Modern possibilities of combined pharmacotherapy for cough

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Cough, being a public manifestation of a wide range of diseases, significantly reduces the quality of life of patients and remains the most common reason for seeking medical help in outpatient practice. The classification of cough traditionally involves dividing it into acute, subacute and chronic. According to the results of the studies, more than half of patient complaints are related to the acute and subacute cough, which in most cases has infectious origin. In the clinical picture of respiratory infections, cough is often the most painful and long-lasting symptom. Treatment of cough, first of all, involves eliminating its causes. At the same time, there is a need for the use of symptomatic therapy. The basis of symptomatic therapy includes mucoactive drugs, the clinical effect of which is characterized by facilitating sputum discharge and reducing the intensity of cough. Among the drugs used in this clinical situation, an important place is occupied by combined mucoactive drugs, which have a complex effect and ensure maximum effectiveness of treatment. This article examines modern views on the symptomatic treatment of cough and discusses the possibility of using a combined domestic drug containing bromhexine, guaifenesin and salbutamol (Bromgecomb®) in patients in this category.

Full Text

Restricted Access

About the authors

Anna G. Romanovskikh

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: anngerom@gmail.com
ORCID iD: 0000-0001-9675-7451
SPIN-code: 9034-2708

Cand. Sci. (Med.), Associate Professor at the Department of Pulmonologyn

Russian Federation, Moscow

Yu. G. Belotserkovskaya

Russian Medical Academy of Continuous Professional Education

Email: anngerom@gmail.com
ORCID iD: 0000-0003-1224-1904
Russian Federation, Moscow

I. P. Smirnov

Russian Medical Academy of Continuous Professional Education

Email: anngerom@gmail.com
ORCID iD: 0000-0001-8954-5303
Russian Federation, Moscow

I. L. Klyachkina

Russian Medical Academy of Continuous Professional Education

Email: anngerom@gmail.com
ORCID iD: 0009-0006-8640-4920
Russian Federation, Moscow

