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)

Using radiolabeled, monodispersed aerosols (99mTc-iron oxide) and gamma camera analysis, we measured the efficacy of cough for clearing mucus from the airways of the lung following inhalation of the bronchodilator ipratropium bromide (IB) (Atrovent, Boehringer Ingelheim, Inc), a drug that has been shown to have no effect on mucociliary clearance in COPD. Clearance of radiolabeled aerosol was studied over a 2.5-h period on three separate days, a control day with no coughing, and two study days during which the patient performed controlled cough maneuvers over the course of clearance measurements following IB or placebo therapy (double blind, crossover). Fifteen patients, age > 45 years, with stable moderate-to-severe airway obstruction (mean FEV1/FVC = 0.45) were studied. IB diminished the effectiveness of cough for clearing the radiolabeled particles from the airways. This effect of IB on cough clearance may be due to (1) changes in the airflow dynamics induced by bronchodilation or (2) altered rheology or depth of airway secretions.
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PMID:The acute effect of ipratropium bromide bronchodilator therapy on cough clearance in COPD. 843 42

Acute exacerbations of chronic bronchitis can be recognized clinically by (1) increased cough and dyspnea, (2) a change in character of sputum, and (3) an increase in quantity of sputum. Routine chest radiographs are probably not warranted in initial evaluation. Therapy is aimed at control of inflammation, infection, bronchoconstriction, and mucin production. Corticosteroids improve flow rates in patient with respiratory insufficiency. Antibiotic therapy appears to decrease hospital stay and improve flow rates in patients with bacterial infection, as determined by sputum examination or the presence of two of the following symptoms: increased dyspnea, increased sputum production, purulent sputum. Gram's stain of expectorated sputum often allows targeted and cost-effective therapy. Ipratropium bromide (Atrovent) is the bronchodilator of choice; concomitant use of beta agonists has additional benefit. Research on future therapy may focus on the role of corticosteroids, mucolytic agents, and drugs that counteract the effects of neutrophil elastase. Smoking cessation is the first step in prevention. Antibiotic prophylaxis is warranted only in patients with four or more exacerbations per year. Pneumoccoccal and influenza vaccinations are effective and safe; unfortunately, they are underutilized at present.
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PMID:Acute exacerbations of chronic bronchitis: focusing management for optimum results. 860 17


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