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PubMedDate not supplied

[Rhinitis and cough syndrome. Are epidemiologic, clinical and functional characteristics useful in the differential diagnosis with bronchial asthma?].

UNLABELLED: Patients often visit family practitioners or respiratory specialists complaining of cough. In non-smokers, the most common cause is postnasal drip secondary to rhinitis. The second most common cause is bronchial asthma. OBJECTIVES: a) To know the epidemiological, clinical and functional features of patients who visit our outpatient pneumology clinic complaining of chronic cough as an isolated symptom, in whom bronchial asthma is suspected, but who have received a diagnosis of rhinitis. b) To analyze the differences between such patients and those in whom chronic cough has been attributed to bronchial asthma. PATIENTS AND METHODS: One hundred thirty-one patients with chronic cough were enrolled for study under the following protocol: 1) taking of a detailed case history (epidemiological and clinical data), 2) physical examination, 3) blood work-up, 4) paranasal sinus and chest X-rays, 5) spirometry at baseline and after 200 micrograms of salbutamol if obstruction was present, 6) methacholine challenge test, 7) skin tests for common respiratory tract allergens, 8) other techniques, depending on suspected diagnosis (CT chest scan, fiberoptic bronchoscopy, consultation with a gastroenterologist or otorhinolaryngologist). RESULTS: One hundred seventeen (89.3%) patients received a diagnosis of rhinitis. Chronic cough was attributed solely to rhinitis in 61 (46.5%) patients. Forty-four (33.5%) were diagnosed as bronchial asthma; 38 (29%) also had rhinitis. Chronic cough was attributed to a different diagnosis in 26 cases (19.8%). The 61 patients with rhinitis as the sole cause of chronic cough were aged 23.8 +/- 10.8 years (9-63 years); 33 (54% of the 61) were men and 28 (46% of the 61) were women. We found that patients with rhinitis more often suffered nasal symptoms (chi 2 = 22.4; p = 0.01), pharyngeal irritation (chi 2 = 9.63, p = 0.05), dry cough from the upper respiratory tract (chi 2 = 16.4, p = 0.001), atopy (chi 2 = 18.1, p < 0.001) and greater FVC (F = 5.28, p = 0.006) than did patients with asthma or other diagnoses. CONCLUSIONS: 1) Rhinitis was the most common cause of chronic cough in the studied patients in whom a diagnosis of bronchial asthma had been suspected. 2) Epidemiological characteristics did not aid differential diagnosis between rhinitis and bronchial asthma (with or without associated rhinitis). 3) A detailed medical history focusing on upper airway symptoms can be useful, although there may be cases of silent postnasal drip syndrome. 4) Paranasal x-rays help to rule out complications of rhinitis. 5) A positive bronchial challenge test does not necessarily indicate a diagnosis of bronchial asthma. 6) Allergy to pollen is the most common finding among atopic patients with rhinitis.

Adult↗
PubMed1975

Studies on the localization of central cough mechanism; site of action of antitussive drugs.

The localization of the central cough mechanism was studied by electrically stimulating the lower brainstem in cats lightly anesthetized with pentobarbital sodium or in unanesthetized midcollicular decerebrate preparations. Cough responses were recorded with the aid of a microphone. The cough responsive region was concentrated in an area dorsomedial to the trigeminal tract and nucleus. The sites of action of antitussive agents (dextromethorphan, codeine, clonazepam, diazepam and caramiphen) were studied on the centrally induced cough responses. Each of these drugs was administered intravenously to determine the dorsal levels for cough suppression. In other series, the threshold dose via the intravertebral route was determined first. Because the agent necessary to prevent cough via this route was so small in amount, recovery usually occurred in 20 to 90 minutes. Then the same agent was given intravenously in an attempt to obtain an effective dose which was close to the minimum dose for blocking the cough. The mean effective doses of these agents to abolish the cough via the vertebral artery were only about 1/20 of those required via intravenous injection. The findings suggest that these agents act centrally to suppress the cough responses. Clonazepam was found to be the most potent antitussive among these agents, the mean effective dose being about 1/35 of that of codeine. The antitussive potency of benzodiazepines is not well correlated with their muscle relaxant activity. For instance, clonazepam and diazepam have the same potency in depressing polysynaptic spinal reflexes, whereas the former is 6 times more potent than diazepam as an antitussive. This finding indicates that clonazepam has a high specificity as an antitussive.

Animals↗
PubMed2001

Are beta2-agonists effective treatment for acute bronchitis or acute cough in patients without underlying pulmonary disease? A systematic review.

