Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

St Christophers' Hospice near London is now internationally known as a special centre for the care of terminally ill patients. In these cases, the relief of symptoms is paramount, and prominent among those symptoms is pain. Such pain can almost always be relieved without euphoria or lessening of consciousness. More than 60% of patients admitted to St Christopher's complain of pain, and the scheme of management outlined below results in substantial or complete relief of pain in all of them. Addiction does not occur when control of the patient's pain is part of the pattern of total care. The author considers management of pain of varying severity, together with associated symptoms such as vomiting, anorexia, dry mouth and hiccup, dyspnoea, cough, anxiety and depression, insomnia, constipation and diarrhoea.
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PMID:Drug control of common symptoms in the terminally ill patient. 6 49

Thirty observations done on infants formed the base of a review of the literature on the epidemiology, the clinical signs and the physiopathological mechanisms of passive smoking (PS). The main signal was a chronic cough but in infants under 12 months, PS also provoked, as well, an "asthmatoid bronchitis", progressing relentlessly since the coming out of maternity ward, in relation with the maternal tobacco addiction. In these patients, examinations failed to disclose the different causes of recurring respiratory infections. Among the granulocytic tests, only the spontaneous migration of neutrophil polykaryocytes in the absence of chemotactic stimulus was significantly lowered, by comparison with the controls. The authors did a review on epidemiological surveys done to this day; they revealed a direct relationship between the parent's addiction to tobacco and the frequency of recurring respiratory disorders. It was particularly evident when the mother smoked and the child was under 12 months. At this age it was independant from the infection eventually transmitted by the parent's cough. The constituants of tobacco smoke probably have a depressive action over the regional or perhaps the general means of immunitary defense as it is suggested by the decrease of leukocyte migration noted in parents with PS. It is therefore necessary in our country to define the true risks of PS in infants thanks to well organized epidemiological surveys and to obtain the means of an efficient preventive policy.
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PMID:[Respiratory signs linked to passive inhalation of tobacco smoke in infants (author's transl)]. 47 73

Adverse effects of opioids are multiple. They are most often receptor-mediated and inseparable from their desired effects. The most severe mishaps with opioids are related to their respiratory depressant effect, which is widely influenced by factors such as pain, previous opioid experience and awareness. Other relevant central nervous system effects of opioids include cough suppression, nausea and vomiting, rigidity, pruritus and miosis. The cardiovascular adverse effects of opioids are mainly related to histamine release and differ widely between agonists and agonist-antagonists. Gastrointestinal effects such as constipation, reflux and spasms of the bile duct are well described. Adverse effects on endocrine, immunological and haematological functions are possible, while allergic reactions are extremely rare. The adverse effects of long term use are overestimated. Systemic toxicity is negligible and development of tolerance is minimal while treating pain. In the clinical setting of pain control, addiction and withdrawal do not pose significant problems. Nevertheless, the possible effects of opioids on the unborn child should always be considered. Overall, opioids show a good record of safety. Their use should not be unduly limited by unfounded fears of adverse effects, but these effects should be avoided by anticipation and prevention.
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PMID:Adverse effects of systemic opioid analgesics. 135 45

The effect that codeine has on the process of addiction and recovery is unclear. Confusion about definitions, study endpoints, and a lack of well-controlled clinical studies has led to this uncertainty. Codeine addiction is uncommon in people who do not have existing vulnerability to addiction, including alcoholism. Codeine use can sustain addiction or increase the risk of relapse in patients afflicted with addiction. The risk of relapse must be considered when treating conditions such as pain or cough in a person recovering from addiction. Codeine use may be circumvented with the appropriate use of alternative treatments for pain or cough. If codeine use becomes necessary, cautious prescribing and reliance on the patient's recovery support network become imperative.
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PMID:Safe use of codeine in the recovering alcoholic or addict. 200 86

