own, as they are quite serious and have side effects.
• Bronholitin, Stoptussin, Tussin and Lorraine - antitussive combination medications. They are popular among both therapists and patients. They are taken several times a day. Duration of therapy is a week.
• Levopront, Gelicidin and Libexin - peripherally acting medications. They are not as effective, but they have virtually no side effects. Therefore, they are used not only to treat adults, but also children.

Therefore, treatment should be continued with other groups of medications:

1. Expectorants: Licorice, Thermopsis and Althaea. Herbal natural elements of medicines are harmless, so they are prescribed for dry cough, regardless of age, but only if there is no predisposition to allergic reactions to natural components.
2. Anti-inflammatory medications: Pulmotin, Sinupret, Ascoril, Gedelix and Eucabal.
3. Mucolytic: Mucobene, ACC, Lazolvan, Pertusin, Bromhexine and Hakixol are used for treatment everywhere and have proven themselves to be quite effective medications for eliminating symptoms.

In order for the therapy to have an effect and the symptoms of the disease to be neutralized in the first couple of days, you should consult a therapist.

The most effective therapy is the use of various drugs simultaneously.

In addition, the form in which medications are used for dry cough is also of great importance.

For treating children, it is best to use medications in the form of effervescent capsules and tablets, as they are absorbed much faster and their effectiveness is significant.

Among the most effective medications, it is worth highlighting the medicine ACC.

Acetylcystine ACC: an effective antitussive drug for dry cough

The drug is widely used for treatment at the first appearance of “barking” symptoms.

The mechanism of action of ACC is based on the dilution of fairly viscous and very thick sputum, which facilitates its immediate removal from the bronchi.

A medicine such as ACC is rapidly absorbed into the walls of the gastrointestinal tract.

It easily passes through the hematoplacental barrier and accumulates in the amniotic fluid, which is why this drug is contraindicated for pregnant women.

Indications for use of ACC

The drug is prescribed in the following cases:

• tracheitis;
• laryngitis;
• at any stage;

ACC is the best medicine against “barking” dry cough.

How to take ACC?

When treating dry bronchitis, the medication is used as follows:

1. and up to 2 years, 50 mg several times a day.
2. Children over 2 years old and under 5, 4 times 400 mg.
3. From 6 years – 3 times a day, 600 mg. Therapy can last a couple of months.
4. Upon reaching 14 years of age - 600 mg several times a day. Duration of treatment is a week. For chronic bronchitis, therapy can last up to 6 months.

For dry cough, the antitussive drug ACC is taken after meals.

The sachet or capsules are dissolved in a small glass of water or tea, at your discretion, and taken orally.

How to treat bronchitis in babies?

Antitussive medications come in different forms, but not all of them are suitable for children.

Here are some of the best drugs that are popular among doctors and consumers:

• Ambrohexal and Lazolvan. The main element in these drugs is ambroxol, which helps restore the immune system; in addition, it is an excellent anti-inflammatory agent. These drugs are prescribed for the treatment of bronchitis even in infants.
• Bromhexine. Liquefies mucus and removes it from the respiratory system.
• Broncathar. It contains carbocisteine, which promotes the removal of sputum and enhances the performance of cells that are responsible for bronchial secretion.
• Bronchicum is a herbal medicine used to treat children aged 6 months and older.
• Libexin. The drug is prescribed in the early stages of the disease. The drug suppresses “barking”, while not impairing breathing against the background of the central nervous system. Bithidion has the same effect.
• Phytopectol No. 1,2 and Chest collection - collection of herbal healing components. To prepare the healing composition, the consumer mixes all the ingredients independently. Such remedies usually include: oregano root, St. John's wort, field chamomile, plantain and other beneficial herbs.

What medications are allowed during pregnancy?

During pregnancy, a girl’s body is exposed to the negative effects of environmental irritants.

This is how the body functions taking into account the needs of two living beings.

Therefore, before taking this or that medicine, you should consult your doctor.

