Cough expectorant

Coughing is an important protective reflex of the body to expel foreign bodies, mucus or dust from the lungs. The coughing reflex therefore frees the airways and prevents them from becoming narrowed. Coughing can occur in the course of respiratory diseases, heart disease or as a side effect of medication.

Most often, however, the cough is due to a cold. Usually, a dry, unproductive cough appears at first and develops into a productive cough after a few days. Productive cough is understood to be the promotion of secretions, i.e. mucus or similar, by the cough.

A distinction is made between two different types of medication that are intended to influence the cough. On the one hand the cough removers (expectorants) and on the other hand the cough suppressants (antitussives). Cough relievers are used to treat productive coughs, to support the expectoration of the mucus and thus to eliminate the cause of the cough, namely the mucus.

Cough suppressants: The unproductive irritable cough is treated with cough suppressants to suppress the disturbing coughing irritation. We can only advise against combined preparations which are intended to promote and satisfy coughs, as the respective agents work against each other. Although the irritation is disturbing, it should not be suppressed, especially when the cough is very productive.

Cough expectorant

The so-called expectorants (mucolytic agents) are supposed to promote the secretion of brochial secretions and reduce viscosity. This means that the mucus is produced in greater quantities and is more fluid. They comprise a variety of different drugs, which are further divided into secretolytics and mucolytics.

Secretolytics promote the formation of bronchial mucus by stimulating the glands that produce secretions, while mucolytics are mainly used to liquefy the mucus. However, before resorting to drug therapy, an attempt should be made to dissolve the mucus with simple home remedies. The simplest and most important advice is to drink a lot.

The liquid will liquefy the mucus and enable better expectoration. Water or hot tea should therefore be taken in sufficient quantity. Steam inhalation also dissolves the mucus.

The easiest method is to boil water and sit over the hot water with a cloth over your head and inhale the hot steam. Herbal preparations can also have a cough-relieving effect. Essential oils such as eucalyptus, ciliated needle, peppermint or thyme have a mucolytic and expectorant effect.

These can be added to the water bath when inhaling. Most of the essential oils also relax the bronchial muscles and thus facilitate coughing. It is important to note, however, that these essential oils can cause glottal spasms in asthmatics, infants and small children and thus lead to acute shortness of breath.

They should therefore be used with special care if an underlying asthmatic disease is known and in the case of children a doctor should be consulted before use. Alternatively, there are also creams that contain the essential oils and are spread on the chest. The body heat makes inhalation via the lungs effective.

The essential oils are also contained in numerous cough syrups, cough drops and bath oils. Angelica root is also a vegetable expectorant that helps against the feeling of tightness in the chest. Primrose root is also a natural healing cough expectorant.

Its active ingredients, the saponins (also contained in liquorice), have a dissolving and stimulating effect on the secretions and can be taken in the form of tea or are contained together with thyme extract in the phytotherapeutic bronchicum. The combined preparation Myrtol from natural medicine brings together cineol, pine extract and lime. Thus it acts not only secretolytically but also secretomotorically, dilates the bronchial tubes and is antimicrobial.

Furthermore, ivy (Prospan, Sinuc, Hedelix, Bronchostad cough expectorant) is also used as a herbal expectorant. Three active ingredients are at the forefront of drug therapy: acetylcysteine (ACC), bromhexine and ambroxol. ACC is most frequently prescribed as a cough expectorant.

The active principle, which has been accepted for a long time, is based on the assumption that ACC reduces the viscosity of the mucus by breaking down chemical compounds (disulphide chains) in the long-chain mucus molecules through acetylcysteine.However, since this effect cannot be confirmed in today’s oral application, it is now assumed that the properties of the mucus will be restored to the physiological norm and that acetylcysteine will continue to act as an antioxidant. When taking ACC and antibiotics at the same time, it is important to note that the antibiotics are absorbed more quickly by ACC. Therefore, there should be a two-hour interval between the intake of both drugs.

In contrast to ACC, bromhexine changes the viscosity of the mucus by inducing certain enzymes, since the enzymes are responsible for the breakdown of the mucus. Bromhexine also stimulates the production of mucus. Bromhexine gives rise to the drug Ambroxol, which is a metabolic product of bromhexine.

It has another mechanism of action. This describes the activation of so-called surfactant, which reduces the surface tension of the mucus and thus reduces the cohesion of the mucus. Even for the last-mentioned drugs, there should be a two-hour break in taking them in case of antibiotic therapy.

All drug-based cough relievers can cause side effects. While taking ACC, allergic reactions, gastrointestinal complaints, headaches and tinnitus may occur. Bromhexine and Ambroxol can also cause gastrointestinal symptoms, as well as hypersensitivity reactions of the skin and mucous membranes and shortness of breath. However, numerous studies have not demonstrated superiority of the medicinal cough relievers over placebo or fluid intake. The use of cough expectorants should therefore be critically reviewed.