Thanks

Cough is a reflex act aimed at cleansing the surface of the mucous membranes of organs respiratory system from accumulated particles of mucus, pus and dead cells. In other words, coughing is a way to cleanse the mucous membranes of the bronchi, trachea, lungs and throat from accumulated and irritating particles. Since the respiratory organs are constantly in contact with environment, then they are often exposed to various irritating substances and pathogenic microorganisms that cause a cough reflex. That is why cough is the most common symptom that people see their GP or pharmacist for.

There is currently wide range various drugs, which in everyday consciousness are combined into one large group called "cough". However, this group is heterogeneous from the point of view of pharmacology and doctors, since it also includes drugs that suppress the cough reflex, and facilitate sputum discharge, and thin the secret, etc. In principle, all these drugs in one way or another affect the cough, but this does not mean that any of them can be taken in all cases. The choice of the drug "for cough", which in this particular case will be effective, depends on the type of cough and the underlying disease that provoked the symptom. To do this, you need to know the types cough medicines and features of their action.

Cough tablets - classification, brief description, international names of active ingredients

Depending on the mechanism and features of action, all cough preparations, including tablets, are divided into three large groups:
1. Antitussives;
2. mucolytic agents;
3. Expectorants.

Antitussive drugs are means that depress the cough reflex itself at the level nervous system. As a result of the action of drugs of this group, a person simply turns off the cough reflex in the brain or at the level of nerves, and he stops coughing.

Mucolytic agents are drugs that thin thick and viscous sputum, facilitating its removal from the various bodies respiratory system.

Resorptive expectorants are currently used quite rarely, since a wide range of highly effective and safe means reflex action, containing natural herbs. It is expectorant preparations of reflex action that represent the majority of cough remedies displayed in pharmacies.

In addition to the listed groups, there are also combined cough preparations, among which the following varieties are distinguished:

• Antitussives with an expectorant effect - Tussin, Stoptussin, Prothiazin;
• Antitussives with anti-inflammatory effect - Broncholitin;
• Mucolytics with expectorant effect - Bromhexine, Ambroxol, Ascoril;
• Expectorants with anti-inflammatory effect - Breast collection 1, 2 and 4, Sinupret, Pulmotin, licorice root syrup, Glyciram;
• Expectorants with antibacterial effect - Gelomirtol, Prospan, Evkabal;
• Expectorants with a bronchodilator effect - Gedelix;
• Expectorant with mucolytic and anti-inflammatory effect - Suprima-Broncho.

The above classifications are international titles all cough medicines available on the domestic pharmaceutical market, regardless of their form of release. Among these drugs there are tablets, and syrups, and drops, and chewable lozenges. In the future, we will give names and consider only those drugs that are available in the form of tablets.

Cough pills - names

Here are the commercial and international names of cough tablets from various groups(antitussive, mucolytic and expectorant drugs). In this case, we will first indicate the international name of the active substance, and in brackets next to it are the commercial names of finished drugs available on the pharmaceutical market.

Antitussive tablets include the following drugs:

• Codeine (Quintalgin, Caffetin, Codelac, Codelmixt, Codterpin, Nurofen Plus, Parkocet, Pentabufen, Prohodol forte, Terkodin, Tepinkod, Tedein);
• Glaucine (Glauvent, Bromhexine, Ascoril, Solvin, Bronholitin);
• Oxeladin (Paxeladin, Tusuprex);
• Ethylmorphine (Ethylmorphine hydrochloride);
• Dextromethorphan (Alex Plus, Grippex, Gripend, Kaffetin Cold, Padevix, Toff Plus);
• Butamirat (Codelac Neo, Omnitus, Panatus);
• Prenoxdiazine (Libeksin).

All of the above tablets have the ability to stop a painful, hysterical, dry cough of various origins.

Mucolytic tablets include the following:

• Acetylcysteine ​​(ACC, Acestine, Vicks Active ExpectoMed, N-AC-ratiopharm, Fluimucil, Mukobene);
• Carbocisteine ​​(Mukodin, Karbocisteine, Mukopront, Mukosol);
• Bromhexine (Ascoril, Solvin, Bromhexine, Flegamine);
• Ambroxol (Lazolangin, Lazolvan, Deflegmin, Suprima-Kof, Mukobron, Ambrobene, Ambrohexal, Ambrolan, Ambrotard 75).

All of these mucolytic tablets thin the mucus and facilitate its discharge. The drugs relieve severe and straining cough, in which a small amount of viscous, dense and sticky sputum is secreted.

Cough tablets with expectorant action include the following:

• Potassium iodide (Amtersol);
• Sodium bicarbonate (Sodium bicarbonate 0.25 g);
• Guaifenesin (Stoptussin, Ascoril);
• Thermopsis (Cough tablets, Thermopsol, Thermopsis herb tablets 0.1 g, Codelac Broncho);
• Althea root (Mukaltin);
• Licorice (Doctor MOM, Linkas Lor, Travisil, Fitolor);
• Thyme (Gelomyrtol, Bronchicum C, Bronchipret).

Expectorants are rarely available in tablet form because it is relatively difficult to manufacture. Since most of the drugs in this group are extracts and other extracts from medicinal plants, it is more convenient to produce liquid dosage forms, such as syrups, solutions, granules or powders for the preparation of solutions, etc.

Cough pills - what are the varieties

Currently cough pills depending on their physical properties and application features are divided into the following varieties:

• Coated tablets. These tablets must be swallowed whole, without chewing and drinking plenty of water (at least half a glass);
• Effervescent cough tablets. These tablets are intended for the preparation of solutions for oral administration. Effervescent tablets are either mucolytic drugs or expectorants;
• Sucking (chewable) cough tablets. These tablets are intended for slow absorption or chewing in the mouth. Chewable tablets are mucolytic or expectorant drugs with a distracting effect.

Effervescent cough tablets

Effervescent cough tablets available on the domestic market are ACC and Mukobene. At the same time, both drugs - both ACC and Mucobene are mucolytics, that is, they thin the mucus and facilitate its discharge. In terms of the severity of their clinical effects, effervescent mucolytic tablets do not have any advantage over conventional coated tablets. However, when using effervescent tablets, the clinical effect occurs much faster, therefore, with a subjectively severe tolerance of a cough with thick sputum, it is recommended to use this dosage form. In other situations, you can use those cough tablets that a person likes more for some subjective reasons.

Sucking cough tablets

Sucking cough tablets with the most pronounced clinical effect are Alex Plus lozenges and Dr. MOM. Moreover, Doctor MOM pastilles are expectorants, and Alex Plus is mucolytic. In addition to these drugs, there is a wide range of different sucking lozenges sold in pharmacies not as medicines, but as over-the-counter symptomatic remedies, and also related to cough tablets. An example of such sucking cough drops are Halls et al.

In principle, cough lozenges have the same clinical effects as coated ones. However, sucking tablets contain components that have a distracting effect due to a cooling effect in the oral cavity, which subjectively makes a person feel much better.

In addition, sucking cough tablets are effective for irritation. upper divisions respiratory tract that occurs against the background of inhalation of various harmful substances, dust particles, etc. In such cases, the effect of sucking tablets is similar to antitussives. peripheral action, that is, they suppress cough and relieve a person from a painful symptom. There is currently a wide variety of similar lozenges for coughs, which include extracts of honey, cherries, menthol, eucalyptus, licorice, acacia, linden and glycerin.

Cough tablets - application (selection rules depending on the type of cough)

The choice of cough tablets should be made individually, taking into account all the features of the current disease and this particular person. For the selection of drugs, the following main factors should be considered:

• Type of cough (dry, wet, productive with viscous sputum);
• The presence and type of sputum (thick, thin, large or small amount, etc.);
• A possible provoking factor for coughing (for example, acute respiratory infections, acute respiratory viral infections, chronic bronchitis, allergic cough, etc.).

Only after clarifying the above factors, you can proceed to the selection of cough tablets. General rule The choice of tablets can be formulated as follows:

• For dry, irritating cough without sputum discharge, antitussive drugs are indicated. Moreover, it is recommended to use either central non-narcotic antitussives (Glaucin, Bromhexine, Ascoril, Solvin, Paxeladin, Tusuprex, Padevix, Kaffetin Cold, Panatus, Codelac Neo), or peripheral drugs (Prenoxdiazine, Libeksin). Centrally acting narcotic antitussives (Codeine, Codelac, Codterpin, etc.) are recommended to be used only as prescribed by a doctor, since they can cause severe side effects (constipation, hallucinations, etc.) and addiction quickly develops to them;
• For severe cough with departure not a large number viscous, sticky and thick sputum, it is necessary to use mucolytic agents, such as ACC, Acestin, Mukobene, Fluimucil, Carbocysteine, Mucosol, Solvin, Flegamine, Ambroxol, Lazolvan, Ambrobene, etc. These drugs thin the mucus, exfoliate it from the surface of the respiratory tract and facilitate coughing. Mucolytics are the preferred drugs for severe bronchospasm because they do not increase mucus production;
• With a productive cough with abundant sputum discharge, expectorants are shown, such as Amtersol, sodium bicarbonate, Stoptussin, Ascoril, Thermopsis, Thermopsol, Mukaltin, Travisil, Bronchipret, Gelomirtol, etc. These drugs accelerate the removal of sputum from the respiratory tract, eliminating its stagnation and secondary infection.

