Cough drops

Different in composition drops from cough refer to pharmacological agents that are used in the treatment of cough - either to dilute sputum and facilitate its departure from the bronchi (with a wet, that is, productive cough), or to suppress the cough center - if the cough is dry.

Indications for use of drops of cough: ARD and SARS, pharyngitis, tracheitis, laryngotracheitis, acute and chronic bronchitis of various etiologies, tracheobronchitis, pneumonia, bronchopneumonia, whooping cough.

Names of drops from cough prescribed for better sputum discharge with productive cough: drops, ammonia-anise, chest drops from cough, Bronchitis, Bronchosan, Gedelix. ATX Code R05C A10.

The names of drops of cough, which are recommended for use with a dry (non-productive) cough: Sinekod, Stoptussin. ATX Code R05D B13.

[1]

Pharmacodynamics

The expectorant effect of ammonia-anise drops is provided by active substances - essential oil from anise seeds and ammonia solution (aqueous ammonia liquor). Aniseed oil contains phenolic compounds possessing antiseptic properties - aromatic ether anethole (1-methoxy-4-propenylbenzene) and its isomer para-allyl anisole, as well as organic carboxylic acids (propionic and oily). A solution of ammonia acts not only on the ciliated epithelium of the respiratory tract, but also on the nerve endings, reflexively stimulating the respiratory center and expectoration of phlegm.

Pharmacodynamics The chest drops from cough (identical to the Thoracic elixir) are provided by the same anise oil and ammonia solution that stimulate the secretory function of the mucosa of the upper respiratory tract, as well as the licorice root extract (licorice root), which contains saponins and glycyrrhizic acid, which help cough and cough . In addition, flavonoid licorice glabridin removes inflammation of the upper respiratory tract.

Combined expectorant Bronchipret facilitates the withdrawal of sputum due to the combined action of the active substances of the drug: the extract of thyme grass (terpenes, phenols and flavonoids of essential oil) and tincture of ivy leaves (containing saponins and organic acids).

The mechanism of pharmacological action by a drop of cough Bronchosan is based on the components of the drug - bromhexine and essential oils of anise, fennel, oregano, eucalyptus and peppermint. Bromhexine provides the drug expectorant effect and mucolytic (reducing the viscosity of bronchial secretions) effect. And essential oils - in addition to analgesic and relieving spasms - contribute to the relief of breathing, to the decrease in the intensity of cough and to the decrease in the inflammation of bronchial mucous membranes caused by staphylococcal infection.

Pharmacodynamics drop Gedelix is caused by hederin, saponins and organic acids extract of ivy leaves (Hedera helix L.), which contribute to the separation, formulation and excretion of mucus from the respiratory tract of the bronchi and lungs.

Drops Sinecode affects the cough center of the medulla oblongata and depresses the cough reflex; active substance of the preparation butamirate 2- (2- (diethylamino) ethoxy) ethyl 2-phenylbutyrate dihydrogen - also dilates the bronchial lumens, facilitating breathing and excretion of accumulated mucus.

Cough drops Stoptopsin on pharmacological action is classified as a complex means, because in their composition, in addition to the suppressive coughing of butamirate, there is guaifenesin, which reduces the viscosity of sputum glycerol ester of 2-methoxyphenol (glycerol guaiacolate). Guaifenesin is rapidly absorbed into bronchial mucosa, destroys acid mucopolysaccharides of mucus, which leads to an increase in sputum production. And its excretion is accelerated due to irritation of the ciliary epithelium of the bronchi with phenolic compounds of guaiacolate.

Pharmacokinetics

It should be noted that the pharmacokinetics of many drops used to treat cough are not represented by drug manufacturers.

The pharmacokinetics of Bronchosan, according to the official instruction, are described only on the basis of absorption and transformation of bromhexine, which is rapidly absorbed into the blood from the digestive tract, reaching the highest concentration in the blood plasma 60 minutes after ingestion. Splitting occurs in the liver with the formation of an active metabolite of ambroxol, which exerts an expectorant effect. Excretion - through almost and intestines.

Butamyrate in drops Sinecod and Stopptsin is absorbed in the gastrointestinal tract, enters the bloodstream and binds to proteins. Biotransformation of butamirate begins in the blood plasma - with the formation of pharmacologically active metabolites analogous to the effect on the body. Metabolites are excreted in the urine for 12 hours.

Metabolism of guaifenesin in drops Stopptissin passes in the liver, biotransformation products are excreted in urine by the kidneys, and also with phlegm through the lungs.

Dosing and Administration

Cough drops are taken internally. Recommended dosage of ammonia-anise drops: for adults - 3-4 times a day for 10-15 drops (diluted in 50 ml of water); for children - one drop for each year of life (children under 1 year - one drop) - three times a day.

Dosage Breast drops from cough: from 20 to 40 drops per reception 3-4 times a day (dilute in a small amount of water, take half an hour before or one hour after a meal).

The standard single dose of Gedelix is 30 drops (after meals) - adults and children after 10 years (three doses per day), children 4-10 years - 20 drops, 2-4 years - 15 drops.

Adult adults need to take Bronchipret up to four times a day (after meals) - 35-40 drops per session; single dose for children 7-11 years - 10-15 drops, 12-17 years - 20-25 drops. The drops are diluted in 100 ml of water.

Recommended doses Bronchosan: adults and children after 6 years - four times a day for 20 drops, children 2-6 years for 10 drops (in diluted form, 25-30 minutes before meals).

Drops Sinekod and Stopoutsin also should be dissolved in water and take: adults and children over two years - 20-25 drops (four times a day).

Overdose Breast drops from cough may increase the manifestation of side effects; at long application in the raised doses the deficiency of a potassium in an organism can arise.

Exceeding the recommended doses of Bronchipret and Gedelix may cause vomiting and disruption of the bowel; an overdose of Bronchosan - an increase in side effects; drop Stopptsin and Sinekod - dizziness, lower blood pressure, nausea, vomiting and diarrhea.

[4], [5],

Use of drops of cough during pregnancy

In the treatment of cough in pregnant women to apply ammonia-anise drops, chest drops from cough, drops Gedelix is prohibited. Drops Bronchitis during pregnancy is not recommended.

The use of Bronchosan, Stoptopsin and Sinekod drops in the first trimester of pregnancy and during lactation is contraindicated, the doctor decides whether to take this drug at a later date, according to the indications, but taking into account that active substances of these drugs penetrate the BBB and can affect on fetal development.

Contraindications for use

The main contraindications to the use of a drop of cough:

• droplets of ammonia-anise - increased acidity of gastric juice, peptic ulcer, age up to three years;
• Chest drops from cough - high blood pressure, liver and kidney function, hypokalemia, severe obesity, age under 12;
• Bronchitis - age up to 6 years;
• Bronchosan - severe renal or hepatic insufficiency, gastric and duodenal ulcers, liver cirrhosis, alcoholism, age of up to three years;
• Gedelix - bronchial asthma, children's age of up to two years;
• Sinecode - pulmonary hemorrhage, age to two years;
• Stoptussin - cardiac arrhythmia, myocarditis, increased blood pressure, peptic ulcer exacerbation, hyperthyroidism, diabetes mellitus, glaucoma.

[2], [3]

Side effects of drops of cough

In official instructions, the following most likely side effects of cough drops are noted:

• drops of ammonia-anise can lead to a decrease in heart rate, irritation of the gastric mucosa and vomiting;
• Breast drops from cough provoke allergic reactions, bronchospasm, nausea and vomiting, can cause swelling and increased blood pressure;
• Bronchypret drops give skin allergic reactions in the form of rashes and itching, cause bouts of nausea;
• Bronchosan - in addition to itching and allergic rhinitis, there may be nausea, vomiting and activation of liver enzymes;
• When using Gedelix drops, nausea, vomiting, diarrhea may occur, abdominal pain is not excluded;
• Drops Sinecod and Stoptussin can cause allergic skin rashes, headache and dizziness, nausea and diarrhea. In addition, a long reception of Stopsussin often causes epigastric pain.

Interactions with other drugs

Manufacturers of these drugs pay attention to interactions with other drugs.

Breast drops from coughing strengthen the action of certain diuretics and laxatives, which can cause a violation of the electrolyte balance; these drops from cough should not be taken concomitantly with antibiotics and nitrofurans.

Drops Bronchipret and Bronchosan with parallel administration of antibiotics or sulfonamides increase their concentration in the respiratory tract and bronchial tissues.

Drops from the cough of Stoptopsin increase the effect of acetylsalicylic acid and all drugs containing it, and also potentiate the effect of medications, muscle relaxants, sleeping pills and alcohol.

Conditions for storing drops from cough: in a dark place, at room temperature (not higher than + 25-27 ° C.

Shelf life: drops ammonia-anise, chest drops from cough - 3 years; Bronchipret, Bronhosan - 2 years; Geleliks - 2 years (the printed bottle is allowed to be stored no longer than 6 months); Sinecode and Stopoutsin - 5 years.