Diseases of the upper and lower respiratory tract in adults and children are often accompanied by the formation of thick, viscous sputum.

In this case, the cough becomes unproductive, suffocating, painful. Under such circumstances, it is simply impossible to do without special expectorant drugs. The accumulation of a large amount of mucus in the bronchi is dangerous due to the creation of favorable conditions for the attachment and reproduction of pathogenic microflora.

Therefore, in such a situation, only drugs that dilute and remove sputum from the bronchial lumens will come to the rescue.

Why are expectorants needed?

Cough is a protective reflex that is triggered by irritation of the mucous membranes of the respiratory tract. But if the reaction is absolutely normal, then why do you need to take expectorant drugs? Let's try to figure it out.

In organism healthy person the trachea and bronchi secrete a specific substance - tracheobronchial mucus. It neutralizes the negative impact of pathogenic microflora and viruses on the respiratory system, helps to eliminate microparticles that irritate the mucous membranes. respiratory organs and entering the body with the inhaled air. A person swallows about 100 ml of this secret per day.

When an infection is attached, the volume of mucus produced increases, and can be up to 1.5 liters per day. Such sputum is the optimal habitat for pathogenic bacteria. To get rid of its excessive accumulation, the cough reflex is triggered.

Viscous and thick sputum cannot come out of the bronchi on its own, as a result of which a sharp deterioration in a person’s well-being occurs. To remove mucus and make breathing easier, special expectorants are prescribed.

Classification

Means that have the ability to thin and remove sputum are divided into antitussive, mucolytic and expectorant.

1. Antitussives and combined drugs. Such medicines are prescribed for an unproductive, painful cough.
2. Expectorants A. They are prescribed for a productive cough, accompanied by the formation of a thin and easily separated secret.
3. Mucolytics. Such medications are indicated for patients with a productive cough, in which the sputum is thick and viscous, so it cannot leave the bronchi on its own.

Expectorants are divided into several types:

1. Reflex drugs. When they enter the gastric mucosa, the gag reflex is activated. But at the same time, the patient does not feel the urge to vomit, but the peristalsis of the muscles of the bronchi improves, resulting in an increase in the volume of mucus in the bronchi. Stimulation of expectoration and sputum production occurs due to irritation of the mucous membranes of the stomach. This effect is mainly pharmaceutical preparations made on the basis of extracts of marshmallow, thyme, coltsfoot, etc.
2. Drugs of direct resorptive action. These drugs are absorbed in the stomach and irritate the bronchi, increasing the volume of fluid, under the influence of which sputum is formed. Improved expectoration contributes to the accumulation of water in the sputum, which dilutes it.

Mucolytics that thin sputum are divided into:

• agents that affect the elasticity and viscosity of mucus (ACC, etc.);
• drugs that promote the excretion of sputum (Ambroxol, Abrol, etc.);
• drugs that inhibit the process of sputum production (glucocorticoid drugs, Libeksin Muko, etc.).

All drugs should be prescribed only by the attending physician. It should be borne in mind that mucolytics cannot be used in combination with antitussives. However, there are combination drugs that have both expectorant and antitussive effects.

Medications dilute sputum and can be used if the patient has a cough accompanied by difficult, viscous and thick sputum. These are one of the basic groups of drugs that doctors prescribe during the treatment of a productive (“wet”) cough.

There are certain features of use and activity medicines from the group of mucolytics:

• Clinical efficacy when using expectorant and mucolytic drugs is observed 5-7 days after the start of the use of medications.
• At the beginning of therapy, patients may note the effect of "imaginary worsening".
• The use of mucolytics is not recommended during the treatment of bedridden patients due to the "flooding effect".

Mucolytic drugs are thiol-containing, visicinoids, proteolytic enzymes.

Often patients ask themselves: what is a mucolytic effect? After entering the bronchial mucus, the action of the active components of the drugs is aimed at the destruction of protein molecules that provide its viscosity and density. There is a decrease in the viscosity of mucus and facilitation of its removal from the bronchial area - this is the mucolytic effect.

The use of this group of drugs contributes to:

1. Inhibition of the formation of bronchial secretions.
2. Restoration of damaged mucous membranes of the bronchi.
3. Sputum rehydration.
4. Normalization of elasticity of lung tissues.
5. Stimulation of sputum excretion from the lumen of the bronchial tree.

Classification by active substance

Mucolytics are drugs that help thin mucus.

