Cough pills

To successfully get rid of a cough, first of all, you should determine the type of cough and only then proceed to choosing a drug that will help overcome, and not aggravate, the disease.

Most cough medicines are available over the counter, but it is important to remember that the path to recovery begins with a correct diagnosis. Cough pills prescribed for one type of cough can be harmful for another type of illness. That is why you should pay attention to your condition.

A dry cough can be recognized by debilitating attacks with a sore throat that prevent you from sleeping at night. In medical circles, this type of cough is called unproductive, characterized by the absence of sputum, as well as pain in the muscles of the abdomen and chest. The cause of such a cough is irritation of the pharyngeal cough receptors. Antitussives that stop the attack will help to cope with the problem in this situation.

Productive cough is accompanied by the discharge of secretions. The removal of sputum from the bronchi, trachea and lungs is facilitated by expectorants (increase secretion production) or mucolytics (liquefy sputum). Some cough tablets help clear the respiratory tract by stimulating special cilia.

The use of drugs containing codeine (a narcotic substance) is possible in the most severe cases. Preference should be given to pure codeine or its analogue dextromethorphan. As for combination drugs, they have an expectorant effect. As a result, on the one hand, such drugs facilitate the secretion of sputum, and on the other hand, they consist of components aimed at suppressing cough, preventing the discharge of secretions. The latter is unacceptable for a productive type of cough.

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Indications for the use of cough tablets

Cough is not always caused by respiratory diseases. Cough often accompanies infectious diseases of viral or bacterial origin, which include: laryngitis, sinusitis, tonsillitis, pharyngitis, pneumonia, bronchitis, tuberculosis, etc. Cough can be caused by childhood diseases, such as whooping cough, as well as allergic conditions. Coughing attacks characterize pathological processes of the organic type of the brain, manifest themselves on nervous grounds, with cardiac disorders (heart disease, angina, etc.), with damage to the respiratory tract by aggressive environments. This list can be continued indefinitely. Therefore, it is important to establish and eliminate the root cause of the disease, and not to solve the cough problem in any way possible.

The choice of cough tablet depends on the nature of the cough. In conditions accompanied by a dry, painful cough, drugs that suppress the cough center in the brain are indicated:

• combination drugs with the active ingredient codeine - "codelac", "terpincod N", "tercodin";
• lozenges based on dextromethorphan - “Alex Plus”;
• substances with butamirate - "sinekod", "omnitus", "panatus".

Libexin tablets with the active substance prenoxdiazine soothe cough receptors in the throat, maintaining respiratory functions and not causing drug dependence. The drug is equal to codeine in terms of its medicinal effect. Coughing attacks are also relieved by lozenges based on menthol and eucalyptus (pectusin), as well as licorice preparations - "glycyram"

For viscous, poorly separated and scanty sputum the following are effective:

• mucolytic agents based on bromhexine - "bromhexine", "ascoril", "solvin";
• preparations with ambroxol - “ambroxol”, “codelac broncho”, “ambrobene”, “flavamed”;
• expectorant mucolytics acetylcysteine - "ACC", "fluimucil", "acestin".

Indications for the use of cough tablets with the active ingredient acetylcysteine concern cases where it is necessary to increase the amount of secretions.

An expectorant effect is also achieved by using herbal preparations - "mucaltin", "lycorin", "pectussin", "thermopsis".

In addition to the correct selection of medications, it is important to ensure sufficient humidity in the room and drink more fluids (up to 6-8 glasses per day).

Release form

All cough tablets can be divided into the following groups:

1. drugs that suppress the cough center in the brain and affect the nerve endings of receptors;
2. agents that affect smooth muscle structures and bronchial mucosa;
3. drugs that have a direct effect on bronchial secretions (phlegm).

From the above, we can make an unambiguous conclusion that treatment is selected individually for each case. The form of release of the drug is also important. Effervescent tablets and lozenges are characterized by high speed of action and absorption, but are unlikely to be suitable for babies. Sweet cough syrups are recommended for very young patients. Effervescent cough suppressants will be contraindicated for people suffering from peptic ulcer disease, hyperacid gastritis or having increased acidity of gastric juice.

