How to suppress a cough. Centrally acting medications

When a child or adult coughs, others consider them sick. This is true, but cough itself is not a disease, but only one of the symptoms of an existing disease. Therefore, it is necessary to treat not only the cough, but also the main ailment, which everyone can have their own: from a common cold to severe pneumonia and a tumor of the mediastinum.

The causes of dry cough are varied:

acute bronchitis and tracheitis, ARVI, bronchial asthma, COPD (chronic obstructive pulmonary disease), pleurisy, tuberculosis, tumors of the lungs and mediastinum. Read about how to treat cough with tracheitis;
bronchial irritation from tobacco smoke, gases, dust;
pharyngitis, laryngitis, sinusitis, rhinitis with the flow of mucus from the nasal passages into the bronchi along the back wall of the pharynx;
heart disease with symptoms of heart failure;
Problems digestive system and, in particular, GERD (gastroesophageal reflux disease);
adverse reaction of the body to inhalation of oxygen;
consequences of taking a number of medications, for example, Amiodarone;
pathology psycho-emotional sphere, so-called habitual cough, and etc.

The goal of the doctor (and the patient himself) is to correctly select medicines to alleviate a dry cough and transfer it to a wet one, accompanied by expectoration (mucus separation from respiratory tract).

In this article we will perform detailed analysis antitussive drugs for dry cough. Their choice depends on the age and condition of the patient, clinical symptoms, the presence of other diseases and a number of other reasons.

Classification of antitussive drugs and agents

Cough suppressants can be classified according to various signs, such as:

release form;
country and manufacturing company;
composition: natural or synthetic components;
mechanism of action.

In turn, antitussive drugs can be produced in various dosage forms:

pills;
syrup, elixir;
drops;
teas with extracts medicinal plants;
herbs and herbal preparations;
chewing lozenges, lollipops;
rectal suppositories.

There are other types of classifications intended for specialists. The last item in this list (mechanism of action) means that the antitussive drug belongs to one or another group. Let's take a closer look at this point.

How do cough medicines work?

Drugs

They block the cough reflex by inhibiting brain function. Prescribed with caution, especially to children, because addictive. However, there are cases when you cannot do without them: pleurisy or whooping cough with bouts of debilitating cough. Find out when and to whom they do it. Examples of a narcotic antitussive drug include: Codeine, Dimemorphan, Ethylmorphine.

Non-narcotic antitussives

Unlike the drugs in the group described above, non-narcotic drugs do not affect brain function and block the cough reflex without causing consequences in the form of addiction to the drug. They are usually prescribed when severe forms influenza and ARVI, accompanied by a severe dry cough that is difficult to treat. An example of a non-narcotic antitussive drug is Butamirate, Glaucine, Oxeladin, Prenoxyndiosine.

Medicines - mucolytics

Used to keep dry nonproductive cough became productive. They do not suppress the cough reflex, but the patient’s well-being improves due to the dilution of sputum. With bronchitis or pneumonia, the patient's bronchi are clogged with viscous mucus, which is not released on its own due to its thick consistency. Mucoltic antitussives help clear the bronchi of sputum and, accordingly, colonies of microorganisms. Often medicinal base theirs are herbs. An example of a mucolic antitussive drug is ACC, Ambroxol, Mucaltin, Solutan.

Combined action agents

In some cases, doctors prescribe combination drugs that give multiple effects to their patients. With their help, you can stop the inflammatory process, eliminate bronchospasm, and increase cough productivity. An example of a combination antitussive drug is Doctor MOM, Codelac phyto.

List of the most effective medicines

Below is a list of popular and effective antitussive drugs.

