SARKAR, RUHIT
2200938
MD-3E
LGD-2, SGD-3
DEFINITION
Cough is an essential reflex that protects the
airways and lungs by clearing out harmful
substances like mucus or foreign particles.
A weak cough can lead to complications like
infections or respiratory distress, while
excessive coughing can cause exhaustion, pain,
and even social discomfort.
Cough can signal respiratory diseases, and
persistent cough often leads to medical
attention.
EPIDEMIOLOGY
Cough is common worldwide and can result from
various conditions such as respiratory infections,
smoking, and environmental factors like air
pollution. In areas with high tuberculosis
prevalence, a persistent cough may signal active
pulmonary tuberculosis, which requires immediate
attention. Chronic cough is also linked to exposure to
pollutants in poorly ventilated homes, workplaces,
or outdoor environments.
ETIOLOGY OF COUGH
1. Acute Cough (<3 weeks):
- Respiratory tract infection
- Aspiration
- Inhalation of noxious chemicals or smoke
2. Subacute Cough (3-8 weeks):
- Tracheobronchitis (e.g., pertussis, postviral cough)
3. Chronic Cough (>8 weeks):
- Common Causes:
- Asthma (including cough-variant asthma)
- Gastroesophageal reflux disease (GERD)
- Rhinosinusitis with postnasal drainage
- Medications (e.g., ACE inhibitors)
- Chronic bronchitis (e.g., in smokers)
4. Chronic Cough with Normal Chest X-ray:
- ACE inhibitor use
- Postnasal drainage
- GERD
- Cough hypersensitivity syndrome
CLINICAL FEATURES
Cough can occur with other respiratory symptoms
like wheezing or shortness of breath, or it may
present alone. Based on duration:
Acute cough (<3 weeks) often results from
infections or irritants.
Subacute cough (3–8 weeks) may follow
bronchitis.
Chronic cough (>8 weeks) is often related to
conditions like asthma, GERD, or postnasal drip.
A detailed patient history and physical examination
help identify potential causes of chronic cough, but
sometimes chest radiography or more advanced
diagnostic tests are needed.
MECHANISM OF COUGH
PHASES OF COUGH
TYPES OF COUGH
OTHER TYPES:
BRASSY COUGH (Metallic)
BOVINE COUGH (Loss of Explosive Nature)
WHOOPING COUGH (Continuous Cough f/b Deep Inspiration)
NOCTURNAL COUGH
MORNING COUGH
EXERCISE/ EXERTION INDUCED
SUPPRESSED COUGH
DIAGNOSTICS
Chest Radiograph: Initial test for chronic cough; helps
identify serious conditions like tumors or infections.
Sputum Analysis: Examines mucus for infections or
malignancy.
pH Probe and Manometry: Measures reflux and
esophageal pressures for GERD evaluation.
Spirometry: Assesses asthma by measuring airflow
and reversibility.
SPUTUM CHARACTERISTICS
Viral Infection
COPD,Chronic Bronchitis
P. Aeruginosa, Bronchial Asthma
[Link]
Klebsiella
Pneumoconiosis
Liver Abscess(Ruptured)
Pulmonary Edema
Lung Abscess, Aspitation Pneumonitis
MEDICATIONS FOR COUGH
PHARYNGEAL DEMULCENT:
LOZENGES, COUGH DROPS, LINTUSES
EXPECTORANTS:
BRONCHIAL SECRETION ENHANCERS: SODIUM OR POTASSIUM
CITRATE
MUCOLYTICS: BROMHEXINE, ACETYLCYSTEINE
ANTITUSSIVES:
OPIOIDS: CODEINE
NON-OPIOIDS: DEXTROMETHORPHAN
ANTI-HISTAMINES: DIPHENHYDRAMINE
ADJUVANT ANTITUSSIVES: SALBUTAMOL
TREATMENT AND MANAGEMENT
Antibiotics
Smoking Cessation
Anti-TB Therapy (RIPE)
Albuterol, Cortisone
Diethylcarbamazine (DEC)
Antibiotics
H1- Anti Histamines
PPI,H2-Anti Histamines
Telmisartan
No Treatment