Modern pharmacology provides the following list of mucolytic drugs:

• Drugs that help accelerate the excretion of sputum based on bromhexidine and ambroxol.
• Medicines that help reduce the formation of mucus.
• Medications based on acetylcysteine ​​contribute to influencing the quality of viscosity and elasticity of bronchial mucus.

Mucolytic cough suppressants can also have direct and indirect effects.
With direct exposure, there is a rapid destruction of the polymer bonds of the mucus, which is located in the bronchi.

• Acetylcysteine ​​​​(ACC), Mucaltin, Mukomista, Mukobene, Fluimucil, infusion of marshmallow root, plantain leaves, coltsfoot, marshmallow.
• Enzyme preparations that reduce the viscosity of sputum: Trypsin, Chymotrypsin, Ribonuclease, Streptokinase.
• Carbocysteine: Mukopront, Mukosol, Bronkatara.

If it is necessary to provide indirect action, the use of:

• Bromhexine: Broxin, Fulpena, Bizolvon, Flegamine.
• Ambroxol: Amrosana, Ambrobene, Lasolvana, Medoventa.
• Antihistamine and anticholinergic drugs that contribute to a change in the productivity of the bronchial glands.

Patients are advised to refrain from self-medication. If a cough occurs, you should consult a doctor and find out the exact cause of the symptom. A suitable treatment regimen will be prescribed after an internal examination and a comprehensive examination.

Mucolytics with acetylcysteine

Mucolytic drugs based on acetylcysteine ​​are among the most active. Available in the form of tablets or powders for oral administration.

When dissolving the drug, the manufacturer recommends using glassware. The drug is taken immediately after the main meal.

The active ingredient is part of the following products:

• Fluimucila.
• Mukomist.
• Mukobene.
• Exomuk 200.
• N-Ats-Ratiopharm.
• Espa National

It is recommended to refrain from the use of drugs based on acetylcysteine:

1. During the treatment of patients with bronchial asthma, since there is a risk of bronchospasm.
2. With exacerbation of gastric and duodenal ulcers.
3. During the treatment of patients under 2 years of age.
4. In the treatment of pregnant and lactating women.

The combination of acetylcysteine ​​with drugs that include nitroglycerin enhances the vasodilation effect and antiplatelet properties.

Antibiotics based on cephalosporin, tetracycline and penicillin are recommended to be used no earlier than a few hours after the use of acetylcysteine.

Mucolytics with bromhexine

Bromhexine contributes to liquefaction of sputum, providing a weak antitussive effect. I use drugs during the treatment of acute and chronic bronchitis, pneumonia, tracheobronchitis.

This active ingredient is part of the following drugs:

• Phlegamina.
• Solvin.
• Flekoksina.
• Bronchostop.
• Bronchotila.
• Bromhexine 8 Berlin-Chemie.

Tablets are recommended to be taken orally, after meals, drinking plenty of fluids. The duration of the use of the drug is determined by the doctor, taking into account the therapeutic effect and indications for use.

There are certain features of the use of drugs with this active substance:

• Under the action of Bromhexine and Ambroxol, the processes of producing substances that cover the mucous membranes of the bronchi (surfactant) are activated, which prevent small villi from sticking together, which promote mucous formations from the bronchi.
• Bromhexine enhances the effectiveness of antibiotic therapy.
• In the event that a combination of mucolytics with herbal expectorants is used, an increase in the positive therapeutic effect is observed.

In order to enhance the mucolytic effect of preparations based on bromhexidine and ambroxol, it is recommended to drink fruit juice.

Mucolytics with carbocysteine

Medicines based on carbocysteine ​​are used in the course of complex treatment of bronchitis, whooping cough, bronchial asthma, otitis, sinusitis. Pharmacological activity is similar to acetylcysteine, the active substance is part of such medicines:

• Bronchobos.
• Libeksina Muko.
• Fluditheca.

The use of Carbocysteine ​​is acceptable in the treatment of patients with a history of bronchial asthma. Unlike drugs that contain acetylcysteine, carbocysteine ​​​​does not contribute to the development of bronchospasms.

Mucolytics with ambroxol

Bromhexine is a prodrug and Ambroxol is the active metabolite of Bromhexine.

Ambroxol, as well as Bromhexine, is a synthetic analogue of the vizicine alkaloid obtained from the plant Yustitia vascular.