Here is a small list of medications that can be taken while expecting a baby:

• In the first trimester: Equabal, Mucaltin, known to us for a long time, simple marshmallow root, and natural natural medicines that can be used without any fear.
• Doctor IOM, Gedelix and Bronchicum, their use is permissible, but only as prescribed by the therapist. Since the effect of medications on the embryo has not yet been sufficiently studied.
• Libexin belongs to the group of synthetic drugs. Prescribed to a woman expecting a child in the 1st trimester only in special cases. Various dietary supplements can be used as an addition to therapy.
• In the second and third trimester of pregnancy for bronchitis, it is permissible to use medications recommended by doctors for the 1st trimester. If the disease is quite severe, instead of Libexin, you can use Bromhexine, Acodin or Stoptussin.

You should know!

Treatment of an infectious or cold disease is possible only with the help of special drugs for dry cough prescribed by the attending physician.

But only additional procedures can bring the stage of recovery closer, since the secret to a quick and high-quality recovery is complex therapy.

But remember, before you start, you need to find out its cause and choose the right medications, only in this case will you achieve the desired effect!

Everyone is familiar with a cough firsthand, but not everyone knows how a cough occurs and what its role is in ensuring a person’s life. In fact, coughing is a physiological process of removing various waste from the body that occurs as a result of illness or exposure to unfavorable external conditions. The cough center of the brain controls the coughing process.

What is a cough center

The cough center collects data from cough receptors located near the nose, ears, vocal cords, on the back of the pharynx, in the pleura, larynx, pericardium, and the bifurcation of the trachea and large bronchi. All these areas are united by the vagus nerve; it collects signals from these receptors and sends impulses to a special segment of the brain called the cough center.

In turn, the cough center sends impulses to the nerve fibers that control the muscles of the diaphragm, chest and abdominals. They contract, and then a cough occurs.

Interestingly, there are no such receptors in the small bronchi, and when they are damaged, instead of coughing, shortness of breath occurs.

The cough center is located in the medulla oblongata, located closer to the base of the skull. There is a vomiting center nearby, so with prolonged coughing, impulses from the cough center spread to the neighboring one and the patient begins to vomit.

Antitussives that depress the cough center

Cough is not a disease, but a symptom associated with a specific disease. There is no point in treating a cough separately from the disease, therefore, first of all, it is necessary to diagnose the patient and entrust this to a specialist.

Cough medications are divided into several groups depending on the mechanism of action on the body:

1. Antitussive drugs act either on the receptors, reducing their sensitivity, or directly on the cough center. They are effective for dry, prolonged cough with bronchitis, laryngitis, ARVI. But these drugs cannot be used, for example, for pneumonia, because this may interfere with the removal of mucus from the bronchi.
2. Expectorants help remove sputum from the bronchi by reducing the viscosity of the secretion, but at the same time the volume of sputum increases.
3. Mucolytics help thin the sputum without increasing its volume. Taking mucolytics leads to the fact that a dry, non-productive cough turns into a productive one.
4. Combined-action drugs help eliminate inflammatory processes, relieve spasms in the bronchi and increase cough productivity.

As you can see, the mechanism of cough remedies is different, and many sick people, self-medicating, simultaneously take drugs with different effects and this only causes harm to the body.

List of drugs that block the cough center

Drugs that block the cough center are divided into narcotic, non-narcotic, local antiseptic drugs and mixed-action drugs. In narcotic drugs prescribed only to adults, the main component is codeine phosphate, which acts directly on the brain. Non-narcotic drugs do not affect the brain and are not addictive.

Herbal based

There are many herbs, decoctions and infusions of which are good for cough relief. These include wild rosemary shoots, licorice root, thyme grass, elecampane, plantain, and pine buds. There are also tablets containing plant materials, for example, Thermopsis. But in advanced cases it is better to use pharmacological agents.

Pharmacological agents

Pharmacological agents are available in various forms: tablets, mixtures, syrups, drops.

The most popular non-narcotic cough medications are Glaucine, Butamirate, Tusuprex, Libexin. They are prescribed for severe forms of influenza and ARVI, accompanied by a dry cough.

Local preparations are syrups, teas, lozenges based on plant extracts; they form a protective film on the mucous membrane, because have an enveloping effect. Of the synthetic agents, the most commonly used is Prenoxdiazine, which causes a direct antispasmodic effect.

Examples of combined action agents include Doctor MOM, Codelac, Stoptussin.

