Cough is one of the body's defensive reflexes, can clear respiratory secretions and harmful factors, cough center is located in the dorsal part of the medulla oblongata, close to the respiratory center, generally believed to be related to the solitary nucleus, and controlled by the cerebral cortex. Whether cough is needed depends on the clinical situation.
In general, a mild cough will naturally relieve with the discharge of sputum or foreign body, and it is not necessary to take cough medicine. However, frequent, severe coughing can cause discomfort in patients, affect rest and sleep, and lead to a decline in quality of life, at which point cough drugs should be used.
Cough medicines are generally considered to be targeted at the following conditions:
1. When the cough is severe, affecting the patient's quality of life, or there is a possibility of complications such as pneumothorax, rib fracture, cough reflex syncope, etc.;
2. Idiopathic cough that cannot be treated for the cause, or has a long time of onset of effect on the cause;
3. There is no effective treatment, such as lung cancer that cannot be surgically treated.
Common cough drugs are summarized as follows:
One. Central antitussive drugs
Central cough suppressants are drugs that act on the center of bulbar cough and have a cough suppressant effect. Depending on whether there is dependence on the drug, it is divided into dependent and non-dependent cough suppressants.
Dependent antitussives refer to morphine alkaloids and their derivatives, which are the most potent antitussive drugs, including morphine, codeine phosphate, and forcodine; non-dependent antitussives include dextromethorphan, pentovirlin, phenylpropiperine, and cloperastin.
Long-term use of dependent antitussives is addictive and has respiratory-suppressing effects, so clinical use is limited [1-2].
1. Commonly used central dependence cough drugs
2. Commonly used non-centrally dependent cough drugs
Two. Peripheral cough medicine
Refers to a cough receptor, afferent nerve, efferent nerve, effector on the cough reflex arc as a point to produce a cough suppressant effect.
Since the drug cannot enter the central nervous system through the blood-brain barrier, it does not produce opioid-like sedative effects.
Peripheral antitussive drugs can be divided into two categories: local anesthesia and mucosal protective agents. Local anesthetic drugs include benzonaramate, nacotin, lidocaine, etc.; mucosal protective agents include licorice flow extract.
Three. Compound preparations
Cough with polyphlegm, should be combined with expectorants such as ammonium chloride, bromoxencin, acetylcysteine, etc., to facilitate sputum discharge and antitussive effect. At this time, a combination of drugs including antitussive, expectorant, antihistamine and other drugs can also be applied:
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Cough is only a symptom, if you want to stop coughing, you must first identify the cause, and choose the appropriate drug according to different causes:
Stop taking the drug for coughs caused by drugs, such as coughs caused by captopril;
Caused by COPD and bronchiectasis, if there are more sputum coughers, it is necessary to combine sputum drugs at the same time;
For patients with severe dry cough, especially pleurisy, cough accompanied by chest pain, or lung cancer, central antitussive drugs such as codeine can be used.
In addition, the drug should be selected according to age and physiological characteristics:
For groups suffering from underlying diseases such as hypertension and coronary heart disease, especially the elderly, cough drugs that are harmless to the heart, liver and kidneys should be selected;
Pregnant women and lactating women should choose cough drugs that do not pass through the placental barrier, and should be banned or used with caution for dextromethorphine, forfloxadine, etc.;
For children, it is best to choose pediatric preparations.
For cases where the cause is unknown and some serious diseases cannot be ruled out, such as early lung cancer and bronchial tuberculosis, it is not advisable to blindly apply cough drugs to avoid covering up the delay in diagnosis and treatment of the disease [5-6].
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