OBJECTIVE: Our goal was to determine whether beta2-agonists improve the symptoms of acute bronchitis or acute cough in patients who do not have underlying pulmonary disease. STUDY DESIGN: We performed a systematic review including meta-analysis. DATA SOURCES: We included randomized controlled trials comparing beta2-agonists with placebo or alternative therapies identified from the Cochrane Library, MEDLINE, EMBASE, conference proceedings, Science Citation Index, the System for Information on Grey Literature in Europe, and letters to manufacturers of beta2-agonists. OUTCOMES MEASURED: We measured duration, persistence, severity or frequency of cough, productive cough, and night cough; duration of activity limitations; and adverse effects. RESULTS: Two trials in children with cough and no obvious airway obstruction did not find any benefits from beta2-agonists. Five trials in adults with cough and with or without airway obstruction had mixed results, but summary statistics did not reveal any significant benefits from beta2-agonists. Studies that enrolled more wheezing patients were more likely to show benefits from beta2-agonists, and in one study only patients with evidence of airflow limitation were more likely to benefit. Patients given beta2-agonists were more likely to report tremor, shakiness, or nervousness than those in the control groups. CONCLUSIONS: There is no evidence to support using beta2-agonists in children with acute cough and no evidence of airflow obstruction. There is little evidence that the routine use of beta2-agonists for adults with acute cough is helpful. These agents may reduce symptoms, including cough, in patients with evidence of airflow obstruction, but this potential benefit is not well-supported by the available data and must be weighed against the adverse effects associated with beta2-agonists.

Acute Disease↗
PubMed2003

[The relationship between polymorphism of angiotensin converting enzyme gene and cough caused by angiotensin converting enzyme inhibitors].

OBJECTIVE: To investigate the relationship between the polymorphism of angiotensin converting enzyme (ACE) gene and ACE inhibitor (ACEI)-induced cough in Chinese elderly with essential hypertension. METHODS: ACE I/D polymorphism was performed on DNA samples from patients using the polymerase chain reaction (PCR) followed by agarose gel electrophoresis. Serum ACE levels were measured using a colorimetric assay. RESULTS: The frequencies of ACE II genotype were 40% in patients with cough and 20% in those without cough, respectively (P < 0.05). The frequencies of I allele were 60% in patients with cough and 41% in those without cough (P < 0.01); The serum ACE level was highest in the DD genotype, followed by the ID genotype and the II genotype. The ACE level in patients with cough was significantly lower than that in patients without cough (P < 0.001). The sensitivity and specificity were 81% and 78% respectively when the serum ACE levels were used to predict ACEI-induced cough. CONCLUSION: ACEI-induced cough was related to the serum ACE level and ACE gene polymorphism in Chinese elderly with essential hypertension.

Aged↗
PubMed2004

Evaluation of the patient with chronic cough.

Patients with chronic cough should avoid exposure to irritants that can trigger cough, and those who smoke should stop smoking. Patients who develop chronic cough in association with angiotensin-converting enzyme inhibitor therapy should be switched to an agent from another drug class. If cough persists, a chest radiograph should be ordered to rule out malignancy and other serious conditions. Postnasal drip syndrome, asthma, and gastroesophageal reflux disease are the most likely causes of chronic cough in adults. If postnasal drip syndrome is suspected, a trial of a decongestant and a first-generation antihistamine is warranted. Pulmonary function testing with a methacholine challenge is the preferred test for confirming the diagnosis of asthma. Gastroesophageal reflux disease usually is diagnosed based on the symptoms and after a trial of therapy. If the cause of chronic cough remains unclear, high-resolution computed tomographic scanning of the chest, bronchoscopy, and referral to a pulmonary specialist may be indicated. The approach to diagnosing chronic cough in immunocompromised patients and children is similar to the approach in immunocompetent adults. However, a CD4+ cell count can help determine the potential for opportunistic infections in immunocompromised patients. Respiratory tract infections, asthma, and gastroesophageal reflux disease are the most common causes of chronic cough in children. Foreign body aspiration should be considered in young children. Congenital conditions, cystic fibrosis, and immune disorders are possible diagnoses in children with chronic cough and recurrent infection.

Algorithms↗
PubMed2004

Levocloperastine in the treatment of chronic nonproductive cough: comparative efficacy versus standard antitussive agents.

