The Rational Use Of Mucolityc Drugs In Children And Worsening Of The Cough As Adverse Drug Reactions After Carbocysteine In Children | 13280
Clinical Pharmacology & Biopharmaceutics
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Carbocysteine is a mucolytic drug similar to acetylcysteine regard to clinical uses. Carbocysteine is widely used
in children with respiratory diseases such as bronchitis, pneumonia and other diseases in which the viscous and sticky mucus
secretion is present. Annually, in the paediatric emergency department (EDP) are evaluated, investigated and treated on average
24 000 children aged from a couple of weeks up to 18 years.
Materials and Methods:
This study started from the observation that many children who received carbocysteine on arrival in
EDP presented a worsening cough and even bronchospasm. We believe these symptoms are carbocysteine adverse drug reactions
(ADRs). It is a retrospective study on 192 children who had various respiratory diseases. The special paper was used for the
recorder of ADRs, a paper provided by Pharmacovigilance Department. Children were divided into two groups: group A (89
subjects) - who received carbocysteine and group B (103 subjects) - who have not received carbocysteine. The data were processed
statistically using chi square test (
The most common symptom was cough in both groups (93.26% and 88.35%), followed by fever (65.17% and 65.05%) and
rhinoreea (22.47% and 20.39 %). The most common combination of symptoms was cough + fever + rhinoreea (22.47% in group A
and 20.39% in group B). In both groups prevailed the productive cough (46.99% and 45.05%). Dry cough and spastic cough was
found in 21.69% and 12.05% in group A, respectively, 18.68% and 14.29% in group B.
It could be, this drug has an irritating effect on the airways, thus, it should be used with caution in children. In all
cases of worsening cough, this effect was associated with carbocysteine. Also, the use for a few days of carbocysteine was associated
with the development of wheezing and bronchospasm. In cases of asthma, recurrent wheezing or other similar diseases the use of
carbocysteine should be avoided.
Ioan Magyar has completed his Ph.D. at the age of 43 years from University of Oradea. A several postdoctoral studies (organized by British
Pharmacological Society) was carried out in London UK. These workshops include Enzymes as Drug Targets (2011) and Drug Discovery (2012). He
is head of Department of Pharmacology, University of Oradea and he is also involved in clinical medicine (emergency medicine). He has published
about 50 papers (some of them in Romanian and others in English).
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