General Practice 2022

Child expectorant: cough syrups with phlegm

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Child expectorant: cough syrups with phlegm
Child expectorant: cough syrups with phlegm
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Cough with sputum is a reflex of the body to expel phlegm from the respiratory system and, therefore, should not be avoided with drugs that inhibit the elimination of phlegm, but with drugs that make phlegm more liquid and easy to eliminate and that promote its expulsion, in order to treat the cough more quickly and effectively.

Generally, the expectorant active substances used in children are the same as those used by adults, however, pediatric formulas are prepared in lower doses. On most of the packaging of these medicines, "child use", "pediatric use" or "children" is mentioned, to make it easier to identify.

Before giving the syrup to the child, it is important to take the child to the pediatrician, so that the most suitable expectorant is prescribed individually and to identify what may be causing the cough. Find out what each color of phlegm can mean.

Some of the drugs indicated to treat cough with phlegm are:

1. Ambroxol

Ambroxol for children helps to make phlegm less thick, facilitating its elimination and can be found in the form of 15mg/5mL pediatric syrup or 7.5mg/mL oral solution for children from 2 years old, as generic or with the trade names Mucosolvan or Sedavan.

Ambroxol drops or syrup are not recommended for children under 2 years of age.

How to use

Doses of pediatric ambroxol depend on age or weight and on the intended dosage form, drops or syrup, and include:

Introduction

Recommended dose

How to use

Orally

Ambroxol syrup (15 mg/mL)

  • Children from 2 to 5 years: the recommended dose is 2.5 mL of syrup, which corresponds to ¼ of the measuring cup, 3 times a day, that is, 1 dose every 8 hours, as directed by the pediatrician;
  • Children from 5 to 10 years: the recommended dose is 5 mL of syrup, which corresponds to ½ of the measuring cup, 3 times a day, that is, 1 dose every 8 hours, as instructed by the pediatrician.
Take orally, using the measuring cup provided in the package.
Ambroxol solution in drops 7.5 mg/mL
  • Children from 2 to 5 years: the recommended dose is 1 mL (25 drops), 3 times a day, that is, 1 dose every 8 hours;
  • Children from 6 to 12 years: the recommended dose is 2 mL (50 drops), 3 times a day, that is, 1 dose every 8 hours;
  • Adolescents over 12 years old: the recommended dose is 4 mL (100 drops), 3 times a day, that is, 1 dose every 8 hours.
Take orally, preferably during a meal, it is recommended to dilute the drops in water, fruit juice, milk or tea, for example.

By inhalation

Ambroxol solution in drops 7.5 mg/mL

  • Children from 2 to 5 years old: it is recommended to take 1 to 2 inhalations a day, with 2 mL (50 drops), as recommended by the pediatrician;
  • Children over 5 years and adolescents: it is recommended to take 1 to 2 inhalations/day with 2 mL (50 drops) to 3 mL (75 drops), according to pediatrician's advice.
Add the drops mixed in saline solution, in the proportion of 1:1, that is, you must put the same amount of drops and saline solution in all types of modern inhaler, however, it must not be used steam inhaler.

The doses of ambroxol drops or pediatric syrup can also be calculated by the pediatrician considering the child's weight.

Contraindications

Ambroxol should not be used by children who are allergic to ambroxol or any other component of the formula and should only be given to children under 2 years of age if advised by a doctor.

Possible side effects

Although it is generally well tolerated, ambroxol can cause some side effects such as altered taste, nausea, vomiting, diarrhea, heartburn or poor digestion.

2. Acetylcysteine

Acetylcysteine ​​for children helps relieve coughing, as it makes the phlegm more liquid, facilitating its elimination, and is available as a 20mg/mL pediatric syrup, as a generic or under the trade names Fluimucil or Cisteil.

How to use

Acetylcysteine ​​syrup should be taken orally, using the measuring cup provided in the package. The normally recommended doses are:

  • Children from 2 to 4 years old: the recommended dose is 5 mL, 2 to 3 times a day, as recommended by the pediatrician;
  • Children over 4 years: the recommended dose is 5 mL, 3 to 4 times a day, as directed by the pediatrician.

The treatment time with pediatric acetylcysteine ​​syrup should be guided by the pediatrician and is usually 5 to 10 days.

Contraindications

Acetylcysteine ​​should not be used by children who are allergic to acetylcysteine ​​or any other component of the formula and in children under 2 years of age, unless recommended by a doctor.

Possible side effects

Some of the most common side effects that can occur during treatment with acetylcysteine ​​are gastrointestinal disorders such as nausea, vomiting or diarrhea.

3. Bromhexine

Bromhexine helps dissolve phlegm, allowing it to be eliminated more easily, and is available as drops or in 4mg/5mL children's syrup and can be found generically or under the trade names Bisolvon or Pulmed.

How to use

The doses of bromhexine in children depend on age or weight and the pharmaceutical form to be used, drops or syrup, and include:

Introduction

Recommended dose

How to use

Orally

Bromhexine syrup (4mg/ 5mL)

  • Children from 2 to 6 years: the recommended dose is 2.5 mL of syrup, 3 times a day as directed by a doctor;
  • Children from 6 to 12 years old: the recommended dose is 5 mL of syrup, 3 times a day, according to medical advice;
  • Adolescents over 12 years old: the recommended dose is 10 mL, 3 times a day, according to medical advice.
Take orally, using the measuring cup provided in the package.