Antitussive drugs used for bronchospasm, allergic inflammation, pharyngitis, laryngitis, tracheitis, tracheobronchitis, bronchopneumonia, chronic bronchitis, bronchial asthma, pleurisy or emphysema, accompanied by a dry, painful, debilitating cough. In addition, antitussive drugs can be used in the initial stages of colds, when there is no sputum production yet, and a painful cough does not give you the opportunity to rest. Antitussives, with the exception of Bromhexine and sucking tablets, are only allowed to be used by adults and children over 7-10 years old.

Mucolytic drugs used when acute laryngitis, tracheitis, bronchitis or pneumonia to thin viscous sputum. These drugs are indicated for use in the first days of the disease in combination with moisturizing steam inhalations.

Expectorants should be used when a productive cough appears with a discharge of a large amount of sputum. This must be done so that the sputum does not stagnate in respiratory tract, provoking secondary infection and the spread of the inflammatory process to neighboring organs and fabrics. In addition, timely removal of sputum is necessary so that decay products are not absorbed into the bloodstream, causing intoxication.

Important! Antitussive, mucolytic and expectorant drugs should not be used simultaneously, believing that they are all "cough pills". You can combine mucolytic and expectorant drugs, gradually switching to taking only expectorant tablets. It is impossible to combine antitussive drugs with expectorants or mucolytics, under any circumstances, since they have multidirectional effects. As a result of the use of mucolytics or expectorants in combination with antitussives, aspiration of sputum and mucus may occur, followed by asphyxia.

Tablets for various types of cough

Consider what types of tablets should be used when various types cough.

Dry cough tablets

If a dry cough appeared against the background of any colds, then it is recommended to use drugs from the group of mucolytics, such as ACC, Acestin, Mucobene, Fluimucil, Kabocisteine, Mukosol, Solvin, Flegamine, Ambroxol, Lazolvan, Ambrobene, etc. Mucolytics thin thick and viscous sputum, which is very difficult and difficult to separate from the surface of the respiratory organs, and therefore provokes a strained, painful and dry cough. When the cough becomes productive with sputum discharge, it is recommended to switch to taking expectorants.

If a dry cough appeared against the background of chronic diseases of the respiratory organs, for example, obstructive bronchitis, pleurisy, emphysema, tracheitis and others, it is recommended to take antitussive drugs of peripheral or central action. Moreover, for long-term diseases, peripheral antitussives are recommended, such as Prenoxdiazine, Libexin, etc., since they act gently, without provoking additional bronchospasm. At acute diseases with a dry cough, it is recommended to take non-narcotic antitussive drugs of central action, such as Glaucine, Bromhexine, Ascoril, Solvin, Paxeladin, Tusuprex, Padevix, Kaffetin Cold, Panatus, Codelac Neo. These drugs can be taken until the relief of symptoms.

Only with painful and debilitating dry cough, characteristic of pleurisy, whooping cough or heart disease, it is necessary to use centrally acting narcotic antitussives, such as Codeine, Quintalgin, Caffetin, Codelac, Codelmixt, Codterpin, Terkodin, Tepinkod, Tedein. Codeine preparations can only be taken for 5 to 7 days in a row, because with more long-term use getting used to.

Wet cough pills

Wet cough tablets must be taken in order to ensure the removal of all sputum from the lumen of the respiratory organs. If a small amount of sputum is secreted when coughing, then it is recommended to take mucolytic drugs (for example, ACC, Carbocysteine, Fluimucil, Ambroxol, etc.) or combined agents with mucolytic and expectorant effects, for example, Bromhexine, Ambroxol, Ascoril, Suprima-Broncho. After the appearance of a large amount of sputum, you should switch to taking expectorants.

If a sufficiently large amount of sputum is released during coughing, then it is necessary to take expectorants (Amtersol, sodium bicarbonate, Stoptussin, Ascoril, Thermopsis, Thermopsol, Mukaltin, Travisil, Bronchipret, Gelomirtol), which will improve, accelerate and facilitate its removal from all, even the most small bronchi. Expectorant drugs are necessary in order to prevent sputum from stagnating and causing secondary infection of nearby organs.

Among expectorants, it is recommended to use Bronchipret, Stoptussin, Thermopsis, Mukaltin and other tablets, which include thermopsis herb, guaifenesin or herbal ingredients. Tablets containing sodium bicarbonate or iodides (for example, Amtersol) may have bad taste and cause painful side effects in the form of diarrhea, constipation, etc.

Allergy cough pills

Allergic cough tablets should only be used as an emergency remedy because given state requires the systematic use of drugs. So, if a person has an attack of an allergic cough provoked by any irritating factors, then he needs to take narcotic antitussive tablets of central action based on codeine (for example, Codeine, Quintalgin, Caffetin, Codelac, Codelmixt, Codterpin, Terkodin, Tepinkod, Tedein). If it is not possible to take a drug with codeine (they are sold only by prescription), then you can use a non-narcotic antitussive agent of central action, for example, Glaucin, Ascoril, Solvin, Paxeladin, Tusuprex, Padevix, Kaffetin Cold, Panatus, etc.

In addition, with an allergic cough, you must additionally take some antihistamine, for example, Erius, Telfast, Zyrtec, Cetirizine, Fenistil, Suprastin, etc., which will eliminate spasm and swelling of the soft tissues of the respiratory tract, and also stop mucus production.

Cough pills for bronchitis

Cough tablets for bronchitis must be taken depending on the stage and form of the pathological process. So, in chronic bronchitis, accompanied by a dry and unproductive cough, it is recommended to use mucolytic drugs (ACC, Carbocysteine, Fluimucil, Ambroxol) or peripheral antitussive drugs (Libeksin). During periods of exacerbation of chronic bronchitis, it is imperative to use mucolytics and expectorants (Amtersol, sodium bicarbonate, Stoptussin, Ascoril, Thermopsis, Thermopsol, Mukaltin, Travisil, Bronchipret, Gelomirtol).

At acute bronchitis in the initial stages, when the cough is dry and unproductive, it is necessary to use peripheral antitussives and mucolytics. Then, when a cough with sputum appears, you should switch to taking expectorant tablets. Moreover, expectorant tablets must be taken until the cough stops completely.

Cough tablets for children

The rules for the selection and use of cough tablets in children are in general the same as for adults. However, due to the peculiarities of the structure and physiology of the respiratory tract in children, there are some peculiarities in the use and selection of cough tablets. Consider these features of the use of cough remedies in children.

First, antitussive drugs of central action based on codeine (Quintalgin, Caffetin, Codelac, Codelmixt, Codterpin, Nurofen Plus, Parcocet, Pentabufen, Prohodol forte, Terkodin, Tepinkod, Tedein, etc.), which are narcotic, do not occur in children. apply. These funds are used only by doctors of specialized hospitals in critical situations.

The main direction in the treatment of cough in children is its transition from dry and obsessive to wet and productive with sputum discharge. This tactic is due to the fact that in children cough is mainly associated with the formation of viscous and thick sputum, which is separated with great difficulty from the walls of the respiratory organs. Therefore, when a dry, straining cough appears in a child under 7 years old, he needs to be given mucolytics, such as Bromhexine, Ambroxol, Dornase Alpha, ACC, Carbocysteine, Stoptussin, Guaifenesin. And in a child over 7 years old, antihistamines (Erius, Telfast, Suprastin, etc.) should be added to these drugs to relieve bronchospasm. Mucolytics only thin the sputum without increasing its volume, so there is no risk of aspiration into the lungs when used. In principle, mucolytics are the drugs of choice for treating cough in children. The only situation where mucolytics should not be used in children is a cough against the background bronchial asthma.

When a wet cough with sputum is produced, children should be given expectorants to remove all the mucus from the respiratory system. Most expectorant preparations are made on the basis of medicinal plants, but this does not mean that they are all safe for children; rather, on the contrary, many are quite dangerous. So, expectorant tablets containing ipecac and thermopsis should not be given to a child, since they increase the gag reflex, which can provoke aspiration of sputum into the lungs. If a child has diarrhea against a cough, then tablets containing licorice, oregano and anise should not be given, since they have a laxative effect. Iodide tablets are not tolerated by children because the therapeutic dose is too high and can provoke poisoning. Thus, with a wet cough, a child can be given expectorant tablets containing guaifenesin (Stoptussin, Ascoril), marshmallow (Mukaltin) or thyme (Bronchipret, Gelomirtol, etc.).

Antitussives in children are used very rarely, only with a very strong cough with vomiting, which exhausts the child and does not allow him to sleep. In such situations, you can give the child peripheral antitussives, for example, Glaucine, Paxeladin, Tusuprex.

Cough pills during pregnancy

Pregnant women can use tablets containing dextromethorphan as an active ingredient to relieve dry cough. This substance does not pass through the placenta, and does not affect the growth and development of the fetus.

Currently, the following antitussive drugs in tablets containing dextromethorphan and approved for use in pregnant women are available on the domestic market:

• Padevix;
• Tussin plus.

