coughs Flashcards
what are the symptoms of cough?
A cough is a natural protective reflex of the body. It normally occurs in response to blockage or irritation of the airway. Productive (chesty) coughs are where sputum is produced. If coughs produce a clear or white-coloured sputum, it is not infected, but is known as mucoid. Dry coughs are usually caused by self-limiting viral infections and do not produce any sputum. Coughs can be associated with a tickling sensation in the throat. Coughs are
normally mild and self-limiting, usually resolving itself within 2 weeks.
red flags for a cough?
● A cough lasting longer than 21 days – urgent referral for possible cancer
● Coloured sputum (yellow/green): may indicate a bacterial chest infection
● Haemoptysis (blood in sputum) warrants an urgent
referral as it can indicate an infection, malignancy or cardiovascular problems, such as pulmonary oedema.
● Persistent fever and night sweats associated with a cough and haemoptysis, which may indicate a tuberculosis infection
● Chest pain should be referred to the doctor, unless it only occurs upon coughing
● A persistent harsh barking cough is indicative of acute laryngotracheitis, also known as
croup, and should be referred
● Difficulty breathing
● Whooping cough
● A recurrent nocturnal cough is indicative of new or poorly controlled asthma and should be
referred routinely, especially in children
● Patients taking ACE inhibitors should be referred for a medication review, as these drugs
are associated with a cough in 2-10% of patients taking them
● If a postnasal drip is the suspected cause of the cough, it may be indicative of allergic
rhinitis, sinusitis, or (often in children) a foreign body in the nose, the possibility of which should be excluded
what are the lifestyle style / non medical treatments for a cough?
● Fluid intake should be encouraged as it can help with symptoms.
● Honey and lemon home remedies may help relieve soreness in the throat from coughing
● Smoking cessation is an appropriate lifestyle intervention to reduce the likelihood of
coughs, especially in patients suffering from COPD
what are the drug treatment options for a cough?
- demulcents
- expertorants
- cough suppressants
- antihistamines
what are examples of demulcents?
Simple linctus, Glycerin, Honey and Lemon
how do demulcents work?
Contain soothing ingredients such as syrup and glycerol
● May suppress cough mechanism, providing some symptomatic relief
● Can be used for both productive and non-productive coughs
● Options for younger patients, such as paediatric simple linctus
what are examples of expertorants?
Guaifenesin, Ammonium Chloride, Ipecacuanha, Squil
what are expertorants used for ?
● Can be used for the management of productive chesty coughs
● In theory cause the expulsion of bronchial secretions and mucus, but evidence for this is
lacking
● May be useful for patients who feel the need to take something for their cough rather than
to let it run its course
what are examples of cough suppressants?
Pholcodine linctus, Codeine, Dextromethorphan
what are cough suppressants used for?
● Can be used to treat dry, irritating, non-productive coughs
● Do not treat a productive cough with cough suppressant as this will lead to a build-up of
mucus, which may provoke an infection
● Included in some mixtures with multiple medications
● Pholcodine has fewer side effects compared to codeine
● Dextromethorphan and menthol suppress the cough reflex but do not have the side effects
associated with pholcodine and codeine, so can prove to be better options
what are the side effects of cough suppressants?
○ Constipation
○ Dependence
when are cough suppressants not recommended?
○ Children under the age of 6 years due to the risk of respiratory side effects
○ Adolescents between the ages of 12 and 18 who have problems breathing
○ Breastfeeding
what are antihistamines used for?
● Suppress cough, dry up secretions that may act as cough triggers, such as from post-nasal drip
● Cause drowsiness as a side effect, so are useful in treating nocturnal coughs that keep patients up at night
