Pastilles from a sore throat

As local symptomatic treatments, lozenges from throat pain that gradually dissolve in the mouth can be used, and the medicinal substances contained in them have antiseptic, disinfectant and analgesic effects on the mucous membranes. Since they are all antiseptic, they have an ATC code - R02AA20.

Indications for the use of analgesic antimicrobial pastilles include: ARI and SARS with sore throat and hoarseness of voice, acute and chronic tonsillitis (angina), laryngitis, pharyngitis, laryngotracheitis, and inflammation of the oral mucosa (stomatitis) and gums (gingivitis).

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Pharmacodynamics

The therapeutic effect of lollipops from the pain in the throat of Septotelet is based on the antiseptic benzalkonium chloride (2,4-dichlorobenzyl alcohol), which is included in their composition, which blocks the process of hydration of cells of pathogenic microbes, which leads to their dehydration and death. Also, the drug contains thymol - an anesthetic and antiseptic monoterpene phenol, levomenthol and essential oils of peppermint and eucalyptus. Mint oil, thanks to menthol, blocks the channels of Ca2 +, dilates the vessels and relieves pain. A monoterpene compound of cineole in mint and eucalyptus oils is a strong antibacterial, antifungal and antiviral substance.

Pharmacodynamics of pastilles Astracept is due to the same dichlorobenzyl alcohol, as well as phenolic antiseptic amylmetacresol, which stops the synthesis of proteins in microbial cells.

Active substances pastilles Anti-Angina: halogen chlorhexidine, tetracaine hydrochloride analgesic and antioxidant vitamin C (ascorbic acid). The antiseptic component chlorhexidine destroys many bacteria, trichomonads, and also neutralizes the activity of the fungus candida and herpesvirus by binding the phosphates of the cytoplasmic membranes of their cellular structures.

Analgesic and antibacterial action of Angal pastilles provide lidocaine hydrochloride (by blocking Na + channels in the cells of peripheral nerve fibers and stopping the conduction of nerve impulses) and the already mentioned chlorhexidine.

Hazsadrups (Laboratoires Doms Adrian, France) shows bactericidal activity against strepto- and staphylococci, since the active antiseptic biclutymol (biphenol derivative of 6-chlorothymol) destroys the bacterial cell walls by coagulating mucopolysaccharides; also has analgesic properties. In addition, these pastilles contain ioxagolic acid, which is an iodine-containing radiopaque substance. The manufacturer in the manual does not explain how this substance acts with sore throat, although it is known that iodine is also an antiseptic and absorbed by the mucosa.

Pharmacodynamics Eucalypt-M is based on the effects of essential oil of eucalyptus and levomenthol. The main active substance of pastilles Sage is an essential oil of medicinal sage containing such anti-inflammatory and antimicrobial compounds as cineole, borneol and thujone.

The lozenges from the perspiration in the throat of Isla-Mint (Isla-Moos) act as antiseptics due to the presence in them of an aquatic extract of the Icelandic (Icelandic moss) centerland, which contains antimicrobial acids - usninovuyu, lichesterinovuyu,

Pharmacokinetics

Since the lozenges from the pain in the throat are kept in the mouth, their active substances in small amounts, with saliva, are in the stomach. Most manufacturers of these medicines do not provide information on their pharmacodynamics. Some note that "pharmacokinetics studies of the drug have not been carried out."

It is known that benzalkonium chloride is not absorbed by the mucous membranes. Chlorhexidine is almost not absorbed by the mucous membrane of the mouth, throat and in the gastrointestinal tract, and what is absorbed, is 10% decomposed in the liver and excreted by the intestine.

Local anesthetics of tetracaine hydrochloride and lidocaine are absorbed by the mucous membrane of the oropharynx. Tetracaine binds to blood plasma proteins, but after 60-90 minutes it is cleaved by a hydrolytic enzyme cholinesterase in the liver; excreted in urine and bile.