Bromhexine solution drops (2 mg/mL)

  • Children from 2 to 6 years: the recommended dose is 20 drops (2.7 mg), 3 times a day, as directed by a doctor;
  • Children from 6 to 12 years: the recommended dose is 2 mL (4 mg) of the solution in drops, 3 times a day, as directed by a doctor;
  • Adolescents over 12 years: the recommended dose is 4 mL (8 mg) of the solution in drops, 3 times a day, as directed by a doctor.
Take orally, as recommended by your doctor.

By inhalation

Bromhexine solution drops (2 mg/mL)

  • Children from 2 to 6 years: the recommended dose for inhalation is 10 drops (approximately 1.3 mg), 2 times a day, according to medical advice;
  • Children from 6 to 12 years: the recommended dose for inhalation is 1 mL (2 mg) of the solution in drops, 2 times a day, according to medical advice;
  • Adolescents over 12 years: the recommended dose for inhalation is 2 mL (4 mg), 2 times a day, as directed by a physician.
Add the drops mixed in saline solution, in the proportion of 1:1, that is, you must put the same amount of drops and saline solution, being recommended to heat the bromhexine bottle before use, rubbing it between your hands, so that it reaches body temperature.

It is important to use the inhalation solution with bromhexine drops immediately after preparation.

The treatment time with bromhexine syrup for children or drops should be guided by the pediatrician.

Contraindications

This medication should not be used by children who are allergic to bromhexine or any other component of the formula and in children under 2 years of age.

Furthermore, bromhexine syrup should not be used by children who have a fructose intolerance.

Possible side effects

Some of the side effects that can occur during treatment with bromhexine are nausea, vomiting or diarrhea.

4. Carbocysteine

Carbocysteine ​​is an expectorant remedy that facilitates the elimination of phlegm and can be found in the form of a 20mg/mL infant syrup, as a generic or under the trade name Mucofan.

How to use

Carbocysteine ​​should be used orally and should not be used by children under 2 years of age.

To use carbocisteine ​​syrup for children, use the measuring cup provided in the package. The dose normally recommended for children between 2 and 12 years of age is 0.25 mL of syrup for each kg of body weight, which is equivalent to 5 mg of carbocysteine ​​per kg of weight, 3 times a day, or as directed by the doctor. pediatrician.

The duration of treatment with carbocysteine ​​syrup for children should be guided by the pediatrician.

Contraindications

This medication should not be used by children who are allergic to carbocysteine ​​or any other component of the formula and in children under 2 years of age.

Side Effects

Some of the most common side effects that can occur during treatment with carbocysteine ​​are gastrointestinal disorders such as nausea, diarrhea and gastric discomfort.

5. Guaifenesin

Guaifenesin is an expectorant that works by making the phlegm less thick, which facilitates its elimination.

How to use

To use guaifenesin syrup for children, use the measuring cup provided in the package. Doses depend on the age or weight of the child and include:

  • Children aged 2 to 6 years: the recommended dose is 7.5 mL (50 mg) every 4 hours, ie 1 dose every 6 hours, or as per pediatrician's guidance;
  • Children from 6 to 12 years: the recommended dose is 15 mL (100 mg) every 4 hours, ie 1 dose every 6 hours, or as directed from the pediatrician.

The maximum daily limit for administration of the drug for children is 6 doses per day, that is, for children aged between 2 and 6 years, it should not exceed 300 mg per day, and for children aged 6 to 12 years, maximum dose is 600 mg per day.

The duration of treatment with guaifenesin syrup for children should always be guided by the pediatrician.

Contraindications

This medication should not be used by children who are allergic to guaifenesin or any other component of the formula and in children under 2 years of age.

Furthermore, this syrup should be used with caution by diabetic children as it contains sugar.

Possible side effects

Some of the side effects that may occur during treatment with guaifenesin are gastrointestinal disturbances such as nausea, diarrhea, gastric discomfort, drowsiness or headache.

6. Acebrophyllin

Acebrophylline is a drug that helps to eliminate phlegm more easily and is available in pediatric syrup 5 mg/mL, as a generic or under the trade names Brondilat or Filinar.

How to use

Pediatric acebrophylline syrup is indicated for children from 2 years of age and must be taken orally, using the 10 mL measuring cup provided in the package. The normally recommended doses are:

  • Children from 2 to 3 years: the recommended dose is 2 mg per kg of body weight per day, divided into two administrations, every 12 hours, or as directed from pediatrician;
  • Children from 3 to 6 years old: the recommended dose is half a measuring cup, which corresponds to 5 mL of syrup every 12 hours, or according to the pediatrician's guidance;
  • Children from 6 to 12 years: the recommended dose is 1 measuring cup, which corresponds to 10 mL of syrup, every 12 hours, or according to the pediatrician's guidance;
  • Adolescents from 12 years of age: the recommended dose is 1 measuring cup, which corresponds to 10 mL of syrup, every 12 hours, or as directed by the pediatrician.

The duration of treatment with pediatric acebrophylline syrup should be guided by the pediatrician.

Contraindications

This syrup should not be used by children who are allergic to acebrophyllin or any of the other ingredients in the formula, or by children with severe liver, kidney or cardiovascular disease, active peptic ulcer disease, or a history of seizures.

Also, it should not be used on children under 2 years of age.

Possible side effects

Some of the side effects that may occur during treatment with acebrophylline syrup for children are constipation, diarrhea, excessive salivation, dry mouth, nausea, vomiting, generalized itching or excessive tiredness.

Also know some natural remedies that can help relieve a cough.

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