The medical and social impact of cough is substantial. Current antitussive agents at effective doses have adverse events such as drowsiness, nausea and constipation that limit their use. There is also recent evidence that standard antitussive agents, such as codeine, may not reduce cough during upper respiratory infections. Therefore, there is a need for more effective and better-tolerated agents. The efficacy of levocloperastine, a novel antitussive, which acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree in treating chronic cough, was compared with that of other standard antitussive agents (codeine, levodropropizine and DL-cloperastine) in six open clinical trials. The studies enrolled patients of all ages with cough associated with various respiratory disorders including bronchitis, asthma, pneumonia and chronic obstructive pulmonary disease. Levocloperastine significantly improved cough symptoms (intensity and frequency of cough) in all trials, and improvements were observed after the first day of treatment. In children, levocloperastine reduced nighttime awakenings and irritability, and in adults it was effective in treating cough induced by angiotensin-converting enzyme inhibitors. When compared with other antitussive agents, levocloperastine had improved or comparable efficacy, with a more rapid onset of action. Importantly, no evidence of central adverse events was recorded with levocloperastine, whereas drowsiness was reported by a significant number of patients receiving codeine. Levocloperastine is an effective antitussive agent for the treatment of cough in patients of all ages. It has a more rapid onset of action than standard agents with an improved tolerability profile.

Adolescent↗
PubMed2006

[Etiology and a diagnostic protocol for patients with chronic cough].

OBJECTIVE: The spectrum and frequency of causes and the diagnostic protocol for chronic cough were explored. METHODS: A total of 194 patients with at least 3 weeks of chronic cough and normal chest radiographs were recruited from the outpatient clinic of Guangzhou Institute of Respiratory Diseases between July 2003 to June 2004. The causes were investigated using a well-established protocol. The diagnostic protocol included history inquiring and physical examination, pulmonary function tests, induced sputum cell differentials, 24 h esophageal pH monitoring, CT of the paranasal sinuses or chest, fiberoptic rhinoscopy or bronchoscopy. The final diagnosis was made based on clinical manifestation, examination findings and a positive response to therapy. RESULTS: The cause of chronic cough was defined in 95.4% of the patients, with a single cause found in 153 patients (82.7%), and multiple causes in 32 patients (17.3%). The five most important causes of cough were: eosinophilic bronchitis (n = 51, 22.4%), rhinitis and/or paranasal sinusitis (PNDs, n = 39, 17.1%), cough-variant asthma (n = 31, 13.6%), atopic cough (n = 28, 12.3%), and gastroesophageal reflux (n = 27, 11.8%). CONCLUSIONS: The spectrum and frequency of causes of chronic cough in our study is different from the previous reports in western countries. Eosinophilic bronchitis and atopic cough are important causes of chronic cough. A modified diagnostic protocol was established accordingly.

Adolescent↗
PubMed2006

Effects of thorax irradiation on citric acid-induced cough in guinea pigs.

Thoracic irradiation may cause an acute lymphocytic alveolitis or hypersensitivity pneumonitis. It is well known that cough reflex is sensitized by a number of inflammatory mediators. The purpose of the present study was to investigate the effect of the thoracic irradiation on the cough response in awake guinea pigs. Guinea pigs (Trik strain) were exposed to sham irradiation (n=16), a single irradiation dose of 10 Gy (n=12), and a fractionated irradiation dose (in five fractions) of 15 Gy (n=12) delivered to the thorax. Cough was induced by citric acid aerosol inhalation in gradually increasing concentrations (0.05-1.6 M) during the first week after thoracic irradiation. The cough response was expressed as a total number of coughs induced during all citric acid challenges. Irradiated animals with single dose of 10 Gy exhibited a time- dependent significant increase of citric acid-induced cough in the 6th day after irradiation compared with control animals (P=0.005), whereas cough was not altered significantly in irradiated animals with fractionated dose of 15 Gy. This study demonstrates that the increased cough response may be a determinant of the functional changes of airway nerve-endings mediating cough in the early phase after thoracic irradiation.

Animals↗
PubMed2007

Infant deaths associated with cough and cold medications--two states, 2005.