Codeine (Methylmorphine)
Effectively reduces the cough reflex. A single dose of the drug provides a period of rest from attacks of dry cough for 5-6 hours. Has a depressing effect on respiratory center, which is why Codeine is rarely prescribed. Reduces the degree of ventilation of the lungs and leads to other undesirable consequences– addiction, drowsiness, intestinal sluggishness, constipation. At simultaneous reception with alcohol, sleeping pills or psychotropic drugs may cause life-threatening conditions. This cough medicine is contraindicated in children aged 0-2 years, as well as pregnant women.
Ethylmorphine (Dextromethorphan)
A synthetic substitute for methylmorphine, demonstrating equally high antitussive activity. At the same time, the number and severity of side effects with this drug are much lower.
Glaucine (Glauvent)
This antitussive drug is available in several dosage forms - antitussive tablets, tablets, syrup. Effectively transforms a non-productive cough into a wet one, is relatively inexpensive, but can cause arterial hypotension, weakness, dizziness or allergic reactions. Patients with low blood pressure who have had a myocardial infarction and are prone to allergies this drug not prescribed.
Levopront
Inexpensive, but quite effective medicine for adults and children, available in the form of drops and antitussive syrup with pleasant taste. Side effects from taking it: upset stool, nausea, heartburn, drowsiness, weakness, skin rashes. The drug is not prescribed to pregnant and nursing mothers, as well as to patients with renal failure.
Libexin
Effectively fights dry cough, reduces bronchospasm, and has a local analgesic effect. The effect of taking this antitussive drug for dry cough lasts about four hours. Indications for use: ARVI, pleurisy, bronchial asthma, pneumonia, emphysema, etc. There are also side effects, which can manifest as dry mouth, sluggish digestion, nausea, and allergies.
Sedotussin (Pentoxyverine)
There are two forms of release of this antitussive drug - syrup and rectal suppositories. It is prescribed for dry, exhausting cough, for acute and chronic form bronchitis, pneumonia. Contraindication to use is a history of the following diseases: allergy to individual components medications, bronchial asthma, some forms of glaucoma, pregnancy, lactation, elderly age and under 4 months of age.
Tusuprex (Paxeladin, Oxeladin)
Synthetic drug aimed at stopping attacks of dry cough. Possible side effects from its intake in the form of nausea, vomiting, increased fatigue, decreased concentration, drowsiness.
Butamirat (Sinekod)
A drug combined action, has anti-inflammatory and expectorant effects, expands the bronchi, facilitates external breathing.
Prenoxdiazine (Libexin)
A drug of combined action and selective effect on brain activity. It does not depress breathing, relieves pain when coughing, relieves bronchospasm, and reduces the excitability of peripheral receptors. It is prescribed with special caution to expectant mothers.
Tussin Plus
Syrup based on guaifenzine and dextromethorphan, which has expectorant and antitussive effects. Can be used in the treatment of adults and children from six years of age.
Stoptussin
Two dosage forms: drops for oral administration and tablets. The main active ingredient is butamirate, which has a bronchodilator, analgesic, and antitussive effect. Another component in this antitussive drug is guaifenzine, which acts as a mucolytic.
Bronholitin
A combination drug, one of the most popular among ENT doctors and their patients. The active ingredients in it are ephedrine and glaucine, thanks to which a dry cough becomes less painful and painful, inflammatory phenomena and bronchospasm decrease, the patient’s well-being improves. Available in syrup form for children from three years of age and adults.

Safe antitussives for children

Lazolvan (Ambrohexal, Ambrobene)
They are based on ambroxol, which strengthens the immune system. child's body and has an anti-inflammatory effect. These antitussive drugs for dry cough are given even to premature babies.
Bronkatar (Mukopront, Mukodin)
The active substance in them is carbocysteine, which helps to thin sputum and increase the activity of cells that produce bronchial secretions.
Bromhexine
Effectively thins mucus and removes it from the respiratory tract.
Bronchicum
A herbal preparation available in the form of syrup, elixir and lozenges. Indicated for children from six months of age with a dry cough with difficult to separate sputum.
Linux
Another drug based on plant materials with antitussive, antispasmodic and mucolytic effects. Indicated for children from one year of age and only with a doctor's prescription, because has an effect on blood glucose levels.
Libexin
Can be taken at the first sign of a cold. The drug suppresses the cough reflex without inhibiting respiratory functions at the level of the central nervous system. Bithiodine pills have approximately the same effect.
Chest collection No. 1, 2, 3, 4; Phytopectol No. 1,2
Fees medicinal herbs for self-preparation of decoctions and infusions. The composition includes marshmallow root, licorice, oregano; plantain, sage, coltsfoot, wild rosemary, chamomile, mint, violet, pine buds and etc.

In this vein, the question arises: are drugs used in the treatment of children that block cough at the level of the brain (for example, codeine, ethylmorphine, dimemorphan)?

Answer: this happens extremely rarely and only in in case of emergency when it is urgent to stop a painful attack of dry cough with whooping cough, pleurisy, malignant tumor mediastinum.

Drugs allowed during pregnancy

During the waiting period for the baby, the body of the expectant mother is extremely vulnerable, and immunity is reduced. We can say that the pregnant woman and the fetus share the same metabolism. Therefore, the choice of antitussive drugs during pregnancy should be approached very carefully and nothing should be taken without a doctor's prescription. Without going into details of how this or that substance overcomes the placental barrier, we present general information about which antitussive drugs for dry cough can be taken during pregnancy.

