Cough suppressants and combination therapies for dry and wet coughs

Cough suppressants are less popular in the treatment of this symptom compared to mucolytics and expectorants. Nevertheless, stimulation of sputum expectoration is not always necessary even with a wet cough, let alone a dry one. If it was possible to pacify the rampant infection, inflammation begins to subside, the amount of expectorated sputum decreases, but the irritated bronchi may still react sensitively to any factors, including cool or too dry air. Coughing becomes unproductive, but can be exhausting for a person already weakened by the disease. In this case, it is a good idea to turn to cough suppressants.

The same drugs help young children with severe coughs that cause anxiety, decreased appetite, sleep and breathing disorders. If there is no infection or allergens in the respiratory tract, there is no special need to clean them, so you can start fighting unnecessary coughing attacks that do not bring relief or recovery.

Reduce the intensity of cough syndrome can be used one of two types of drugs: expectorants of combined action, reducing the intensity and number of acts of expectoration of sputum, or cough suppressants, reducing the sensitivity of mucous to stimuli and the activity of the cough center.

Stoptussin

One of the effective drugs with a combined composition, which successfully combines an antitussive component and expectorant (a substance with expectorant action). The drug is available as tablets, non-alcohol-based drops, sweet syrup with caramel flavor.

Pharmacodynamics. The action of the drug is due to the combination of active substances, which, at first glance, have an opposite effect. But the fact is that the anti-cough effect of butamirate is based on a decrease in the sensitivity of bronchial receptors to irritation, so the cough center receives fewer signals of "alarm". This substance does not have a direct effect on either the cough brain or the respiratory center, so it does not buy cough as a symptom, but only reduces the number of such acts. Guaifenesin, in turn, eases coughing and makes attempts to cough up accumulated sputum more productive.

Such a drug can be prescribed by a doctor even in the active phase of the disease, if frequent coughing attacks greatly affect the quality of life of the patient. It will also be effective in a low-productive, but compulsive cough at the beginning of the disease.

Pharmacokinetics. Both active substances of the drug quickly penetrate into the blood at oral administration, but the effect of butamirate is more prolonged. The drug is excreted by the kidneys.

Method of administration and dosage. Tablets that must be swallowed whole, drinking a neutral liquid or juice, refer to medicines for adolescents and adult patients. It is recommended to use them from the age of 12 years. When dosing, not only the age, but also the weight of the patient is taken into account.

Thus, if the patient's weight is less than 50 kg, the single dose will be half a tablet. This dose will have to be taken 4 times a day. If the patient's weight is between 50-70 kg, you will need to take one tablet three times a day, and if the body weight is over 70 kg - one and a half tablets.

Patients whose weight is more than 90 kg, doctors recommend taking the drug 4 times a day for one and a half tablets.

Syrup is allowed to be taken from the age of six months. When calculating doses, again rely on the patient's body weight. Measure the amount using the pipette provided.

Infants up to 12 kg can be given 1.25 ml of syrup up to 4 times a day. If the weight is less than 20 kg, children should receive 2.5 ml of the drug three times a day, and if the body weight is between 20-40 kg - four times a day.

Patients who weigh more than 40 kg but less than 90 kg receive 5 ml per dose. Those whose weight is less than 70 kg receive this dose 3 times during the day, and those who weigh more - 4 times.

Patients with a weight of more than 90 kg should take the syrup in a dosage of 7.5 ml. Frequency of administration up to 4 times a day.

The best time to take the syrup is after the main meals.

Drops "Stoptussin", which do not contain ethanol, are allowed to be used from the newborn period, taking into account the weight of the child. Newborns with a body weight of less than 7 kg need 8 drops of the drug in water, babies with a body weight of up to 12 kg is enough 9 drops. Children should take the medicine 3-4 times a day (as prescribed by the pediatrician).

If the child's weight is more than 12, but less than 30 kg, the recommended dose is 14 drops. If the weight is less than 20 kg, this norm should be taken 3 times during the day, and if the body weight is more than 20 kg - the doctor may prescribe three or four times a day.

Adolescents with a weight between 30-40 kg are prescribed an effective dose of 16 drops 3 to 4 times a day.

At a weight of 40-50 kg, the dose is equal to 25 drops, 60-70 kg - 30 drops. Patients with a body weight of 70 kg and above need to take 40 drops of the drug at a time. The frequency of administration for adult patients is 3 times a day.

The drops are diluted in water or other neutral liquid. Dosages are per 100 ml of liquid. If the amount of liquid needs to be reduced (e.g., for infants), reduce the number of drops, trying to maintain the desired concentration of the solution.

It is considered that the interval between taking any form of medication should be no less than 4 and no more than 6 hours.