In the instructions for use, manufacturers may indicate that dextromethorphan is contraindicated for use in the first trimester of pregnancy. but this information is inaccurate and outdated, because during the last 1 - 2 years clinical trials, showing the safety of dextromethorphan at any stage of pregnancy. However, the bureaucracy is clumsy, and therefore it takes a long time to register any changes in the instructions for the use of medicinal products due to careful checks of the scientific data presented. And therefore, in any instructions for a drug with dextromethorphan, in the contraindication column, "the first trimester of pregnancy" is indicated. But women should know that the drug has been tested and is safe for pregnant women at any time.

Dextromethorphan is the best drug to eliminate dry cough in pregnant women. However, many drugs, along with dextromethorphan, contain other active ingredients that should not be used by pregnant women.

In the presence of a wet cough with sputum, expectorant and mucolytic drugs are indicated, most of which are made on the basis of medicinal herbs. Often, cough tablets contain herbal ingredients, many of which should not be taken by pregnant women, as they can adversely affect the course of pregnancy, provoking an increase in uterine tone and other adverse effects. Pregnant women can take cough tablets containing linden, ivy, or citrus peel ingredients. Among vegetable tablets with antitussive and expectorant action, pregnant women can use the following:

• Bronchicum C - lozenges;
• Bronchipret - coated tablets.

The instructions for use for these drugs may indicate that use during pregnancy is undesirable. This phrase means that the drug has been tested on animals, and in experimental models no negative impact on the fetus and the course of pregnancy. But in order to indicate in the instructions that the drug is safe for pregnant women, animal experiments are not enough, tests should be carried out on women "in position". For obvious reasons, such studies are not carried out. Therefore, drug manufacturers, based on data on the safety of the drug obtained during animal experiments, but not having test results on pregnant women, indicate in the instructions that "the drug is undesirable for use during pregnancy and breastfeeding". Therefore, this phrase does not mean that the drug is potentially dangerous for a pregnant woman and fetus.

In addition, with a wet cough, pregnant women can take medications containing bromhexine as an active substance. Currently, the following drugs containing bromhexine are available on the domestic market:

• Bromhexine syrup, tablets, capsules;
• Solvin solution and tablets.

All of the above cough tablets can be used at any stage of pregnancy. In addition, there are also drugs that can be taken starting from the second trimester, which include drugs containing antitussive components codeine and libexin, for example, Stoptussin, Coldrex Night, Falimint, Libexin, etc.

In general, the most simple and affordable rule for choosing cough medicines for a pregnant woman is the following - she can take those medicines that are allowed for children under 3 years old.

good cough pills

In medical practice, there is no such thing as "good" or "best" because the drugs on the market are designed for different situations. This means that each specific medicine, including cough tablets, has clear indications and contraindications, which include conditions in which the drug is most effective. This means that in each specific situation, those cough tablets that are shown in this case will be good. And such drugs are called optimal, not the best or good.

For example, with a dry cough, tablets with antitussive components - codeine, dextromethorphan, glaucine, oxeladin, butamirate, prenoxdiazine or levodron propizine - will be good. Among those listed, the most dangerous will be tablets containing codeine, and products with other antitussive components are safe.

With a wet cough with a small amount of sputum good means there will be mucolytics, among which the most safe, effective, well tolerated and rarely provoking side effects are tablets containing as active ingredients guaifenesin, bromhexine, ambroxol, acetylcysteine ​​or carbocysteine.

With a wet cough with a lot of sputum, expectorant tablets containing herbal ingredients as active ingredients, for example, Mukaltin, Bronchipret, Gelomirtol, Thermopsis, etc., will be good.

cheap cough pills

The following cough tablets are the cheapest:

• Expectorants - Sodium bicarbonate 0.25 g tablets, Potassium iodide, Thermopsis grass tablets 0.1 g, Cough tablets, Thermopsol, Mukaltin, Travisil, Stoptussin;
• Mucolytic drugs - Stoptussin, Bromhexine, Ambrohexal, N-AC-ratiopharm, Mukosol;
• Antitussives - Codterpin, Glauvent, Tusuprex, Ethylmorphine hydrochloride.

Before use, you should consult with a specialist.

Tablets 1 tab.
codeine 8 mg
thermopsis lanceolate herb 20 mg
sodium bicarbonate 200 mg
licorice roots 200 mg

Tablets; contour packaging without cells 10;

Tablets; blister pack 10 carton pack 2;

Tablets; blister pack 10 carton pack 1;

Tablets; blister pack 10 carton pack 3;

Tablets; blister pack 10 carton pack 5;

Tablets; blister pack 10;

Pharmacodynamics of the drug Cough tablets

The action is determined by the properties of the components included in the drug.

Codeine reduces the excitability of the cough center and interrupts the reflexes that cause prolonged cough, has a weak analgesic and sedative effect. In not large doses does not cause oppression of the respiratory center, does not disrupt the function of the ciliated epithelium and does not reduce bronchial secretion.

The herb lanceolate thermopsis contains isoquinoline alkaloids as active substances. Stimulates the respiratory and stimulates the vomiting centers. It has a pronounced expectorant effect, manifested in an increase secretory function bronchial glands, increased activity ciliated epithelium and accelerating the excretion of secretions, increasing the tone of the smooth muscles of the bronchi due to the central vagotropic effect. The biologically active substances contained in the plant have ganglioblocking properties.

Sodium bicarbonate causes a shift in the pH of bronchial mucus to the alkaline side, reduces the viscosity of sputum. Stimulates the motor function of the ciliated epithelium and bronchioles.

Licorice root has an expectorant, anti-inflammatory and antispasmodic effect. Expectorant properties are due to the content of glycyrrhizin, which stimulates the activity of the ciliated epithelium in the trachea and bronchi, and also enhances the secretory function of the mucous membranes of the upper respiratory tract.

The antispasmodic effect on smooth muscles is due to the content of flavone compounds (the most active is liquiritozide). The anti-inflammatory effect is manifested in the relief of inflammatory reactions caused by histamine, serotonin and bradykinin.

Glycyrrhizic acid, undergoing metabolic transformations in the body, has a GCS-like effect.

Use of the drug Cough tablets during pregnancy

Contraindicated in pregnancy (especially I and III trimesters). At the time of treatment should stop breastfeeding.

Contraindications to the use of the drug Cough tablets

hypersensitivity;

respiratory failure;

Asthmatic status;

Children's age up to 2 years.

Caution:

threatened miscarriage;

Pregnancy (especially I and III trimesters);

Lactation period (danger of developing respiratory depression in a child due to the fact that codeine penetrates well through the placental barrier and BBB).

Side effects of the drug Cough tablets

Allergic reactions: skin itch, urticaria; nausea. With prolonged use - the development of drug dependence on codeine.

Dosage and administration of the drug Cough tablets

Inside, 1 tab. 2-3 times a day.

Overdose of cough tablets

Symptoms: vomiting, constipation, urinary retention, headache, drowsiness, incoordination of eyeball movements, miosis, depression of the respiratory center.

Treatment: gastric lavage with activated carbon or potassium permanganate. The introduction of respiratory analeptics, atropine and a competitive antagonist of codeine - naloxone.

Drug interactions Cough tablets with other drugs

Pharmacodynamic: chloramphenicol inhibits the metabolism of codeine in the liver and thereby enhances its action in the body. With the simultaneous use of drugs that depress the central nervous system (hypnotics, antipsychotics, etc.), it is possible to increase the sedative effect and the inhibitory effect on the respiratory center. Codeine enhances the effect of ethanol on psychomotor functions.

Pharmacokinetic: when codeine is used in high doses, the effect of cardiac glycosides may be enhanced, tk. due to weakened peristalsis, their absorption increases. Adsorbents, astringents and enveloping drugs can reduce the absorption in the gastrointestinal tract of alkaloids and codeine, which are part of the drug.

Special instructions when taking the drug Cough tablets

In patients with impaired renal function, the excretion of codeine is slowed down, so it is recommended to lengthen the intervals between doses of the drug. During the period of treatment, care must be taken when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration of attention and speed of psychomotor reactions.

Storage conditions of the drug Cough tablets

In a place protected from light.

Expiry date of the drug Cough tablets

Belonging of the drug Cough tablets to ATX-classification:

R Respiratory system

R05 Cough and cold preparations

R05C Expectorants (excluding combinations with antitussives)

R05CA Expectorants

Many diseases are very often accompanied by cough, which is considered a protective physiological reaction of the body in response to the irritant action of chemical, physical or organic factors on the mucous membrane of the respiratory tract. The body, with the help of a cough, tries to clean and free the airways as much as possible from foreign bodies or sputum, which is produced in response to the inflammatory process, in a word, from everything that should not be normal in the respiratory system.

In this regard, the question of suppressing the cough reflex should not arise in principle. Indeed, in the absence of the ability to cough, the respiratory tract will overflow with constantly produced sputum and become impassable to air. But it is still necessary to eliminate the cough when it acquires an excruciating painful character, being absolutely unproductive, or to alleviate it, making it more effective for releasing the bronchi from the secret.

