3 minute read
Cough
COPING WITH COUGH
Cold and flu season is the time of the year when pharmacists are more likely to see patients scanning the pharmacy shelves in search of the perfect remedy to manage a cough. Patients may be overwhelmed by the numerous OTC cough products, but pharmacists are in an ideal position to evaluate and aid patients in selecting a cough product for self-treatment, as well as to encourage patients to seek further medical care when warranted.
During winter, most coughs are caused by viruses such as colds and flu and can be safely managed at home using OTC remedies. Coughs are classified as “acute” or “chronic”. An acute cough is most common and lasts up to three weeks. It’s usually caused by a cold or flu virus and most improve after one to two weeks.
SYMPTOMS
Chronic cough lasts for eight or more weeks. The most common causes include acid reflux, asthma, TB, COPD, bronchitis and smoker’s cough. Red-flag signs include:
Coughing up blood Unexplained weight loss
Night sweats
Cough worsening after three weeks
Shortness of breath
Voice changes
Lumps/swellings in neck
Chest pain
Dry or chesty cough?
A dry cough is caused by inflamed airways due to a viral infection such as a cold or flu. A chesty cough produces phlegm. This is caused by the lungs producing extra fluid due to an infection.
It is important to get a detailed overview of the patient’s symptoms. Is their cough productive? How long have they had the cough and what action has been taken? Pharmacists should ask if a patient has any medical conditions that may affect any treatment or product you recommend. Coughs can be described by: Behavior or experience. When and why does the cough happen? Is it at night, after eating, or while exercising? Characteristics. How does your cough sound or feel? Hacking, wet, or dry? Duration. Does your cough last less than 2 weeks, 6 weeks, or more than 8 weeks?
Effects. Does your cough cause related symptoms such as urinary incontinence, vomiting, or sleeplessness? Grade. How bad is it? Is it annoying, persistent, or debilitating?
TREATMENT
The role of cough medicine is to ease symptoms while the body heals. There are many brands of OTC cough medicines. Expectorants help thin mucus, making it easier to cough up. The ingredient is guaifenesin. Suppressants help cut the number of times someone coughs. The active ingredient listed is usually dextromethorphan (DM). Other cough suppressants include camphor, eucalyptus oil, and menthol. Combination cough products have more than one active ingredient. They have both guaifenesin and dextromethorphan. Cough medicines may also contain ingredients to help coat and soothe the throat. Combination products may have medicines to ease other symptoms, that may include decongestants for stuffy nose, antihistamines for allergies or a runny nose, or painkillers. Cough drops can also help relieve a cough and may ease a sore throat.
COUGH IN CHILDREN
When temperatures start turning colder and kids are inside and interacting with each other in greater numbers, cold and flu season inevitably follows. Children under the age of 6, and particularly under age 2, are at an especially high risk during cold and flu season. Whilst it is known that antibiotics won’t help when it comes to clearing up an infection, there are steps pharmacists can advise parents to take to help their child feel better while their immune system battles the virus.
When to refer
Children with a cough should be seen by a doctor if they: have a cough for more than 3 weeks have a fever above 102°F (38.89°C) or any fever in children ages 2 months and younger become so out of breath that they can’t talk or walk turn bluish or pale are dehydrated or unable to swallow food are extremely fatigued make a “whoop” noise during violent coughing attacks are wheezing in addition to coughing
