Treatment of upper respiratory tract infections in children

The symptoms of ARVI are varied; in 40% of cases the disease is accompanied by a cough.

Cough is a rapid increase in intrathoracic pressure (up to 300 cm H2O) due to muscle contraction (from the larynx to the pelvic diaphragm), which helps to squeeze sputum out of the small bronchi into the large ones. When the glottis opens quickly, air comes out at a speed of up to 200-300 m/s, clearing the bronchi. Rare coughing impulses are physiological, they remove the accumulation of mucus and saliva above the entrance to the larynx.

The appearance of a cough is pathognomonic for a pathology of the upper respiratory tract (laryngitis, tracheitis, bronchitis). A cough caused by an acute disease of the upper respiratory tract has a number of typical features:

• unproductivity or low productivity;
• high intensity;
• paroxysmal;
• tracheal type pain.

The onset of the disease is characterized by a dry cough (unproductive), not leading to the discharge of sputum and subjectively felt as obsessive. The intensity and nature of the cough vary depending on the etiologic factor. With influenza and influenza-like acute respiratory viral infections, the mucous membrane of the larynx and trachea is initially affected, clinically this is manifested by attacks of dry unproductive cough, significantly aggravating the course of the disease. In children with elevated temperature, prolonged coughing attacks provoke the development of severe hyperthermia, increasing the risk of febrile seizures and the need for antipyretic drugs. With intense and unproductive cough, whole layers of ciliated epithelium are torn out of the mucous membrane of the respiratory tract, which leads to an even greater disruption of the drainage function.

Attacks of unproductive or low-productive cough in children worsen the child's quality of life, lead to sleep disturbances and are difficult for adults around the child to bear. Over time, the cough becomes moist, but excessive formation of viscous sputum is not typical for ARVI (both in adults and children). Prolonged cough (more than 2 weeks) after ARVI is observed quite often (more than 50% of children with adenovirus infection cough for more than 20 days). This cough is associated with a dying down inflammatory process and post-infectious hypersensitivity of cough receptors.

According to modern clinical recommendations, the main goal of treating acute bronchitis is to relieve the severity of cough and reduce its duration. According to pharmacoepidemiological studies, the main types of interventions used to treat ARVI accompanied by cough are non-drug treatment, taking expectorants and antitussives.

Among all the medications used to treat cough, the most justified is the use of drugs that simultaneously affect several components of the pathological process and have a modeling effect on cough. These are the properties of combination drugs that have antitussive, anti-inflammatory, expectorant properties and improve the regeneration of the mucous membrane of the respiratory tract. Their positive effect is based on increasing the cough threshold, reducing the intensity of cough and increasing its productivity. These drugs shorten the cough period in cases of debilitating cough, significantly impairing the quality of life and leading to sleep disorders. In the presence of viscous sputum, a combination of expectorants with antitussives allows you to reduce the intensity of cough, increase sputum discharge and make the cough more productive.

Codelac FITO is a modern medicinal product containing codeine in a subtherapeutic dosage and phytocomponents (dry thermopsis extract, thick licorice root extract, liquid thyme extract). During the development of the product, a thorough clinical and pharmacological analysis of the properties of each component was carried out and an optimal combination in terms of composition and dosage was selected, which allowed, while maintaining the positive properties of each component, to reduce their dosage and avoid the development of side effects. Each component of Codelac FITO has a specific effect on the pathogenesis of cough.

1. Codeine, a phenanthrene alkaloid, is an opioid receptor agonist, has an antitussive effect, and reduces the excitability of the cough center. Codelac contains codeine in a subtherapeutic dosage, which does not suppress the cough center, but only reduces the intensity of cough, promoting more effective clearing of the bronchi from sputum.

According to leading global and domestic sources of information on medicines, codeine is characterized by a high degree of safety, including when used in pediatric practice, and causes serious side effects only with prolonged use in high doses.

The safety of codeine in pediatric practice is confirmed by many sources: the British Pharmacopoeia Martindale allows the use of codeine as an analgesic in newborns at a dose of 1 mg / kg with a low risk of respiratory depression: according to a systematic review prepared by experts from the Cochrane Collaboration, in a number of randomized controlled trials of the use of codeine to relieve cough in children, no side effects were found.

2. Thermopsis herb contains isoquinoline alkaloids, which:
   • increase the secretory function of the bronchial glands;
   • enhance the activity of the ciliated epithelium;
   • accelerate the evacuation of secretions;
   • stimulate the respiratory center;
   • increase the tone of the smooth muscles of the bronchi due to the central vagoduct effect.
3. Licorice root contains glycyrrhizin, which:
   • undergoing metabolic transformations in the body, it has an anti-inflammatory effect similar to glucocorticosteroids, manifested in the relief of inflammatory reactions caused by histamine, serotonin, bradykinin;
   • stimulates the activity of the ciliated epithelium in the trachea and bronchi;
   • enhances the secretory function of the mucous membranes of the upper respiratory tract;
   • has a spasmolytic effect on smooth muscles.
4. Thyme herb extract contains a mixture of essential oils that have:
   • expectorant, anti-inflammatory and bactericidal action;
   • as well as antispasmodic and reparative properties.

Due to the above properties, Codelac FITO is characterized by a unique ability to simultaneously affect the central and peripheral links of the pathogenesis of cough in ARVI and have a modeling effect on cough based on increasing the cough threshold, reducing the intensity of cough and increasing its productivity.