Chronic cough Flashcards
Physiology
causes
algorithm for diagnosis and management
.
coughing has 2 functions
1) clear mucus and inhaled substances
2) Protect airway from inhaling foreign substances
cough receptors stimulate which nerve
Vagus
Where is the cough center
medulla, nucleus tractus solitarius
3 nerve outputs of cough
Spinal motor
Phrenic
Vagus
3 causes of chronic cough
1) upper airway cough syndrome
2) asthma
3) GERD
where are the cough receptors stimulated in upper airway cough syndrome
in the laryngeal mucosa
causes of upper airway cough syndrome
allergic rhinitis
Vasomotor rhinitis
sinusitis
4 treatment options for Upper airway cough syndrome
1) antihistamines
2) decongestants
3) topical nasal steroids
4) ipatropium - for vasomotor rhinitis
what type of infection can cause a chronic cough?
viral
think about pertussis and TB
Post viral coughs may respond to
Inhaled ipatropium bromide
anti-cholinergic
when is the pertussis nasopharyngeal swab most effective
Highest sensitivity is the first few weeks of symptoms
Treatment for pertussis
Macrolide Abx - azithromycin or clarithromycin
how do ACE inhibitors cause cough
Accumulation of bradykinins which stimulate cough receptors
when does an ACEi cough present
usually within 1 week but up to 6 months
