Chesty Cough

Question 1

Do chesty coughs require a counselling room?

Answer 1

No

Question 2

What are 9 red flags for referral with chesty coughs?

Answer 2

1. Persistent fever
2. Respiratory noises
3. Shortness of breath
4. Discolored sputum
5. Pain on inspiration
6. Chest pain
7. Suspected adverse drug reaction
8. Persistent nocturnal cough
9. Cough > 2 weeks and not improving

Question 3

Do chesty coughs have a PSA self-care card?

Answer 3

Yes (Cold and Flu)

Question 4

What is the preferred treatment option for chesty coughs?

Answer 4

Duro-Tuss Chesty Forte (Bromhexine 8mg/Guaifenesin 200mg per 10mL)

Question 5

What are the directions for Duro-Tuss Chesty Forte (Bromhexine 8mg/Guaifenesin 200mg per 10mL) for chesty coughs in adults and children over12 years?

Answer 5

10mL FOUR times daily

Question 6

What are the directions for Duro-tuss Chesty Forte (Bromhexine 8mg/Guaifenesin 200mg per 10mL) for chesty coughs in children aged 6 to 11 years?

Answer 6

5mL FOUR times daily

Question 7

What are 2 non-preferred options for chesty coughs and why?

Answer 7

1. Bromhexine monotherapy liquid: doesn’t provide dual action
2. Bromhexine tablets: doesn’t line throat

Question 8

Is Duro-tuss Chesty Forte (Bromhexine 8mg/Guaifenesin 200mg per 10mL) safe in pregnancy?

Answer 8

Yes

Question 9

Is Duro-tuss Chesty Forte (Bromhexine 8mg/Guaifenesin 200mg per 10mL) safe in breastfeeding?

Answer 9

Yes

Question 10

What is the age range for Duro-tuss Chesty Forte (Bromhexine 8mg/Guaifenesin 200mg per 10mL)?

Answer 10

Safe in children over 6 years

Question 11

What are 5 pieces of non-pharmacological advice for chesty coughs?

Answer 11

1. Rest
2. Increase fluid intake as this will prevent dehydration and help to thin mucus.
3. Steam inhalations may promote expectoration and reduce chest tightness.
4. Steam can be inhaled during a hot shower or by placing the head over a bowl of hot (not boiling) water.
5. Discourage smoking.

Question 12

What is the mechanism of action of guaifenesin in chesty coughs?

Answer 12

Guaifenesin is an expectorant, meaning it aims to promote expectoration of bronchial secretion

Question 13

What is the mechanism of action of bromhexine in chesty coughs?

Answer 13

Bromhexine is a mucolytic, decreasing the viscosity of mucous.

Question 14

What is the role of sedating antihistamines in chesty coughs?

Answer 14

Avoid use of sedating antihistamines because of the risk of viscid mucous plugs forming.

Question 15

Describe the role of cough medicines in children.

Answer 15

Expectorants, decongestants, opioid cough suppressants and sedating antihistamines should not be used for cough in children.

Question 16

What is the preferred treatment of cough for children under 6 years?

Answer 16

A demulcent (simple linctus, lemon and honey) is preferable and may help in children < 6 years.

Question 17

What is a common cause of a secondary cough?

Answer 17

Postnasal drip

Question 18

What is postnasal drip characterised by?

Answer 18

Sinus or nasal discharge that flows behind the nose and into the throat.

Question 19

What are 3 signs of postnasal drip?

Answer 19

1. Having to swallow mucous
2. Having to clear the throat more often
3. Usually worse at night

Question 20

How can postnasal drips be treated?

Answer 20

Treat with antihistamine/sympathomimetic.
What may a recurrent night-time cough indicate?
Asthma (especially in children).