Clinical Reference Systems: Pediatric Advisor 10.0

DESCRIPTION

• The cough reflex expels air and secretions from the lungs with a sudden explosive noise.
• The cough can be dry and hacking or wet and productive.
• A coughing spasm is more than 5 minutes of continuous coughing.

CAUSE

Most coughs are caused by a viral infection of the trachea (windpipe) or bronchi (larger air passages in the lungs). These infections are called tracheitis and bronchitis, respectively. Most people get a cough infection a couple of times a year as part of a cold. Keep in mind that coughing clears the lungs and protects them from pneumonia. Bronchitis isn't serious.

EXPECTED COURSE

Usually bronchitis causes a dry tickly cough that lasts 2 to 3 weeks. Sometimes the cough becomes loose (wet) for a few days, and you cough up a lot of phlegm (mucus). This is usually a sign that the end of the illness is near.

HOME CARE

1. Medicines to loosen the cough and thin the secretions
   • Cough drops: Most coughs can be controlled by sucking on cough drops or hard candy freely. Any brand will do. These help coat the irritated throat.
   • Warm liquids for coughing spasms: Warm liquids usually relax the airway and loosen up the mucus. Start with warm lemonade, warm apple juice, or warm herbal tea.

2. Cough-suppressant medicines

   Cough-suppressant drugs reduce the cough reflex. However, the cough reflex helps protect the lungs. Use cough-suppressant drugs only for dry coughs that interfere with sleep, school attendance, or work. They also help people who have chest pain from coughing spasms.

   Most nonprescription cough suppressants contain dextromethorphan (DM). You need the medicine recommended by your physician.

   You may want to use cough drops during the day and DM at bedtime and during the night. DM is also available as a cough lozenge and as a long-acting liquid (effective for 12 hours).

3. Humidifiers in the treatment of cough

   Dry air tends to make coughs worse. Dry coughs can be loosened up by drinking extra water and by using a humidifier in your bedroom.

4. Exercise

   You will find that gym and exercise trigger coughing spasms when you have bronchitis. If so, you should avoid such physical activity temporarily.

5. Active and passive smoking

   Don't be around anyone who smokes. Also avoid smoking since a cough may last weeks longer than it would without smoking.

6. Common mistakes in treating cough

   Antihistamines, decongestants, and antipyretics are found in many cough syrups. There is no proof that these ingredients will help your cough, and the antihistamines may make you sleepy. Expectorants are of unproven value but harmless. Stay with the simple remedies mentioned above or use dextromethorphan (DM).

   Milk does not need to be eliminated from the diet. Restricting it improves the cough only if you are allergic to milk.

CALL YOUR PHYSICIAN IMMEDIATELY IF:

• Breathing becomes fast or labored (when you are not coughing).

CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:

• A fever (over 100 degrees F, or 37.8 degrees C) lasts more than 3 days.
• The cough lasts more than 3 weeks.
• You have other concerns or questions.