COUGH
| · Reflux Phenomenon, as a part of Body defence when pathways irritated.
· Most common Cause: INFECTION. · Can be Dry Cough or a/w Sputum. |
|
| Dry cough:
URTI Viral bronchitis Hycoplasma pneumonia Whoopi ng cough Pleurisy Bronchogenic carci noma
Productive cough Bronchiectasis Chronic bronchitis Pneumonia Lung abscess Post nasal drip.
|
|
| Cough > 3 weeks not responding to antibiotics à Chest X Ray PA view & sputum culture requiredà R/O TB
Atypical Pneumonia |
|
| General instructions for cough management
· Steam i nhalations 2-3 times/day . Add to water Tinc.Benzoi ne, Vicks / Ayurvedic steam capsules. · Warm salt water gargles. · Take Hot drinks Li ke Hot tea / Ayush laada. · Severe cough Advise rest at home (voice rest) · Stop smoki ng. · Use lozenges. · Cover mouth while coughi ng. |
|
| FOR BRONCHODILATION & EXPECTORATION
Syrup ASCORIL /CAPABRON 2TSP TDS x 3days (Terbutali ne Sulphate + Bromhex ine + Guaiphensi n) Syrup ASTHALIN <6yrs :5-10 TID (Salbutalmol Sulphate) 6-12 yrs: 10ml TID Tab. MUCINAC (Acetyl cysteine) 600mg BD/TID i n water. |
|
| FOR COUGH SUPPRESSION
1. Syrup VISCODYNE D 2tsp TDS x 3 days (Dextromethorphan hydrobrom1de + Chlorpheneramine Maleate) 2. Syrup ALEX 2tsp TDS x 3days (De tromethorphan Hydrobromide, Phenyl phri ne hydrochloride & Chlorphenerami ne Maleate) Dosage 1-5 years – 1.25 ml 6-12 yr – 2.5 ml >12 yr – 5ml TID 3. SYP. AMBROLITE D 2tsp TID.
|
|
| FOR PREGNANT
1. Syp. ASCORIL (Terbutali ne sulphate + Bromhexi ne +Guaiphensi n ) 2. Syp. BENYLIN (Diphenhydrami ne HCl, Dextromethorphan -Guaiphensi n. Dextromethorphan HBR) |
|
| FOR DIABETICS
1. ASCORIL SF : Bromhexi ne hydrochloride.guai phenesi n + Terbutali ne. 2. MACBERY XT: Ambroxol + Guaifenesi n + Terbutali ne. 3. BENYLIN Adult : Diphenhydrami ne HCl .Dextromethorpha n-Guaif enesin.Dextromethorphan HBR. 4. ALEX sugar free : Dextromethorpha n Hydrobromide. Phenylephri ne, hydrochloride & Chlorphenerami e oleate. · Always ask GERD in case of Dry Cough. |
|
| CHRONIC COUGH
· a/w Fever –+ s/o Infective cause · a/w Wheezi ng +s/o Asthmatic bronchitis/chronic bronchitis Is it dry /with expectoration · Character of sputum · Cough more in Lying position –+ s/o Post nasal drip Sinusitis GERD Stum Blood stained à s/o Pulmonary TB,Bronchiectasis.Pneumonia,Ca Bronchus • Cigarette smoker à s/o smokers bronchitis or malig nancy • Loss of weight à s/o TB,HI V,mallgnancy • h/o contact with TB Pt . à s/0 PT B • Polluted workplace à s/o Pneumoconiaslis, Asbetosl s • Exposu re to pets/bi rdsà s/o Psittacosis Edema of feel & Exertional dyspnea à s/o Left ventricular Failur. |
|
| Lab Test
If no response, ask for investigation I. Hb%, WBC for eosinophilia. II. X-ray chest for TB, pneumonia etc. III. Blood for Sugar & HIV test. IV. Spirometry. |
|
| Indication for immediate X-ray
I. Cough > 15 days. II. Chest pain on breathing, high fever or dyspnea. III. Rales, cavity or abnormal breath sounds. IV. Loss of weight or gross emaciation. V. Hemoptysis VI. No response to antibiotics for 1wk. |