ACC for dry and wet cough

Cough is always exhausting effect on a person. Cough causes unpleasant physical sensations, and it also always leads to psychological discomfort. Many people know the situation when a choking cough and sore throat catch a person with the most inappropriate situation: in transport, at a business meeting, at a lecture meeting, or just during an important event. And often, recovery and the inability of a person to go to work, close a sick-list, occurs precisely as a result of the fact that a cough does not disappear for a sufficiently long period of time (despite the fact that the main symptoms of the disease have long ceased to bother a person). The cough may persist for several weeks after recovery from colds, inflammatory diseases of the respiratory tract. It is interesting that cough can accompany various diseases: pneumonia, bronchitis, sore throat, tracheitis. It is equally likely to develop with viral, bacterial, and even allergic diseases. Get rid of it does not always work. However, the ACC for coughing can now help. It stands for acetylcysteic acid.

N-acetylcysteine (NAC) is the second most popular drug for the treatment of acute cough in Germany, with a 23.5% OTC market share of non-prescription drugs in 2015 (source: IMS OTC report) [1]

Indications Cough cough

ACC for wet and dry cough known to many of us. It helps a person to get rid of symptoms such as severe coughing, burning, scratchy, increased and soreness in the lymph nodes, night snoring. No, perhaps, not a single person who at least once in his life would have accepted the ACC. The range of indications for its use is quite extensive. It is recommended for any diseases of the upper respiratory tract (especially if this condition is accompanied by intense pain, cough, runny nose). It helps with redness of the throat, inflammation of the tonsils and lymph nodes, a sharp increase in temperature, [2]in the treatment of COPD.[3]

Effectively relieves, prevents complications and recurrences of cough. The active ingredient prevents stagnation, accelerates metabolic processes. Recovery is much faster. It is used in both therapeutic and pediatric practice for a long time.

[4], [5], [6], [7]

Release form

ACC is available in the form of tablets, granules and syrup for children. Effervescent tablets, designed to be dissolved in water. White on the one hand there is a risk. There is a pleasant blackberry aroma, but some note a rather perceptible smell of sulfur. Granules produced in bags (foil). Sold in a carton box of 20 bags. Soluble in water. For children, a sweet syrup with a lemon, orange and blackberry aroma is produced.

• Effervescent cough tablets ACC

One of the most convenient and favorable pharmaceutical forms that are prescribed to provide therapeutic effects. Especially often used in therapeutic practice, otolaryngology. Phthisiology, pulmonology. You can drink up to three tablets of ACC per day. Effervescent cough pills are not recommended for children. Also, they are not recommended for use by people suffering from a lack of lactase, with glucose-galactose malabsorption. As a contraindication may be diabetes.

• ACC cough syrup

ACC in the form of syrup is intended for children. Coughing helps pretty quickly. There is conflicting evidence in the literature regarding the age at which this remedy can be given. Some doctors are inclined to believe that the drug can be taken from 2 years, others believe that it is better not to give it until the child is 5 years old. Anyway, the child is recommended to give 100 mg per dose. In the package, along with the syrup contains a measuring spoon. One measuring spoon contains 5 ml of solution, which is equal to a single dose.

• ACC Cough Powder

It is a white powder. This is already a semi-finished dosage form. In order to fully prepare the ADC cough suppressant, it is necessary to pour all the powder contained in the package into a glass or cup, pour it with warm water, and stir until it dissolves completely. Need to drink completely. It is advisable to do this before the solution has cooled. You also need to ensure that at the bottom there were no undissolved grains, because the effectiveness of the drug will decrease dramatically. To ensure control, it is recommended to use a clear glass, which should be dissolved in a glass of warm water before use. In one bag contains a single dose.

• ACC Long

This is the newest form of the classic drug - ACC. It has been refined to achieve a more durable mechanism of action. This is achieved due to a slight change in the drug formulation of the drug. Contains 600 mg, that is, the daily dose. Enough to drink one pill (1 bag).

• Children's ACC

Children under 2 years old are given only syrup (in accordance with the instructions). Since the age of two, tablets and granules can be given. But still it is better to use the syrup. As for tablets and granules, they are dissolved in water just like adults. From 2 to 5 years prescribed half the standard dose per day (300 mg), from 5 to 12 years - at 400-500 mg per day. After 12, 600 mg per day is allowed. For safety reasons, the method of application, the optimal dose should be selected only by a doctor.

Pharmacodynamics

If we talk about pharmacodynamics, the first thing you should pay attention to is that it removes the inflammatory process, restores the body, stimulates metabolic processes, boosts immunity. Additionally, it has antipyretic effects, and a slight analgesic (analgesic effect).

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Pharmacokinetics

Speaking of pharmacokinetics, we note that the active substance, which is part of the drug, shows tropism to the receptors of the alveolar pathways.

Due to its lytic properties, it changes the physico-chemical properties, viscosity and consistency of sputum, surfactant. This makes it more fluid, resulting in easier excretion. Thins the sputum, brings it out. By stimulating the receptors, it strengthens the cough, which also contributes to the reflex release of sputum. It accumulates in the bronchopulmonary tissue, penetrates into the alveoli and bronchioles after 1-2 hours after ingestion. Peak concentration is detected in about 2-3 hours. Then the substance begins to be distributed in tissues and biological fluids, providing a therapeutic effect on the entire body. Excreted by the kidneys.[9], [10]

Dosing and administration

Assign inside. If we are talking about tablets, one tablet should be dissolved; if we are talking about granules, one packet is dissolved. The standard single dose is 200 mg for an adult (one tablet or bag). 600 mg per day is allowed.