I trimester
Mucaltin, Equabal, marshmallow root - herbal preparations, which can be consumed without danger.
Bronchicum, Gedelix, Doctor IOM - used as prescribed by a doctor. Possible action the embryo has not been studied enough.
Libexin – synthetic drug, prescribed to a pregnant woman in the first trimester only in exceptional cases.
As an addition to the main treatment, dietary supplements can be used: Florafors, Mamavit, Bifidophilus, Pregnacare.
II and III trimesters
In the second and third trimesters of pregnancy, in case of dry cough, you can use the drugs recommended for the first trimester.
In particular difficult cases instead of the above-mentioned Libexin, you can (as prescribed by a doctor!) Apply Akodin, Bromhexin, Stoptussin.

Find out about antibiotics allowed during pregnancy.

Patient Guide: Important information about cough treatment

In the process of treating dry cough, patients make many mistakes. This guide will help you avoid them.

Before starting treatment, you should make sure that it is a dry (and not wet) cough.
The choice of antitussive therapy is the prerogative of the doctor, because it is he who knows the mechanism of action of a particular drug, indications, contraindications and side effects.
The simultaneous use of mucolytics and drugs that suppress the cough reflex is prohibited.
A cough accompanied by vomiting and severe shortness of breath cannot be treated at home. Especially if the patient is a child.
A dry cough that lasts more than six weeks and cannot be treated using standard regimens should be a reason to visit a doctor.
The doctor who selects drugs for dry cough must be informed about the existing chronic diseases, such as diabetes, allergies, arterial hypertension, glaucoma, etc. This will reduce the risk of side effects.

Do not forget about traditional medicine - inhalations, irrigations, mustard plasters, cups, etc. In combination with drugs traditional medicine they will get rid of dry cough as quickly and effectively as possible.

Cough is a complex reflex reaction of the airways, the main function of which is to restore their normal patency.
The occurrence of cough may be due to irritation of cough receptors in the nose, ears, back wall pharynx, trachea, bronchi, pleura, diaphragm, pericardium, esophagus. External and internal factors (foreign bodies, cold and dry air, air pollutants, tobacco smoke, nasal mucus, phlegm, inflammation of the mucous membranes of the respiratory tract, etc.) excite cough receptors, subdivided into irritant, quickly responding to mechanical, thermal, chemical stimuli, and C-receptors, mainly stimulated by inflammatory mediators (prostaglandins, kinins, substance P, etc.). The resulting impulse is transmitted through afferent fibers vagus nerve to the cough center located in medulla oblongata. The reflex arc closes efferent fibers vagus, diaphragmatic and spinal nerves going to the muscles chest, diaphragm and abdominal press, the contraction of which leads to the closure of the glottis with its subsequent opening and expulsion with high speed air, which is manifested by coughing.
In addition, cough can be caused or suppressed voluntarily, since the formation of the cough reflex is under the control of the cerebral cortex.
Cough is classified by nature (non-productive, or dry, and productive, or wet cough), by intensity (coughing, light and coughing), by duration (episodic, paroxysmal and persistent cough), along the course (acute - up to 3 weeks, prolonged - more than 3 weeks and chronic - 3 months or more).
In a number of cases, cough loses its physiological purpose and not only does not contribute to the resolution pathological process V respiratory system, but also leads to the development of complications.
The reflex arc of the cough reflex includes receptors, cough center, afferent and efferent nerve fibers, and the executive link - the respiratory muscles. Cough is most effectively suppressed at two levels - the receptor level and the level of the cough center. In this regard, antitussive drugs are divided into 2 groups: central and peripheral action. In turn, drugs central action can be divided into narcotic and non-narcotic drugs.

Mechanism of action and pharmacological effects Centrally acting narcotic antitussives
These include morphine-like compounds such as codeine, ethylmorphine and dextromethorphan, which suppress the function of the cough center of the medulla oblongata. The most famous antitussive medicine The narcotic effect is codeine, which is a natural narcotic analgesic from the group of opiate receptor agonists. Medicines from the codeine group are very effective, but have significant drawbacks. Their antitussive effect is not selective; they simultaneously depress the respiratory center. Dextromethorphan is a synthetic antitussive drug, chemical structure and activity similar to opiates ( codeine); has a central effect, increasing the cough threshold.