This substance is part of drugs with the following trade names:

• Lazolvan in the form of tablets and capsules for oral administration, solution for inhalation, syrup for adults and children, lozenges for resorption.
• Neo-Bronchol in the form of lozenges.
• Flavamed in the form of tablets and oral solution.
• Flavamed Max in the form of effervescent tablets.
• Ambrosan - tablets for internal use.
• Ambroxol in the form of tablets and syrup for oral administration.
• Halixol in the form of tablets and syrup for oral administration.
• Vicks active abromed - syrup for oral administration.
• Ambrohexal - syrup, solution, tablets.

It is recommended to refrain from using drugs based on ambroxol in the treatment of patients with gastric ulcer, convulsive syndrome, bronchial motility disorders, large volumes of excreted secretions (due to the risk of developing mucus stagnation in the bronchial area), during the 1st trimester of pregnancy and breastfeeding.

Mucolytics with a combined composition

Mucolytics with a combined composition contain several active ingredients that mutually reinforce each other's therapeutic effect.

• Codelac Broncho with thyme- combined mucolytic with ambroxol, sodium glycyrrhizinate, thyme liquid extract. Can be used in the treatment of children from 2 years. It has an expectorant, antispasmodic and anti-inflammatory effect. Not recommended for use during pregnancy and breastfeeding.
• Ascoril Expectorant- a drug based on bromhexine, salbutamol, guaifenesin, racementol. Available in the form of a syrup for oral administration. The combination of active ingredients with salbutamol prevents and eliminates the development of bronchospasm. This drug is used in the treatment of obstructive bronchitis, bronchial asthma. Among the contraindications are the period of pregnancy and breastfeeding, hypertension, cardiac arrhythmia, the development of decompensated diabetes, thyrotoxicosis, exacerbation of gastric and duodenal ulcers.

Ribonuclease

One of the expectorants that help thin sputum and have an anti-inflammatory effect are enzyme preparations, for example, Ribonuclease. The active substance is obtained from the pancreas of cattle.

The mechanism of operation of enzyme preparations is associated with their ability to:

• Act only in the area of ​​necrotic tissue and viscous secretions. Such drugs do not show efficacy in areas of healthy tissue.
• Break peptide bonds in protein molecules.
• Reduce the viscoelastic properties of sputum.

The use of the drug may cause the development allergic reactions and irritation of the mucous membranes of the respiratory tract. Due to the high risk of developing bronchospasm, this type of mucolytic is prescribed in rare cases.

Mucolytics are a group of drugs that are prescribed to treat phlegm or accumulated mucus. They are not always used to affect the respiratory system, because mucus often accumulates in the nasal cavity and sinuses.

Relevance. Currently, this group of drugs is successfully used to remove sputum from the surface of the mucous membranes. The range of application is quite wide, and the use of the drug depends on the age of the patient. Funds are used in childhood, as well as in the elderly.

Mucolytics and expectorants

Mucolytic agents: indications for use

• Pneumonia. In this case, the alveoli are freed from the secret that fills them. The epithelium of the alveoli gets the opportunity to contact with oxygen. The gas exchange of the lungs is restored.
• Bronchitis. With this disease, the work of the ciliated epithelium is stimulated. As a result, mucus is evacuated faster through the bronchial tree.
• Rhinitis. By changing the composition of sputum, drugs help get rid of nasal congestion. This facilitates nasal breathing.
• Sinusitis, Sinusitis. By lowering the viscosity of the mucus, it is easier to remove it from the sinuses. Symptoms of the disease, such as headache, are reduced.
• Otitis. Only with the exudative form is the secretion accumulated in the auditory tubes removed.

For children, these funds are very often used. But the choice of mucolytic agents depends on the age of the patient.

Preference given in childhood plant-based mucolytics. The release form is mainly in syrups or inhalers. The tablet form is difficult to use in young children. Most often it is marshmallow and its derivatives in the form of syrup. Indications for its appointment - obstructive bronchitis, pneumonia with the formation of a thick secret.

thermopsis effective in the accumulation of sputum in the bronchi and other parts of the respiratory tract. These include Codelac, Stoptusin, Coldrex, Bronchicum. The mechanism of their action is based on a decrease in the viscosity of the resulting mucus, as well as an increase secretory function bronchial tree.

Absolutely natural means are also used, such as breast collection. Used by people with a predisposition to allergic diseases and intolerance to any chemical agent.

