coughs

• Coughs

  Body's normal response to try and clear the airway of mucus/irritants
• Non-coloured, clear sputum

  • Meaning non-infected
• Green, yellow/ brown phlegm/mucus

  • Indicates bacterial infection warranting referral
• Productive cough

  Excess sputum is secreted in response to an irritation of the airways, classed as productive if patient coughs and can hear mucus on the chest as well
• Non-Productive cough

  Dry, tickly throat. Irritating cough, that can be worse at night.
• Causes of cough

  • Smoking
  • Heartburn (acid reflux)
  • Allergies
  • Hay fever
  • Post nasal drip - mucus dripping down the the back of the nose into the throat
• cough treatments : Expectorants

  Guaifenasin, Ipecacuanha, Ammonium chloride, Squill. (chesty cough treatment only)
• cough treatment: Cough Suppressant

  Pholcodine, Codeine, Dextromethorphan. (dry cough treatment only)
• Cough treatment: Antihistamines

  Diphenhydramine, Promethazine. (sedating antihistamines, dry up secretions that may be triggering the cough/ also helps aid sleep)
• Cough treatment: Soothing agents/ Demulscents

  Glycerin, Lemon & Honey, Simple Linctus. (coat the back of the throat to create a soothing effect, suitable for patients who can't tolerate medicated cough mixtures)
• Cough REFER?

  > 3 weeks

  > green, yellow, brown sputum

  > blood in sputum- pink & frothy (suspect Heart failure)

  > dark red may indicate tuberculosis. Rusty coloured may indicated community acquired pneumonia

  > Barking cough (suspect croup)

  >Difficulty breathing

  > Chest pain

  >very bad cough/quickly worsens (hacking cough and cannot stop)

  > feeling very unwell

  > unexpected weight loss

  > side of patients neck feels swollen & painful (swollen glands)

  > patient has a weak immune system - chemotherapy or diabetic patient

  >Ace inhibitors (dry cough especially on initial treatment )
• Counselling for cough


  > Chesty cough mixtures are licensed for 6 years old and above

  > Combined cough mixtures can contain pseudoephedrine/decongestants careful in BP/heart patients

  >Unproductive/dry cough - commonly caused by viral infections and is self limiting

  >drink plenty of fluids

  > avoid smoking

  >Robitussin range is sugar free- suitable for diabetics

  >children remember sodium chloride NASAL drops to unblock the nose- helps ease coughs