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)

Patients with cough may be conveniently divided into those with acute, usually viral, illness and those with chronic cough. Acute cough represents the largest single cause of consultation in primary care, whereas chronic cough is one of the commonest presentations in respiratory medicine. The world-wide market in cough treatments is several billion dollars. In both syndromes, cough sensitivity is upregulated, but the inflammation giving rise to cough is localised to the larynx and large airways in acute cough. Whilst this is also true of cough-predominant asthma, the origin of cough in chronic disease may also lie in the oesophagus, nose or sinuses leading to errors in diagnosis and treatment.
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PMID:Epidemiology of cough. 1209 81

The practice guideline 'Acute cough' from the Dutch College of General Practitioners stresses the fact that a cough of less than 3 weeks' duration seldom heralds serious pathology. However, for sound reassurance of patients presenting with a cough of short duration, the general practitioner needs to know much about the signs and symptoms connected to low-prevalence serious pathology in these patients. The practice guideline distinguishes upper and lower respiratory tract infections and defines serious lower respiratory tract infection. The diagnostic value of symptoms and laboratory findings like a sedimentation rate or C-reactive protein in order to make such distinctions, is not explained in detail. Antibiotics are reserved for serious lower respiratory tract infection with the exception of acute bronchitis, croup and bronchiolitis, which can be treated without antibiotics. Recommendations for treatment of acute bronchiolitis with bronchodilators or corticosteroids, and croup with corticosteroids are based on consensus. This practice guideline can be considered as a clear and valuable piece of work for all physicians in primary and secondary care.
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PMID:[The practice guideline 'Acute cough' from the Dutch College of General Practitioners; a response from the perspective of general practice]. 1511 6

Coughing is one of the most prevalent symptoms for which patients seek medical attention. Acute cough is defined as a symptom that lasts less than 3 weeks, is mostly transient and with minor consequences. Upper airway infections, and especially the common cold, are the main cause of acute cough. Acute cough is only occasionally due to life-threatening causes like severe pneumonia or pulmonary embolism. The Dutch College of General Practitioners has issued a comprehensive, practical guideline for diagnosis and treatment of acute cough. As viral infections are the most prevalent cause of acute cough, the guideline emphasises the need to be as cautious as possible with the prescription of antibiotics. Unfortunately, a paragraph on the causes of reduced cough effectiveness, which may lead to a more complicated course of illness, is missing from this guideline. Hopefully, this guideline will lead to a more standardized approach to patients presenting with acute cough.
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PMID:[The practice guideline 'Acute cough' from the Dutch College of General Practitioners; a response from the perspective of pulmonology]. 1528 30

Cough is among the most common complaints for which patients seek medical attention. Acute cough, usually due to a viral upper respiratory tract infection, generates a huge expenditure on prescription and over-the-counter cough and cold preparations worldwide. Most of these agents, however, have not been shown to be more effective than placebo in adequately performed clinical trials. The goal of management in chronic cough is treatment of its underlying cause. However, certain situations will necessitate cough suppressant therapy for symptomatic relief. Unfortunately, currently available antitussives, such as the opioids, are not consistently effective, or achieve therapeutic effect at the expense of unpleasant or intolerable side effects. Safer and more effective cough suppressants are desperately needed. Potential novel antitussives will need to be evaluated in properly formulated clinical trials, measuring relevant subjective and objective end points in appropriate subject populations.
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PMID:Currently available antitussives. 1877 44

Acute cough due to viral upper respiratory tract infection (URI) is the most common form of cough and accounts for tremendous expenditure on prescription and non-prescription cough products worldwide. However, few agents have been shown in properly conducted clinical trials to be effective for cough due to URI. The present study evaluated the effect of benzonatate 200mg (B), guaifenesin 600 mg (G), their combination (B+G), and placebo (P) on capsaicin-induced cough in 30 adult nonsmokers with acute URI. On 3 separate days within a 7-day period, 1h after ingesting randomly assigned study drug in a double-blind fashion, subjects underwent capsaicin cough challenge testing, which involved inhalation of incremental doubling concentrations of capsaicin until the concentration of capsaicin inducing 5 or more coughs (C(5)) was attained. Each subject received 3 of 4 possible study drugs. G (p=0.01) but not B (p=NS) inhibited cough-reflex sensitivity (log C(5)) relative to P. The combination of B+G suppressed capsaicin-induced cough to a greater degree than B alone (p<0.001) or G alone (p=0.008). The mechanism by which the combination of B+G causes a potentiation of antitussive effect remains to be elucidated. Our results suggest that B+G may be an effective therapy for acute cough due to the common cold (URI).
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PMID:Inhibition of cough-reflex sensitivity by benzonatate and guaifenesin in acute viral cough. 1912 73