References

  1. Finley C.R., Chan D.S., Garrison S., et al. What are the most common conditions in primary care? Syst Rev Can Fam Physician. 2018;64 (11):832–40.
  2. Tilley A.E., Walters M.S., Shaykhiev R., Crystal R.G. Cilia dysfunction in lung disease. Ann Rev Physiol. 2015;77:379–406. doi: 10.1146/annurev-physiol-021014–071931.
  3. Sykes D.L., Morice A.H. The cough reflex: the Janus of respiratory medicine. Front Physiol. 2021;12: 684080.
  4. Koskela H.O., Lätti A.M., Pekkanen J. The impacts of cough: a cross-sectional study in a Finnish adult employee population. ERJ. Open Res. 2018;4:00113–2018. doi: 10.1183/23120541.00113-2018.
  5. Irwin R.S., French C.L., Chang A.B., et al. Classification of сough as a symptom in adults and management algorithms: CHEST guideline and expert panel report. Chest. 2018;153(1):196–209. doi: 10.1016/j.chest.2017.10.016.
  6. Синопальников А.И., Клячкина И.Л. Кашель. М., 2013. 168 с. [Sinopalnikov A.I., Klyachkina I.L. Cough. M., 2013. 168 p. (In Russ.)].
  7. Eccles R., Fietze I., Rose U.-W. Rationale for treatment of common cold and flu with multi-ingredient combination products for multi-symptom relief in adults. Open J Respir Dis. 2014;4:73–82. doi: 10.4236/ojrd.2014.43011.
  8. Авдеев С.Н., Зайцев А.А., Лещенко И.В. и др. Клинические рекомендации: Острый бронхит у взрослых. 2022 г. Доступно на: Минздрав РФ (spulmo.ru). [Avdeev S.N., Zaitsev A.A., Leshchenko I.V. and others. Clinical recommendations: Acute bronchitis in adults. 2022. Available at: Ministry of Health of the Russian Federation (spulmo.ru). (In Russ.)].
  9. Чучалин А.Г., Абросимов В.Н. Кашель. М., 2016. 60 с. [Chuchalin A.G., Abrosimov V.N. Cough. M., 2016. 60 p. (In Russ.)].
  10. Синопальников А.И., Клячкина И.Л. Кашель в таблицах и схемах. М., 2022. 102 c. Sinopalnikov A.I., Klyachkina I.L. [Cough in tables and diagrams. M., 2022. 102 p. (In Russ.)].
  11. Task Group on Mucoactive Drugs. Recommendations for guidelines on clinical trials of mucoactive drugs in chronic bronchitis and chronic obstructive pulmonary disease. Chest. 1994;106(5):1532–37. doi: 10.1378/chest.106.5.1532.
  12. Balsamo R., Lanata L., Egan C.G. Mucoactive drugs. Eur Respir Rev. 2010;116:127–33. doi: 10.1183/09059180.00003510.
  13. Poole P., Black P.N. Mucolytic agents for chronic bronchitis and chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006;19(3):CD001287. doi: 10.1002/14651858.CD001287.pub2.
  14. Оковитый С.В., Зайцев А.А., Анисимова Н.А. Фармакодинамические подходы к применению мукоактивных препаратов. Лечащий врач. 2020;10:6–10. [Okovityi S.V., Zaitsev A.A., Anisimova N.A. Pharmacodynamic approaches to the use of mucoactive drugs. Lechashchii vrach. 2020;10:6–10. (In Russ.)]. doi: 10.26295/OS.2020.62.62.001.
  15. Чуланов В.П., Горелов А.В., Малявин А.Г. и др. Острые респираторные вирусные инфекции (ОРВИ) у взрослых. Клинические рекомендации 2021. Доступно на: Рубрикатор КР (minzdrav.gov.ru). [Chulanov V.P., Gorelov A.V., Malyavin A.G. and others. Acute respiratory viral infections (ARVI) in adults. Clinical guidelines 2021. Available at: Rubricator of Clinical guidelines (minzdrav.gov.ru). (In Russ.)].
  16. Zanasi A., Mazzolini M., Kantar A. A reappraisal of the mucoactive activity and clinical efficacy of bromhexine. Multidiscip Respir Med. 2017;12:7. doi: 10.1186/s40248-017-0088-1.
  17. Малявин А.Г., Белоцерковская Ю.Г., Болиева Л.З. и др. Практические аспекты применения новой фиксированной комбинации препаратов амброксол+гвайфенезин+левосальбутамол в терапии острого бронхита у взрослых. Резолюция совета экспертов. Профилактическая медицина. 2023;26(6):108–12. [Malyavin A.G., Belotserkovskaya Yu.G., Bolieva L.Z. et al. Practical aspects of the use of a new fixed combination of drugs ambroxol + guaifenesin + levosalbutamol in the treatment of acute bronchitis in adults. Resolution of the expert council. Profilakticheskaya meditsina. 2023;26(6):108–12. (In Russ.)]. doi: 10.17116/profmed202326061108.
  18. Ohar J.A, Donohue J.F, Spangenthal S. The role of guaifenesin in the management of chronic mucus hypersecretion associated with stable chronic bronchitis: a comprehensive review. Chron Obstr Pulm Dis. 2019;6(4):341–49. doi: 10.15326/jcopdf.6.4.2019.0139.
  19. Поморцева И.В., Михайлов И.Б. Патофизиологические и фармакологические концепции в лечении бронхолегочных заболеваний. Медицинский совет. 2022;16(19):79–86. [Pomortseva I.V., Mikhailov I.B. Pathophysiological and pharmacological concepts in the treatment of bronchopulmonary diseases. Meditsinskii sovet. 2022;16(19):79–86. (In Russ.)]. doi: 10.21518/2079-701X- 2022-16-19.
