Does the cough need to be treated?
Last reviewed: 07.06.2024
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The clinical picture of the disease is usually called a set of symptoms, the specificity of a particular health pathology. The most common symptom characterizing diseases of the respiratory system is a cough. And it is worth it to appear, as we immediately think about methods to combat this unpleasant phenomenon. How justified this behavior, whether it is necessary to treat cough, if sputum expectorates without external intervention and what are remedies for wet cough, we will talk in this article.
A human being is a complex self-regulating organism consisting of a huge number of cells, which are formed and function not in a phaotic manner, but according to a strictly planned scheme. What does that mean? It means only that we have such a structure that controls all the processes taking place inside us. This controlling organ is the central nervous system (CNS).
In one of the CNS departments, namely in the medulla oblongata, there is a cough center, which gives a command to action, having previously analyzed its necessity. In this case, coughing, as an inflammatory process, scientists consider as its own physiologically conditioned reaction of the body, which is designed to stabilize the processes occurring in the body every second, and in particular the process of breathing.
Dust entering the respiratory tract, mucus and bacteria accumulating there during inflammation are not needed by the body. To avoid getting "garbage" into the bronchioles and lungs (which complicates the situation by preventing normal air circulation), the nervous system takes action to remove it from larger structures: trachea and bronchi. Thus, coughing should be considered as a CNS-controlled process of clearing the respiratory tract.
But how does the brain know what is going on in the airways and when they need to be cleared? The brain receives signals from many sensitive cells (receptors) located in the upper and lower respiratory tracts (the greatest number of receptors are in the larynx, at the junction of the larynx and trachea, and in the mediastinum, while there are no such receptors in the smaller pathways of the lungs).
Receptor irritation is a danger signal perceived by the immune system. Specific cells rush to the site of the signal, with which the inflammatory process is associated. In the focus of inflammation there is an active secretion of mucus, containing and immune system cells designed to destroy microbes that have invaded the respiratory system.
The signal from specific receptors also arrives to the cough center of the brain through sensitive nerve pathways, and from there in the opposite direction to the pectoral muscles - through motor ones. The signal is transmitted in both directions through the sensitive and motor fibers of the vagus nerve.
Thoracic muscles receive a signal from the CNS to contract, which they do. In this case, out of the respiratory tract jerked out a stream of air, taking with it irritants and excess mucus accumulated in the respiratory tract, which doctors call sputum.
But if the mechanism of coughing is the same, why in some cases sputum is formed in large quantities and is easily expectorated by the emerging cough reflex, and in others - it seems to be absent or does not want to be removed from the bronchi? In addition, in some cases, sputum seems to accumulate a lot, and its expectoration is very difficult, accompanied by painful sensations. So, how to distinguish a dry cough from a wet cough?
The formation of large amounts of sputum is associated with irritation of the respiratory tract and the development of the inflammatory process. This is to some extent a positive process, indicating the normal functioning of the mucosal cells of the trachea and bronchi, producing a special secret to clean and moisturize the respiratory tract. Such secretion is easily separated when coughing, facilitates breathing, reduces irritation of sensitive receptors.
If there is a lot of sputum accumulated and it is easily expelled by coughing, we are talking about a wet version of this symptom. In this case, it can be said that the body copes with the arisen task successfully, and it does not need help from the outside. In such cases, there is no need to take any cough medicine at all, it is enough to drink more liquid, which will maintain the balance of moisture in the composition of sputum.
But as the active secretory cells of the respiratory mucosa decrease, the volume and character of sputum may change. Despite the active inflammatory process of sputum seems to become less and it is transformed into a thicker sticky mass, which hardly comes out under air pressure, although in the bronchi and lower parts of the trachea a person feels an incomprehensible lump and cloche. Such a cough, in which sputum accumulates in sufficient quantities to prevent the normal passage of air, but is separated with difficulty, is also called wet cough.
But this symptom already requires special attention, because full cleaning of the respiratory tract does not occur, and congestion only contributes to the multiplication of infection. Remedies for wet cough in this case - it is both optimizing the cleaning of pathways for air circulation, and relief of distressing symptom, and prevention of complications,
In cases where coughing is caused by severe irritation of receptors without the development of inflammation (for example, when a foreign body enters the respiratory tract), we speak of a dry cough. The same type of cough is usually observed at the end of colds, when part of the mucosal cells of the tracheobronchial tree died during the inflammatory process, so the epithelium produces less mucus, which in addition becomes more viscous (worse contact with water and harder to separate from the inner surface of the respiratory tract).