The pharmacokinetics of lidocaine hydrochloride is characterized by the formation in the liver of active metabolites, which are excreted by the kidneys in 4-18 hours.

Biklotimol in the composition of lozenges Hexadereps is absorbed through the mucous membranes and is present in the oral cavity long enough.

Names of troches of pain in the throat

In pharmacies, there is a large choice of means for local symptomatic therapy of the aforementioned airway diseases, and it is possible to pick up lozenges from the throat swelling, depending on the severity of the symptom and etiology of the disease, bacterial or viral.

Among them, the following are the names of pastilles for sore throat: Sepptelet (Sepptelet D, Septoleto Neo), Astracept (Agicept, Gorpils, Suprima- lor, Lorgpils), Anti-Angin, Angal, Hexadrupps, Eucalyptus-M, Sage, Isla-Mint (Isla-Moos) and others.

Pastilles Doctor MOM, containing the isomer of menthol, levomenthol, extracts of licorice, ginger and embryo (aml), are an expectorant and are used with an unproductive cough accompanying a cold.

In most cases, lozenges from sore throats are contraindicated for children if the child is younger than 6 years old, and Eucalyptus M lozenges are not used until age 8. Sucking pills from the throat of Astracept, Angal and Sage are allowed to be used by children from the age of 5, Sepptethon and Isla Mint - after 4 years.

Pastilles from sore throat with anesthetic hydrochloride tetracaine - Anti-Angin; with lidocaine hydrochloride - Angal. Sepptelet, Astracapt (Adjicept), Eucalyptus-M have in their composition menthol or levomenthol, which acts on the receptors of the mucous membrane of the oropharynx, which provides an anesthetic effect of these pastilles.

Pastilles from the throat with antibiotic are not produced, since antibacterial drugs for bacterial diseases of the upper respiratory tract and ENT organs are systemic and should be prescribed by a doctor, and in what cases see Antibiotics for angina, antibiotics for laryngitis.

Cheap lozenges for sore throats - Agicept and Goppils of Indian origin, their average price in pharmacies is almost twice lower than the cost of their synonyms (see above), as well as their analogue Sepptelet (Krka, Slovenia) or pastilles H.Ten Herkel , The Netherlands).

If you need good lozenges from sore throat (the definition of "good" is not entirely correct for medicines), pharmacists advise paying attention to their composition and mechanism of therapeutic action (pharmacodynamics), as well as their contraindications and possible side effects.

The way of using pastilles against pain in the throat

The only way to use the pastilles for sore throat is to keep it in your mouth until it dissolves completely.

Septopet and Astracept adults and children over 12 years should use one lozenge at least three hours (the maximum daily amount - 8 pastilles); children 4-10 years - four pastilles during the day, 10-12 years - six. Duration of application - no more than four consecutive days.

Anti-Angina and Angal adults are recommended for 6 lozenges a day (2-3 hours), children - three lozenges (at intervals of 4 hours).

Adults can take up to 6 Hexadropes pastilles (under the tongue) during the day, children after 6 years - half as much.

Eucalyptus-M is allowed to apply one paste to four times a day - adults, children - no more than two pastilles during the day. Duration of use - no more than five days. Maximum allowable daily amount of pastilles Sage for adults and children over 15 years old - 6 (at intervals of 2.5 hours); children 10-15 years - 4 lozenges a day, 5-10 years 3 lozenges (after 4 hours). Use Sage Salves can last no longer than seven days.

The maximum daily dose of Isla-Mint (Isla-Moos) pastilles for adults and children over 12; children 4-12 years - 6 pastilles (on the lozenges every 2-2.5 hours).

The use of lozenges against pain in the throat during pregnancy

Septolete can be used during pregnancy only on the recommendation of a doctor; Also, use these lozenges for pain in the throat during lactation.

In the instructions to AstraSept, Anti-Angina and Heksadreps, information about the possibility of their use during pregnancy is absent.

In the period of pregnancy and lactation, the panicles of Angal can be used, but in the exact recommended dosage and not longer than three days.