The best cough suppressant

There is no universal remedy for cough; in each specific case, the doctor examines the patient’s condition and prescribes appropriate treatment. Taking cough suppressants is necessary for dry coughs without phlegm. If you suppress a wet cough, the sputum will remain in the lungs and bronchi, this will aggravate the patient’s condition. It should also be taken into account that almost all antitussive drugs cause side effects.

Of course, the most effective way to treat a cough is to have a strong immune system. In order to catch colds less often and not get sick, you need to harden yourself, spend more time in the fresh air, regardless of the weather, and do physical exercise. You also need to monitor your diet, eat more berries, fruits and vegetables, which help accumulate enough vitamins and minerals in the body that increase the body’s resistance to infections.

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:

• dilution of sputum 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:

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

Prohibitions for use and precautions

Taking drugs 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.

A dry (non-productive) cough is an unpleasant symptom that indicates a disease.

Antitussives for dry coughs are effective drugs with therapeutic effects on the bronchial tree.

Important! The main therapeutic task is to transform the cough reflex into a productive (wet) form, which promotes the removal of bronchial secretions.

Dry cough: determining the causes

However, it should be remembered that before choosing an antitussive pharmacological agent, it is necessary to clearly determine the reasons that cause a dry cough.

Among the many diagnoses that cause irritation of the cough center, the following cause-and-effect factors can be identified:

• bronchial asthma;
• obstructive condition of the pulmonary system;
• acute or chronic bronchitis;
• sensitivity to external irritants (dust, gas, tobacco smoke);
• painful conditions of the nasopharynx;
• irritant side effect on the drug;
• problems with the functioning of the gastric or intestinal tract.

How are cough medications classified?

On a note! There are no universal antitussive drugs for dry cough. All pharmacological combinations are aimed at eliminating the cough reflex and differ in the type of effect on the respiratory tract.

Thus, these pharmacological antitussive groups can be classified according to the following parameters:

• drugs with combined antitussive action;
• therapeutic forms of peripheral action;
• centrally acting pharmacological agents;
• expectorants;
• mucolytics.

Expensive and inexpensive antitussive drugs for dry cough can be produced by the manufacturer in various dosage forms and forms:

• in the form of tablets;
• in the form of an elixir or syrup;
• in the form of dry collection of plants;
• in the form of lollipops or chewable pastilles;
• in the form of suppositories (candles).

The principle of action of antitussive drugs

Let's consider the most effective dosage forms for the treatment of dry cough and the mechanism of action of various antitussive drugs on the bronchopulmonary system.

Centrally acting antitussives (non-narcotic)

• Paxeladine is a pharmacological drug that has a softening effect on the respiratory tract of the respiratory system, inhibits irritation of cough receptors and does not have a narcotic effect on the central organ of the nervous system. This antitussive drug for dry cough in adults is recommended for the following conditions: smoker's cough, allergic cough, bronchitis, pneumonia, and so on. A contraindication for use is the body's hypersensitivity to the drug. Before using the drug Paxeladin, you should consult your doctor!
• Sedotussin is an effective antitussive pharmacological agent of central action, suppressing hyperstimulation of the cough center, having a local anesthetic and bronchodilator effect, the active substance of which is pentoxyverine.
• Sinekod is another medicinal antitussive form of central non-narcotic effect on the respiratory tract. Available in the form of tablets and syrup, which is recommended as an expectorant for children. The drug has an anti-inflammatory and moderate bronchodilator effect on the receptors of the cough center, which significantly improves oxygenation and blood spinometry.

Other medicinal antitussive forms of non-narcotic action include: Ledin, Ethylmorphine, Tusuprex, Akodin, Butamirate and so on.

Peripheral antitussives

Dosage forms of this pharmacological group have a suppressive effect on irritated receptors of the cough center, promote the formation of secretions and their removal from the respiratory tract:

• Libexin is an antitussive agent that allows you to block the reflex peripheral areas of the cough center without causing depression of the respiratory tract. Libexin has an anesthetic and bronchodilator effect on the inflamed areas of the bronchopulmonary system within 3-5 hours after administration.
• Bitiodine is an antitussive drug that has a beneficial effect on the upper respiratory tract and lungs during various inflammatory processes in the bronchopulmonary system.
• Prenoxdiazine is a synthetic antitussive agent that has a bronchodilator and anesthetic effect on cough receptors in the respiratory tract. The drug does not depress breathing, is not addictive, and has an anti-inflammatory effect in various chronic diseases of the bronchial tree.