A dry cough at the beginning of the disease is due to insufficient mucus production. The cough is caused by irritation of the receptors of the larynx, where the infection is initially localized. This cough can be called laryngeal cough, it is loud, irritating, it is difficult to stop (also due to dry mucous membranes). The immune system to rocking will take some time, during which the microbes usually have time to move noticeably towards the trachea and bronchi, so when the transition of dry cough into a wet cough changes and the localization of the focus of irritation.
Dry cough is a reflex reaction arising from irritation of receptors, which is not accompanied by active mucus production. Such a cough is often called non-productive, and it occurs not only in infectious-inflammatory diseases of the respiratory system (for example, whooping cough and tuberculosis), but also in pathologies such as bronchial asthma, allergies or reflux esophagitis. Coughing without sputum production or with little sputum may also occur in cardiac pathologies.
Treatment of dry cough is associated with the question of the correct choice of drugs, because in some cases it is necessary only to extinguish the cough reflex caused by hypersensitivity of receptors, and in others it is necessary to increase the production of sputum, without which it is almost impossible to qualitatively clean the respiratory tract. For example, at the beginning of colds it makes sense to prescribe drugs that facilitate expectoration of sputum and increase its amount, and at the end - cough medicines that stop the cough reflex.
With a wet cough, the need for medication is not always necessary. If the sputum comes out easily, you can do without medication, but a difficult cough, accompanied by wheezing and cloping sound, must be treated and very actively.
So, to summarize. Dry cough is a reflex arising from irritation of the upper parts of the larynx. We feel it as a cough coming from the throat. Wet cough occurs when the infection spreads deep into the respiratory system: to the bronchi and lungs, so a person will complain of a feeling of a foreign body in the chest area and a coughing symptom coming from somewhere deep in the respiratory tract. It can be both productive, not requiring special treatment, and unproductive, heavy, debilitating, which must be treated.
The most popular question that usually arises in such a situation: how to get rid of a wet cough? Yes, you do not need to get rid of it. Get rid of the cough can get rid of special anti-cough medicines. But it is fundamentally wrong to treat a productive cough with cough suppressants that affect the CNS. The problem is not in the brain, but in the fact that the body itself is not able to produce enough mucus of appropriate quality, necessary for good cleaning of the respiratory system. It is necessary to help your body to do everything to make coughing more productive, so that there is no stagnation of mucus, where the microbes.
We will talk more about this, about the choice of drugs for wet cough. After all, not only our condition at the time of treatment, but also the likelihood of complications in the future depends on how fully the choice corresponds to the situation.
Form of release of preparations for wet cough
At one time, the most popular form of release of various drugs used to treat all sorts of diseases and their symptoms were pills. They are still firmly holding their position today. But here means for the treatment of wet cough in the form of tablets and capsules today are no longer as popular as before, because a lot of more convenient for adults and children forms of drugs with mucolytic and expectorant action have been developed.
Such well-known cough medicines as "Ambroxol", "Bromhexin", "Acetylcysteine", "Mukaltin", "Stoptussin", "Cough tablets with thermopsis" and others are still available in tablet form. A few later, new names of cough medicines appeared, and the list has noticeably expanded. Tablets and capsules began to produce such remedies for wet coughs as "Codelac", "Lazolvan", "Atsc", "Regnalin", "Ascoril", "Erespal", "Gedelix", "Pulmolor", "Ambrobene", "Prospan", "Fluimucil", "Atma" and others. At the same time, it is not always about the usual tablets, it can be effervescent firms, dissolved in water (for example, "Atsc"), or tablets that need to be resorbed (for example, "Regnalin").
One of the variants of tablets are cough lozenges "Doctor MOM", "Gerbion", "Broncho-Veda", Dr. Taisse lozenges and others. Such medicine is definitely more pleasant to taste, but usually contains sugar, so it is not suitable for diabetics and people with problems in glucose assimilation.