  20. Клячкина И.Л., Синопальников А.И. Фиксированные комбинации мукоактивных препаратов в программе лечения кашля. Практическая пульмонология. 2015;1:74–82. [Klyachkina I.L., Sinopal’nikov A.I. Fixed combinations of mucoactive drugs in a cough treatment program. Prakticheskaya pul’monologiya. 2015;1:74–82. (In Russ.)].
  21. Jayaram S., Desai A. Efficacy and safety of Ascoril expectorant and other cough formula in the treatment of cough management in pediatric and adult patients – a randomised double-blind comparative trial. J Indian Med Assoc. 2000;98:68–70.
  22. Prabhu Shankar S., Chandrashekharan S., Bolmall C.S., Baliga V. Efficacy, safety and tolerability of salbutamol+guaiphenesin+bromhexine (Ascoril) expectorant versus expectorants containing salbutamol and either guaiphenesin or bromhexine in productive cough: a randomised controlled comparative study. J Indian Med Associat. 2010;108 (5):313–20.
  23. Клячкина. И.Л. Лечение кашля при ОРВИ и гриппе. Русский медицинский журнал. 2012;1:278–85. [Klyachkina. I.L. Treatment of cough due to ARVI and influenza. Russkii meditsinskii zhurnal=Russian medical journal. 2012;1:278–85. (In Russ.)].
  24. Лещенко И.В., Эсаулова Н.А. Результаты наблюдательного исследования лечения пациентов с продуктивным кашлем в постковидном периоде. Русский медицинский журнал. 2023;1:6–11. [Leshchenko I.V., Esaulova N.A. Results of an observational study of treatment of patients with productive cough in the post-Covid period. Russkii meditsinskii zhurnal=Russian medical journal. 2023;1:6–11. (In Russ.)].
  25. Бабак Л.С., Горелов А.В., Зайцев А.А. и др. Грипп у взрослых. Клинические рекомендации 2022. Доступно на: Рубрикатор КР (minzdrav.gov.ru). [Babak L.S., Gorelov A.V., Zaitsev A.A. et al. Influenza in adults. Clinical guidelines 2022. Available at: Rubricator of Clinical guidelines (minzdrav.gov.ru). (In Russ.)].
  26. Авдеев С.Н., Демко И.В., Зайцев А.А. Хронический бронхит. Клинические рекомендации 2021. Доступно на: Рубрикатор КР (minzdrav.gov.ru). [Avdeev S.N., Demko I.V., Zaitsev A.A. Chronical bronchitis. Clinical guidelines 2021. Available at: Rubricator of Clinical guidelines (minzdrav.gov.ru). (In Russ.)].
  27. Государственный реестр лекарственных средств Минздрава России. Инструкция по медицинскому применению лекарственного препарата БРОМГЕКОМБ. РУ: ЛП-№(000324)-(РГ-RU) от 27.07.21. Доступно на: Государственный реестр лекарственных средств (minzdrav.gov.ru). State register of medicines of the Ministry of Health of Russia. Instructions for medical use of the drug BROMGEKOMB. RU: LP-No. (000324)-(RG-RU) dated 07/27/21. Available at: State Register of Medicines (minzdrav.gov.ru). (In Russ.)].
  28. Государственный реестр лекарственных средств Минздрава России. Инструкция по медицинскому применению лекарственного препарата БРОМГЕКОМБ экспекторант. РУ: ЛП-006723 от 26.01.21. Доступно на: Государственный реестр лекарственных средств (minzdrav.gov.ru). [State register of medicines of the Ministry of Health of Russia. Instructions for medical use of the drug BROMGEKOMB expectorant. RU: LP-006723 dated 01/26/21. Available at: State Register of Medicines (minzdrav.gov.ru). (In Russ.)].
  29. БромгеКомб таблетки 8 мг + 100 мг + 2 мг 20 шт купить по цене 233,0 руб в интернет-аптеке в Москве – лекарства в наличии, стоимость, доставка на дом (доступно на сайте:gorzdrav.org). Дата доступа 07.03.2024. [BromgeComb tablets 8 mg + 100 mg + 2 mg 20 pcs buy at a price of 233.0 rubles in an online pharmacy in Moscow – medications in stock, cost, home delivery (available at: gorzdrav.org). Access date 03/07/2024. (In Russ.)].
  30. Бромгекомб экспекторант Сироп флакон 2 мг + 50 мг + 1 мг/5 мл 100 мл купить по цене 294,0 руб в интернет-аптеке в Москве – лекарства в наличии, стоимость, доставка на дом (доступно на сайте: gorzdrav.org) Дата доступа 07.03.2024. [Bromgecomb expectorant Syrup bottle 2 mg + 50 mg + 1 mg/5 ml 100 ml buy at a price of 294.0 rubles in an online pharmacy in Moscow – medications in stock, cost, home delivery (available at: gorzdrav.org) Accessed 03/07/2024. (In Russ.)].

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig.1

Download (109KB)
3. Fig.2

Download (80KB)
4. Fig.3

Download (50KB)

Copyright (c) 2024 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies