Expectorants and Cough Suppressants: An Overview

Introduction:

Mild coughs caused due to a cold or flu usually do not require treatment as they go away on their own. Some coughs should not be treated with medicines as they help in keeping the lungs clear. But coughs that interfere with day-to-day activities or disturb sleep often require treatment with cough medicines. The two common types of over-the-counter cough medicines are cough suppressants and expectorants. Cough suppressants work by blocking the cough reflex, whereas expectorants work by thinning the mucus and clearing them from the airway.

What Are Expectorants?

Expectorants are cough medicines that are used to treat coughs that produce mucus. They help in thinning down the airway secretions and clear mucus from the airway. They are available as an ingredient in flu medication or as a standalone drug. Expectorants are effective in controlling the symptoms of respiratory tract infections like pneumonia, bronchitis, and common cold that cause mucus accumulation in the throat and lungs.

How Do Expectorants Control Cough?

Expectorants are used in controlling mucus-filled wet coughs. They act by lubricating the airways. Expectorants loosen up the mucus and make the cough more productive. They make it easier for the person to cough up mucus and clear the throat. Coughing up the mucus by using expectorants helps in getting rid of the discomfort felt from chest congestion. Coughing up the mucus also reduces the risk of infections as mucus contains infectious debris like viruses and bacteria.

What Are the Types of Expectorants?

Expectorants can be mainly divided into two types. They are medicinal and natural expectorants. Medicinal expectorants are available in tablet, pill, and liquid forms.

• Medicinal Expectorants:

  • Guaifenesin: It is one of the commonly used expectorants. Guaifenesin is found in flu, cold, and common cough medications. It works by hydrating the mucus to reduce the stickiness.

  • Potassium Iodide: Potassium iodide is a high-strength expectorant that is often used to treat chronic lung disease. A few examples of chronic lung diseases that produce excess mucus include bronchitis, asthma, and pulmonary emphysema. Potassium iodide works by loosening the mucus and making it easy to cough up.

• Natural Expectorants:

  • Ivy Leaf Extract: Ivy leaf is an effective expectorant that treats cough by reducing the thickness of the mucus and making it easier to cough up.

  • Menthol: Menthol is obtained from plants of the mint family. It relieves sore throat by giving a cooling sensation. Menthol improves cough by allowing more air to enter the respiratory system.

  • Steam: Inhaling moist and warm air controls cough by loosening the mucus present in the airway.

  • Hydration: Increasing the intake of water and staying hydrated helps in calming a cough. Drinking plenty of water or having a cup of herbal tea can clear mucus and eliminate throat irritation.

  • Honey: Honey helps in relieving cough by loosening up the mucus. Having honey mixed in a cup of tea or warm milk before going to bed can reduce the severity of the cough.

What Are the Side Effects of Expectorants?

The side effects of expectorants are as follows:

• Constipation.

• Headache.

• Dizziness.

• Skin rashes.

• Nausea and vomiting.

• Excess salivation.

• Diarrhea.

• Tiredness.

• Abdominal pain.

• Sore gums.

• Acid reflux.

What Are Cough Suppressants?

Cough suppressants that fall under the category of antitussives control cough by blocking the urge to cough. Cough suppressants are mainly effective against hacking and dry coughs. The most commonly used cough suppressant is Dextromethorphan. Certain cough medicines containing cough suppressants like Dextromethorphan have other ingredients that can counterbalance the cough-blocking effect. Some severe non-productive coughs require strong cough suppression that has narcotic medications like Codeine.

How Will Cough Suppressants Control Cough?

Cough suppressants are used in controlling dry coughs. They work by blocking the cough reflex. These medicines will give relief to a person from coughing, but they do not treat the cause of the cough. Cough suppressants often do not give a speedy recovery. They work by reducing the activity in the region of the brain that is responsible for causing coughs.

What Are the Types of Cough Suppressants?

Cough suppressants are available both as over-the-counter and prescription medicines.

• Over-The-Counter Medications: Dextromethorphan and Diphenhydramine are the commonly available over-the-counter formulations.

  • Dextromethorphan: Dextromethorphan is a synthetically manufactured over-the-counter cough suppressant. It works by entering the bloodstream and crossing the brain, thereby suppressing the cough reflex. It is ideal for dry coughs that do not contain phlegm.

  • Diphenhydramine: It is used to treat runny nose in colds and allergy symptoms. Diphenhydramine is found in many cough medications and is indicated to be used at night time as it causes drowsiness.

• Prescription Medications: Prescription medicines are often given when over-the-counter medications do not work and the cough becomes severe at night, causing discomfort. The common ones are as follows:

  • Codeine: Codeine is useful for sedation, pain relief, and suppression of cough reflexes. Codeine starts acting only after getting converted into morphine by the liver.

  • Hydrocodone: Hydrocodone acts by suppressing the cough center in the brain. It also acts as a pain reliever. But when used in high doses, it can often depress breathing.

What Are the Side Effects of Cough Suppressants?

The side effects of cough suppressants are as follows:

• Blurred vision.

• Drowsiness.

• Restlessness.

• Unusual excitement.

• Constipation.

• Dry mouth.

• Nervousness.

• Unsteady walk.

• Irritability.

• Stomach pain.

How Do Expectorants and Cough Suppressants Vary From Each Other?

Although both expectorants and cough suppressants are cough medicines, expectorants do not stop the cough, unlike cough suppressants. Expectorants act by enabling a productive cough that clears the airway from bacteria and other germs. Cough suppressants act by blocking the cough reflex. Expectorants treat wet cough, whereas cough suppressants treat dry cough. Thus cough suppressants stop a person from coughing, whereas expectorants make coughing more effective by producing more mucus in the lungs and airways.

Conclusion:

Cough can occur due to upper respiratory infections. Although cough is not a serious condition, those which persist for more than two weeks need to be informed by a doctor. Often prolonged coughs indicate serious respiratory conditions. Treating a cough should be done only after determining the cause and type of cough. Hence identifying the type and treating the underlying cause of the cough helps a person to get rid of the cough quickly and lead a normal life.