Before continuing reading: If you are looking for effective method getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to look into site section Book after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

In each case, you have to select certain "cough pills". By the way, this title is completely incorrect. medical concepts. It sounds as ridiculous as the phrase "pills for the head." But due to the fact that such a concept has taken root among the people, in this article we will use such phrases for the convenience of our readers in order to talk in an accessible way about the principles of choosing and using cough medicines.

This topic is very important, because often sick people try to self-medicate without going to a doctor, but to pharmacists who work in a pharmacy, where entire display cases are filled with various antitussive drugs in the form of tablets, drops, inhalers, sprays, syrups, potions, infusions , tinctures, suspensions, etc., the number of which simply dazzles the eyes. As a result, a sick person relies on the advice of a pharmacist, who is forbidden to advise anything at all. After all, which cough pills to choose, only a specialist doctor has the right to advise.

Why is the list of cough medicines so long?

The answer to this question is quite simple - cough cough discord. It arises due to many causes and various diseases, which is why it is necessary to select strictly defined, most effective cough remedies to treat the corresponding ailment, eliminate or alleviate a certain kind cough.

The respiratory tract, or rather, the mucous membranes of the bronchi, constantly produce a certain amount of mucus, regardless of whether the person is sick or healthy. But with the development of the pathological process, the amount of sputum or mucus increases dramatically, and their excess is removed only by coughing. But even without sputum production, any irritation of the respiratory mucosa leads to a cough, only a very unproductive one.

From this large list, it is difficult for a person ignorant in medicine to understand which antitussive medications to choose so that the treatment is effective, and the cough is productive, easier and faster.

Basic principles for the treatment of dry cough

At the very beginning of the development of the inflammatory process in the respiratory tract, as well as in many other diseases not associated with the pathology of the respiratory system, coughing can be very severe, painful, and hacking. Dry cough without sputum formation occurs against the background of irritation of the mucous membrane of the respiratory tract, which can have a wide variety of genesis, for example, inflammatory, allergic, infectious and non-infectious.

In this case, coughing does not bring any benefit, but only exhausts an already exhausted sick person. The only way to eliminate such a cough is the use of antitussive drugs that suppress the activity of the cough center or act on the receptors of the bronchial mucosa.

At this stage of treatment, narcotic and non-narcotic drugs, for example, Codelac tablets, which are based on Codeine, will be very effective. Codeine-containing drugs are very effective, but they are sold in a free pharmacy network, but only on special prescriptions from doctors, because they can cause drug addiction.

But instead of them, the pharmacological industry offers no less effective, but safer ones that do not affect the respiratory center, quite available drugs containing no drugs. These include a fairly large list of non-narcotic cough medicines - Libexin, Tusuprex, Paxeladin, Glaucin, etc.

These drugs work mainly through the peripheral route, desensitizing receptors in the bronchial mucosa, although they may also affect the cough center. Bronchial receptors are very sensitive, they instantly react to irritation and send signals to the medulla oblongata, where the cough center is immediately activated and a cough reflex occurs. These drugs are not addictive, do not lead to drug dependence, so they can also be used for cough treatment for children.

Combination medicines for dry cough are also becoming very popular, for example, Bronholitin, which, in addition to the antitussive substance Glaucine, also contains the well-known Ephedrine, as well as Basil oil. The list of tablets, medicines, cough syrups in this category is very large, and certain principles must be followed for the use of these medicines.

It is forbidden to use these very effective and good tablets for the treatment of any kind of cough, if it becomes wet, otherwise the blockade of the cough will lead to impaired lung clearance, sputum removal, and this is a direct path to the development of pneumonia, impaired lung ventilation. Should know general contraindications for the use of drugs in this group:

1. If there is hypersensitivity to acting and auxiliary components medicines;

2. Not prescribed for pregnant and lactating women;

4. Identified respiratory failure 2-3 tbsp.;

5. In history - aggravated form of bronchial asthma.

Which is better to choose and how to take tablets for the treatment of dry cough?

Of course, there is no single answer to this question, because the choice of medicine is always selected according to an individual scheme. In addition, when choosing a medicine, you need to pay attention to the form of release of the drug. For example, it is better for young children to buy not tablets, but a syrup for the treatment of dry cough.

A form such as effervescent or absorbable tablets in the treatment of cough is absorbed much faster, their effect comes very soon, but they are also not suitable for babies.

In addition, effervescent tablets, as an antitussive, should not be taken by those who have high acidity. gastric juice, hyperacid gastritis, as well as peptic ulcer.

1. Libexin

If a dry cough occurs at the onset of a cold, flu, acute or exacerbation of chronic bronchitis, as well as in patients suffering from heart failure, it is recommended to use Libexin. These cheap cough medicines are quite comparable in their effectiveness to codeine-containing drugs.

The drug reduces the sensitivity of cough receptors, affects the cough reflex, but does not have a depressing effect on the respiratory center. In addition, Libeksin has a mild anti-inflammatory and bronchodilator action.

If this drug is sold under the name Libexin muco, then this means that it contains a mucolytic - Carbocysteine, which reduces the viscosity of sputum. Libeksin can be prescribed to young children, but with caution.

According to the instructions, the Libexin tablet preparation is used according to the scheme, which involves taking it up to 4 times a day at a dose corresponding to the age of the patient - from ¼ to 2 tablets at a time, without chewing the tablets, because they cause anesthesia of the oral mucosa. The duration of action of this drug is quite short - 3-4 hours.

This rather simple cough medicine may have another trade name, Glauvent. The drug has a central effect directly on the cough center, but it does not apply to narcotic drugs, does not cause respiratory depression and intestinal motility, addiction to it.

Glaucine can be prescribed to children from 4 years of age, but is not prescribed to persons who have had a myocardial infarction who are diagnosed with arterial hypotension because it can lower blood pressure. A pronounced antitussive effect occurs after 30 minutes and lasts almost 8 hours, which is why it is enough to apply it 2-3 times a day.

3. Bitiodin

Among the drugs of peripheral action, Bitiodin, a common and simple cough pill, can be called very effective, which is quite comparable in strength to Codeine, but at the same time does not cause addiction as narcotic antitussives and has very few side effects. This feature allows it to be used in the treatment of cough in children.

Bitiodine is used up to 2-3 times a day, it has practically no contraindications, except in cases where patients experience hypersensitivity to the drug.

4. Stoptussin

A very popular antitussive drug Stoptussin, which, in addition to inhibiting the cough reflex, has mucolytic abilities. It contains butamirate and guaifenesin, which causes an expectorant effect. These effective antitussive tablets are used up to 4-6 times a day, because the half-life of the drug is 6 hours.

For all its effectiveness, Stoptusin has a large list of contraindications: it cannot be used in the first trimester of pregnancy (with caution in the 2nd and 3rd trimester), it cannot be used during breastfeeding, for the treatment of children under 12 years of age, and also for myasthenia gravis. During treatment, side effects may occur in the form of diarrhea, dyspepsia, abdominal pain and headaches, dizziness and allergic reactions.

For the treatment of cough for pregnant women, it is better to choose other, safer options than Stoptussin.

5. Broncholitin

Broncholitin is available as a syrup, is a combination cough medicine, which includes glaucine and ephedrine. In addition to the antitussive effect, inhibition of the cough reflex, the drug dilates the bronchi and has an anti-inflammatory effect. The range of application of this syrup is very large - from catarrh of the upper respiratory tract, bronchitis, pneumonia, to the treatment of whooping cough, COPD and bronchial asthma.

Broncholithin can increase blood pressure, increase heart rate, cause extrasystoles, dizziness, insomnia, hand tremors, dyspepsia, visual impairment. However, this drug is widely used in pediatrics for the treatment respiratory diseases children over the age of 3 years. It expands the bronchi well, reduces sputum secretion and gently affects the cough center.

During pregnancy, give preference to other drugs in the treatment of cough, safer, but in case of urgent need, Broncholitin can only be used in the 2nd and 3rd trimester under medical supervision. It should not be included in the treatment regimen during breastfeeding, for patients with hypertension, coronary artery disease, heart failure, with thyrotoxicosis, hyperplasia prostate and pheochromocytoma.

Topical cough medicines

The group of antitussive drugs includes drugs that inhibit the cough reflex by anesthesia of the mucous membrane of the respiratory tract, which dramatically reduces the irritant effect of various infectious and non-infectious, physical and chemical factors. Such drugs can reduce the viscosity of sputum and relax the bronchi.

These drugs are used mainly in the form of inhalations for irrigation in order to moisten the mucous membrane of the respiratory tract, which seriously reduces the cough reflex. For this, benzoate or sodium and ammonium chloride, sodium bicarbonate are added to the composition of inhalations.

Many essential oils and vegetable extracts, for example, eucalyptus, wild cherry, acacia, have a good effect. Local anesthetics, such as Tetracaine, Benzocaine or Cyclaine, are injected into inhalers (nebulizers). But this way treatment can be used only in stationary conditions.

TO local anesthetics include Libexin tablets, which we wrote about above, as well as Falimint and Tusuprex.

1. Falimint

Falimint lozenges are used in case of unproductive irritating cough caused by catarrh of the upper respiratory tract. The drug has a mild local anesthetic effect, reduces the intensity of dry cough, and thins sputum.

