Cough is a protective reflex, its purpose being removal of respiratory secretions and foreign particles from air passages.
Cough may be useful or useless.
Suppression of Useless (nonproductive ) cough is very important. ( non productive means cough without sputum)
Useful (productive) cough serves to drain or clean the airway.So, its suppression is not advantageous even it may be harmful.
- except one condition where the amount of sputum production is less than to the effort of continuous coughing.
The commonest cause of acute cough (lasting < 3 weeks) is respiratory viral infections.
Apart from specific remedies (anti biotics),
Nonspecific therapy is .
DEMULCENTS AND EXPECTORANTS
1.Steam inhalation and proper hydration may be more helpful in clearing airway mucus.
2.In case of dry cough due regular coughing pain and inflammation occur in pharyngeal mucosa.So,Pharyngeal demulcents uses which is relieve the pain of throat and reduce inflammation pharyngeal mucosa.
3.Expectorants (Mucokinetics) are drugs which is uses to make easier removal of mucus by coughing throughincrease mucus secretion or reduce its thickness.
- Firstly Sodium and potassium citrate are increases the bronchial secretion.
- And other one Brochial glands secret Potassium iodide and which can irritate the airway mucosa. Longterm use of potassium iodide gradually affects thyroid function and produce iodism.because of It is not used now.
- Guaiphenesin, vasaka, tolu balsam are plant products which are increases bronchial secretion and mucociliary function
- Lastly Ammonium salts are nauseating- reflexly increase respiratory secretions.
The US-FDA has stopped marketing of all expectorants, except guaiphenesin.
Mucolytics
1.Bromhexine and it’s metabolite Ambroxol
- A derivative of the alkaloid vasicine obtained from Adhatoda vasica (Vasaka), is a mucolytic and mucokinetic.And also it is capable of inducing thin copious bronchial secretion.
- It is Particularly useful in case of mucus plugs are present in respiratory tract.
- In addition Side effects are rhinorrhoea and lacrimation, nausea. gastric irritation, hypersensitivity.
Dose:
adults 8 mg TDS( 3 times a day)
children 1-5 years 4 mg BD( 2 5-10 years 4 mg TDS.
BROMIIEXINE 8 mg tablet, 4 mg/5 ml cltxir.
Dose: 15- 30 mg TDS. AMBRIL, AMBROLITE, AMBRODlL, MUCOLITE 30 mg tab, 30 mg/5 ml liquid, 7.5 mg/ml drops, ACOCONTfN 75 mg CR tab.
Acetylcysteine
- because It decreases the thickness of mucus.
- It can be administered through orally (200-600 mg TDS) as well as by inhalation of I0-20% nebulized solution.
- Subsequently In intubated patients, the thick sticky secretion can be liquefied by instillation of I0- 20% acetylcysteine solution directly into the respiratory tract.
- Injectable solution of acetylcysteine can be nebulized/ instilled through tracheotomy tube.
MUCOTAB 600 mg tab, FLUIMUCIL 200 mg, 600 mg effervescent tab; “1UCOMIX 200 mg/ml inj in l,2,5 ml amps.