Application for children

Let out syrups. Assign, regardless of the etiology of cough. Effective if the cough is caused by a bacterial process, and if the cough is caused by a viral, and even allergic process. Independently decide on the appointment of this drug to children in any case can not, because it is dangerous serious consequences and complications. Application for children has its own specifics, so be sure to consult with your doctor.[16]

Use Cough cough during pregnancy

It is usually considered that the use of any medications is contraindicated during pregnancy. But if the inflammatory process, the cough begins to progress, admission is allowed (the effects of cough will be much more serious than all possible risks of therapy). N-acetylcysteine is a well-tolerated drug that can be a potentially effective treatment for cough during pregnancy. Dosage is individual. [11], [12] To date, there is no data whether ACC affects the fetus.[13]

Contraindications

There are not many contraindications, but they are all quite serious. Basically, any serious pathology of the lungs and the digestive system, the postoperative period, is considered a contraindication. It is necessary to refrain from taking ACC during exacerbation of ulcers and duodenal ulcers, with ulcer gastritis, as well as with pulmonary, gastric, intestinal hemorrhage, hemoptysis, with the appearance of blood impurities in the sputum. This is primarily due to the fact that the drug thins the blood. This should be taken into account for people with bleeding disorders. Strict contraindication - hemophilia, bleeding tendency.

Not recommended for use in renal failure, diseases in the acute stage. Also, there is a load on the urinary system, the drug can cause intoxication, edematous syndrome, hypertension, tachycardia, so caution should be taken for kidney disease. For the same reason, once again, it is not necessary to prescribe to pregnant women, children under 3 years old, with increased individual sensitivity (if it is possible to refrain from taking, it is better not to take). When intolerance to histamine is also not recommended.

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Side effects Cough cough

It is recognized as a relatively safe drug, so side effects are rarely observed. Possible violations of the kidneys, liver, urinary disorders or excretion of bile, a violation of digestion. With a tendency to an allergic reaction, edemas, dermatitis, eczema, and urticaria develop. When the tendency to bleeding can develop bleeding, because the drug reduces blood clotting.

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Overdose

Overdose is accompanied by disorders of the digestive system, respiratory organs, bleeding. Nausea, flatulence develops. Sometimes there are signs of poisoning. In order to provide emergency care, you need as soon as possible to induce vomiting, flush the stomach. This will eliminate the substance from the body. Then you should call an ambulance, after informing the dispatcher about a possible poisoning, overdose.

Interactions with other drugs

It should be borne in mind that this pharmacological group of drugs reduces the activity of antiseptics and antibacterial drugs, and increases the activity of nitroglycerin. Relatively well tolerated by the body. No specific interaction with other drugs is not registered. There are data: able to react with antiviral drugs, but they are not officially confirmed.

In the study, both groups of people treated with fluticasone and salmeterol and placebo showed that N-acetylcysteine has a synergistic effect with these drugs. The authors suggested that the antioxidant effects of this drug were responsible for its therapeutic effects.[17]

Storage conditions

ACC should be stored in original packaging. Usually storage conditions are prescribed in the instructions. You can store the drug in room conditions, or in the refrigerator, on the door, on the bottom shelf (children's syrup). Temperature - not higher than 25 degrees. The package must not be exposed to direct sunlight.

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Shelf life

May be stored for two years from the date of production. The drug should be discarded if the expiration date has expired, since there will be no effect on the treatment. Open syrup is stored no more than a month.

Analogs

The closest analogues are Linkas, Erespal, Doctor Mom, Ambroxol, Ambrobene, Bronchobos, Bromhexine, Mucaltin.

• Bronchobos

It belongs to the group of antitussive, mucolytic agents. Indications for administration are diseases such as tracheobronchitis, bronchitis, and a strong cough. Used for the relief of bronchospasm, asthma attack.

• Bromhexine

Acts quickly, because the bulk of it accumulates in the lung tissue. It is better to prescribe for chronic pathologies, since it acts for a rather long time, exerting a maximum therapeutic effect. The mechanism of action is the dilution of sputum. Drink plenty of drink.

• Ambroxol

The effect of the drug begins immediately after administration, the duration of action is 6-12 hours. The main action - sekretomotorny, secretolytic, expectorant. Stimulates serous cells, increasing their activity. The phlegm becomes thinner. Contributes to the normalization of patency, the elimination of the inflammatory and infectious process. There is a direct effect on the alveoli, alveolar cells and pneumocytes. Differs absolute bioavailability.

• Mukalla

Helps to eliminate sputum, relieve inflammation. Stimulates the production of local immunoglobulin, interferon, reduces the reactivity of the bronchi. The action of this substance is aimed at restoring the carbohydrate metabolism of the microorganism. Considered as a complex antitussive medication.

Reviews

It may be noted that positive reviews prevail. Negative reviews are extremely rare. In addition, it was found that negative reviews are observed only with improper use of the drug, or when exceeding the dosage. ACC cough significantly relieves the condition, quickly relieves cough (dry, wet), eliminates pain, inflammation, prevents the development of complications, reduces the temperature. The drug has the ability to dissolve (dissolve) sputum, bring it outside, stimulating cough. Acts fast. In 2-3 days cough, nasal congestion decreases. Apply to both children and adults. Children really like syrup, because it is sweet, tasty, with a pleasant aroma. Adults are suitable pills, powder. Full recovery usually occurs on the 5th day; this is the minimum course of treatment.

[19], [20]