The type and dosage of the drug is prescribed by the doctor based on the symptoms, age and individual characteristics of the patient's body. For any pharmacological agent, regardless of the form of release, there are contraindications and side effects. For example, a popular medicine for wet cough - Thermopsis, consisting entirely of natural ingredients, is prohibited in the treatment of bronchitis and pneumonia in infants. Babies are not able to cough up a large amount of mucus, which in some cases provokes respiratory failure. In children under five years of age, the drug provokes a gag reflex in case of overdose, it is contraindicated for pregnant women and people suffering from gastric ulcer and duodenal ulcer.

Therefore, before starting treatment, you should establish a correct diagnosis and get recommendations on taking cough suppressants from a specialist.

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Pharmacodynamics of cough tablets

Today, there is no universal cough pill, due to the fact that the therapeutic effect on dry and wet cough is fundamentally different. In the presence of a dry cough, it is inappropriate to use tablets for wet cough with a stopping effect, which will cause blockage of the bronchial lumens with outgoing sputum. Medicinal substances for productive (wet) cough, which help to reduce viscosity and easily remove sputum, are useless in the case of a dry cough caused by inflammation of the trachea, irritation of the bronchial mucosa, and the influence of aggressive environments.

Medicines that actively affect the cough center are divided according to the principle of action on: central, peripheral and combined influence. The pharmacodynamics of cough tablets (the mechanism of action on the human body) is characterized by the properties of the constituent components. For example, drugs with the narcotic substance codeine are quite effective for dry, debilitating cough without expectoration. However, these drugs are dispensed strictly by prescription, as they are addictive. Modern pharmacology has no less effective, safe, non-narcotic drugs that do not affect the respiratory center. Such affordable cough tablets include "libexin", "tusuprex" and others. They most often reduce the receptor sensitivity of the bronchial mucosa (peripheral effect), but are also able to block the cough reflex. This group of drugs does not cause addiction, so they are used to treat cough in children.

Multicomponent cough tablets are effective in any course of the disease, excluding wet cough. Stopping cough in this case can disrupt the cleansing ability of the lungs, the removal of mucus and lead to the development of pneumonia, problems with ventilation of the lungs. Combined drugs have the most impressive list of side effects and contraindications. It also becomes difficult to select the correct dosage and the inability to combine them with other drugs.

When it comes to wet cough, the most popular cough tablets "Thermopsis" are most often remembered. And here the patient needs to be extremely attentive. The fact is that the familiar and inexpensive remedy "Thermopsis" is now available in two compositions:

1. does not contain chemicals, includes only lanceolate thermopsis herb and sodium bicarbonate (therapy for children is possible);
2. consists of codeine (a narcotic substance), thermopsis herb, sodium bicarbonate and licorice root.

Let's consider the pharmacodynamics of this drug:

• codeine - is characterized by a slight sedative, analgesic effect, blocks the cough reflex without suppressing the respiratory center and the functions of the ciliated epithelium, does not reduce the amount of secretion in the bronchi;
• Thermopsis herb (with active components - isoquinoline alkaloids) - activates the respiratory and vomiting centers. It has a pronounced expectorant effect, helps to activate the secretory function of the bronchial glands, stimulate the ciliated epithelium and accelerate the processes of mucus removal;
• sodium bicarbonate – causes the pH of bronchial mucus to shift towards an alkaline environment and reduces the viscosity of sputum. Stimulates the work of the ciliated epithelium and bronchioles;
• licorice root – ensures easy discharge of secretions due to the content of glycyrrhizin. Has an anti-inflammatory and antispasmodic effect.

Pharmacokinetics of cough tablets

Pharmacokinetics is understood as the biochemical transformation of drug molecules in the human body. The main pharmacokinetic processes include absorption, excretory, distribution and metabolic properties.

The absorption of a cough tablet occurs after dissolution, usually in the small intestine. Then the drug molecules enter the systemic bloodstream. Absorption has two characteristics - speed and degree of absorption (decreases if the pharmacological substance is used after food).

