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Symptomatic treatment of pneumonia
Last reviewed: 04.07.2025
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Antitussives
Antitussives are prescribed to patients with acute pneumonia in the first days of the disease, when the cough is painful, dry, and interferes with sleep at night. An extremely strong cough is dangerous due to the possibility of spontaneous pneumothorax.
Antitussives are divided into narcotic and non-narcotic.
Narcotic antitussives (cause addiction and can depress the respiratory center):
- codeine phosphate - prescribed at 0.1 g 2-3 times a day;
- methylformin (codeine) - prescribed at 0.015 g 2-3 times a day;
- codeterpine - combination tablets containing 0.015 g codeine, 0.25 g sodium bicarbonate and 0.25 g terpin hydrate;
- cough tablets - contain 0.02 g codeine, 0.2 g sodium bicarbonate, 0.2 g licorice root and 0.01 g thermopsis herb;
- ethylmorphine (dionin) - prescribed in tablets of 0.01 g 2-3 times a day.
Non-narcotic antitussives (they do not cause addiction and do not depress the respiratory center, which is why these drugs are preferred over narcotic antitussives):
- glaucine hydrochloride - obtained from the yellow machete plant, prescribed in tablets of 0.05 g 2-3 times a day;
- ledin - obtained from wild rosemary, suppresses the cough center, has a bronchodilatory effect, is prescribed in tablets of 0.05 g 3 times a day;
- bithiodine - suppresses cough receptors of the mucous membrane of the respiratory tract and the cough center of the medulla oblongata, prescribed in tablets of 0.01 g 3 times a day;
- libexin - equal to codeine in antitussive activity, suppresses the cough center of the medulla oblongata, prescribed at 0.1 g 3-4 times a day;
- Tusuprex - suppresses the cough center, prescribed in tablets of 0.01-0.02 g 3 times a day.
Antipyretic and analgesic drugs, anti-inflammatory drugs
Anti-inflammatory drugs are prescribed to reduce inflammatory edema and improve microcirculation. These same drugs have an antipyretic effect. Their use is indicated primarily for very high body temperature (39-40 °C). Acetylsalicylic acid is prescribed at 0.5 g 2-3 times a day, paracetamol at 0.5 g 2-3 times a day.
In case of severe pleural pain, metindol retard 0.075 g 1-2 times a day, voltaren 0.025 g 2-3 times a day and other non-steroidal anti-inflammatory drugs can be recommended. However, it should be taken into account that many anti-inflammatory drugs have a significant effect on the immune system, significantly suppress phagocytosis. Therefore, in the acute period, the use of these drugs should not be long-term. For chest pain, analgin can also be used.
Cardiovascular agents
Camphor oil is traditionally used for acute pneumonia. Camphor has a tonic effect on the cardiovascular and respiratory systems, enhances the contractile function of the myocardium. Excreted through the mucous membrane of the respiratory tract, camphor causes an expectorant effect, and also has a bactericidal effect. Camphor has also been described as significantly improving alveolar ventilation. Camphor is used primarily in severe pneumonia. Subcutaneous administration of camphor oil is recommended at 2-4 ml 3-4 times a day. Infiltrates (oleomas) may form during treatment with camphor.
Sulfocamphocaine is a compound of sulfocamphoric acid and novocaine. It is used as a 1% solution intramuscularly, subcutaneously, intravenously 2-3 times a day. It has all the positive properties of camphor, but does not cause the formation of oleomas, is quickly absorbed when administered subcutaneously and intramuscularly, and can be administered intravenously.
Cordiamine is a 25% solution of nicotinic acid diethylamide, stimulates the respiratory and vasomotor centers, is used 2-4 ml subcutaneously, intramuscularly and intravenously 3 times a day for severe arterial hypotension in patients with acute pneumonia, especially during a crisis (with lobar pneumonia).
The indicated cardiovascular agents help to normalize hemodynamics in the pulmonary circulation.
In case of significant reduction of the contractile ability of the left ventricle (most often this happens with the development of diffuse myocarditis, complicating the course of lobar pneumonia), it is possible to use cardiac glycosides, but it is necessary to remember the hypersensitivity of the inflamed myocardium to them and prescribe them intravenously by drip in small doses (for example, 0.3 ml of a 0.05% solution of strophanthin).
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