Non-narcotic antitussive drugs of central action
These include oxeladine, butamirate, glaucine, pentoxyverine, ledin and pholcodine, which have a selective central effect. They partially suppress the cough center without exerting a pronounced inhibitory effect on the respiratory center. Not inferior in potency to codeine, they do not cause addiction or addiction, do not depress breathing and do not affect intestinal motility (do not cause constipation). Some antitussive drugs have additional effects, improving their action. Thus, oxeladine, butamirate and ledin are characterized by some bronchodilator action. Butamirate also has expectorant and anti-inflammatory effects.

Non-narcotic antitussive drugs of peripheral action
This group of drugs includes prenoxdiazine, levodopropizine, benpropyrine and bithiodine, which affect the afferent component of the cough reflex, acting on the mucous membrane of the respiratory tract as an anesthetic and reducing reflex stimulation cough reflex. In addition, they have a local anti-inflammatory effect and promote relaxation. smooth muscle bronchi.

Enveloping drugs also refer to peripheral antitussive drugs of afferent action. Their action is based on the creation of a protective layer on the mucous membrane of the nasopharynx and oropharynx. They are oral tablets or syrups and teas containing plant extracts of eucalyptus, acacia, licorice, wild cherry, linden, etc., glycerin, honey, etc.
One of the ways to influence the afferent part reflex arc is also the use of aerosols and steam inhalations to moisturize the mucous membranes of the respiratory tract. Water vapor inhalation, alone or with the addition of sodium chloride or herbal decoctions or extracts - the most available method hydration. Along with inhalations it can be used drinking plenty of fluids.
Antitussive drugs with local anesthetic activity reduce the feeling of soreness and irritation in the throat, reduce sensitivity to various irritating factors, weakening the cough reflex. The drugs are used in the form of medicines for resorption in the oral cavity.
Local anesthetics (benzocaine, cycline, tetracaine) are also drugs with afferent action, but are used only in a hospital setting for special indications.

Pharmacokinetics
Most drugs are well absorbed after oral administration. The maximum concentration in the blood plasma of codeine is achieved after 1 hour, butamirate citrate - after 1.5 hours. In the latter case, it is 6.4 μg/ml, protein binding is 95%. Both drugs undergo biotransformation in the liver and are almost completely excreted in the urine in the form of metabolites and unchanged. T1/2 of codeine - 3-4 hours, butamirate citrate - 6 hours. The pharmacokinetics of most other drugs and their components have not been studied.

Tactics for choosing medications for cough
If the reason for prescribing medications is the cough itself, it is better to use medications that act on the specific cause of the cough for this case. Antitussive drugs are drugs symptomatic therapy. To relieve cough associated with acute symptoms respiratory infection, moisturizing inhalations and drugs with enveloping peripheral action or their combination with non-narcotic drugs of central action such as prenoxdiazine are indicated. In the presence of sputum, it is advisable to prescribe expectorants or mucolytics. When a patient coughs with symptoms of bronchospasm, along with hydration, it is advisable to prescribe bronchodilators and anti-inflammatory drugs, however, narcotic antitussive drugs and mucolytics, with the exception of bromhexine and ambroxol, are contraindicated. For targeted suppression of non-productive cough caused by irritation of the mucous membrane of the respiratory tract (for example, with whooping cough), in children it is possible to use antitussive non-narcotic drugs of central action.

Place in therapy
Antitussive drugs are used to suppress frequent dry coughs that disturb the patient's condition. For coughs associated with irritation of the upper respiratory tract, the use of antitussive drugs with local anesthetic activity is indicated. They are drugs for symptomatic therapy in the treatment inflammatory processes in the pharynx (sore throat, pharyngitis) and larynx (laryngitis). Actually, local anesthetics are used for afferent inhibition of the cough reflex during bronchoscopy or bronchography.

Contraindications and warnings
Prescribing antitussive drugs to a patient with a wet cough leads to stagnation of sputum in the respiratory tract, which worsens bronchial obstruction and can contribute to the development of pneumonia. Narcotic antitussives may cause respiratory depression.