Distribution of the drug occurs into the blood, intercellular fluid and tissue cells.

The excretion of drugs is carried out unchanged or as substances of biochemical transformation - metabolites, which have a higher polarity and solubility in an aqueous medium in comparison with the original substance, which causes simple excretion with urine.

Excretion (removal) of the drug is possible through the urinary, digestive system, as well as through sweat, saliva and exhaled air. The excretory function is affected by the rate of drug entry with the bloodstream into the excretory organ and by the characteristics of the body's own excretory systems. The most common route is the kidneys, bronchial glands and the mucous membrane of the respiratory system.

The pharmacokinetics of cough tablets is based on the main active ingredient included in the drug:

• codeine - characterized by a high absorption rate, blocks cough within half an hour after administration, provides a persistent antitussive and analgesic effect for up to six hours. Transformed in the liver, the half-life process begins in 2-4 hours;
• glaucine hydrochloride – is well absorbed by the digestive system, transformation occurs in the liver, excretion via the kidneys (primary metabolites);
• ambroxol - maximally absorbed, excreted in urine;
• bromhexine - absorption reaches 99% half an hour after use. In plasma, it forms a bond with proteins. It is characterized by penetration through the placenta, accumulation in the liver, kidneys, adipose and muscle tissue. Half-life occurs after an hour and a half;
• carbocysteine - is actively absorbed and metabolized during the first pass through the liver. Maximum concentration is reached two hours after oral administration. Excretion occurs in the urine almost unchanged;
• acetylcysteine - has low bioavailability (no more than 10%), which is explained by the formation of cysteine during the primary passage through the liver. Peak concentration - after 1-3 hours. Characterized by penetration through the placental barrier. The kidneys are responsible for excretion, an insignificant part of the substance is excreted unchanged by the intestines.

Method of administration and dosage

The specifics of taking antitussive drugs depend on the nature of the disease, the patient's age, individual characteristics of the body, the presence of chronic diseases, the presence of bad habits (for example, smoking), body weight and a number of other factors.

A specialist should establish the correct diagnosis and prescribe the correct treatment. The method of application and dosage are also determined by the doctor on an individual basis.

The cough medicine tablet "libexin" or "libexin muco" (with the mucolytic carbocysteine, which reduces the viscosity of sputum) is used without chewing up to 4 times a day. The dosage depends on the patient's age and varies from a quarter of a tablet to two tablets per single dose. The duration of the effect is up to four hours.

Cough tablets "Stoptussin" are taken up to 6 times a day, since the period of partial elimination is six hours. The medicine for resorption "Falimint", which helps with unproductive irritating cough, is allowed for use up to 10 times a day, provided that the duration of therapy is no more than several days.

Mucolytic drugs based on plant materials should be taken before meals. The recommended dose of "mucaltin" for adults is 1-2 tablets up to 4 times a day, for children - from half a tablet to two tablets per single dose. "Termopsis" without codeine is prescribed one tablet three times a day for a course of up to five days. The maximum daily dosage of the drug is 0.3 g or 42 tablets. Children over 12 years old are allowed one tablet 2-3 times a day. The prescription of "bromhexine" for adults and children from 10 years old is 8 mg three to four times a day. Children under two years of age take this drug 2 mg three times a day. The treatment course can be up to four weeks.

Effervescent cough tablets "ACC" are taken after meals, having previously dissolved the medicine in half a glass of water, juice or cold tea. The daily dose of the drug depends on body weight: patients weighing more than 30 kg use up to 800 mg of the drug. For children, the dosage is selected based on age: up to 2 years - 50 mg. 2-3 times a day, from 2 to 5 years - 400 mg. in four doses, from 6 years - 600 mg. in three doses. The duration of treatment varies from three to six months, which is affected by the complexity of the pathological condition.

Using Cough Tablets During Pregnancy

Before taking a cough pill, a pregnant woman should carefully read the instructions and consult a doctor. The specialist will determine the cause of the cough and prescribe appropriate treatment. Coughing attacks are caused not only by upper or lower respiratory tract infections, but also by allergic, neurotic reactions, stomach or diaphragm problems, thyroid disease, cardiovascular dysfunction, etc.