It should be remembered that peripherally acting drugs can cause addiction and drug dependence. Therefore, such pharmacological agents are dispensed in pharmacies with a prescription from the attending physician.

Combined antitussives

On a note! Combined-action antitussives, which stimulate the excretion of bronchial secretions, facilitate breathing and promote dilation of the bronchi, will help suppress attacks of dry cough and turn it into a productive (wet) form.

The most effective pharmacological agents are:

• Doctor Mom is a combined antitussive drug made on the basis of an extract of medicinal plants. The pharmacological agent is available in various dosage forms: syrup, ointment, pastille. Doctor Mom does not contain narcotic or sleeping pills, synthetic substances or alcohol, so it can be recommended as an antitussive drug for children with dry cough.
• Codelac Phyto is a combination cough medicine. Contains only extracts of natural plant components (thyme, licorice root, thermopsis, etc.). The drug is recommended for patients with symptomatic therapy suffering from dry (non-productive) cough with various etiologies of respiratory tract dysfunction. Codelac Fito can be recommended for children from the age of two. In this case, supervision of a pediatrician or local pediatrician is required.
• Cofex is an antitussive and antihistamine drug with combined action. The composition of the pharmacological agent includes chlorpheniramine maleate, which has an antiallergic effect. Therefore, Cofex is an effective medicine for dry coughs of an allergic and/or infectious nature.

Mucolytics

The functional purpose of this type of pharmacological combinatorial agent is concentrated on the dilution and removal of accumulated mucus from the respiratory tract. In other words, transforming a dry, debilitating cough into a wet, that is, productive type. The main mucolytics that suppress the receptors of the cough center in dry cough are:

• Acetylcysteine ​​is a drug that belongs to the category of the most active antitussives. Acetylcysteine ​​has an antimicrobial, antiexudative and antitoxic effect, allowing it to dilute bronchial secretions and promote its active removal from the bronchopulmonary duct.
• Bromhexine is a drug that has an expectorant effect, allowing to increase the secretion of bronchial secretions and reduce sputum viscosity. The drug is very effective for various diseases of the respiratory system, such as pneumoconiosis, chronic and acute inflammation of the trachea, bronchitis and so on.
• Mucaltin is the most common expectorant pharmacological agent recommended for various diseases of the lungs and respiratory tract. In addition to the auxiliary components, the drug contains marshmallow root extract, which spontaneously regenerates the tissues of the bronchopulmonary tract, reducing and blocking inflammatory processes.

Cough remedies for children: review of drugs

A dry cough in a child may be the result of a developing pathology of the upper respiratory tract, such as laryngitis or pharyngitis. During a medical examination, a pediatric otolaryngologist prescribes special antitussive medications only when attacks of the dry cough reflex become unbearable, exhaust the child, and prevent the baby from sleeping peacefully. To suppress the cough center, drugs of combined, central and/or peripheral action are used. In addition to the above-described medicinal antitussives, approved for use in children over 2 years of age, there are other effective drugs that can improve the condition of the respiratory system in a child.

Let's review the most effective and popular medicinal antitussives for children:

• Tussin or Tussin-plus is a drug with a mucolytic and expectorant effect that stimulates the secretory cells of the bronchial mucosa thanks to the main component - guaifenesin. Glycerin, which is part of the structural content of the pharmacological agent, allows for a beneficial effect on inflammatory processes in the pharynx, relieving soreness and reducing pain.
• Herbion (syrup) is a unique medicine that has antispasmodic, mucolytic and bronchodilator effects, which contains biologically active additives based on ivy extract. Without causing side effects, this drug is well tolerated by young patients. A contraindication may be an allergic reaction in a child, a problematic condition of the gastrointestinal tract, or some endocrine and dermatological diseases.
• Bronchicum is an excellent drug that has an effective pharmacological effect aimed at treating diseases of the upper and lower respiratory tract, cough and other inflammations of the bronchial tree. Bronchicum is available in various pharmacological forms: in the form of drops, tablets, cough lozenges, syrup, balm, inhalate and even tea. Bronchicum contains the following natural ingredients: primrose and pimpinella roots, grindelia herb, thyme and rosehip flowers.