Pholcodine has antitussive activity similar to, or somewhat greater than, that of codeine in animal test systems. The drug, which has been formulated in many combination medications (45)--some rational and some quite irrational pharmacologically--also appears to be active in man, although the clear-cut demonstrations, unfortunately, are in artificially-induced cough models. Additional efficacy studies are needed. Preclinical toxicity studies demonstrate a generally safer profile for pholcodine than codeine, although pholcodine appears to have greater depressant effects on the respiratory and cardiovascular systems in animals. These effects have not been observed in man after administration of therapeutic doses. Pholcodine appears to be devoid of addiction liability in man. In contrast to codeine, pholcodine is not metabolised to morphine in man, a fact which may contribute to its more favourable toxicity profile, and it is metabolised and eliminated much more slowly than codeine.
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PMID:Pholcodine. 328 58

The potential role of nicotine in tobacco dependence was investigated using the strategies of abuse liability assessment. Eight male volunteer cigarette smokers with histories of drug abuse resided on a research ward for the duration of the study. Each subject was tested with three doses of i.v. nicotine (0.75, 1.5 and 3.0 mg/10-sec infusion) and placebo each test day, and with three doses of inhaled nicotine, in the form of research cigarette smoke (0.4, 1.4 and 2.9 mg estimated yield) and placebo (sham-smoking), given on alternate test days. Each subject was tested on 4 days with both routes of administration, according to identical experimental protocols. Physiologic, subjective and observer data were collected at intervals ranging from 15 sec to 10 min beginning 10 min before drug administration and continuing for 30 min after administration. Both i.v. and inhaled nicotine produced dose-related increases in heart rate and blood pressure, and i.v. nicotine produced a transient bradycardia in four subjects during the first 30 sec after drug administration. Skin temperature was decreased by nicotine and pupil diameter was not consistently changed. Ratings of drug dose "strength" and drug "liking" were directly related to dose level whereas "desire to smoke cigarettes" was inversely related. Scores on the Morphine-Benzedrine Group (or Euphoria) scale of the Addiction Research Center Inventory were elevated by nicotine, and i.v. doses were identified frequently as cocaine. Signs and symptoms were similar for nicotine across the two routes of administration and included coughing, dizziness, nausea and relaxed feelings. Nicotine shared the pharmacologic profile of prototypic drugs of abuse. The study supports the hypothesis that the role of nicotine in tobacco dependence is equivalent to the role of other psychoactive drugs in substance abuse, e.g., to the role of cocaine in coca leaf use.
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PMID:Abuse liability and pharmacodynamic characteristics of intravenous and inhaled nicotine. 400 94

The synthesis of a novel class of antitussive agents is described. The compounds were examined for antitussive activity in guinea pig after cough induction by electrical or chemical stimulation. Ethyl 2-[(2-methoxyphenoxy)methyl]-beta-oxothiazolidine-3-propanoate (BBR 2173, moguisteine, 7) and other structurally related compounds showed a significant level of activity, comparable to that of codeine and dextromethorphan. The compounds presented in this paper are characterized by the N-acyl-2-substituted-1,3-thiazolidine moiety, which is a novel entry in the field of antitussive agents. The serendipitous discovery of the role played by the thiazolidine moiety in determining the antitussive effect promoted extensive investigations on these structures. This optimization process on N-acyl-2-substituted-1,3-thiazolidines led to the initial identification of 2-[(2-methoxypheoxy)methyl]-3-[2-(acetylthio)acetyl]- 1,3-thiazolidine (18a) as an interesting lead compound. The careful study of the rapid and very complicated metabolism of 18a provided further insights for the design of newer related derivatives. The observation that the metabolic oxidation on the lateral chain's sulfur of 18a to sulfoxide maintained the antitussive properties suggested the introduction of isosteric functional groups with respect to the sulfoxide moiety. Subsequent structural modifications showed that hydrolyzable malonic residues in the 3-position of the thiazolidine ring were able to assure high antitussive activity. This optimization ultimately led to the selection of moguisteine (7) as the most effective and safest representative of the series. Moguisteine is completely devoid of unwanted side effects (such as sedation and addiction), and its activity was demonstrated also in clinical studies.
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PMID:N-acyl-2-substituted-1,3-thiazolidines, a new class of non-narcotic antitussive agents: studies leading to the discovery of ethyl 2-[(2-methoxyphenoxy)methyl]-beta-oxothiazolidine-3-propanoate. 785 44