The greatest danger is a dry, painful cough. Such attacks can increase the intra-abdominal and arterial pressure of the expectant mother, which can trigger the mechanism of premature termination of pregnancy, placental abruption and even cause termination of pregnancy.

Most pharmacological drugs are prohibited for use during pregnancy. However, the use of cough tablets during pregnancy based on herbal components such as:

• "Mukaltin", containing marshmallow herb. Taken under strict doctor's supervision three to four times a day, before meals. Duration of therapy is one to two weeks;
• Eucalyptus-based lozenges (preferably sugar-free) – the inclusion of herbal mixture in them is usually minimal. The positive effect is achieved due to the abundant production of saliva, which moisturizes and softens the pharyngeal area and larynx, where the urge to cough begins;
• drugs with the active ingredient dextromethorphan (suppresses the cough center) are prescribed for severe attacks when it is not possible to eliminate the problem in any other way;
• Bromhexine, as part of many expectorant medications, is also often used to treat pregnant women;
• "Bronchipret" is a German medicine made from herbal ingredients. It is indicated for coughs of any origin (one tablet three times a day, after meals). The course lasts from seven to ten days;
• "Ambroxol" - liquefies thick viscous mucus, facilitates expectoration. Allowed for treatment of pregnant women under the supervision of a specialist in the second/third trimester;
• "codelac" - not recommended during pregnancy, as codeine is a drug that can cause dysfunctions in embryonic development, often causing heart defects. It is prescribed only in emergency cases, when other means are powerless.

In any case, you should not self-medicate during pregnancy, even with folk remedies. Oddly enough, even herbal raw materials can cause harm if you have an individual intolerance. The choice of treatment method, dosage of the drug and duration of therapeutic effect are prescribed by the doctor strictly individually.

Contraindications to the use of cough tablets

Each medicine has indications, contraindications and a list of side effects. Cough pills are selected according to an individual scheme for each patient. Particular caution is required when treating cough in small children, pregnant and lactating women.

Combination antitussive drugs are not prescribed in cases of individual intolerance, during pregnancy and lactation, to children under two years of age, as well as when second/third degree respiratory failure is detected and there is a severe form of bronchial asthma.

The use of expectorant tablets is unacceptable in parallel with the intake of substances that suppress the cough center and inhibit the cough reflex. Such a combination provokes severe inflammatory diseases of the lower respiratory tract (for example, pneumonia).

Contraindications to the use of cough tablets "Termopsis" apply to infants with bronchitis or pneumonia, since with abundant sputum discharge they will not be able to cough up, which will cause respiratory failure. Known tablets in large doses cause nausea in children at the beginning of the course.

Mucolytics "bromhexine", "ACC", "ambroxol" are not recommended during exacerbation of bronchial asthma due to the risk of bronchospasm. "Bromhexine" is contraindicated in the first three months of pregnancy, children under three years old, in the presence of a stomach ulcer, recent bleeding and individual intolerance. "ACC" tablets can be prescribed after the tenth day of life, but are not used for pulmonary hemorrhage, stomach ulcer, hepatitis, in cases of renal failure and fructose intolerance. The drug is not combined with tetracycline, a semi-synthetic group of penicillins, aminoglycosides, cephalosporins, as well as with other antitussive drugs to avoid congestion in the respiratory tract.

Effervescent or lozenge cough tablets are famous for their rapid absorption and effectiveness, but they are not suitable for treating patients with high acidity, gastritis and gastric ulcer.

When choosing a cough remedy, you should follow the instructions, but it is best to visit a competent specialist who will determine the cause of the painful condition and prescribe the most effective remedy.

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Side effects of cough drops

Cough tablets have their own list of side effects, from nausea to drug addiction.

The drug "libexin" requires taking strictly according to the prescribed scheme (four times a day in accordance with the patient's age), without chewing, to avoid anesthesia of the oral mucosa. The popular drug "stoptussin" can cause diarrhea, headache, abdominal pain, dyspepsia, allergic reaction and dizziness. When taking "tusuprex", used to treat dry, unproductive cough, some patients experience indigestion.