Eucalyptus-M lozenges, according to the instructions, require caution when used during pregnancy. A sachet of sage (as both plant and essential oil contain plant estrogens) in this case should not be used.

Information on the negative effect of the Isla-Mint pastilles on pregnant and breastfeeding producers (Engelhard Arzneimittel GmbH & Co, Germany) has not been reported.

Contraindications for use

The pastilles presented in the review from pain in the throat have the following contraindications to the use:

• Septhotte - galactosemia, glucose malabsorption syndrome, hypersensitivity to the constituent substances (fructose), lack of lactase or isomaltase; age younger than 4 years.
• Astracept - hypersensitivity, children under 5 years.
• Anti-Angin - hypersensitivity to components; the instructions mention the use of pastilles in children aged 5-10 years, but the local anesthetic tetracaine hydrochloride is contraindicated in children under 10 years old.
• Angal - increased sensitivity to incoming components, age to five years. It should be borne in mind that lidocaine hydrochloride (which is included in these troches) is contraindicated in case of atrioventricular block and heart failure of 2-3 degrees, in the presence of weakness syndrome of the sinus node; it is not recommended for severe bradycardia, low blood pressure, myasthenia gravis, and children under 12 years of age.
• Heksadreps - hypersensitivity, children under six years. There are no other contraindications in the instructions, but, given the presence of Hexadereps biclutymol in the pastilles
• it should be borne in mind that the released iodine can accumulate in the thyroid gland in the form of metabolites, which is unacceptable in thyrotoxicosis.
• Eucalyptus-M - children under 8 years of age and hypersensitivity to essential oils, with caution - in the presence of diabetes.
• Sage - similar to Astraseptum.
• Isla-Mint (Isla-Moos) - hypersensitivity to ingredients, including intolerance to fructose, age up to 4 years.

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Side effects

Some lozenges from sore throat can have side effects. Thus, the use of tablets for resorption from the pain in the throat of Septotelet, Astracept (Agicept, Gorpils, Suprima- lor, Lörpils), Eucalyptus-M or Sage can cause allergic reactions.

Anti-angina, in addition to an allergic reaction, because of the presence of tetracaine hydrochloride, can lead to irritation of the oral mucosa, cyanosis and CNS excitation.

Among the possible undesirable effects of Angal pastilles are diarrhea, irritation of the mucous membrane of the oropharynx, and in children - difficulty breathing. Side effects of Heksadreps and Isla-Mint have not been identified to date.

Overdose

Exceeding the recommended amount of pastilles from the pain in the throat of Septotelet and Astracept is expressed in nausea, vomiting and diarrhea. Producers report in the instructions of Eucalyptus-M and Isla-Mint that no cases of overdose have been reported. Abuse of pastilles Sage contributes to the development of allergic reactions. This information is not available for Hexadereps pastilles.

An overdose of tertacaine, which is contained in the anti-angina pathes, can provoke general weakness and dizziness, lowering of arterial pressure and vomiting, agitation and convulsions, respiratory failure and collapse.

And those containing lidocaine hydrochloride pastilles Angal, in addition to the just listed symptoms, with an overdose can cause depression, cardiac arrhythmia, decreased myocardial tone and systemic circulatory disturbance.

Interactions with other drugs

In the instructions for the use of pastilles, Astracept, Anti-Angin, Hexadrupps, Eucalypt-M, data relating to their interaction with other drugs are not provided.

Clinically significant drug interaction of the pastilles Sage and Isla-Mint (Isla-Moos) was not revealed.

All other lozenges from the pain in the throat, which were discussed in the review, are not allowed to be applied simultaneously with other local antiseptic agents.

Conditions for storing pastilles from pain in the throat : at a temperature not higher than + 25 ° С.

Shelf life of Septollette, Astracept, Anti-Angin, Eucalyptus-M, Sage - 3 years; Angal - 5 years; Heksadreps, Isla-Mint - 2 years.