We analyzed 55 confirmed cases of tuberculosis in patients over 65, a sample that amounted to 9% of all patients seen in our practice over a period of 5 years. Mean age was 72.4 and the male/female ratio was 4/1. The most frequently associated diseases were tobacco addiction (49%), chronic obstructive pulmonary disease (33%), alcoholism (25%) and prior diagnosis of tuberculosis (20%). Lung involvement was the most common clinical presentation (76%), followed by pleural (9%) and skeletal (7%) involvement. The clinical picture was non specific, with 13% remaining asymptomatic. Cough was the most frequent symptom (45%) and unilateral apical fibrosis with ulceration was the most frequent radiological finding. Pleural discharge and cavitation were demonstrated in 14 and 22%, respectively. Scarring was visible on X-rays in 44%. The tuberculin test was positive in 88% of the cases in which it was performed. Mean delay in diagnosis was 3.4 months; 62% were diagnosed by sputum test, 11% by culture, and 27% histology. In 4% death was directly caused by tuberculosis. Three patients withdrew from treatment, in one case treatment failed, and there was one relapse detected at follow-up. We observed adverse side effects in 33%, and found no statistically significant differences between the 2 therapeutic protocols used (2 months RHS/7 months RH and 2 months RHZS/4 months RH). The incidence of tuberculosis among the elderly is low in our practice and the entity behaves much as it does in the rest of the adult population. Both the efficacy and tolerance of treatment can be considered optimal.
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PMID:[Efficacy and tolerance of the treatment of tuberculosis in the aged]. 863 89

A non-combustible nicotine inhaler, administered orally, has been developed for treatment of smokers. The inhaler allows weaning from nicotine while maintaining partial reinforcement of the ritual/sensory phenomena of smoking. Subjects were randomly assigned to active (n = 112) and placebo (n = 111) groups. Some behavioral intervention occurred as a function of participation. Strict abstinence (primary outcome criterion) was defined by CO < or = 8 ppm with no slips allowed at any time and cotinine values < or = 14 at 1 year. Survival analysis showed active inhaler was superior to placebo (p < 0.01). Active vs. placebo success rates were: 63% vs. 47% (day 3), 46% vs. 28% (week 1), 36% vs. 19% (week 2), 33% vs. 16% (week 3), 29% vs. 14% (week 6), 24% vs. 10% (3 months), 17% vs. 9% (6 months) and 13% vs. 8% (1 year). chi 2 analyses were significant through 3 months but not at 6 months (p < 0.08) or 1 year. Craving was relieved with active inhalers at day 3 and week 1. Subjects averaged six inhalers/day. Cotinine levels were 57-61% of smoking levels. Common side effects included throat/mouth irritation and coughing. Failure was predicted by early slips. The inhaler is clearly useful for short-term smoking cessation with potential for long-term efficacy. Extended access to the inhaler and relapse prevention training could improve success rates. Another promising approach would be to combine the inhaler with a nicotine patch.
Addiction 1996 Sep
PMID:Efficacy of a nicotine inhaler in smoking cessation: a double-blind, placebo-controlled trial. 885 66

Cough mixture misuse has become a focus of concern in Hong Kong since the late 1980s. Psychiatric admissions related to cough mixture misuse have been reported with increasing frequency during the past 5 years. A retrospective chart review of psychiatric admissions related to cough mixture misuse for a 54-month period was conducted in two psychiatric units in Hong Kong. Twenty-seven subjects were identified. The main psychiatric presentations included acute organic brain syndrome, schizophreniform psychosis and affective episode. They appeared to be associated with the pharmacological activities of opiates, antihistamines and sympathomimetics, the main ingredients of most cough mixtures.
Addiction 1996 Sep
PMID:Cough mixture misuse in Hong Kong--an emerging psychiatric problem? 885 73


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