Falimint is very quickly absorbed and can be used up to 10 times a day, but the duration of treatment should not exceed a few days. These lozenges should not be used for the treatment of cough in children under 4 years of age, in pregnant and breastfeeding children, and in case of hypersensitivity to it and the presence of fructose intolerance.

2. Tusuprex

very popular and very effective pills for the treatment of dry unproductive cough Tusuprex has a weak expectorant effect and a depressant effect on the cough reflex. But unlike Codeine, Tusuprex does not depress breathing, does not lead to addiction and drug dependence. However, in the process of treatment, the medicine can cause digestive disorders.

Tusuprex is often used to treat cough in children even under 1 year of age. According to the instructions, these pills should not be used against the background of bronchospasm, bronchial asthma, bronchiectasis and bronchitis with difficult sputum discharge.

The mechanism of action of expectorant drugs: features of treatment

Expectorant drugs in a reflex way increase the secretion of sputum in the bronchi, thin the secret and make it easier to discharge from the lower sections of the respiratory tract to higher sections. These drugs irritate the receptors of the gastric mucosa, excite the vomiting center, which is located in the medulla oblongata, thereby significantly increasing the secretion of sputum by the bronchial glands.

Expectorants are prescribed in cases where little or a lot of sputum is produced, but it is very thick, viscous, difficult to separate, which occurs with bronchitis, laryngitis, tracheitis, pneumonia, bronchiectasis, bronchial asthma, as well as with pneumoconiosis and cystic fibrosis.

When treating respiratory diseases with expectorants, they cannot be combined with drugs that depress the cough center and inhibit the cough reflex, because with such a symbiosis, a large amount of sputum accumulates in the respiratory tract, leads to their obliteration and the occurrence of severe inflammatory diseases of the lower respiratory organs, for example , pneumonia.

There are two groups of expectorant drugs for wet cough, which differ in their mechanism of action - drugs with a reflex and direct effect.

The most popular herbal expectorants

Expectorants with a reflex action are mainly represented by medicinal herbs and their extracts, which enhance and accelerate the excretion of sputum from the respiratory system. This group very extensive, and most of these drugs are drugs of plant origin.

Plant extracts have expectorant properties - licorice, marshmallow, ninesil, anise, wild rosemary, plantain, oregano, coltsfoot, thyme, ipecac, violet, sundew, thermopsis, pine buds, thyme, etc.

Plant extracts of these herbs are included in various chest fees, powders, tablets, wet cough syrups.

1. Doctor "Mom"

One of the most prominent representatives of herbal expectorant medicines are tablets, syrup or lozenges for cough "Doctor Mom", which includes several plant extracts - aloe, elecampane, basil, ginger, licorice, turmeric, cubeba pepper, Indian nightshade and terminalia. This tool is a combination. Its scope is from laryngitis to pneumonia.

The drug has anti-inflammatory, bronchodilator, expectorant, emollient, secretomotor, muco- and secretolytic and expectorant actions. Due to this, sputum quickly liquefies and is easily removed from the inflamed bronchi, and a dry, hacking cough quickly transforms into a wet one.

"Doctor Mom" ​​is available not only in the form of syrup, but also in the form of cough lozenges of orange, lemon, raspberry, strawberry, pineapple, fruit and berry flavors, which children really like. True, lozenges are prescribed only from the age of 14, and syrup can be used to treat 3-year-old children and older.

2. Mukaltin

Mukaltin tablets are based on only one plant substance - marshmallow extract. It has a pronounced anti-inflammatory, expectorant effect, which is due to reflex stimulation of the activity of the ciliated epithelium of the respiratory tract, as well as an increase in the peristalsis of the bronchioles and the secretion of the bronchial glands.

The composition of tablets for the treatment of wet cough Mukaltin also includes sodium bicarbonate, which helps to make sputum more liquid and increase bronchial secretion. Currently, this rather old drug is recognized as one of the most effective expectorant drugs, as evidenced by the numerous reviews of these tablets, which were used to treat coughs.

3. Thermopsis - cough tablets

When asked what are the best wet cough tablets, they immediately recall the rather old and still very popular Thermopsis tablets, which include the Thermopsis herb itself and sodium bicarbonate, which enhances sputum secretion, while reducing its viscosity. Many years have passed since the moment Thermopsis appeared, but the effectiveness and popularity of this medicine in the treatment of cough does not decrease.

There are no chemicals in these tablets, and compared to new ones, they are very expensive medicines they are virtually ineffective. There are contraindications for the drug - peptic ulcer of the stomach and duodenum, individual intolerance and pregnancy.

Thermopsis is an excellent remedy for treating cough in children. However, this drug should not be used in infants if they have bronchitis or pneumonia with a lot of sputum production. Babies simply will not be able to cough up due to increased secretion of mucus in the airways, which will quickly lead to respiratory failure.

In a large dose, Thermopsis exhibits an emetic effect, at the beginning of treatment (up to 5 days) it can cause nausea in children.

4. Other herbal expectorant tablets

The pharmacy chain now sells a lot of imported expectorants, they are quite expensive, although, in fact, they have the same effect and action as cheap, but very effective, domestic cough medicines.

The right of each person to which drug to give preference, but Bronchicum, Gedelix, Eucabal and many drugs will have a similar effect to the familiar and accessible Mukaltin or Thermopsis.

Expectorants of artificial origin

Expectorant antitussive drugs with direct action increase the excretion of bronchial secretions by affecting the sputum itself and stimulating the bronchi. This group is mainly represented by artificial medicinal substances, for example, iodized sodium and potassium salts, sodium hydrochloride, potassium bromide, sodium benzoate, ammonium chloride, as well as essential oils - eucalyptus, anise or Terpinhydrate.

These expectorants are mainly used for inhalation, but when they enter the gastrointestinal tract, due to their resorptive action, they quickly penetrate the circulatory system, and then are excreted through the bronchial mucosa and thin and increase the amount of sputum. Their effectiveness is quite decent against the background of the fact that these drugs are very affordable and cheap.

In the pharmacy network, you can find combined preparations for the treatment of cough, which combine plant matter and cheap chemistry, for example, all the same - Thermopsis or Ammonia-anise tablets. The proven Pertussin, which contains potassium bromide and thyme extract, has become very popular in this group.

Scope of mucolytic drugs

Expectorants, first of all, increase the production of bronchial secretions, and the action of mucolytics is aimed at thinning the viscous and thick secretion of the bronchial glands to facilitate their removal from the respiratory tract without increasing sputum secretion.

Mucolytic tablets are one of the main remedies in the treatment of wet cough. They restore the mucous membranes of the bronchi damaged during the pathological inflammatory process, as well as the elasticity of the lungs.

This group of drugs includes Bromhexine, ACC, Ambroxol, Karbotssiten and many others. With the combination of various herbal expectorants with mucolytics, the effectiveness of both increases dramatically.

It should be noted that both Bromhexine and Ambroxol affect the formation of pulmonary surfactant, which ensures the functioning of the alveoli of the lung tissue, preventing them from sticking together and collapsing. In addition, Ambroxol inhibits the breakdown of surfactant. This circumstance speaks in favor of the use of these drugs in pediatric practice for the treatment of very young children, especially those under the age of 5 years.

But these drugs have one unpleasant feature. They are able to cause bronchospasm, which is why they are contraindicated for use during an exacerbation of bronchial asthma. In such cases, bronchodilators are preferred, but not atropine, which makes the sputum more viscous and difficult to remove.

1. Bromhexine

This mucolytic drug in the pharmacy network can be represented under the trade name Solvin, Flegamine, Bizolvon. Its action is to reduce the viscosity of sputum and stimulate its secretion by bronchial glands, which explains the expectorant effect of the drug. According to the instructions, Bromhexine tablets can be used to treat cough in children from the age of 3, because this drug has low toxicity.

This medicine can be used for a long time - up to 4 weeks. It is contraindicated only in the first trimester of pregnancy, children under 3 years old, with stomach ulcers and recent bleeding, as well as hypersensitivity to the drug. In other cases, this is a very effective and popular cough remedy.

2. Ambroxol

Very popular drug Ambroxol, has a pronounced mucolytic and expectorant effects. In the pharmacy chain, the medicine is sold under the names Ambrobene, Ambrolytic, Lazolvan, Lindoxil, Bronchopront, Viskomcil, Mukozan, Mukofar, Mucovent, Mukosolvan, Fluixol, Secretil, etc.

The active substance is a derivative of Bromhexine, it perfectly stimulates alveolar secretion. The mucolytic agent Ambroxol affects the concentration of antibiotics in the lung tissue, which contributes to more effective anti-inflammatory and antibacterial therapy.

At the same time, Ambroxol practically does not suppress cough, but it is not recommended to combine it with other antitussive drugs. This medicine is widely used by pediatricians in the treatment of even infants.

By the way, the difference between all the listed analogues of Ambroxol lies only in the name of the manufacturing company, despite the fact that the Kiev “antitussive” tablets Ambroxol are in no way inferior to the German Lazolvan in terms of effectiveness, but they are several times cheaper than the imported counterpart.

