New crown cough, how to choose a treatment drug?

For medical professionals only

On December 7, 2022, the Comprehensive Group of the Joint Prevention and Control Mechanism of the State Council issued the "Guidelines for Home Treatment of Persons with New Coronavirus Infection", pointing out that if home treatment personnel have symptoms of cough and sputum, symptomatic treatment or oral drug treatment
can be carried out.
So what medications can be taken for coughing up phlegm? How to use it fairly?

Cough and sputum treatment medication

Infection with the new coronavirus may cause varying degrees of cough and sputum production
.
In the "Reference Table of Common Drugs for Home Treatment of Patients with New Coronavirus Infection", drugs that improve the symptoms of cough and sputum include bromohexine, ambroxol, guaiacs, acetylcysteine, etc
.

• Bromhexine is a mucous sputum dissolving agent, which can reduce the viscosity of sputum, make sputum thinner, and make mucous sputum easy to cough up
  .
  The dosage form suitable for home is bromohexine hydrochloride tablets
  .
  

  
  

• Ambroxol is the active metabolite of bromohexine in the body, and the mechanism of action is similar to that of bromohexine, which can reduce the viscosity of sputum, increase bronchial cilia movement, and make mucous sputum easy to cough up
  .
  It is suitable for those with
  thick sputum and not easy to cough up.
  The dosage form suitable for home use is ambroxol hydrochloride oral solution
  .
  

  
  

• Guaifenether is a nausea expectorant, which can stimulate the gastric mucosa and cause mild nausea, thereby reflexively causing increased secretion of bronchial mucosal glands, reducing sputum viscosity, and making mucus easy to cough up
  .
  The home-ready dosage form is guaifera syrup
  .
  

  
  

• Acetylcysteine is an amino acid containing sulfhydryl groups, which can reduce the viscosity of sputum and make it easy to cough up
  sputum.
  Suitable dosage forms are acetylcysteine granules and acetylcysteine effervescent tablets [1].
  
  

Know the contraindications to medication

• Bromhexine is irritating to the mucosa of the gastrointestinal tract, and patients with gastritis or gastric ulcer should be used
  with caution.
  

  
  

• Ambroxol can penetrate the placenta and is banned
  in women up to 3 months of pregnancy.
  Use with caution during lactation and women over 3 months of pregnancy
  .
  

  
  

• Guaifenether is contraindicated
  in women within 3 months of pregnancy.
  Patients with pulmonary hemorrhage, nephritis, acute gastroenteritis, and gastrointestinal ulcers are banned
  .
  Lactating women and women over 3 months of pregnancy should be used
  with caution.
  Children under 1 year of age should be used
  with caution.
  

  
  

• Acetylcysteine is contraindicated
  in children under 2 years of age.
  Contraindicated
  in patients with asthma.
  Acetylcysteine effervescent tablets contain aspiring, which is a source of phenylalanine, so it is contraindicated
  in patients with phenylketonuria.
  Pregnant and lactating women should be used
  with caution.
  Patients with peptic ulcers, allergic patients, and elderly patients with severe respiratory insufficiency should be used with caution [2].
  
  

Four precautions for medication

• Ambroxol can cause nausea, stomach upset, lack of appetite, etc.
  , and is recommended to be taken
  after meals.
  

  
  

• The components of guaiacin syrup contain ethanol, which should be avoided in combination with cephalosporin antibiotics that can cause disulfiram-like reactions and antibacterial drugs such as metronidazole and tinidazole
  .
  

  
  

• Acetylcysteine granules and effervescent tablets should be taken after dissolving in warm water not exceeding 40 ° C, too high a water temperature can lead to the destruction
  of the active ingredient.
  

  
  

• acetylcysteine should not be used simultaneously with penicillin and cephalosporin antibiotics; And should be avoided with highly acidic drugs, so as not to lead to a decrease in efficacy; When combined with nitroglycerin, it causes marked hypotension and increases the dilation of the temporal artery, and headache symptoms may occur [3].
  
  

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