Literature

Belousov Yu.B., Moiseev V.S., Lepakhin V.K. Clinical pharmacology and pharmacotherapy. M., 1997; 530.
Danilyak I.G. Cough: Etiology, pathophysiology, diagnosis, treatment. Pulmonology. 2001; 3:33-7.
Clinical pharmacology. Ed. V.G. Kukesa. M., 1991.
Lekmanov A. Cough: if treated, then with what? Materials of the VII Russian National Congress "Man and Medicine". Educational news. 2001; 19.
Rational pharmacotherapy of respiratory diseases: Handbook. for practicing doctors / A.G. Chuchalin, S.N. Avdeev, V.V. Arkhipov, S.L. Babak et al.; Under the general editorship. A.G.Chuchalina. - M.: Litterra, 2004. - 874 p. - (Rational pharmacotherapy: Ser. Handbook for practitioners; V.5).
Samsygina G.A. Antitussive drugs in pediatrics. Consilium medi- sit. 2001; 2: 18-22.
Chuchalin A.G., Abrosimov V.N. Cough. Ryazan, 2000.

Cough is a complex reflex reaction of the body aimed at normalizing the patency of the airways. In some cases, the cough is not productive (not accompanied by sputum discharge), does not contribute to the provision of a protective effect, but significantly impairs the quality of life of the patient, disturbing sleep and rest. Antitussive drugs help to reduce the intensity and frequency of coughing.

The selection of the drug is carried out individually after a full-time examination of the patient and comprehensive survey. The main goals during antitussive treatment are:

Reduce cough.
Normalize general health patient.
Restore ability to work.

Antitussive drugs that depress the respiratory center are classified into:

Central action, contributing to the inhibition of the central links of the cough reflex, localized in the medulla oblongata. This group drugs are in turn divided into:
Opioid (narcotic) analgesics based on codeine phosphate and morphine hydrochloride, codeine, ethylmorphine hydrochloride.
Non-opioid (non-narcotic) preparations based on glaucine, tusuprex. The doctor may recommend the use of Sinecod, Glauvent, Tusuprex, Sedotussin, Paxeladin.
Peripheral: Libeksin, Helicidin.
Combined action, providing complex impact: help provide a bronchodilator, expectorant, anti-inflammatory effect, and also reduce the cough reflex. The doctor may recommend the use of Tussin plus, Broncholitin, Stoptussin, Lorraine.

Medications may also be used local action in the form of lozenges (for example, Falimint), which help suppress the cough reflex by anesthetizing the mucous membranes. As a result, it decreases irritant effect factors of infectious, non-infectious, physical and chemical origin.

Centrally acting drugs

Antitussive drugs for dry cough in adults from the category of narcotic analgesics can cause euphoria and drug dependence.

Such medications are dispensed only after presenting a prescription from the attending physician.

Codeine use

The most famous representative of the group of narcotic analgesics is Codeine, which, in addition to being an antitussive, also promotes dry airways and provides an analgesic and sedative effect.

This drug can be used for coughs with painful sensations. The active substance blocks the cough reflex for 5-6 hours.

The drug is prescribed rarely, in short courses, because it can depress the respiratory center, helps reduce tidal volume, and causes dependence.

Glaucine

Glaucine is a drug plant origin, selectively inhibiting the activity of neurons located in the cough center. Unlike Codeine, it does not cause dependence, addiction, and does not provoke depression of the respiratory center.

Tusuprex

Tusuprex has an antitussive and moderate mucolytic effect, is not addictive and drug addiction. Indicated for dry cough, catarrh of the respiratory tract, and lung diseases. Taking tablets is contraindicated in case of narrowing of the lumen of the bronchi, bronchiectasis, bronchial asthma, bronchitis.

Peripheral cough medicines

An antitussive for dry cough of peripheral action affects the receptors and nerve endings, localized in the area of the tracheobronichal tree.

Libexin

In addition to the antitussive effect, taking Libexin helps to provide the following effects:

Local anesthetic effect.
A bronchodilator effect that helps suppress stretch receptors that are involved in the cough reflex.
A slight decrease in the activity of the respiratory center (the drug does not depress breathing).

During complex therapy bronchitis active substance promotes anti-inflammatory effect. The tablets do not affect the functioning of the central nervous system.

The dosage is selected taking into account the age and body weight of the patient. It is recommended to refrain from taking pills in conditions accompanied by copious discharge bronchial secretions, after inhalation anesthesia, in case of intolerance to the components of the drug.

Bithiodine

The drug affects the mucous membranes of the respiratory tract and the receptors located in them, as well as the center of the medulla oblongata. The use of tablets can cause constipation and allergic reactions. The medicine is taken up to 3 times a day.