3. ACC - cough tablets Acetylcysteine

ACC effectively liquefies thick and viscous sputum, ensuring its faster discharge, but at the same time acts as an antidote for paracetamol, aldehydes and phenols. Due to the fact that it readily crosses the placenta, it should be used with caution during pregnancy, although ACC has not been shown to have an embryotoxic effect. It is often prescribed to nursing mothers, but only under medical supervision.

The instruction clearly indicates how to drink ACC cough tablets, while it is worth noting that this drug can be prescribed from the 10th day of a child's life. The duration of the course of taking the drug can reach several months, which indicates the absence of toxicity, subject to correct dosage.

It is worth considering that side effects when taking Acetylcysteine ​​do exist, and they are quite extensive - from dyspepsia, rise in blood pressure, bronchospasm to skin and allergic manifestations.

ACC is not used in case of bleeding in the lungs, stomach ulcers, hepatitis, renal failure, history of fructose intolerance. The drug can not be used in conjunction with Tetracycline and its derivatives, aminoglycazides, cephalosporins, semi-synthetic penicillins. It can not be combined in treatment with other antitussives in order to prevent stagnation of the respiratory tract.

Features of the use of combined antitussives

IN Lately combination cough preparations have become very popular, which contain more than two active ingredients that have antitussive, antihistamine, bronchodilator, mucolytic and expectorant effects. Often they include antipyretic and antibacterial substances.

Of course, they are very effective, however, contraindications and the presence of a large number side effects are directly dependent on the amount of medicinal ingredients, which makes it very difficult to select a dose and combine them with other drugs. For children, such cough medicines are not recommended.

The list of combined drugs includes Codelac phyto, Stoptussin, Doctor Mom tablets (lozenges), Tussin plus, Bronholitin.

Remember that if the cough does not go away for several weeks, it is accompanied by painful sensations in the chest and the release of thick purulent sputum while maintaining the temperature, this is a reason to urgently consult a doctor, even if at least one of the listed symptoms is present.

To successfully get rid of a cough, first of all, you should determine the type of cough and only after that proceed to the choice of a drug that helps to overcome, and not aggravate the disease.

Most cough medicines are available over-the-counter, however, it must be remembered that the road to recovery begins with a correct diagnosis. Cough pills indicated for one type of cough can be harmful in another course of the disease. That is why pay attention to your condition.

Dry cough can be recognized by debilitating bouts with sore throat, preventing sleep at night. In medical circles, this type of cough is called unproductive, characterized by the absence of sputum, as well as pain syndrome 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.

A productive type of cough is accompanied by discharge of the discharge. Excretion of sputum from the bronchus, trachea and lungs is facilitated by expectorants (increase the production of discharge) or mucolytics (thinn sputum). Some cough tablets help clear the airways by stimulating special cilia.

The use of drugs containing codeine (a narcotic substance) is possible in the most severe cases. Pure codeine or its analogue, dextromethorphan, should be preferred. As for the combined drugs, they have an expectorant effect. As a result, on the one hand, such drugs facilitate the release of sputum, and on the other hand, they consist of components aimed at suppressing coughing that prevent discharge of the discharge. The latter is unacceptable with a productive form of cough.

Indications for the use of cough tablets

Cough is not always caused by respiratory diseases. Cough often accompanies infectious diseases viral or bacterial course, which include: laryngitis, sinusitis, tonsillitis, pharyngitis, pneumonia, bronchitis, tuberculosis, etc. Coughs can be caused by childhood illnesses, such as whooping cough, as well as allergic conditions. Coughing fits characterize pathological processes organic type brain, appear in nervous ground, with cardiac disorders (heart disease, angina pectoris, 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 problem of coughing in any way as quickly as possible.

The choice of cough pill depends on the nature of the cough. In conditions accompanied by a dry painful cough, means are shown that depress the cough center in the brain:

• combined preparations with the active substance codeine - "codelac", "terpincod N", "terkodin";
• lozenges based on dextromethorphan - "Alex Plus";
• substances with butamirate - "sinekod", "omnitus", "panatus".

Tablets "libeksin" with the active substance prenoxdiazine soothe the cough receptors of the throat, while maintaining respiratory functions and without causing drug dependence. The drug is comparable in strength to codeine. Coughing attacks are also stopped by means for resorption based on menthol and eucalyptus (“pectusin”), as well as preparations from licorice - “glycyram”

With viscous, poorly discharged and scanty sputum, the following are effective:

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

Indications for the use of cough tablets with the active ingredient acetylcysteine ​​relate to cases when it is necessary to increase the amount of discharge.

The expectorant effect is also achieved through the use of phytopreparations - "mukaltin", "likorin", "pectussin", "thermopsis".

In addition to the correct selection of medicines, it is important to ensure sufficient humidity in the room and drink more fluids (up to 6-8 glasses a 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 the receptors;
2. agents affecting 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 the treatment is selected individually for each case. Also important is the form of release of funds. Effervescent tablets and for resorption are characterized by high speed of action and digestibility, but are unlikely to be suitable for babies. Very young patients are recommended sweet antitussive syrups. People suffering peptic ulcer, hyperacid gastritis or having an increased acidity of gastric juice, effervescent antitussives will be contraindicated.

The type and dosage of the drug is prescribed by the doctor based on the symptoms, age and individual characteristics 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, an overdose of the drug provokes a gag reflex, it is contraindicated in pregnant women and persons suffering from stomach ulcers and 12-intestinal ulcers.

Therefore, before starting treatment, you should establish the correct diagnosis and get recommendations for taking antitussive drugs from a specialist.

Pharmacodynamics of cough tablets

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

Actively acting on the cough center, drugs are divided according to the principle of impact on: central, peripheral and combined effects. Pharmacodynamics of cough tablets (mechanism of action on human body) is characterized by the properties of the forming components. For example, preparations with the narcotic substance codeine are quite effective for dry, debilitating cough without sputum discharge. However, these drugs are sold strictly by prescription, as they are addictive. Modern pharmacology has no less effective, safe, non-narcotic means that do not affect the respiratory center. Such available antitussive tablets include - "libeksin", "tusuprex" and others. They most often lower the receptor sensitivity of the bronchial mucosa (peripheral effect), but they 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.

Multi-component cough tablets are effective in any course of the disease, excluding a wet cough. Stopping the cough in this case can disrupt the cleaning ability of the lungs, the removal of mucus and lead to the development of pneumonia, problems with lung ventilation. Combined funds 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 coughs, the popular cough pills "Thermopsis" are most often remembered. And here the patient needs to be as careful as possible. The fact is that the familiar and inexpensive remedy "thermopsis" is now available in two compositions:

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

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 grass (with active ingredients - 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 excretion;
• sodium bicarbonate - causes pH-shift of bronchial mucus to the side alkaline environment and reduces the viscosity of sputum. Stimulates the work of ciliated epithelium and bronchioles;
• licorice root - provides easy secretion due to the content of glycyrrhizin. It has anti-inflammatory and antispasmodic effect.

Pharmacokinetics of cough tablets

Pharmacokinetics is the biochemical transformation of drug molecules in the human body. The main pharmacokinetic processes include - suction, excretory (excretory), distribution and metabolic properties.

Absorption of a cough tablet occurs after dissolution, usually in the small intestine. Next, the drug molecules enter the systemic circulation. Suction has two characteristics - speed and degree of suction (reduced in the case of pharmacological substance after food).

The distribution of the drug occurs in the blood, intercellular fluid and tissue cells.

The release of drugs is carried out unchanged or as substances of biochemical transformation - metabolites that have a higher polarity and solubility in the aquatic environment compared to the parent substance, which leads to a simple excretion with urine.

Excretion (excretion) of the drug is possible through the urinary, digestive system, as well as through sweat, saliva and exhaled air. The excretory function is influenced by the rate of drug entry with the bloodstream to the excretory organ and by the characteristics of its own excretory systems. The most common pathway is through the kidneys, bronchial glands, and mucous membranes of the respiratory system.

The pharmacokinetics of cough tablets is based on the main active ingredient that is part of the drug:

• codeine is characterized high speed absorption, blocks cough within half an hour after ingestion, provides a persistent antitussive and analgesic effect for up to six hours. It is transformed in the liver, the half-life process begins in 2-4 hours;
• glaucine hydrochloride - well absorbed by the digestive system, transformation occurs in the liver, excreted by the kidneys (metabolites of the primary type);
• ambroxol - maximally absorbed, excreted in the urine;
• bromhexine - absorption reaches 99% in 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, fat and muscle tissue. Half-life occurs after an hour and a half;
• carbocisteine ​​- actively absorbed and metabolized during the primary passage through the liver. Achievement of the maximum concentration is observed two hours after oral administration. Excretion is carried out in the urine almost unchanged;
• acetylcysteine ​​- has a 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. It is characterized by penetration through the placental barrier. The kidneys are responsible for excretion, a small part of the substance is excreted unchanged by the intestines.

