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Treating cough

Making the right choice

Expectorants can liquefy highly viscous mucus (mucolytics) or increase the volume of secretion (secretolytics). Patients then find it easier to cough up stiff mucus. For example, ambroxol and bromhexine have been tried and tested for secretolysis and N-acetylcysteine for mucolysis. With all expectorants, the mucolytic effect of the medicine is improved if patients drink a lot throughout the day.

Bromhexine and its metabolite ambroxol are available in numerous dosage forms, including juice, tablets and drops. In rare case, severe skin reactions such as Stevens-Johnson syndrome may occur as an ADR (adverse drug reaction). Patients must then stop treatment immediately and seek medical advice.

N-acetylcysteine also facilitates expectoration in cold-related bronchitis. Adults and adolescents from 14 years of age take 400 to 600 mg of acetylcysteine daily, children from six to 14 years, 400 mg and children from two to five years, 200 to 300 mg.

The active ingredient guaifenesin is more common in English-speaking countries. If centrally depressant preparations or muscle relaxants are inadvertently combined with this active ingredient, its effect can increase in an unpredictable way.

Dampening the irritation

A constant coughing irritation is particularly agonising at night. Antitussives with dextromethorphan make it easier to sleep through the night. The cough blockade sets in after 15 to 30 minutes and lasts for up to six hours with non-retarded preparations. The combined administration of antitussives with expectorants is only possible with a time delay, otherwise the cough blocker will prevent the expectoration of mucus that has already been loosened. Therefore, it is best for patients to take the expectorant until the afternoon at the most, and then use the cough suppressant in the evening.

A classic among the antitussives is dextrometorphan. Its antitussive effectiveness with colds has been confirmed in studies, most of which were financed by manufacturers. Self-medication is limited to a maximum of five days; it is contraindicated for children under six years of age. Inappropriate use may cause symptoms such as respiratory depression, consciousness disorders, hypotension and tachycardia. Moreover, there is also a risk of developing dependence.

Pentoxyverine acts directly in the cough centre of the brain and inhibits the cough stimulus there. Medicines with pentoxyverine are not addictive and do not reduce breathing capacity.

For children between the ages of two and 13, the dosage is based on body weight. Adolescents from 14 years of age and adults take a single dose of 20 to 30 mg of pentoxyverine three to four times a day.

Deutsch/German Englisch/English
Abhängigkeit dependence
Abhusten expectoration
Alkoholiker alcoholic
Antitussiva antitussives
Atemdepression respiratory depression
Atemwege respiratory tracts
Expektoranzien expectorants
Husten cough
Hustenblocker cough suppressant
Hustenstiller cough suppressant
Hustenzentrum cough center
Lutschpastillen lozenges
Rachenraum throat area
Reiz irritation
Schleimhaut mucous membrane
Schleimlöser mucolytic, expectorant
Schwangere pregnant women, expectant mothers

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