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Cough Symptomatic TreatmentAka: Cough Drops, Cough Preparation, Intractable Cough, Cough Management

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  1. See Also
    1. Chronic Cough
    2. Cough Suppressant
    3. Cough Expectorant
  2. Management: General measures to relieve cough
    1. See Cough Suppressant
    2. Cough drops
      1. Children over age 4 years only (risk of Choking)
      2. Eucalyptus oil may be best
    3. Homemade cough syrup
      1. Teaspoon honey or corn syrup and 2 drops lemon juice
      2. Avoid honey in younger than 1 year (Botulism Risk)
    4. Warm brews (warm liquids are usually soothing)
    5. Humidifiers may loosen Sputum produced with cough
    6. Mentholated ointment (e.g. Vicks)
      1. Avoid camphor products under age 2 years (risk of absorption and hepatotoxicity)
      2. No proven benefit, but may be soothing
  3. Management: Avoid activities provoking cough
    1. Exercise may trigger coughing spasms
    2. Tobacco Smoke (active or passive) should be avoided!!
      1. Continued smoking will prolong cough for weeks
  4. Management: Treat suspected underlying cause of cough
    1. Allergic Rhinitis: Antihistamine, Nasal Corticosteroid (e.g. Flonase) or Singulair
    2. Acute Bronchitis: Albuterol MDI or Advair
    3. Asthma Exacerbation: Albuterol MDI and Inhaled Corticosteroid (e.g. Advair)
    4. Postnasal Drainage: Nasal Saline and Mucinex
    5. Gastroesophageal Reflux Disease: Antacid Medication (e.g. Proton Pump Inhibitor)
  5. Management: Paroxysmal Cough without RAD exacerbation
    1. Nebulized Lidocaine Solution (2% or 4%)
      1. Dilute in 5 cc Normal Saline
      2. Maximum: 3 mg/kg maximum
  6. Efficacy: nonprescription Cough Preparations
    1. No clear benefit of any agent compared with Placebo
    2. Many agents are associated with adverse effects
    3. Schroeder (2002) BMJ 324:329

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