Use of cough tablets during pregnancy

A pregnant woman should carefully study the instructions and consult a doctor before taking a cough pill. The specialist determines the cause of the cough, prescribes appropriate treatment. Coughing attacks are caused not only by infections of the upper or lower respiratory tract, but also by allergic, neurotic reactions, problems with the stomach or diaphragm, thyroid disease, dysfunction of cardio-vascular system etc.

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

Most of the pharmacological preparations are prohibited for taking while waiting for the baby. However, the use of cough tablets during pregnancy is allowed based on herbal ingredients such as:

• "Mukaltin" containing marshmallow herb. Take under the strict supervision of a doctor three to four times a day, before meals. The duration of therapy is one to two weeks;
• eucalyptus-based lozenges (preferably without sugar) - the inclusion of a 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 region and larynx, where the urge to cough is born;
• preparations with the active substance dextromethorphan (suppresses the cough center) are prescribed for severe attacks when it is not possible to fix the problem in another way;
• bromhexine, as part of many expectorant drugs, is also often used to treat pregnant women;
• "bronchipret" is a German medicine made from herbal ingredients. It is indicated for coughing of any genesis (one tablet three times a day, after a meal). The duration of the course is from seven to ten days;
• "Ambroxol" - thins thick viscous mucus, facilitates expectoration. Allowed to treat pregnant women under the supervision of a specialist in the second / third trimesters;
• "codelac" - not desirable during gestation, since codeine is a drug that can cause dysfunction in embryonic development often leads to heart disease. Assign only in emergency cases, when other means are powerless.

In any case, you should not self-medicate during pregnancy, even with traditional medicine. Oddly enough, even vegetable raw materials can harm when individual intolerance. The choice of method of treatment, dosage of the drug and duration therapeutic impact appointed 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. special care It is required to comply with the treatment of cough in young children, pregnant and lactating women.

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

The use of expectorant tablets is unacceptable in parallel with the intake of substances that depress the cough center and inhibit the cough reflex. This combination provokes severe inflammatory diseases lower respiratory system (e.g. pneumonia).

Contraindications to the use of thermopsis cough tablets 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 dosages cause nausea in children at the beginning of the course.

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

Effervescent or absorbable cough tablets are famous for their speed of absorption and effectiveness, but they are not suitable for treating patients with hyperacidity, gastritis and peptic ulcer.

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

Side effects of cough tablets

Cough pills 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 age of the patient), without chewing, in order to avoid anesthesia of the oral mucosa. The popular drug stoptussin can cause diarrhea, headache, abdominal pain, indigestion, an allergic reaction, and dizziness. When taking tusuprex, used in the treatment of dry, non-productive 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. In such patients, bronchodilators without atropine should be preferred. Taking the drug "ACC", in addition to the above, is fraught with skin reactions, an increase in blood pressure, and dyspepsia.

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

Narcotic cough medicines (for example, with codeine) cause pharmacological dependence, allergies. In case of an overdose, constipation, vomiting, urinary retention, problems with coordinating the movement of the eyeballs, weakness, depression of the respiratory center are observed.

If the coughing attacks intensify, and there is no opportunity to visit a doctor, then carefully study the instructions for the purchased drug for contraindications and side effects.

Dosage and administration

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

A specialist should establish the correct diagnosis, prescribe the correct treatment. The method of administration and dose is also determined by the doctor on an individual basis.

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

Stoptussin cough tablets are drunk up to 6 times a day, since the partial elimination period is six hours. The medicine for resorption "Falimint", which helps with an unproductive irritating cough, is allowed to be used up to 10 times a day, provided that the therapy lasts no more than a few days.

Mucolytic preparations based on vegetable raw materials should be consumed before meals. The recommended dose of "mukaltin" for adults is 1-2 tablets up to 4 times a day, for children - from half a tablet to two tablets for a single dose. "Thermopsis" without codeine is attributed to a tablet three times a day with a course of up to five days. Maximum daily dosage medicinal product - 0.3 g or 42 tablets. Children over 12 years old are allowed to take a tablet 2-3 times a day. The appointment 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 remedy 2 mg three times a day. Treatment course can be up to four weeks.

Effervescent cough tablets "ACC" are drunk after eating, after dissolving the medicine in half a glass of water, juice or iced tea. Daily rate the drug depends on body weight: patients weighing more than 30 kg. use up to 800 mg. facilities. For children, the dosage is selected based on age: up to 2 years - 50 mg. 2-3 times / day, from 2 to 5 years - 400 mg. in four doses, from 6 years old - 600 mg. for three doses. The duration of treatment varies from three to six months, which is affected by the complexity of the pathological condition.

The antitussive agent "ACC" is forbidden to be taken with the tetracycline group, semi-synthetic preparations of penicillin, aminoglycosides and cephalosporins. Do not combine "ACC" with other cough tablets to prevent congestion of the respiratory tract.

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

With regard to the interaction of cough tablets with other drugs that stop the cough reflex, like codeine, it can be unequivocally said that the latter complicate the expectoration of liquefied sputum and its accumulation in the lungs.

A number of pharmacological preparations enhance the action of each other. This effect is observed while taking "glycodine" with narcotic antitussives. In this case, "glycodin" often interacts with monoamine oxidase inhibitors.

Before you start taking any cough medicine, carefully read the package leaflet and be sure to tell your doctor about the medicines you are taking.

Storage conditions for cough tablets

The main conditions for storing cough tablets include the following items:

• the storage place must be dry, closed to light penetration and inaccessible to children;
• the acceptable temperature is most often 15-25С, unless there are special instructions in the instructions;
• place medicines away from heaters/heaters.

The empty part of the blister should not be carefully trimmed in order to preserve the aesthetic appearance of the opened package. After a while, it will be difficult or absolutely impossible to determine what this “white” pill helped with. Moreover, you may take the wrong medicine. The same applies to those who like to shift pills into containers from other drugs.

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

Cough tablets are a drug of the mucolytic group. Given antitussive consists of the main component - thermopsis ( extract of the same plant) and auxiliary - sodium bicarbonate. These drugs are used in diseases bronchopulmonary system accompanied by the formation of viscous sputum.

The therapeutic effect of the drug is to reduce the viscosity of sputum, stimulate the formation of a liquid secretion by the bronchial glands and accelerate its removal from airways. A feature of cough tablets based on thermopsis is a reflex type of action. Thermopsis in moderate doses irritates the gastric mucosa, which reflexively leads to the activation of the bronchial glands. In addition to the above effects, the alkaloids contained in thermopsis lead to the excitation of the respiratory center of the brain, which ultimately leads to an increase in blood oxygen saturation.

Sodium bicarbonate has a strong mucolytic property. After absorption into the blood, this substance penetrates through the epithelium of the bronchi into their lumen and reduces the acidity of the mucus. Along with this, its liquefaction also occurs. As a result, less viscous mucus envelops the respiratory tract and has a protective effect on their inflamed areas. Cough receptors, closely located in the trachea and large bronchi, are less likely to be excited, and, accordingly, less likely to cause cough shocks. Cough, which was initially frequent, dry and painful, becomes rare wet and less painful.

It is important to note that the drug is contraindicated in pregnant women, as it can cause disturbances in the proper formation of the respiratory center and lungs of the fetus, thus increasing the risk of respiratory distress syndrome in the newborn. Children under 12 years of age, the drug is also contraindicated, since its use is associated with the risk of persistent disorders of the gastrointestinal tract.

Types of medication, commercial names of analogues, release forms

One tablet of the drug contains 6.7 mg of thermopsis, 250 mg of sodium bicarbonate, as well as starch and talc. The same combination of active ingredients is not available in any form other than tablets.

This drug exists on the pharmaceutical market under the following names:

• cough tablets;
• thermopsol;
• antitusin.

Manufacturers of cough tablets

Firm manufacturer		Commercial name drug	Producing country	Release form	Dosage
Pharmstandard		Thermopsol	Russia	Tablets	Cough tablets are prescribed 3 times a day during or after meals. The optimal dose for an adult The maximum single dose is 0.1 g in terms of the active substance ( 14 tablets). Maximum daily dose is respectively 0.3 g of active substance ( 44 tablets). Children over 12 years old the drug is indicated 3 times a day for half or a whole tablet, depending on the severity of the underlying disease.
Dalhimpharm		Cough tablets
Tathhimpharmaceuticals		Cough tablets
Himfarm		Cough tablets	The Republic of Kazakhstan
Ternopil FF OAO		Antitusin	Ukraine

The mechanism of the therapeutic action of the drug

As mentioned earlier, cough tablets are a reflex drug. Thermopsis, which is the main component of these tablets, causes irritation of the gastric mucosa in moderate doses. In response to irritation, the gastric mucosa increases the production of liquid secretions in order to protect itself. Since this effect is mediated by vagus nerve, then similar effects develop in other areas of its innervation, that is, in the bronchi, heart, intestines, etc. Under the influence of this nerve, there is an increase in the secretion of liquid mucus by the bronchial glands and an increase in activity transport function respiratory epithelium. The respiratory epithelium consists of many microscopic villi that are able to contract and relax, performing unidirectional oscillatory movements. The direction of movement of the villi is from the smallest bronchioles to the nasal cavity. In this way, sputum is removed along with dust particles and microorganisms that have settled on its surface.

