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Coughing

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Our body has several defence mechanisms to protect itself from foreign intruders. Coughing is one of its combat arsenal’s mechanisms, which helps to protect the pulmonary tract. But it can be troublesome at times. Choosing the right treatment will give you some relief.

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Different types of cough

Coughing is often associated with the cold and flu season. However, it is linked to several other health issues. Although coughing may seem harmless enough, it is always a sign that something is not normal in the lung area. It is our body’s defence mechanism (reflex) whose purpose is to expel an irritation that has lodged in the lungs, bronchial tubes or throat.

Cough can be wet and mucous when there are coloured or clear secretions present. If there is little mucous, the cough is dry. A cough’s duration can vary depending on its cause.

Table 1: Examples of causes of coughing according to duration

Less than 3 weeks

3 to 8 weeks

More than 8 weeks

Upper and lower respiratory tract infections (e.g.: pneumonia, cold, fever)

Asthma

Asthma

Aggravation of asthma or chronic obstructive pulmonary disease (COPD)

Gastric reflux

Secondary effect of a class of drugs commonly known as ACE inhibitors

 

Whooping cough

Lung cancer

 

Bronchitis

Allergic rhinitis

 

Post-infection cough

Smoking

As several circumstances can trigger the coughing reflex, often other symptoms have to be studied in order to identify the correct causal factor.

Drug treatment for coughs

The causes of coughing vary widely, and treatment can be just as diversified, and include:

  • Antitussives (cough suppressants);
  • antibiotics;
  • inhaled corticosteroids;
  • antihistamines.

When a cough is not too severe and lasts only for a short while, you can seek relief using over-the-counter antitussives. If used properly, dextromethorphan is an effective cough medication for dry cough. The abbreviation ‘DM’ found on some cough syrups indicates the presence of dextromethorphan as an ingredient. You must be careful with any chemical interaction dextromethorphan may have with other prescription medication, such as fluoxetine and paroxetine. Other antitussives are also available. Some medications also contain codeine, which has useful antitussive properties. However, it also has more serious side effects, such as causing drowsiness and a risk of dependency. If you want to use an over-the-counter antitussive product, it is always better to consult your pharmacist.    

For wet coughs, some syrups contain guaifenesin. The benefits of this ingredient are not well known and controversial. The best expectorant is still proper hydration. Water makes any secretions more fluid, which helps to expel them. 

Antitussives for children and pregnant women

Some groups of people require more attention when it comes to taking medication; this holds true for pregnant women and children. During pregnancy, the risks of an unborn baby of being exposed to an antitussive must be weighed against the benefits felt by the pregnant mother. Luckily, dextromethorphan is deemed normally safe for pregnant women and is the first choice of expectant mothers when they need a remedy for a severe cough.

With young children, it is no longer recommended to administer cold and flu medication to children younger than 6 years of age. Thus, antitussives should not be given to small babies without the recommendation of a doctor. Rather than medication, other relief measures must be relied upon to treat their cough. Increased water consumption and the use of a cool-mist humidifier are two effective methods to ease children’s coughs. A humidity rating of 50% in summer and 30% in winter is recommended. 

When should you consult a doctor?

Coughing is not a serious symptom. However, some situations require a visit to the doctor for a more thorough examination:

  • cough that lasts more than two weeks;
  • cough that is not relieved by over-the-counter antitussives;
  • complementary symptoms that point to a more serious health condition;
  • aggravation of asthma or chronic obstructive pulmonary disease (COPD).

In short, coughing may seem straightforward at first, but it can become much more complex. For effective relief, it must be categorized in order to choose the correct treatment plan. This is where the pharmacist’s role becomes clear. If you are bothered by coughing, your pharmacist can help you choose the best treatment, because after all, with proper health, you’ll be ‘breathing easy’ once again!

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