Acute cough may cause considerable distress for patients with upper airway infections, and is a symptom commonly presented to doctors. We wanted to assess the evidence basis for pharmacological treatment of this condition. Predefined terms (MeSH and Emtree) and free text were used to search PubMed and Embase for double-blind randomized trials, reviews and guidelines. Little evidence supports the use of guaifenesine, bromhexine and acetylcysteine for acute cough associated with upper airway infections. Likewise, there is insufficient evidence to decide whether noscapine, codeine and ehylmorphine are beneficial for acute cough on this indication. Well-designed randomized controlled trials with valid outcomes are needed to document possible benefits of treatment. Treatment with codeine or ethylmorphine may be at the expense of adverse effects, abuse or dependence.
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PMID:[Pharmacological treatment of acute cough]. 1944 53

Acute cough is a major symptom of viral respiratory tract infection and causes excessive morbidity in human populations across the world. A wide variety of viruses play a role in the development of cough after acute infection and all of these manifest a similar clinical picture across different age groups. Despite the large disease burden surprisingly little is known about the mechanism of acute cough following viral infection. Both in vitro and in vivo experiments show that increased production of neuropeptides and leukotrienes mediate cough after viral infection, along with altered expression of neural receptors. Increased airway mucus production is also likely to play a significant role. This work is reviewed in this article. Following the recent development of a mouse model for rhinovirus infection and the establishment of experimental models of rhinovirus challenge in human subjects with both asthma and COPD the field is expanding to translate in vitro research into clinical studies and hopefully eventually into clinical practice. Developing a clearer understanding of the mechanisms underlying virus induced cough may lead to more specific and effective therapies.
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PMID:Cough and viruses in airways disease: mechanisms. 1948 62

Acute cough is among the most common symptoms for which patients seek medical attention. It accounts for millions of days lost from school and work and billions of dollars spent on medical care. Acute cough is defined as cough present for 3 weeks or less. It most often is caused by a viral infection of the upper respiratory tract ("common cold") or lower respiratory tract (i.e., "acute bronchitis"). The most effective treatment for cough due to the common cold is a combination first-generation antihistamine plus decongestant. Antibiotics are not indicated for most cases of acute cough. Occasionally, acute cough can be a symptom of a life-threatening condition.
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PMID:Clinical approach to acute cough. 1969 82

Cough is a common and important respiratory symptom that can produce significant complications for patients and be a diagnostic challenge for physicians. An organized approach to evaluating cough begins with classifying it as acute, subacute, or chronic in duration. Acute cough lasting less than 3 weeks may indicate an acute underlying cardiorespiratory disorder but is most commonly caused by a self-limited viral upper respiratory tract infection (eg, common cold). Subacute cough lasting 3 to 8 weeks commonly has a postinfectious origin; among the causes, Bordetella pertussis infection should be included in the differential diagnosis. Chronic cough lasts longer than 8 weeks. When a patient is a nonsmoker, is not taking an angiotensin-converting enzyme inhibitor, and has a normal or near-normal chest radiograph, chronic cough is most commonly caused by upper airway cough syndrome, asthma, nonasthmatic eosinophilic bronchitis, or gastroesophageal reflux disease alone or in combination.
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PMID:Cough: a worldwide problem. 2017 52

Cough is among the most common complaints for which patients worldwide seek medical attention. Thus, the evaluation and treatment of cough result in tremendous financial expenditure and consumption of health care resources. Yet, despite the clinical significance of cough, research efforts aimed at improving diagnostic capabilities and developing more effective therapeutic agents have been, to date, disappointing in their limited scope and outcomes. Acute cough due to the common cold represents the most common type of cough. Currently, available medications for the symptomatic management of acute cough are inadequate due to lack of proven efficacy and/or their association with undesirable or intolerable side effects at anti-tussive doses. Subacute cough, often representing a prolonged post-viral response, is typically refractory to standard anti-tussive therapy. Few clinical trials have evaluated therapeutic options for subacute cough. Diagnostic challenges facing the clinician in the management of chronic cough include the determination of whether symptoms of upper airway cough syndrome (formerly, postnasal drip syndrome) or gastro-oesophageal reflux disease are indeed the underlying cause of cough. Chronic, refractory unexplained (formerly, idiopathic) cough must be distinguished from cough that has not been fully evaluated and treated according to current guideline recommendations. Eagerly awaited are new safe and effective anti-tussive agents for use when cough suppression is desired, regardless of underlying aetiology of cough, as well as practical, validated ambulatory cough counters to aid clinical assessment and future research in the field of cough.
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PMID:Cough: an unmet clinical need. 2119 55


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