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Understanding Cough: Types and Treatments

Cough is a forceful expulsion of air from the lungs against a closed glottis, removing foreign substances. It involves 4 phases: irritation, inhalation to generate volume, compression of chest muscles to rapidly increase pressure, and forced expiration through an open glottis. The cough reflex is triggered when receptors in the airways or lungs are stimulated, sending a signal to the cough center in the brainstem. This initiates contraction of respiratory muscles to produce a loud expiration or cough. Coughs are classified based on duration and presence of phlegm, and treated initially by rest, hydration, humidification, and avoiding irritants. Antitussive and expectorant drugs aim to control or

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Nadhirah Zulkifli
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263 views4 pages

Understanding Cough: Types and Treatments

Cough is a forceful expulsion of air from the lungs against a closed glottis, removing foreign substances. It involves 4 phases: irritation, inhalation to generate volume, compression of chest muscles to rapidly increase pressure, and forced expiration through an open glottis. The cough reflex is triggered when receptors in the airways or lungs are stimulated, sending a signal to the cough center in the brainstem. This initiates contraction of respiratory muscles to produce a loud expiration or cough. Coughs are classified based on duration and presence of phlegm, and treated initially by rest, hydration, humidification, and avoiding irritants. Antitussive and expectorant drugs aim to control or

Uploaded by

Nadhirah Zulkifli
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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COUGH

 Voluntary or involuntary forceful release of air from lungs usually against a closed glottis, associated with a characteristic sound
 Removing foreign substances and mucus from lungs and upper airways

4 Phases of Cough Reflex

I. Irritation of airways by stimuli


II. Inhalation/inspiration: generates the volume necessary for an effective cough
III. Compression: closure of the larynx combined with contraction of muscles of chest wall, diaphragm & abdominal wall → rapid rise in intrathoracic
pressure
IV. Expulsion/expiration: violent release of air from the lungs, opening of the glottis, accompanied by a distinctive sound

Cough Reflex: Process

Mechano or chemoreceptor (throat, respiratory passages or stretch receptors in lungs) being stimulated  afferent impulse transferred to cough center (in
brain stem & pons) through vagus nerve  efferent impulse transferred via parasympathetic & motor nerve (vagus, phrenic & spinal nerves) to diaphragm,
intercostal muscles, & lungs  ↑ contraction of inspiratory and expiratory muscles  noisy expiration (cough)

Cough Reflex: Components

 Afferent pathway: sensory nerve fibers located in the ciliated epithelium of the upper airways, cardiac, & esophageal branches from the diaphragm
 Central pathway (cough center): located in the upper brain stem & pons
 Efferent pathway:
o from cough center via the vagus, phrenic & spinal motor nerves to diaphragm, abdominal wall & muscles (impulses)
o nucleus retroambigualis sends impulses to the inspiratory & expiratory muscles
o Nucleus ambiguous sends impulses to the larynx
Classification of cough

 Acute cough
- Less than 3 weeks
- Cold, URTI
 Subacute cough
- 3-8 weeks
- Residual cough after an illness/infection has resolved
 Chronic cough
- Longer than 8 weeks
- Caused by medical conditions and medications
 Productive cough
- Phlegm/mucus from lung/nasal sinuses
- Viral, bacterial, postnasal drip, tobacco use, reflux of stomach
 Non-productive cough
- No sputum
- Residual effects of viral, bacterial, bronchospasm, allergies, medications
- Exposure to irritant, asthma, airway blockage
 Nocturnal cough

Initial Treatments of Cough

 Prevent dehydration
 Sleep with extra pillow
 Cough drop
 Use humidifier
 Avoid from inhaling irritants
 Quit smoking
 Try a teaspoon of honey
 Gargle with salt water
 Eat a frozen treat
Classification of Drug for Cough

Centrally acting (ANTITUSSIVE) – aim to control rather than eliminate cough; useful for dry cough or if disturb sleep or hazardous

 Opioids
 Codeine
 Morphine
 Pholcodeine
 Ethylmorphine
 Non-opioids
 Dexomethorphan
 Noscapine
 Pipazethate
 Chlophedinol
 Oxeladin

Peripherally acting

 Pharyngeal demulcents
o Prenodiazine
o Glycerine
o Lozenges
o Linctus containing syrup
o Liquorice
 Expectorants
o Guaifenesin
o Ammonium chloride
o Sodium citrate
o Potassium iodide
o Ipecacuanha
 Mucolytics
o Acetyl cysteine
o Bromhexine
o Ambroxol
o Vasaka
o Carbocisteine

Mucous

 Fibrous gel containing mucoprotein, mucupolysaccharides, protein & fat


 Functions: protect lung tissues, warmth & hydrates the inhaled air, remove foreign particles
 Produced from epithelial goblet cells, bronchial gland, serous transudate

Mucokinetics agents

 Promote drainage of mucus from the lungs


 Help in the clearance of mucus from airways, lungs, bronchi & trachea
 Expectorant, mucolytic agents, & surfactant

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