Combination medications

Antitussives with combined composition contain at least 2 active substances:

A substance with an antitussive effect of central or peripheral action.
Antihistamine substance.
Mucokinetic.
Antibacterial component.
Bronchodilator.
Antipyretic substance.
Antispasmodic.

Use of Broncholitin

Bronholitin is a multicomponent syrup that has an anti-inflammatory effect, dilates the bronchi, and inhibits the cough center. The drug is used in the treatment of bronchitis, pneumonia, whooping cough, chronic obstructive pulmonary disease, and asthma. Prem syrup is carried out three times a day.

Patients with high blood pressure, heart failure, insomnia, angle-closure glaucoma, and in the first trimester of pregnancy should refrain from using the medicine.

Tussin Plus

Tussin Plus is a two-component drug, active ingredients which increases the cough threshold, reduces the severity of dry cough, and increases the secretion of liquid components of bronchial mucus.

The syrup is recommended to be taken orally after meals. In case of overdose, nausea and vomiting may develop.
It is recommended to refrain from using Tussin Plus in severe organic lesions central nervous system, stomach ulcer, wet cough, during the treatment of children under 6 years of age.

Antitussives for children

Before prescribing an antitussive drug to a child, doctors identify exact reason symptom development. For a cough due to influenza or colds bedtime and drinking regime, use of antitussive medications recommended by a doctor.

The selection of medication is carried out taking into account the age and weight of the child, the cause of the cough. Additionally, antihistamines, antifungals, antivirals, and antibacterial medications are recommended, if necessary.

Stoptussin

Stoptussin in tablet form can be used in the treatment of patients over 12 years of age; oral drops are indicated for children over 6 months of age. The medicine must be used after the main meal. Drops are dissolved in water, tea or juice.

It is necessary to maintain an interval between use of the drug: at least 6 hours.

The drug is well tolerated, possible side effects decrease after dose reduction. Possible development of unwanted adverse reactions in the form of appetite disturbances, headaches, drowsiness, difficulty breathing, dizziness.

The drug cannot be used in the treatment of patients with bronchial asthma, productive cough, chronic bronchitis, emphysema.

Receiving Sinecode

Children are prescribed syrup or drops. The medicine is contraindicated in patients under 2 months of age, syrup - in children under 3 years of age.

The medication is taken before meals, taking into account the doctor’s recommendations regarding the dosage regimen. The duration of treatment is 7 days.

With absence pharmacological effect a repeated consultation with a doctor is required.

Glycodin

Glycodin is a multicomponent syrup that has an antitussive and mucolytic effect. The drug can be used in the treatment of children from 4 years of age.

The active substance inhibits the excitability of the cough center and has an expectorant and antispasmodic effect. Taking the syrup is contraindicated for bronchial asthma and fructose intolerance.

Glauvent

Glauvent quickly eliminates cough and makes breathing easier. Under the action of the active component, additional rendering analgesic and antispasmodic effect.

Glauvent syrup is indicated for children from 4 years of age: it is taken after meals. Under the influence of the syrup, there is no depression of the respiratory center or suppression of the activity of the gastrointestinal tract. The syrup does not cause drug dependence.

Drugs allowed during pregnancy

good therapeutic effect have inhalations with the addition of Rotokan, Novoimanin, herbal decoction, eucalyptus essential oil.

The selection of medications for the treatment of women expecting a baby requires special care. Self-medication is unacceptable because active ingredients a number of antitussive drugs are able to cross the placenta and provoke the development of undesirable side effects.

This substance is included in:

Tussina Plus is a two-component drug, which is taken every 4 hours. May cause nausea, bowel problems, abdominal pain, drowsiness, headache, allergic reactions.
Fervexa for dry cough. The drug is not used in the 1st trimester of pregnancy. In other cases - on the recommendation and under the supervision of a doctor. the medicine must be dissolved in hot water(not boiling water), take no more than 4 times a day. In patients with bronchial asthma, the use of the drug can provoke the development of bronchospasm.
Padevixa.
Akodina.

From the use of antitussive drugs, regardless of the mechanism of their action, it is recommended to abstain when identifying pulmonary hemorrhage, broncho-obstructive conditions, as well as with excessive formation of bronchial secretions. Antitussive drugs should not be combined with mucolytics.

In contact with

Coughing is a complex reflex protective act aimed at clearing the respiratory tract of foreign particles or sputum. Irritation of the cough center in medulla oblongata (part of the brain) or mucous membrane of the respiratory tract causes an involuntary cough. This cough occurs with many respiratory diseases. The most sensitive areas to irritation are in the larynx, trachea, large and medium bronchi. In addition, cough can be caused or suppressed voluntarily, since the formation of the cough reflex is under the control of the cerebral cortex.