In moderate doses, cough tablets cause an increase in the activity of the respiratory center, which leads to an increase in respiratory rate and blood oxygen saturation. However, in high doses ah thermopsis causes nausea and even vomiting due to excessive irritation of the gastric mucosa and activation of the center of vomiting in the brain.

Liquid sputum is much better excreted from the lungs than thick sputum. In this regard, the composition of the drug includes such a component as sodium bicarbonate, which has a direct thinning effect on already formed mucus clots. As a result, a large amount of liquid mucus envelops the respiratory tract. This, in turn, partially reduces the irritation of cough receptors, abundantly located in the respiratory epithelium. As a result, the cough is reduced, it becomes productive ( expectoration) and less painful.

For what pathologies is it prescribed?

Cough tablets, in addition to the main obvious use, are prescribed for the treatment of diseases accompanied by thickening of sputum.

Use of cough tablets

Name of the disease	Mechanism of therapeutic action	Dosage of the drug
Acute respiratory viral infections	Cough tablets cause a reflex increase in the secretion of bronchial glands. An alkalizing effect is exerted on the already formed thick sputum, leading to its softening. In parallel, under the action of the drug, there is an increase in the frequency of oscillatory movements of the villi of the respiratory epithelium. Thus, the removal of mucus from the lumen of the bronchi is accelerated. In addition to the above effects, cough pills affect certain structures of the brain. In therapeutic doses, the respiratory center located in the brain stem is stimulated, and in high doses, the center of vomiting is irritated.	Optimal dose for adults is one tablet 3 times a day. The optimal dose for children over 12 years of age is half - one tablet 3 times a day. Children under 12 and pregnant and breastfeeding women the drug is contraindicated. The maximum allowable single dose for an adult in terms of the active substance is 100 mg, which equates to approximately 14 tablets. The maximum daily dose is 300 mg in terms of thermopsis ( 44 tablets). It must be borne in mind that taking such high doses of the drug is dangerous, because it useful action increases slightly, and side effects increase tenfold. Cough tablets are taken after meals, otherwise the risk of side effects from the gastrointestinal tract increases. The duration of the course of treatment is dictated by the severity of a particular disease, but on average it is 3-5 days.
spicy and Chronical bronchitis
Pneumonia
Broncho-obstructive pneumopathy
Acute tracheitis
Acute and chronic laryngitis

Contraindications for the use of the drug

Cough tablets have the following contraindications:

• allergic reactions to the drug in the past;
• childhood less than 12 years;

Allergy, once developed to a certain substance, persists for the rest of your life. In most cases, with a long-term absence of contact of the body with the allergen, the number of specific antibodies circulating in the blood decreases. However, throughout life, memory cells remain in the blood, which are able to develop allergies even after many decades after the initial reaction. This feature must be borne in mind and not to use cough tablets if they previously caused allergy manifestations in the patient.

In the respiratory tract, excess mucus plays a negative role, but the mucus of the stomach and duodenum has a protective effect on the epithelium and is therefore considered beneficial. Since the use of cough tablets leads to a decrease in the viscosity of mucus, along with this, its protective properties. The acidic environment of gastric juice acts more aggressively on the mucous membrane of the stomach and duodenum, leading to erosive gastritis, the formation of new ulcers and the opening of old ones.

Due to the fact that the children's stomach is less resistant to various kinds of aggressive factors, it is not recommended to prescribe drugs to children that reduce the protective properties of mucus, in particular, cough tablets.

Pregnancy and lactation are also a contraindication to the use of cough tablets, since the latter are able to penetrate the blood-brain barrier. Having penetrated into the blood circulation of the fetus, thermopsis can cause disturbances in the development of the lungs, in particular those associated with the release of surfactant, and also make undesirable adjustments to the formation of the respiratory center of the brain.

How to apply the medication?

Cough tablets are prescribed exclusively for adults and children over 12 years of age. The optimal dose for an adult is one tablet every 8 hours. For children, half to a whole tablet is also recommended every 8 hours. It is necessary to take the drug after meals with a small amount of water in order to reduce its negative effect on the mucous membrane of the stomach and duodenum. The average duration of treatment varies from three to five days. During this period, it is necessary to increase the daily fluid intake to two and a half liters per day or more due to the fact that the effect of the drug is associated with an increase in fluid loss through the lungs. In the presence of fever, the volume of fluid consumed should increase to three to four liters per day.

Renal failure and liver failure of varying severity leads to a delay of the drug in the body and an increase in its concentration in the blood. This, in turn, increases the risk of adverse reactions.

Possible side effects

There are the following side effects of cough tablets:

• nausea and vomiting;
• stomach ache;
• allergic reactions.

Nausea and vomiting

Data adverse reactions on the part of the gastrointestinal tract are the result of a decrease in the viscosity of mucus on the surface of the stomach and duodenum under the action of thermopsis extract and sodium bicarbonate. Mucus on the surface of these organs exhibits protective properties from the aggressive influence of acidic gastric juice. Nausea and vomiting are signs that mucus stores are depleted and hydrochloric acid gastric juice irritates the cylindrical epithelium of the organ. Also, nausea can occur due to the effect of thermopsis extract on the vomiting center of the brain. Such an effect is possible with the use of high doses of the drug.

Stomach ache

Abdominal pain develops for the same reason as nausea with vomiting. However, in this case, the pathological process develops further, leading to damage to the mucous epithelium. As a result, erosions and peptic ulcers appear, in severe cases, complicated by perforation of the organ.

allergic reactions

It must be recognized that hypersensitivity reactions to thermopsis-based cough tablets develop extremely rarely, however, in people predisposed to allergies, such reactions can occur.

The most common manifestations of an allergy to cough tablets are:

• angioedema (angioedema) angioedema);

Hives
Urticaria is the most mild medical point vision manifestation of allergy. It develops when an allergen enters in this case cough pills) in digestive tract. After some time, on average from 15 minutes to 2 - 3 hours, on the skin of the abdomen, back, thighs, perineum, elbows, a small-dotted rash with a diameter of no more than 1 - 2 mm appears, slightly protruding above the surface of the skin. Often the appearance of a rash is accompanied by skin itching of varying intensity, most severe in places of abundant rashes. As the allergy progresses, single elements of the rash merge and form blisters with a diameter of up to 20-30 cm.

Angioedema
angioedema ( angioedema) is a fairly common manifestation of an allergic reaction. According to statistics, every eighth inhabitant of the planet has suffered at least once in his life this species allergic edema. Its feature is the initial defeat of loose unformed connective tissue located around the lips and eyes, in the earlobes, cheeks, interfascial spaces, scrotum and labia. Accordingly, the above parts of the body swell first.

Another feature of this edema is the fact that in most cases it spreads from top to bottom - starting from the periocular tissue and mouth and going down. Upon reaching the level of the cricoid cartilage of the larynx, there is a risk of edema moving to the vocal cords. This is dangerous because the swollen ligaments close, stopping the flow of air into the lungs. In the absence of breathing, the skin and mucous membranes of the patient turn blue, and after 1-3 minutes ( for athletes up to 4 - 5 minutes) becomes unconscious. In case of refusal medical care the patient dies no later than 8-10 minutes after the closing of the glottis.

According to the rate of progression of edema, acute and chronic form pathology. The acute form leads to the closure of the vocal cords in a period of 5 to 30 minutes. chronic edema develops from 30 minutes to 12 hours. Accordingly, in the first case, the promptness of providing the necessary medical care determines the probability of survival of the patient. In the second case, the patient has more time to seek help, so the prognosis for such an allergy is much better.

Anaphylactic shock
Anaphylactic shock or anaphylaxis is perhaps the most formidable manifestation of an allergy to any substance. This reaction develops when even a small amount of an allergen enters an overly sensitized organism. As a result, it develops lightning reaction allergen binding by antibodies circulating in the blood, accompanied by the release of a large amount of biologically active substances that dilate blood vessels. As a result, generalized vasodilation leads to sharp decline blood pressure. In the most severe cases, blood pressure becomes zero. For this reason, the supply of oxygen to the brain stops, the patient falls into a coma, the depth of which increases every minute. The lack of necessary medical care leads to the death of the patient in an average of 5-6 minutes.

Interaction with other drugs

Cough tablets are not recommended to be prescribed together with drugs that have a central antitussive effect. Most prominent representative this group is codeine. A complication of this treatment is the accumulation of mucus in the airways and the maintenance of the inflammatory process.

The combination of cough tablets with antibiotics is positive, since they increase the concentration of the latter in the lumen of the bronchi and lead to a better destruction of pathogenic microbes.

Approximate cost of medication

The price of cough tablets may vary in different regions of the Russian Federation. The reason for the difference in cost is the difference in the quality of the raw materials from which the medicine is made, various technological costs, fare, margins of pharmaceutical companies and pharmacies, and much more.

The cost of cough tablets in various regions of the Russian Federation

City	Price ( 30 pcs.)
Moscow	88 rubles
Kazan	84 rubles
Krasnoyarsk	72 rubles
Eagle	81 ruble
Rostov-on-Don	75 rubles
Samara	74 rubles
Stavropol	84 rubles
Khabarovsk	95 rubles
Chelyabinsk	83 rubles