Side effects of cough tablets of the mucolytic group (bromhexine, ACC, etc.) include the onset of bronchospasm, which is especially dangerous during an exacerbation of bronchial asthma. Such patients should give preference to bronchodilators without atropine. Taking the drug "ACC", in addition to the above, is fraught with skin reactions, increased blood pressure, and dyspepsia.

Thermopsis-based cough tablets can also provoke allergic reactions (itching, skin rash, etc.) and cause nausea.

Cough medicines with narcotic content (for example, with codeine) cause pharmacological dependence, allergies. In case of overdose, constipation, vomiting, urinary retention, problems with eye movement coordination, weakness, and respiratory depression are observed.

If coughing fits get worse and there is no opportunity to visit a doctor, then carefully study the instructions for the drug you are purchasing for contraindications and side effects.

Overdose

The body's reaction to taking a cough pill can be completely different. In some cases, patients are bothered by nausea due to individual intolerance to the components of the drug. An overdose of an antitussive can provoke an allergic reaction in the form of itching, skin rash.

Symptoms of acute or chronic overdose from narcotic tablets (for example, codeine-containing):

• clouding of consciousness;
• sticky, cold sweat;
• weakness, drowsiness;
• change in blood pressure;
• nervous condition;
• rapid fatigue;
• bradycardia;
• causeless anxiety;
• convulsive state;
• breathing problems;
• chest pain;
• miosis;
• respiratory arrest;
• coma;
• loss of consciousness;
• the emergence of pharmacological dependence;
• weight loss/gain.

In the most severe cases, gastric lavage, restoration of respiratory system functions, normalization of blood pressure and heart function, and intravenous administration of special substances, such as naloxone (an opioid analgesic), are required.

Interactions of cough tablets with other drugs

The combination cough tablets with a mucolytic effect "codeterpine" enhance the effect of sleeping pills, sedatives and analgesics. This must be taken into account before taking by persons driving a vehicle and engaged in other activities that require increased attention.

The antitussive drug "ACC" is prohibited for use with the tetracycline group, semi-synthetic penicillin preparations, aminoglycosides and cephalosporins. "ACC" should not be combined with other cough tablets to prevent congestion of the respiratory tract.

"Libexin" should not be combined with mucolytics, expectorants, as this may make it difficult to remove sputum.

With regard to the interaction of cough tablets with other drugs that suppress the cough reflex, such as codeine, it can be said unequivocally that the latter complicate the coughing up of liquefied sputum and its accumulation in the lungs.

A number of pharmaceuticals enhance each other's action. Such an effect is observed when taking "glycodin" simultaneously with narcotic antitussives. At the same time, "glycodin" often interacts with monoamine oxidase inhibitors.

Before you start taking any cough medicine, read the package insert carefully and be sure to tell your healthcare provider about any medications you are taking.

Storage conditions for cough tablets

The basic storage conditions for cough tablets include the following points:

• the storage location must be dry, protected from light and inaccessible to children;
• the acceptable temperature is usually 15-25C, unless otherwise specified in the instructions;
• Place medications away from heating/heating devices.

You should not carefully cut off the empty part of the blister to preserve the aesthetic appearance of the started packaging. After a while, it will be difficult or absolutely impossible to determine what this "white" tablet helped with. Moreover, you can take the wrong medicine. The same applies to those who like to transfer tablets into containers from other drugs.

If cough tablets sealed in a paper blister get wet, throw them away immediately. It is unlikely that such packaging will preserve the medicinal properties of the drug from exposure to the water environment.

A visual change in the color of the tablet, delamination, etc. is a reason for its immediate disposal.

Make a useful rule for yourself - once every six months, conduct an audit of the medicine cabinet, replenish it with the most necessary drugs, including antitussives. It is also advisable to store pharmaceuticals in groups according to their purpose.

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Best before date

Remember that the expiration date on the packaging only applies to sealed medications. Do not store or use expired medications, no matter how “normal” they may seem.

The shelf life of cough tablets can vary from 3 to 5 years.