One of the commonly used tools is licorice, coltsfoot, sage, anise.

Types of mucolytic drugs

Mucolytic drugs form three main types:

• Reduce the viscosity of sputum;
• Increasing secretion excretion;
• Contributing to the reduction of mucus formation.

In the first case the appointment is used for a very dry cough, as a result of which the patient does not notice the presence of sputum. This is usually due to the fact that the sputum is very thick and the excretion process is noticeably worse, it accumulates in the lower sections and causes reflex spasm and a prolonged cough without relief.

The second group of drugs contribute to a change in the composition of sputum, break protein bonds and contribute to a change in its properties. As a result, the sputum becomes more liquid, the consistency contributes to an easier separation.

With excessive formation of mucus, regardless of the place of occurrence of the focus, agents are prescribed that act on the cells that form it. As a result, its formation is inhibited and the patient feels relieved.

Fixed assets currently in use

herbal remedies.

Bronchicum. The drug, the active substance of which is the herb Thyme Ordinary. Release form: lozenges, syrup and elixir. It helps not only to relieve swelling, but also to reduce inflammation and expectoration of mucus. Since the composition contains alcohol, it should not be taken by young children and people with alcohol dependence.

Mukaltin. The active ingredient is Marshmallow in the form of an herbal extract. Available only in the form of tablets, the drug is completely herbal. The spectrum of its action is wide. Helps reduce inflammation, as well as soften the mucosa. Approved for use by everyone except children under three years of age. Approved for use during pregnancy and lactation. For young children, the drug is prescribed in a dose appropriate for age.

Sinupret. herbal remedy, active ingredients which are gentian, primrose, sorrel, elder, verbena. It is able to remove a viscous secret not only from the respiratory tract, but also from the sinuses. Especially often prescribed for sinusitis and sinusitis. Allowed from the age of six. Has quite a few side effects. It has an effect quickly enough, while sparing the body. Available in the form of tablets, syrup and drops.

Linkas. It contains adhatoda, licorice rhizomes, parts of long pepper, violet extracts, hyssop leaves, medicinal marshmallow, as well as other plant components in a smaller dosage. Release form: granules, tablets, syrup, balm and lozenges. The tool promotes better expectoration by thinning the mucus. Allowed for use by children under one year, but only after consulting a doctor. During pregnancy, its intake should be limited.

Synthetics.

Acetylcysteine- This synthetic drug, which helps to facilitate the excretion of sputum. It has antitoxic and regenerating effect.

The release forms are different, it can be a powder for dissolution, tablets, syrup and a solution that is administered orally or used for inhalation.

The indication for use is formation of thick mucus in the respiratory tract.

One of the disadvantages of the drug is that the use is possible only from the age of 14, it can also not be used by pregnant women and those who are breastfeeding.

Bromhexine. A drug that reduces the viscosity of sputum and stimulates bronchial cells. Release forms are tablets, syrup and solution. The indication for use is bronchitis, of varying severity and type. It is allowed for small children and, if necessary, pregnant women.

Lazolvan. A remedy that is used in the development of dry unproductive cough, as well as chronic smoker's cough. Available in the following dosage forms ah: tablets, syrup and solution. It should not be used by children under 18 years of age, as well as by pregnant and lactating women.

Contraindications

In addition to all the positive effects, There are quite a few contraindications to taking mucolytics:

Pregnant women are allowed to take the drug only after consulting a gynecologist and therapist. In this case, the gestational age is also taken into account.

Pregnant women and young children are absolutely contraindicated in drugs containing codeine.

There are also frequently developing adverse reactions.

• Increased sensitivity;
• addictive;
• Gastrointestinal disorders.

Expectorants are remedies, which increase the bronchial secretion, but at the same time contribute to the stimulation of its expectoration. Usually these drugs are of plant origin. Most often these are preparations based on Thermopsis, Altea and Licorice. Not always these funds help in the fight against the disease. Since the time of their action is short, on average, the effect lasts for several hours. Therefore, the number of receptions increases, and this is not always convenient.

In some cases, the amount of sputum increases so much that it cannot completely go away with a cough. So, having accumulated in the lower respiratory tract, pathogenic microorganisms continue to multiply in it. One of side effects expectorant drugs is to increase the gag reflex and reflex irritation of the vagus nerve. Therefore, in severe cases of the disease, preference is given to mucolytic drugs.

