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Posted On : 16 Jun 2015

THERE R THREE GROUPS OF SYP AVAILABLE FOR COUGH.FIRST ONE IS Terbutaline and AMBROXAL COMBINATIONS SECOND GROUP IS Dextromethorphan AND ANTI HISTAMINIC COMBINATIONS THIRD GROUP IS ANTIHISTAMININCS SYP.CAN U GUIDE ME WHAT R THE SPECIFIC CONDITION WHERE THESE THREE TYPES OF SYP COULD BE ADVISED IN PEDIATRIC AGE GROUP.

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Answer 1

Cough syrups are one the most commonly used over the counter medications.Their efficacy, although,is doubtful due to the lack of conclusive evidence to whether they work or they do not work.

Many people belive that these do work by giving mainly symptomatic relief. This is usually based on anecdotal evidence,not scientific research. One of the reviews from the Cochrane Reviews database concluded that there is no good evidence for or against the effectiveness of OTC medications in acute cough. The results of this review have to be interpreted with caution because the number of studies in each category of cough preparations was small. A recent FDA public health advisory about these syrups states that questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age.

Although these may be used for symptomatic relief, with caution, the main cause behind the cough needs to be found out and treated.

The various categories of cough syrups available are:
1.Terbutaline with Ambroxol with or without guaiphenesin:
Terbutaline is a selective beta2 -adrenergic agonist which stimulates beta2-receptors, thus producing relaxation of bronchial smooth muscle. Ambroxol is a mucokinetic, improves mucus transport and is secretolytic. It promotes the removal of thick secretions in the respiratory tract and reduces mucus stasis, with anti-oxidant activity. Guaiphenesin, increases respiratory tract fluid secretion, reducing the viscosity,acting as an expectorant.It also may increase the water bonding in the sputum,decreasing its viscosity and leading to an increase in mucokinesis.It is effective in both productive and nonproductive coughs. This combination is effective for symptomatic relief of cough due to bronchitis, bronchial asthma, emphysema and other bronchopulmonary disorders where bronchospasm, mucous plugging and problems of expectoration co-exist.

2.Dextromethorphan with or without antihistamines:
Dextromethorphan is an antitussive, acting centrally by suppressing the center for cough activity. It can be used mainly for dry cough, where only tempoaray relief is required, if the cough is interfering with sleep.It does not treat the cause nor does it hasten recovery.It comes alone or in combination with antihistamines, cough suppressants, and decongestants. Since most cough is associated with a postnasal drip, it should be combined with a decongestant like phenylephrine, Pseudoephedrine and phenylpropanolamine. But they can make some children hyperactive or irritable.Dextromethorphan, can rarely cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. For children 4-11 years of age, use caution.

3.Antihistamines:
Recent data suggests that these cannot be used in children for tretament of chronic cough.

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