lung and airway disorders
Cough in Adults
Treatment of Cough
The best way to treat cough is to treat the underlying disorder. For example, antibiotics can be used for Overview of Pneumonia , and inhalers containing medications that widen airways (bronchodilators) or corticosteroids can be used for There are two basic approaches to people who are coughing: Cough suppressants (antitussive therapy), which reduce the urge to cough Expectorants, which are meant to thin the mucus blocking the airways to the lungs and make mucus easier to cough up (but evidence of effectiveness is lacking) Cough suppressants include the following: Opioids Dextromethorphan Benzonatate Allopioidssuppress cough because they reduce the responsiveness of the cough center in the brain.Codeineis the opioid used most often for cough.Codeineand other opioid cough suppressants may cause nausea, vomiting, and constipation and may be addictive. They can also cause drowsiness, particularly when a person is taking other drugs that reduce concentration (such as alcohol, sedatives, sleep aids, antidepressants, or certain antihistamines). Thus, opioids are not always safe, and doctors usually reserve them for special situations, such as cough that persists despite other treatments and that interferes with sleep. is the active ingredient in many over-the-counter (OTC) and prescription cough preparations. It is not addictive and, when used correctly, causes little drowsiness. However, it is frequently abused by people, particularly adolescents, because in high doses, it causes euphoria. Overdose causes hallucinations, agitation, and sometimes coma. Overdose is particularly dangerous for people who are taking medications for depression called Selective serotonin reuptake inhibitors (SSRIs) . Benzonatateis a local anesthetic taken by mouth. It numbs receptors in the lungs that respond to stretching and thus makes the lungs less sensitive to irritation that triggers cough. Certain people, especially those who are coughing up a large amount of sputum, should limit their use of medications that suppress cough. Some doctors recommend expectorants (sometimes called mucolytics) to help loosen mucus by making bronchial secretions thinner and easier to cough up. Expectorants do not suppress a cough, and evidence indicating effectiveness of these medications is lacking. The most commonly used expectorants are over-the-counter preparations that containguaifenesin. In people with Cystic Fibrosis (CF) , Also, inhaling a saline (salt) solution or inhalingacetylcysteine(for up to a few days) sometimes helps thin excessively thick and troublesome mucus. Antihistamines, which dry the respiratory tract, have little or no value in treating a cough, except when it is caused by an allergy involving the nose, throat, and windpipe. When coughs have other causes, such as bronchitis, the drying action of antihistamines can be harmful, thickening respiratory secretions and making them difficult to cough up. Decongestants (such aspseudoephedrine) that relieve a stuffy nose are only useful for relieving a cough that is caused by postnasal drip. Steam inhalation (for example, using a vaporizer) is commonly thought to reduce cough. Other topical treatments, such as cough drops, are also popular, but there is no convincing evidence that these other treatments are effective. 