Catad_tema Colds and SARS - Articles

Mucolytic drugs in the daily practice of a doctor

O.V. Zaitseva, Professor, Head of the Department of Pediatrics, Moscow State University of Medicine and Dentistry, Roszdrav, dr honey. Sciences

It is known that for inflammatory diseases the respiratory tract is characterized by a change in the rheological properties of sputum, hyperproduction of a viscous secretion and a decrease in mucociliary transport (clearance). This is especially pronounced in young children.

Therefore, the main goal of therapy in such cases is to thin the sputum, reduce its adhesiveness and thereby increase the effectiveness of coughing.

Medications that improve sputum separation can be divided into several groups:

• means of stimulating expectoration;
• mucolytic (or secretolytic) drugs;
• combined preparations (contain two or more components).

DRUGS THAT STIMULATE Expectoration

This group includes herbal preparations (thermopsis, marshmallow, licorice, etc.) and preparations of resorptive action (sodium bicarbonate, iodides, etc.). They contribute to an increase in the volume of bronchial secretions. Means that stimulate expectoration (mainly herbal remedies) are often used in the treatment of cough in children. However, this is not always justified. Firstly, the effect of these drugs is short-lived, so it is necessary to take small doses every 2-3 hours. Secondly, an increase in a single dose causes nausea and, in some cases, vomiting. Thirdly, drugs in this group can significantly increase the volume of bronchial secretions that young children are not able to cough up on their own, which leads to a significant violation of the drainage function of the lungs and reinfection.

MUCOLYTIC (OR SECRETOLYTIC) DRUGS

In the vast majority of cases, this group of drugs is optimal in the treatment of respiratory diseases in children. Mucolytic drugs (bromhexine, ambroxol, acetylcysteine, carbocysteine, etc.) affect the gel phase of bronchial secretions and effectively thin sputum without significantly increasing its amount. Some of the drugs in this group have several dosage forms that provide different methods of delivery. medicinal substance(oral, inhalation, endobronchial), which is extremely important in complex therapy respiratory diseases in children, both acute (tracheitis, bronchitis, pneumonia) and chronic (chronic bronchitis, bronchial asthma, congenital and hereditary bronchopulmonary diseases, including cystic fibrosis). Also, the appointment of mucolytics is also indicated for diseases of the upper respiratory tract, accompanied by the release of mucous and mucopurulent secretions (rhinitis, sinusitis). Mucolytics are most often the drugs of choice in children in the first 3 years of life. At the same time, the mechanism of action of individual representatives of this group is different.

Acetylcysteine(ACC, N-AC-ratiopharm, Fluimucil) is one of the most active mucolytic drugs. Its mechanism of action is based on the effect of breaking the disulfide bonds of sputum acid mucopolysaccharides. This leads to depolarization of mucoproteins, helps to reduce the viscosity of mucus, thin it and facilitate excretion from the bronchial tract, without significantly increasing the volume of sputum. Restoration of normal parameters of mucociliary clearance helps to reduce inflammation in the bronchial mucosa. The mucolytic effect of acetylcysteine ​​is pronounced and fast. It is extremely important that the drug also contributes to the liquefaction of pus and thereby increases its evacuation from the respiratory tract.

The high efficiency of acetylcysteine ​​is due to its unique triple action: mucolytic, antioxidant and antitoxic. The antioxidant effect is associated with the presence of a nucleophilic thiol SH-group in acetylcysteine, which easily gives up hydrogen, neutralizing oxidative radicals. The drug promotes the synthesis of glutathione, the main antioxidant system of the body, which increases the protection of cells from the damaging effects of free radical oxidation, which is characteristic of an intense inflammatory reaction.

Acetylcysteine ​​has a pronounced non-specific antitoxic activity - the drug is effective in poisoning with various organic and inorganic compounds. So, acetylcysteine ​​is the main antidote for paracetamol overdose.

There are literature data on the immunomodulatory W. Droge] and antimutagenic properties of acetylcysteine, as well as the results of still few experiments indicating its antitumor activity [M.N. Ostroumova et al.]. In this regard, it has been suggested that acetylcysteine ​​seems to be the most promising in the treatment of not only acute and chronic bronchopulmonary diseases, but also to prevent the adverse effects of xenobiotics, industrial dust, and smoking. It is noted that the properties of acetylcysteine ​​are potentially important, associated with its ability to influence several metabolic processes, including glucose utilization, lipid peroxidation and stimulate phagocytosis.

