KT typed:

> Sitting here cos I can't stop coughing (4 am) leads me to thoughts on
> cough linctus.

Have you ever been to the pharmacist's and asked for some medicine for that tickly cough that had been bothering you for a few days? Or have you ever been to see your GP with a chesty cough and asked for a "cough bottle"?
	Have you ever wondered what exactly is in those bottles, and whether or not they actually work? In general, you would be better off avoiding 'cough bottles', although, in certain circumstances, they can help.
	There are four basic types of cough medicine, each of which works in a different way.

Soothing cough medicines
Soothing cough medicines contain syrup of glycerol. They may help an irritating dry cough. Simple Linctus BP is available on prescription and is very cheap to buy over-the-counter. A paediatric version is available for children, although it contains a lot of sugar and may be harmful to teeth if taken frequently.

Expectorants
Expectorants are said to thin the mucus in the lungs so that the phlegm collected there can be coughed up more easily. It is thought that expectorants work by irritating the lining of the stomach. Impulses are then transmitted along nerves which connect the stomach and the lungs so that more mucus is produced in the lungs.
	Unfortunately, this only happens when expectorants are given is very high doses, doses which would almost certainly cause sickness and vomiting. Most medicines which contain expectorants such as ammonium chloride or ipecacuanha contain them in tiny, ineffective doses. Sugared water is as effective as most expectorants.

Mucolytics
Mucolytic cough medicines contain chemicals called enzymes which make mucus less sticky and therefore easier to cough up. They are not generally available on the NHS and are no good for people with asthma or chronic bronchitis. Drinking plenty of fluids and inhaling steam are probably more effective methods of thinning mucus and phlegm.

Cough Suppressants
A medicine which suppresses a cough can be helpful if your sleep is disturbed by a troublesome cough. Remember, though, that a cough is often the body's way of dealing with a cold or flu, and it is rarely a good idea to suppress a cough for anything but short periods of time. Asthmatics and those with bronchitis shouldn't take cough suppressants because they need to cough up whatever phlegm is trapped in their lungs.
	Pholcodine linctus is a reasonable cough suppressant and is available over the counter. Codeine linctus is stronger and only available on prescription, but there is a greater risk of addiction and constipation.

Compound Cough Medicines
There are a number of cough medicines which are advertised on the basis that they contain more than one drug. The implication is that they are more effective than single-ingredient medicines. Frequently, though, one of the ingredients will work in the opposite way to another.
	For example, a medicine that contains an expectorant and a suppressant makes no sense at all: one ingredient is designed to help you cough up the phlegm while another works to suppress the cough! In general, compound cough medicines are best avoided.



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