cough expectorant

what's the difference between exputex and alupent expectorant, was at doctor last week with put me on alupent expect.

any tips for oral thrush have lot's of problem with it. am on seratide diskus 500 for asthma.

chris

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Hi Chris,

Welcome to AUK, although sorry you have had to find your way here.

To try to answer your questions:

Exputex is a syrup containing carbocisteine, which is a drug which helps to thin and break up mucus, enabling it to be coughed up more easily. It is often used in bronchiectasis, as well as in people with asthma and COPD in whom copious, thick, viscous mucus is a problem.

Alupent is a syrup containing orciprenaline, which is a partially selective beta agonist (salbutamol (Ventolin) and terbutaline (Bricanyl) being more or less fully selective beta-2 agonists). This means that orciprenaline is really purely a bronchodilator - it wouldn't really be expected to have particular expectorant effects, except for the obvious fact that if you open up the airways, it can be easier to cough up sputum. As a bronchodilator, it's a bit of an odd choice, as it's usually both less effective than salbutamol or ipratropium, and associated with more side effects, as it is not fully selective and will thus have more of an effect on the beta receptors in the heart and blood vessels.

In terms of oral thrush, have you seen your doctor and had a diagnosis of oral thrush, and what does he/she suggest? Obviously, rinsing the mouth out thoroughly and gargling after using the inhaler is helpful for preventing thrush, as is using an MDI and spacer. Live yoghurt spread on the tongue and mouth and held in the mouth for a few minutes before swallowing can help both prevent and treat oral thrush. Using a very soft toothbrush can be useful to prevent pain to the sensitive areas of your mouth when cleaning your teeth when you have oral thrush. If you get a dry mouth, which can often happen due to medication like ipratropium, taking frequent sips of water can help to prevent your mouth drying out, as a dry mouth can predispose to getting thrush.

Treatments that you can get from your GP include antifungals such as nystatin suspension, miconazole gel (Daktarin oral gel) and, if the infection is severe or is thought to have spread into your oesophagus, fluconazole tablets. Chlorhexadine antiseptic mouthwash can also be useful to help prevent and treat oral thrush, and can also be used temporarily as an alternative to cleaning your teeth if you find this too painful when you have thrush.

Smoking, and wearing dentures, particularly if they are worn for many hours of the day and are not cleaned properly or do not fit well, can both increase the risk of oral thrush. If you have diabetes, good control of your sugars is important to prevent thrush. If you are not known to have diabetes, and you haven't been tested recently, it might be a good idea to pop to your GP, practice nurse or pharmacist to get your sugar checked, especially if you have had a lot of oral steroids in the past.

Hope this helps a little.

Take care,

Em H