Also, acetylcysteine ​​is prescribed during intratracheal anesthesia in order to prevent complications from the respiratory tract.

Acetylcysteine ​​is effective when administered orally, parenterally, with endobronchial and combined administration.

In many years of clinical practice, both in adults and in children, acetylcysteine ​​\u200b\u200b-ACC has proven itself well. The high safety of ACC is associated with its composition - the drug is an amino acid derivative. However, acetylcysteine ​​is recommended to be used with caution in patients with bronchial asthma, tk. some authors sometimes noted an increase in bronchospasm in adult asthmatics. According to the approved instructions, acetylcysteine ​​should be used with caution when peptic ulcer(there are no absolute contraindications).

ACC can be used in children from 2 years of age. ACC is available in granules and effervescent tablets for preparing a drink, incl. hot, in dosages of 100, 200 and 600 mg, applied 2-3 times a day. Doses depend on the age of the patient. Usually, children from 2 to 5 years old are recommended 100 mg of the drug per reception, over 5 years old - 200 mg each, always after meals. ACC 600 (Long) is prescribed 1 time per day, but only for children over 12 years old. The duration of the course depends on the nature and course of the disease and is acute bronchitis and tracheobronchitis from 3 to 14 days, with chronic diseases- 2-3 weeks. If necessary, courses of treatment can be repeated. Injectable forms of ACC can be used for intravenous, intramuscular, inhalation and endobronchial administration.

Carbocysteine(Bronkatar, Mukodin, Mukopront) not only has a mucolytic effect, but also restores the normal activity of secretory cells. There is evidence of an increase in the level of secretory IgA against the background of taking carbocysteine. The drug is available for oral administration (capsules, syrup).

Bromhexine is a derivative of the vizine alkaloid and has a mucolytic, mucokinetic and expectorant effect. Almost all researchers note a lower pharmacological effect of bromhexine compared to the new generation drug, which is an active metabolite of bromhexine - ambroxol. However, the relatively low cost of bromhexine, the absence of side effects, and the convenience of packaging explain the fairly widespread use of the drug. Bromhexine is used for acute and chronic bronchitis of various etiologies, acute pneumonia, chronic broncho-obstructive diseases. Children from 3 to 5 years of age are shown 4 mg 3 times a day, from 6 to 12 years 8 mg 3 times a day, adolescents - 12 mg 3 times a day.

Ambroxol(Ambrogexal, Ambrobene, Lazolvan) belongs to the new generation of mucolytic drugs, is a metabolite of bromhexine and gives a more pronounced expectorant effect. In pediatric practice, it is preferable to use ambroxol preparations that have several dosage forms: tablets, syrup, solutions for inhalation, for oral administration, for injection and endobronchial administration.

Ambroxol affects the synthesis of bronchial secretions secreted by the cells of the bronchial mucosa. The secret is liquefied by the breakdown of acid mucopolysaccharides and deoxyribonucleic acids, while secretion is improved.

An important feature of Ambroxol is its ability to increase the content of surfactant in the lungs, blocking the breakdown and enhancing the synthesis and secretion of surfactant in type 2 alveolar pneumocytes. There are indications of stimulation of surfactant synthesis in the fetus if ambroxol is taken by the mother.

Ambroxol does not provoke bronchial obstruction. Moreover, K. Weissman et al. proved a statistically significant improvement in respiratory function in patients with bronchial obstruction and a decrease in hypoxemia while taking ambroxol. The combination of ambroxol with antibiotics certainly has an advantage over the use of a single antibiotic. Ambroxol helps to increase the concentration of the antibiotic in the alveoli and bronchial mucosa, which improves the course of the disease in bacterial infections of the lungs.

Ambroxol is used for acute and chronic diseases respiratory system, including bronchial asthma, bronchiectasis, respiratory distress syndrome in newborns. You can use the drug in children of any age, even in premature babies.

Thus, in the complex therapy of respiratory diseases in children, mucolytic drugs are the most commonly used, but their choice should be strictly individual and take into account the mechanism pharmacological action drug, the nature of the pathological process, the premorbid background and the age of the child.

At wet cough, inflammation of the bronchi, SARS, patients are prescribed antitussive medications. They are used in case of poor separation of thick sputum. To thin it, the doctor prescribes mucolytics, to facilitate the discharge of mucus - expectorants for dry cough. In order to avoid side effects before using the drug, it is recommended to study the instructions for its use.

