Cough by Arnold Kremer, D.O.

Did you know that cough is responsible for 30 million medical visits yearly or 40 percent of patient volume?

Acute cough is usually less than 3 weeks and most often due to a respiratory infection.  Differential diagnosis includes, but is not limited to chronic obstructive pulmonary disease (COPD), pneumonia, and pulmonary embolism.

Subacute cough is 3-8 weeks with chronic cough being greater than 8 weeks.

The most common causes for subacute and chronic coughs is post-nasal drip, asthma, GERD, or post-infections, usually self-limiting.  Upper airway cough syndrome can include post-nasal drip, allergic and perennial non-allergic vasomotor rhinitis (a condition that causes chronic sneezing, congestion, or runny nose) and nasopharyngitis (a cold).  Ace inhibitors can cause chronic cough in 15 percent of patients on these medications.   Less common causes of chronic cough include, but are not limited to bronchogenic carcinoma, occult heart failure, occult aspiration, tracheobronchial foreign body, occupational asthma, nasal polyps, or psychogenic.

Asthma is the second leading cause of cough and the most common cause in children.

Acute bronchitis-cough lasts at least 5 days (often 1-3 weeks) and doesn’t have findings suggestive of pneumonia (fever, tachypnea, rales) and doesn’t have COPD. The patient may or may not have wheezing.

Chronic bronchitis-cough with sputum over at least 3-month period and can even continue for consecutive years, which is usually seen in smokers.  Treatment is smoking cessation counseling.

For post-nasal drip (upper airway cough syndrome) treatments are:

  • FlonaseArnold Kremer web, D.O.
  • Nasonex
  • Chlorpheniramine
  • Cetirizine
  • Loratadine

Those with excess somnolence may be prescribed azelastine or intranasal ipratropium.

Cough variant asthma treatments include inhaled glucocorticoids and as-needed bronchodilators.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.


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