Cough can be productive (with phlegm) or non-productive (dry). Since an irritating, nonproductive cough is useless, it is best to suppress it. This is exactly what they are used for antitussives .

Depending on the point of application, antitussive drugs of central and peripheral action are distinguished.

Centrally acting antitussives suppress the cough reflex, inhibiting the corresponding areas of the medulla oblongata. The main drugs in this group are morphine derivatives - codeine And ethylmorphine , butamirate , glaucine , oxaldine And prenoxdiazine. It is very important that the respiratory center, which is also located in the medulla oblongata, remains unaffected. Apart from codeine and ethylmorphine, other drugs in this group do not depress the respiratory center. Prenoxdiazine also reduces the sensitivity of the mucous membrane of the respiratory tract (local anesthetic effect), where areas sensitive to irritation are located.

Antitussives of peripheral action affect the sensitive endings in the mucous membrane of the respiratory tract. They have a softening and local anesthetic effect, reducing the flow of “cough stimuli” from the larynx, trachea and bronchi. A typical example of such a drug is acetylaminonitropropoxybenzene .

Due to the undesirable side effects of codeine and ethylmorphine (depression of the respiratory center, decreased tidal volume, the possibility of painful addiction, and so on) in Lately Increasingly, preference is given to more selective antitussives, both central (glaucine, oxeladin, prenoxdiazine and others) and peripheral (acetylaminonitropropoxybenzene, tipepidine) actions. These drugs do not cause addiction, so they are sometimes combined under the name “non-narcotic antitussives.”

Have you noticed that there is constant coughing in theaters and concert halls, and it seems that the number of coughing people is increasing all the time? The way it is. This is another aspect of voluntary cough control. Excitement or anxiety about the inappropriateness of the cough provokes it. Such factors are called psychogenic. Drugs that have a calming (sedative) effect can help in these cases.

Some people have the ability to soften and soothe a cough. antihistamines , in particular diphenhydramine, better known as diphenhydramine .

Antitussive medications are often included in combination drugs for the treatment of colds and flu, which we will discuss later in this chapter.

Individual antitussives are listed below; more information about all drugs in this group can be found on the website.

[Tradename(composition or characteristics) pharmachologic effect dosage forms firm]

Codelac(herbal product) antitussive, expectorant table ICN Pharmaceuticals(USA), produced by: ICN Tomskhimpharm (Russia)

Libexin(prenoxdiazine) antitussive, antispasmodic, anti-inflammatory, local anesthetic table Sanofi-Synthelabo(France)

Sinekod(butamirate) antitussive drops for oral administration for children; syrup Novartis Consumer Health SA(Switzerland)

When hypothermia, people often develop an unproductive dry cough. Tracheitis, bronchitis, laryngitis, pleurisy and other respiratory diseases are accompanied by dry cough, perspiration and inflammation. In order to get rid of these unpleasant symptoms, you need to buy antitussives at the pharmacy. It is advisable to do this after consulting a doctor.

Expectorants and antitussives

Expectorants are drugs that are prescribed for a wet cough. A wet cough produces purulent or mucopurulent sputum. ethnoscience also offers a number of medicinal plants that perfectly cope with cough. Licorice roots, marshmallow, istoda, elecampane, thyme grass, plantain, pine buds, wild rosemary shoots - all these plants relieve cough without harm to the body.

Antitussives may have central mechanism actions, that is, to suppress the central links of the cough reflex. Narcotic analgesics contain codeine phosphate and are used only in complex preparations. There are also non-narcotic antitussives and drugs of peripheral action.

Today there are many combined agents, which are sold in the form of drops, dry and liquid mixtures, lozenges, tablets and syrups. Expectorants include: "Pectusin", "Bronchipret", "Gedelix", "Gerbion", "Pectosol" and so on.

Ambroxol is well absorbed by any route of administration. In the liver, it undergoes biotransformation, producing glucuronic conjugates and dibromanthranilic acid. If a person liver failure there is an increase in half-life.

Bromhexine is absorbed by 99% half an hour after use. The half-life ranges from one to one and a half hours. If you use it for a long time, then some substances of the drug begin to accumulate in the body.

Glaucine hydrochloride makes breathing easier by inhibiting the cough center. This drug lowers blood pressure.