Classification of antitussives

Cough expectorant reduces the viscosity of mucus in the bronchi. When the airways become inflamed, secretions accumulate. Sputum stagnates, it becomes difficult to remove it. Impaired breathing is accompanied by irritation of the respiratory tract. The reaction of the body in this case is a cough against the background of thick and viscous sputum.

In order to avoid the development of serious pathologies (bronchitis, pneumonia, etc.), it is important to consult a specialist in time. The doctor will listen to complaints, check the lungs, the condition of the throat and nose, and send you for testing. To reduce the density and viscosity of mucus, the patient will be prescribed an expectorant. Do not self-medicate! Incorrectly selected medications can lead to an aggravation of the situation.

In medical practice, all cough remedies for adults and children are prescribed depending on the nature of the cough symptom. In accordance with this, medicines are classified into several main groups:

1. Antitussive drugs. They are used if the cough is unproductive, dry. The symptom is accompanied by disorders of sleep, appetite.
2. Expectorants. They are prescribed for adults and children to stimulate the process of sputum discharge and the acquisition of a productive cough. After using the syrup or tablets of this group, the disease passes into the stage of production of not too viscous and thick mucus.
3. Mucolytics. The indication for use is a productive cough with a large amount of viscous and thick mucus. Means are prescribed for its better release from the bronchi.

Cough expectorants are divided into secretomotor and secretolytic drugs. Their differentiation is based on the principle of action of medicines.

Secretomotor drugs

They have a reflex action. It lies in irritation. nerve endings(cough center) located in the brain. It is also activated as a result of reflex action. As a result, there is an increased production of mucus in the bronchi. Strongly coughing people find it difficult to suppress a paroxysmal symptom. The use of a secretory drug often causes a gag reflex. This is due to the fact that the cough and vomiting centers are located in close proximity to each other (medulla oblongata).

This group of medicines includes herbal remedies. Expectorant effect is exerted by licorice root extracts, essential oils(for example, eucalyptus), wild rosemary, thyme. You can prepare syrup for expectoration when coughing dry and wet on your own. If this is not possible, the medication by age is purchased at the pharmacy in accordance with the recommendations of the therapist or pediatrician.

Secretolytic drugs

They have a direct resorptive effect. It consists in increasing the secretion of mucus after irritation of the bronchial membranes. The active substances of the drug are absorbed by the gastric mucosa, and then spread throughout the body and affect the respiratory system.

What pills to give a child to relieve cough

A good effective expectorant is selected individually according to the recommendations of a specialist. At the same time, the form and nature of the course of the disease are taken into account.

Children and pregnant women should take expectorant medicines with extreme caution. When using medications, there are often concomitant symptoms- tearing and runny nose.

In order to avoid the allergic component, as well as relieve swelling, the patient is prescribed antihistamines. Also appointed:

• nasal drops (for inflammation of the paranasal sinuses);
• antipyretic (in case of an increase in body temperature);
• immunostimulants (the patient's body is depleted, so a drug is taken that increases the production of interferons);
• antibacterial or antiviral compounds (with infectious lesion upper and lower respiratory tract);
• physiotherapy (inhalation with saline). They are indicated for asthma and pneumonia, bronchitis, tracheitis, laryngitis. With the help of a nebulizer, it is possible to alleviate the patient's condition. The procedures allow the mucus to swell and be released from the bronchi.

Cough medicines in this group are represented by preparations based on ammonium chloride, potassium, sodium iodide, sodium bicarbonate. They are taken at the stage of sputum production, when they are not quite viscous and thick.

Expectorants for dry cough

An unproductive dry cough accompanies the disease at an early stage. The symptom leads to a narrowing of the lumen of the respiratory tract, the appearance of wheezing and whistles in the bronchi.

Causes of dry cough - SARS, influenza, asthma, inflammation of the lungs and bronchi.

Doctors are faced with the task of converting an unproductive symptom into a productive cough, and then getting rid of it with the help of mucolytics and expectorants.

The following medicines help with dry cough:

1. Syrup Broncholitin. It has a pronounced antitussive effect, as well as a bronchodilator effect.
2. Drops Sinekod. Effective antitussive drug.
3. Syrup Gerbion. Natural psyllium-based remedy for dry cough relief.
4. Tablets Codelac Broncho. Synthetic drug of mucolytic, expectorant and anti-inflammatory action.
5. Tablets Stoptussin. Combined antitussive drug.
6. Syrup Linkas based on herbal ingredients. It contains extracts of licorice, pepper, fragrant violets, etc.

