Cough

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A cough is defined as "a sudden, audible expulsion of air from the lungs through a partially closed glottis, preceded by inhalation. It is a protective response that serves to clear the trachea, bronchi, and/or lungs of irritants and secretions, or to prevent aspiration of foreign materials into the lungs."[1][2]

Chronic cough

Post nasal drip

For more information, see: Allergic rhinitis.

The most common cause of chronic cough is postnasal drip such as from allergic rhinitis.[3][4]

Asthma

For more information, see: Asthma.

The second most common cause of chronic cough is undiagnosed asthma.[3][4]

Occult asthma may be diagnosed with either methyl choline challenge test[3] or measurement of exhaled nitric oxide.[5]

Gastroesophageal reflux disease

For more information, see: Gastroesophageal reflux disease.

The third most common cause is gastroesophageal reflux disease (GERD).[3][4]

Treatment of chronic cough

Postnasal drip

For more information, see: Allergic rhinitis.

1 mg of azatadine maleate combined with 120 mg of sustained-release pseudoephedrine sulfate twice daily may help.[3]

Asthma

For more information, see: Asthma.

Albuterol, two puffs four times a day via metered-dose inhaler may help.[3] If this is not adequate, corticosteroids may be added.

Treatment of acute cough

Cough suppressants

Dextromethorphan is commonly used, but has uncertain benefit.[6][7]

Codeine is commonly used, but has uncertain benefit.[8]

Mucolytics

For treating pneumonia, mucolytics (bromhexine, ambroxol, neltenexine) may have some benefit.[9]

References

  1. National Library of Medicine. Cough. Retrieved on 2007-11-30.
  2. Thiadens HA, Springer MP, Postma DS (2001). "The diagnosis and treatment of cough". N. Engl. J. Med. 344 (14): 1097; author reply 1098. PMID 11291672[e]
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Pratter MR, Bartter T, Akers S, DuBois J (1993). "An algorithmic approach to chronic cough". Ann. Intern. Med. 119 (10): 977–83. PMID 8214994[e]
  4. 4.0 4.1 4.2 Irwin RS, Curley FJ, French CL (1990). "Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy". Am. Rev. Respir. Dis. 141 (3): 640–7. PMID 2178528[e]
  5. Hahn PY, Morgenthaler TY, Lim KG (2007). "Use of exhaled nitric oxide in predicting response to inhaled corticosteroids for chronic cough". Mayo Clin. Proc. 82 (11): 1350–5. PMID 17976354[e]
  6. Eccles R, Morris S, Jawad M (1992). "Lack of effect of codeine in the treatment of cough associated with acute upper respiratory tract infection". J Clin Pharm Ther 17 (3): 175–80. PMID 1639879[e]
  7. Lee PCL, Jawad MS, Eccles R (2000). "Antitussive efficacy of dextromethorphan in cough associated with acute upper respiratory tract infection". J. Pharm. Pharmacol. 52 (9): 1137–42. PMID 11045895[e]
  8. Freestone C, Eccles R (1997). "Assessment of the antitussive efficacy of codeine in cough associated with common cold". J. Pharm. Pharmacol. 49 (10): 1045–9. PMID 9364418[e]
  9. Chang CC, Cheng AC, Chang AB (2007). "Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults". Cochrane Database Syst Rev (4): CD006088. DOI:10.1002/14651858.CD006088.pub2. PMID 17943884. Research Blogging.