Reflex expectorants and antitussives irritate the stomach receptors, increase the secretion of the bronchial glands, activate the ciliated epithelium, increase muscle contraction of the bronchial muscles, and also dilute sputum and exhibit an antimicrobial effect.

Preparations of plantain and marshmallow have enveloping effect, and thermopsis stimulates the respiratory center.

Ambroxol and Bromhexine change the physical and chemical composition of sputum. Ambroxol improves its discharge. Bromhexine may cause gastrointestinal disorder, allergies and neurotic edema. Ambroxol may cause stomach pain, constipation, nausea or allergies.

If the cough significantly worsens the patient's condition, you can combine antitussive and expectorant drugs.

Antitussives classification

Medicines that suppress cough are called antitussives. They are prescribed when cough is not physiologically justified.

Antitussives classification: narcotic, non-narcotic, local anesthetics and mixed-action drugs.

Narcotic antitussives include codeine, dionine, morphine, dextromethorphan, and so on. These drugs suppress the cough reflex and inhibit the functioning of the cough center, which is located in the medulla oblongata. If you use them for a long time, addiction may occur.

Non-narcotic centrally acting antitussive drugs include butamirate, glaucine hydrochloride and oxeladine citrate. They have a hypotensive, antitussive and antispasmodic effect, do not inhibit motor skills intestinal tract, do not inhibit the breathing process and are not addictive.

Lidocaine is considered local anesthetic, it is used for inhalation. Mixed-action drugs include Prenoxdiazine.

Antitussives for children

Antitussives block the cough reflex. They are used when it is necessary to suppress a dry cough, for example, with laryngitis, pleurisy, laryngeal papilomatosis, laryngeal tumors, chronic bronchitis and SARS. Antitussives should not be used when acute bronchitis, cystic fibrosis, pneumonia and other diseases. If they are used for the above diseases, stagnation of sputum in the bronchi may occur.

In general, antitussive medications lead to constipation, nausea, vomiting, and decreased blood pressure, drowsiness, addiction and decreased bronchial ventilation.

Antitussives are not often used for children. They can only be used with the permission of the attending physician, since there is a large number of contraindications.

Centrally acting antitussive

Coughing is a complex reflex reaction that a person needs to restore normal airway patency. It occurs when receptors in the nose, back of the throat, ears, esophagus and pleura are irritated. A cough can be suppressed and caused voluntarily, because it is controlled by the cerebral cortex.

The centrally acting narcotic antitussive contains morphine-like compounds. It suppresses the function of the cough center. Medications from the codeine group are considered effective, but have big amount side effects. They act selectively and depress the respiratory center.

A non-narcotic antitussive agent of central action also acts selectively. However, it does not affect the respiratory center too much. Non-narcotic drugs act no worse than codeine, and they are not addictive.

Peripheral antitussive

Peripheral medications are also used to suppress cough. This includes lozenges, teas and syrups based on plant extracts, honey and glycerin. A peripheral antitussive has an enveloping effect, creating a protective layer on the mucous membrane of the respiratory tract.

Prenoxdiazine is a combined synthetic drug that inhibits the cough center without depressing breathing. The drug has a direct antispasmodic effect, prevents the occurrence of bronchospasm and reduces the excitability of peripheral receptors. These medications do not need to be chewed, but simply swallowed.

How to cure a wet cough?

If a person's sputum is viscous, he needs to drink a lot. Best to use herbal remedies, which have an enveloping, anti-inflammatory and expectorant effect. If there are no contraindications, you can do steam inhalations, which moisturize the mucous membrane and have an analgesic effect.

It is necessary to use expectorants, which make sputum less viscous and eliminate bronchial secretions. iodides, essential oils and ammonium chloride stimulate hydrolysis and proteolysis of sputum.

Licorice, marshmallow and thermopsis irritate the stomach receptors and increase the secretion of the mucous glands of the bronchi and salivary glands.

In order to relieve a cough, you need to constantly humidify the air in the apartment, quit smoking, and avoid sudden temperature changes.

There is among the people great amount recipes that help relieve cough and ease breathing. You can, for example, pour water over lemon and boil it for ten minutes. After it has cooled, cut it and squeeze out the juice, add two tablespoons of glycerin and honey. Take two teaspoons before meals and at night. You can also mix radish juice, carrot juice and milk in equal parts. Drink a tablespoon six times a day.

At all, folk wisdom has a wealth of knowledge in the field of cough treatment, each person finds the most acceptable prescription and uses it when necessary.