Approach to selecting mucoactive medications to treat cough in children

Abstract

Cough is the most common symptom of acute respiratory infections in children. Rational approaches to the therapy of cough should be based on the diagnosis and analysis of cough features. In accordance with sputum quality and quantity, a dry (unproductive, minimally productive) and wet (productive) cough is distinguished. The cough can be acute (up to 4 weeks), subacute, chronic, recurrent in duration. Cough assessment should involve considering the following characteristics: rhythm, timbre, nature, intensity, time of onset, duration, frequency, body position while coughing, impact of cough on the patient’s condition and sleep; presence of airway obstruction, etc. All presentations of cough can change during the development of the disease, which must be considered in the diagnosis and therapy. These characteristics of cough help the therapist select a rational therapy. Particular attention is paid to the therapy of wet cough, which is based on the stimulation of mucociliary clearance, restoration of the drainage function of the lungs; improvement of sputum elimination, thinning and removal of viscous bronchial secretion from the respiratory tract; prevention of mucostasis. The article discusses the pharmacokinetics and mechanism of action for Ambroxol in terms of its indications for OTC drug delivery, clinical data on the use of ambroxol in children. The primary mechanism of action for Ambroxol involves stimulation of surfactant synthesis, a complex mechanism that is not yet fully understood, but which provides Ambroxol with effective mucokinetic and secretion-stimulating properties, thus contributing to mucus clearance, which facilitates expectoration and productive cough.