Another type of solid form of tablets with expectorant action, thinning sputum, are pastilles from dry and wet cough "Prospan", "Linkas", "Bronchostop", "Alex-Plus", "Bronchicum", "Linkas", "Travisil", etc. Pastilles and lollipops are a combination of a drug and everyone's favorite confectionery (candy), though not all therapeutic "candies" are intended for the treatment of children.
When a person has a cough, swallowing tablets and capsules can be difficult even for an adult, not to mention the fact that small children are not suitable for this form of medication. It is much easier to drink the medicine in liquid form, and there are several varieties of such forms.
Drops used for wet and dry cough are alcohol-containing liquid (preservative), in which the active substance is dissolved in a concentrated form. You can take such medicines both undiluted and mixed with a small amount of water. On the shelves of pharmacies you can see several names of preparations in the form of drops: "Sinekod", "Codelac" and "Pectolvan", usually used for dry cough of various etiologies and moist low-productive residual cough after a disease of the respiratory system, as well as "Chest drops from cough", "Bronchofit", "Atma" and "Nashatyr-anise drops" - preparations with expectorant effect.
Despite the fact that such preparations contain alcohol. They can be used from as early as 2 months of age.
If the active ingredient is water-soluble, the drug may also be available in the form of powder for preparation of suspension. The action of such medicines is similar to tablets, but wet cough suspensions are easier to swallow than tablets.
In the form of suspensions are often produced antibacterial agents prescribed for infectious-inflammatory diseases of the respiratory system: powders for the preparation of the drug "Summamed", "Biseptol", "Ospamox", "Amoxiclav", ready-made suspension "Bactrim" and others. Such drugs make it much easier to treat children and patients who have difficulty swallowing tablets.
Cough medicines in this form are rarely available (for example, suspension "Privitus", prescribed from the age of 2 years). A more popular option is considered a mixture for wet and dry cough - a liquid multicomponent mixture. As an example, there are dry cough mixtures for children "Arida", "Cough Mixtura" (available separately for adults and children), "Codelac Broncho with thyme" and others.
Looking ahead, we will say that to liquefy phlegm and facilitate its passage, very effective procedures called inhalations are used. Inhalations from a wet cough can be carried out both with the use of herbs and medicines. For inhalations in nebulizers it is most convenient to use crushed and dissolved tablets, powder for suspension, mixtures, less often used drops, syrups and essential oils (not all devices can work with such medicinal forms, but for steam inhalations they are quite suitable).
Syrups from a wet cough - this is today almost the most common form of release, which can be given to both adults and children. This is most often a tasty sweet medicine, although not always with a pleasant flavor. Nevertheless, it is much more pleasant to take it than other forms of medicines, and it works quite quickly, because the active components are already in a dissolved state.
Children's syrups for wet cough are a great way to relieve cough syndrome in young patients without harming their health. To such syrups can be attributed: "Ascoril-Espectorant", "Gerbion", "Ambroxol", "Lazolvan" and "Ambrobene" with a dosage of 15 mg of ambroxol per 5 ml of syrup, "Pertussin" for children, "Stoptussin phyto", "Fluifort" and "Fluditek" 2%, "Alteika", "Erespal", "Prospan" and others. For the treatment of children under 2-3 years of age, it is important to choose special syrups for children, paying attention to the instruction, which indicates the age from which the use of sweet medicine is allowed.
The following syrups can be used to treat children over 2-3 years old and adult patients: "Bronchostop", "Herbion" (syrups of plantain, primrose, ivy), "Rengalin", "Pertussin", "Codelac", "Fluditek", "Cough syrup with bilberry and licorice", "Broncholitin", "Ambroxol" 2 and 5%, "Gedelix" "Ambrobene", "Licorice syrup", "Thermopsis syrup with licorice", syrups Dr. Taisa and "Dr. MOM", "Inspiron" (secretolytic with bronchodilator and "Dr. MOM", "Inspiron" (secretolytic with bronchodilator, "Ambroxol" 2 and 5%), "Gedelix", "Ambrobene", "Licorice syrup", "Thermopsis syrup with licorice", syrups Dr. Taisa and "Dr. MOM".Taisa and "Dr. MOM", "Inspiron" (secretolytic with bronchodilator action) and many others. Choosing remedies for wet cough in children from 2.3 years, it is important to take into account the cause and nature of the symptom, as well as the recommended doses, which are usually slightly different for children and adults.