Antitussive formulations are indicated in the case of a debilitating symptom. However, doctors do not recommend their use along with mucolytic drugs.

Choosing the best expectorant for dry cough is not easy. One drug composition is suitable for someone, another product becomes effective for someone. Each of them is selected individually.

Expectorants for adults

At various diseases respiratory system, the concomitant symptom of which is a cough, antitussive drugs of a different spectrum of action are prescribed.

With acute and chronic form bronchitis, cough pneumonia, expectorants are prescribed in combination with other groups of drugs (antibiotics, antiviral drugs, immunomodulators). Expectorants are used to:

• decrease inflammatory process mucous membranes of the larynx, trachea, bronchi and lungs;
• alleviate the patient's condition with an unproductive cough;
• liquefaction of the produced mucus;
• stimulation of the release of sputum from the bronchi.

I do not expectorate sputum, what should I do? What remedy for a cough symptom effectively fights bronchitis and other pathologies of the respiratory organs? The following mucolytic drugs are most effective:

1. Ambroxol (expectorant cough tablets or syrup). In the case of transmission from a child to children of an infection and the occurrence of bronchitis, doctors prescribe Ambrovix cough syrup for small patients. The drugs are indicated in diseases with acute inflammation of the bronchi, lungs and other respiratory organs.
2. Lazolvan is the best imported expectorant. Its analogues: Ambrosan, Ambrobene, Flavamed.
3. ACC (Acetylcysteine). It has anti-inflammatory and mucolytic action. In the case of an allergic nature of the origin of the cough, the ACC drug is taken with extreme caution.
4. Solvin (Bronchosan, Bromhexine). It has a slight antitussive effect. It has strong expectorant properties.

What can help with a cough at home

With bronchitis, mucolytic drugs of the reflex group are also prescribed. These include Mukaltin, Alteyka, Thermopsol. They contribute to increased production of viscous and thick mucus.

Folk expectorants

Folk expectorants for coughs are effective, easy to prepare and affordable. Along with drug treatment it is good to resort to the use of homemade decoctions, syrups and infusions.

It is not difficult to prepare remedies at home to eliminate the symptom. To liquefy sputum, folk remedies for coughing for adults are used expectorants:

1. Recipe 1. Milk with butter. The old proven way. Helps to relieve irritation in the bronchi, soften cough and improve the excretion of mucus. The mixture is recommended for adults and children. It is prepared by heating milk, to which 5-10 grams of butter is added. Despite the popularity of the recipe, some pediatricians do not recommend resorting to it due to the increased load on the child's pancreas.
2. Recipe 2. Warm milk with honey and fat. To 250 ml. dairy product added fat and honey. Everything is mixed and drunk. The method helps to thin the sputum and accelerate its discharge from the bronchi. With the allergic component of the cough, resorting to taking a mixture of "milk with honey" should be done with extreme caution.
3. Recipe 3. Honey in radish. Based on the ingredients, juice is prepared. This cocktail has an expectorant effect. It affects the larynx, trachea, bronchi. An expectorant for dry cough is prepared as follows: a hole is made in the radish, where 2 teaspoons of honey are added. When the fruit releases juice, the remedy is drunk in several doses throughout the day.
4. Recipe 4. Milk-fat mixture of fat (badger), milk, aloe, honey. The composition is considered one of the best expectorants for bronchitis, tracheitis, pharyngitis, pneumonia.

Inhalations and fees

Carrying out home inhalations with the addition of herbs for coughing with sputum allows you to effectively thin the mucus, speed up its excretion. The procedure replaces the use of syrups and infusions. Chamomile, oregano, string, sage, calendula, etc. are considered the most effective.

Expectorant cough recipes are also presented drug fees. Folk remedies cough for adults and children is prepared by preparing decoctions based on herbal formulations and tea. Their natural ingredients are healing properties while helping to fight various pathologies of the respiratory system.

Expectorant collection is purchased at the pharmacy. It contains specially selected medicinal herbs. Decoctions contribute to the thinning of mucus, improve its discharge from the bronchi. From dry cough, infusions based on plantain, oregano, thyme, sage, marshmallow and licorice help.