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HEALTH CONDITIONS
Cough
Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Home Remedies
Doctors to Consult
Overview

Common Name/Other Name

Ubo (Fil.;Cebuano); abo (Bicol); ukok (Pang.); uyek (Ilocano)

Definition/Description

Coughing - a short, sudden exhalation of air. It is a mechanism of the body that keeps the lungs and airways clear of phlegm or inhaled particles. However, too much coughing may indicate a disorder or disease.

The two general classifications of cough are: productive coughs (producing phlegm or mucous from the lungs) and nonproductive coughs (dry and not producing any mucous or phlegm). Coughs are also divided into acute (less than 3 weeks' duration) and chronic (more than 3 weeks' duration).

Coughs may be accompanied by shortness of breath, chest pain, blood, or large amounts of sputum or phlegm.

Types of Cough

  • Smoker's Cough. Smoke poisons the cells lining the breathing tubes so mucus cannot be expelled normally. Smoker's cough may lead to a deadly lung disease. Smoking cessation is very important to avoid this kind of cough.
  • Viral and bacterial. Viral infections are the most common causes of cough. Cough due to virus usually has yellow or white mucus on expectoration. In contrast, cough caused by bacterial infection has mucus with rusty or green color and sometimes looks likely that it contains pus. Bacterial infections require antibiotics, while viral infections do not necessarily need antibiotics.
  • Barking cough. Caused by allergies, change in temperature at night or a viral upper respiratory infection. Children younger than three years of age have croup most often because their windpipes are narrow.
  • Whooping coughs. Most likely to occur in children who have not received DPT (Diphtheria-Pertussis-Tetanus) vaccinations. Infants with pertussis usually do not "whoop" after prolonged episodes of coughing, but they may not get enough oxygen or they may even stop breathing.
  • Cough with wheezing. When coughing is accompanied by a wheezing sound when exhaling, it is a sign that something may be partially blocking the airway. This might be caused by a respiratory infection or an inflammation such as bronchitis, pneumonia or asthma.
  • Stridor is noisy, harsh breathing heard when a patient breathes in. It may be caused by croup, epiglottitis or a foreign object stuck in the airway.
  • Night-time/Nocturnal cough. Some forms of cough gets worse at night because the congestion in one's nose and sinuses drains down the throat and causes irritation while lying in bed. This is a problem only if the cough disturbs sleep. Asthma can also trigger night-time cough because the airways tend to be more sensitive at night.
  • Daytime cough. Allergies, asthma, colds and other respiratory infections are the usual culprits. Cold air or strenuous activity can make the cough worse, and they often subside at night or when at rest.
  • Cough with a cold. Because most colds are accompanied by cough, it is normal to develop either a wet or dry cough when one has a cold.
  • Cough with fever. If the child has a cough, mild fever, and runny nose, chances are he has a simple cold. But cough with a fever of 38.5 degrees celsius or higher can indicate a more serious condition such as pneumonia, particularly if the child is listless and breathing fast.
  • Cough in infants. Coughing can wear out babies younger than 6 months. These infants are also at risk for complications from Respiratory Syncytial Virus (RSV) which causes bronchitis and pneumonia in young babies.
Symptoms
  • Sudden release of air from the lungs
  • Irritation to the throat
Risk Factors
  • Respiratory infections. May either be bacterial or viral infections that irritate the airways and cause coughing.
  • Allergies
  • Smoking. Not only does smoking irritate the airways and causes coughing, smoking also damages the lining of the airways, including the hair-like projections (cilia) that normally clear away the debris from the lungs.
  • Post-nasal drip. Nasal secretions drain down the back of the nose and into the throat, sometimes into the trachea, and produces irritation.
  • Gastroesophageal reflux. Causes coughing when the contents of the stomach flow backward from the esophagus into the trachea and airways.
  • Medications. Some drugs such as ACE inhibitors cause bronchoconstriction resulting to cough.
  • Health Conditions. Colds and flu or diseases or disorders such as asthma, chronic obstructive pulmonary disease, and heart failure (when fluid accumulates in the lungs) that leads to bronchoconstriction or the narrowing of the airways can cause cough.
Commonly Prescribed Drugs

Medication for cough should not be given unless coughing interferes with sleep since coughing helps in clearing the airways and bringing up phlegm. Treating the underlying cause of a cough (e.g. asthma, infection or fluid in the lungs) should be given priority.

  • Antitussives. Act by suppressing cough.
    • Codeine is an opioid analgesic used most often for cough. May cause nausea, vomiting, sedation, hypotension and respiratory depression. May cause addiction if used for prolonged periods and has additive depressant effect when taken with alcohol, sedatives, anti-depressants, certain antihistamines and sleeping aids.
    • Dextromethorphan a non-opioid cough suppressant given for a non-productive cough. Should not be given to patients taking monoamine oxidase inhibitors (MAOI). May cause nausea, drowsiness or dizziness.
  • Mucolytics and expectorants. Mucolytics decrease the thickness of mucus while expectorants increase the amount of bronchial secretions which will stimulate the cough reflex, leading to easy expulsion.
    • Acetylcysteine, carbocisteine, guaifenesin, ambroxol, lagundi, bromhexine
  • Bronchodilators, corticosteroids. Effective for cough resulting from narrowing of the airways or bronchoconstriction.
  • Antihistamines. Useful in coughs due to allergies but not in coughs due to other causes since anti-histamines cause drying of the respiratory tract and thickening of the secretions making it difficult to cough up.
  • Decongestants. Used only for cough due to postnasal drip, for example - phenylephrine.
  • Steam inhalation. Moisture from the steam helps stop cough by loosening the secretions, making it easier to expel.
  • Antibiotics. For cough due to a bacterial infection. Antibiotics should be taken strictly as prescribed by the physician.
Treatment and Management
  • Do not smoke and avoid second-hand smoke
  • As much as possible, avoid people who have coughs and colds
  • Stay indoors during times when there are a lot of allergens in the air, especially if you have seasonal allergies
  • Wash hands frequently, especially during the cold and flu season, to avoid infection
  • Get a flu shot every year, and a pneumococcal shot especially if you have asthma, COPD, and/or above 65 years old
  • Make sure that your immunizations are current to lower risk of getting diseases such as whooping cough (DPT shot)
  • Avoid situations where abrupt temperatures may occur as this can aggravate cough
Home Remedies
  • Take a steamy shower or use a vaporizer. The increased moisture in the air assists in liquefying the mucus and/or soothing dry throat
  • Lozenges or hard candy can help with dry, tickling coughs
  • Drink lots of fluids. Fluids help thin out mucus, making it easier to cough out.
Next »
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