Abstract:
:Cough is an essential protective mechanism for the airways and lungs. Cough receptors are situated in the larynx and tracheobronchial tree, and are mediated by rapidly-adapting (irritant) Adelta fibers, although other receptors such as C-fiber receptors may contribute. Cough plasticity and interactions of cough pathways may occur centrally to enhance the cough reflex. The presence of an increased cough reflex as measured by a tussive response to capsaicin or citric acid in patients with a chronic cough indicate that there is sensitisation of the cough reflex. The most common cause of acute cough is that after a common cold, which usually lasts for less than 2 weeks. Cough that persists longer may be due to asthma and its variant forms (cough variant asthma and eosinophilic bronchitis), rhinosinusitis (postnasal drip), gastro-esophageal reflux, bronchiectasis, chronic bronchitis, and angiotensin-converting enzyme (ACE) inhibitor therapy. Chronic persistent cough can contribute to a significant worsening of quality of life measures. Bronchial tumors must be excluded with a chest radiograph. The management of chronic cough includes investigation and treatment of any associated causes, which sometimes leads to control of cough. In a proportion of patients, cough may be idiopathic and remain uncontrolled. Currently-available antitussives such as dextromethorphan or codeine are modestly successful in controlling cough. New antitussives may be developed that act on the sensory receptors or prevent their sensitisation.
journal_name
Minerva Medjournal_title
Minerva medicaauthors
Chung KFkeywords:
subject
Has Abstractpub_date
2005-02-01 00:00:00pages
29-40issue
1eissn
0026-4806issn
1827-1669journal_volume
96pub_type
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