Note when using cough medicine

Coughing is a reflex of the body to clean the airways, not to accumulate secretions, irritants, foreign objects, bacteria... This is a mechanism to protect the respiratory system. However, if the cough affects daily activities, it is necessary to use cough medicine.

Normally, the cough reflex will occur when having a cold, influenza virus infection, allergic conditions, diseases that affect the respiratory tract (asthma, bronchitis, pneumonia, sinusitis, otitis media...), smoking or passive smoking, air pollution, gastroesophageal reflux disease. Some drugs such as ACE inhibitors used to treat high blood pressure can cause cough.

Notes when using cough medicine

Drugs acting on phlegm:Are all drugs that change the characteristics, properties, quantity and adhesion of phlegm on the surface of the respiratory tract. Normally, there is always a layer of mucus on the respiratory tract, with moderate viscosity, moisture and quantity to protect the respiratory tract. But when the respiratory system is diseased, this layer of mucus changes its properties, becomes sticky, thick and then it is called phlegm. Drugs that act on phlegm include phlegm thinning drugs and phlegm-dissolving drugs.

Consulting on medication for patients. Photo: TM

Expectorants are drugs that increase secretions (mainly water) on the surface of the respiratory tract. This increased secretion causes more water to dissolve in the sputum, which increases the mass and volume of the sputum, making it thinner. Typical drugs in this group are guaifenesin, sodiumbenzoate, terpinhydrate... Expectorants are drugs that act directly on the sputum, making it less thick and easier to expel through the cough reflex... These are drugs such as: acetylcysteine, ambroxol, carbocisteine, bromhexine...

Medicines that work on phlegm only work when taken with water. The medicine will not be most effective if you do not drink enough water. Water is a substance that directly increases secretions in phlegm, increasing the dilution of phlegm. Usually, an adult should drink at least 1.5 liters of water per day.

Not all cases require expectorants, but the level of phlegm is determined by the need to use medication. For example, a child under 1 year old has a cough, if there is excessive phlegm secretion, lots of wet and crackling rales, and severe pneumonia, then using medication at this time will make the pneumonia worse. Because when using medication, the lungs will have more fluid, more crackling sounds, and more difficulty breathing...

Or in the case of patients with chronic obstructive pulmonary disease (COPD), the amount of sputum secreted during acute attacks is very severe. If these drugs are continued, it will be very disadvantageous, because the cough will increase and the difficulty in breathing will become more obvious. The problem at this time is to reduce sputum secretion in order to control the amount of sputum allowed before deciding to use drugs that act on sputum at a later time.

Determining the level of phlegm and when to use it depends entirely on the doctor's level of expertise, carefulness, meticulousness in examination as well as treatment experience.

Cough suppressant:Drugs that reduce cough by inhibiting the cough center such as codeine, pholcodine, dextromethorphan. Of which, codeine and pholcodine have addictive, analgesic and mild inhibitory effects on the respiratory center. Dextromethorphan is not addictive and has no analgesic effect.

Cough medicines containing codeine are only for adults, not for children because they cause respiratory depression. In particular, cough medicines containing codeine are contraindicated for children under 18 years of age who have just had adenoidectomy and/or adenoidectomy (used for pain relief). The above cough medicines are only used in cases of dry cough without phlegm (cough due to flu, cough due to irritation, allergy), severe cough that makes the patient tired, sleepless, not used in cases of cough with phlegm (in chronic bronchitis, bronchiectasis); not used for people with respiratory failure, asthma, children, pregnant and lactating women.

Antihistamines:Some antihistamines for allergies (first generation H1 antihistamines) also have soothing, cough-suppressing and sedative effects such as diphenylhydramine, chlorpheniramine, alimemazine, promethazine. The drug is used to treat dry coughs caused by allergies and irritation.

The main disadvantage of these drugs is that they cause drowsiness due to their effects on the H1 receptors in the brain, so they are disadvantageous when used during the day but advantageous when used at night. They should not be used when driving, flying, operating machinery, etc. This type of drug also has the effect of drying out secretions, making it difficult to expel phlegm, and can cause phlegm blockage, so they should not be used in cases of cough with phlegm or asthma.

Use the lowest effective dose and for the shortest possible time to minimize side effects. Do not combine cough suppressants with expectorants because they will produce more phlegm but cannot be coughed up.

In addition, anesthetics, due to their anesthetic effect on the nerve endings that cause the cough reflex, also reduce cough, such as active ingredients such as benzonatate, menthol, lidocaine... used through inhalation or sucking. Cough suppressants, due to their protective effect, cover the sensory centers in the throat, mostly glycerol...

It should be noted that cough medicines that combine many ingredients (neocodion, codepect, atussin, arsiba...) in addition to side effects can cause adverse interactions with other drugs when used at the same time.

According to Giaoducthoidai