Overdose with the drug is usually manifested by symptoms caused by the toxic effect of guaifenesin. Patients may appear lethargic, complain of drowsiness, weakness in the muscles, nausea, etc. Gastric cleansing, taking absorbents and medications to control the symptoms that appear can help to manage the symptoms.

Contraindications to use. Contraindications to the drug are few The main ones are considered hypersensitivity to the drug form and myasthenia gravis (muscle weakness). Syrup is not recommended for patients with hereditary fructose intolerance (the composition includes the sweetener maltitol).

Administration of "Stoptussin" preparations should not be combined with the intake of alcohol.

Use during pregnancy ofany form of the drug is acceptable if there is a special need for it. It is highly undesirable to take the drug in the first 3 months of pregnancy, as there is a correlation between taking guaifenesin preparations and the number of fetal anomalies (inguinal hernia).

There is no information about the penetration of the active ingredients of "Stoptussin" in maternal milk, in this regard it is worth consulting a doctor.

Side effects. Information about the development of undesirable effects during treatment with "Stoptussin" is very rare. To get rid of them helps to correct the dose of the drug.

Most often patients complain of decreased appetite, headaches, weakness, daytime sleepiness. There may also appear: abdominal discomfort, nausea, diarrhea, heart rhythm disturbance and chest pain, allergic and skin reactions. The appearance of urinary stones is considered a rare consequence of treatment.

Interaction with other drugs. Magnesium and lithium drugs enhance the expectorant effect of "Stoptussin". But the side effects of the drug in the form of general weakness and myasthenia gravis are more often manifested as a result of combination with myorelaxants.

The guaifenesin-based drug itself can also enhance specific effects of other drugs, such as the analgesic effects of aspirin and paracetamol. It also increases the depressant effect of alcohol on the nervous system.

Storage conditions. Drops and tablets "Stoptussin" can be stored for 5 years, syrup - a year less. An opened bottle of syrup has a shelf life of only 4 weeks.

The drugs "Pectolvan" (analog by active substances), "Broncholitin", "Bronchoton", "Tos-mai" (analogs by mechanism of action) also have a similar effect.

The drugs "Sinekod", "Codelac", "Rengalin" can not be considered as recommended remedies for wet cough. By acting on the brain areas associated with the cough and pain reflex, they significantly reduce the frequency of coughing, which can cause congestion. However, in the absence of infection and insignificant production of bronchial gland secretion, such drugs can be used to improve the patient's condition (symptomatic therapy of an irrelevant symptom).

It makes no sense to describe all the drugs of this group in this article on the treatment of wet cough, since they are more relevant for the treatment of non-productive (dry) cough. Let's consider only one of the drugs with an interesting composition.

Regnalin

An anti-cough drug that contains a combination of antibodies to sensitive histamine, morphine and bradykinin receptors. Reducing the sensitivity of these receptors, they inhibit the work of pain sensitivity centers in the intermediate brain and the central cough center, which receives significantly fewer signals from the periphery. By suppressing the cough reflex, the drug does not affect the respiratory center, which allows effectively preventing such phenomenon as bronchospasm.

The drug is also characterized by anti-inflammatory and analgesic effect. It effectively relieves allergic tissue edema and makes acts of coughing with difficult sputum production less painful.

This antitussive drug is allowed to be used in the acute phase of bronchial and pulmonary diseases. It is prescribed even in case of productive cough, if this symptom is caused by an allergic reaction (including allergies to products of bacteria and viruses).

The drug is available in the form of tablets for resorption and non-alcoholic solution for internal administration. Both forms of the drug are relevant for the treatment of patients over 3 years of age.

The effective dose of the drug is 1-2 tablets or 5-10 ml of the solution, which should be held in the mouth for some time before swallowing. The medicine should be taken 3 times a day. During the first days of treatment, the frequency of drug administration can be increased up to 6 times a day.

It should be said that the solution is a more preferable form of the drug when it comes to the treatment of children, which is difficult to explain the need to keep in the mouth not the most tasty tablet.

The drug "Rengalin" is not prescribed to patients with intolerance to the components of the selected dosage form. The inclusion of sweeteners in the composition may be an obstacle to the use of drugs in patients with diabetes mellitus and impaired metabolism of sugars.

Children under 3 years of age are not prescribed the drug due to the lack of experimental data on its safety. There is no such data on the treatment of pregnant women, so the decision is made by the attending physician based on the ratio of risks for the mother and fetus. The same applies to breastfeeding mothers.

Overdose with the drug is characterized by the appearance of dyspeptic disorders, which are treated symptomatically.

Among the side effects, only hypersensitivity reactions to the components of the drug are indicated.

Both tablets and solution can be stored for 3 years from the date of issue under normal conditions.