Cough and cold medications that contain nasal decongestants, antihistamines, cough suppressants, and expectorants commonly are used alone or in combination in attempts to temporarily relieve symptoms of upper respiratory tract infection in children aged <2 years. However, during 2004-2005, an estimated 1,519 children aged <2 years were treated in U.S. emergency departments for adverse events, including overdoses, associated with cough and cold medications. In response to reports of infant deaths after such events, CDC and the National Association of Medical Examiners (NAME) investigated deaths in U.S. infants aged <12 months associated with cough and cold medications. This report describes the results of that investigation, which identified deaths of three infants aged <6 months in 2005, for which cough and cold medications were determined by medical examiners or coroners to be the underlying cause. The dosages at which cough and cold medications can cause illness or death in children aged <2 years are not known. Food and Drug Administration (FDA)-approved dosing recommendations for clinicians prescribing cough and cold medications do not exist for this age group. Because of the risks for toxicity, absence of dosing recommendations, and limited published evidence of effectiveness of these medications in children aged <2 years, parents and other caregivers should not administer cough and cold medications to children in this age group without first consulting health-care provider and should follow the provider's instructions precisely. Clinicians should use caution when prescribing cough and cold medications to children aged <2 years. Moreover, clinicians should always ask caregivers about their use of over-the-counter combination medications to avoid overdose in children from multiple medications that contain the same ingredient.

Analgesics, Non-Narcotic↗
PubMed1991

The effect of altering airway tone on the sensitivity of the cough reflex in normal volunteers.

Cough is frequently the presenting symptom of bronchial asthma, although cough can result from a wide variety of other respiratory disease. Treatment of chronic cough has proved extremely difficult. It has been suggested that treatment with bronchodilators may reduce the symptom of cough. In this study the effect of altering airway tone on the sensitivity of the cough reflex was determined. Twelve normal, healthy volunteers took part. The number of coughs following inhalations of single breaths of doubling concentrations of capsaicin (1.95-500 microM) was recorded before and after doses of salbutamol, methacholine and saline which altered forced expiratory volume in one second (FEV1) by 6.2 +/- 2.6%, -8.8 +/- 3.2% and -0.18 +/- 1.38%, respectively. In a further study the cough response was recorded before and after doses of salbutamol and ipratropium bromide, both of which reduced baseline respiratory resistance and resistance measured after capsaicin. Ipratropium bromide, salbutamol and methacholine, despite having significant effects on airway tone, did not change the sensitivity of capsaicin-induced cough. Thus, if bronchodilator drugs are antitussive in non-asthmatic patients, then this is unlikely to be due to an effect on the sensitivity of the cough reflex.

Adult↗
PubMed1987

Cough and bronchoconstriction.

Cough is frequently a symptom in bronchial asthma. Appropriate treatment of asthma is usually associated with a reduction in cough. The relationship between cough and bronchoconstriction is outlined and the role of various airway receptors in the genesis of the two responses is discussed. Experimentally, cough and bronchoconstriction may be separated: inhalations of iso-osmolar aerosols of low chloride ion content appear to be selectively tussigenic and do not cause broncho-constriction. Numerous irritants induce cough and broncho-constriction. Topical lignocaine will abolish cough but has no effect on bronchoconstriction. Beta-agonists and anticholinergic drugs will reduce or prevent bronchoconstriction induced by an irritant and may suppress cough. Cough is mediated by airway receptors and it is possible that broncho-dilating agents act as cough suppressors because they "reset" airway receptors.

Animals↗
PubMed1987

Glottic closure and high flows are not essential for productive cough.

For about 150 years, there has been emphasis on the importance of glottic closure and high flows in coughing. During voluntary coughing in normal subjects, the main expiratory flow usually begins as thoracic and abdominal pressures are rising. However, sometimes it starts at peak pressure whereas at other times flow and pressure rise together. Plateau flow in single coughs remains relatively constant in the face of large changes in pressure. In a group of coughs following a single inspiration, the fall in pressure is less during plateau flow. Consequently, for the same oral flows, it is likely that the mean linear velocity in the intrathoracic airways will be greater than in a single cough. Recordings have also been made of early morning involuntary coughing in patients with obstructive airways disease. Flow, volume and sound were recorded and sputum expectoration was noted. Sputum expectoration usually occurs after groups of coughs following single inspirations. Hence the movement of the equal pressure point peripherally may be important. These patients have very low flows and yet their coughs are productive. Sound often occurs during the whole of the low flow period immediately before the main expulsive phase. This could only occur if the glottis was open. Thus productive cough can occur without glottic closure and with low airflows.

Asthma↗
PubMed1985

Intravenous lidocaine as a suppressant of coughing during tracheal intubation.

Effects of intravenously administered lidocaine on cough suppression during tracheal intubation under general anesthesia were evaluated in two studies. In study 1, 100 patients received either a placebo or 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. The incidence of coughing decreased as the dose of lidocaine increased. A dose of 1 mg/kg or more of intravenous lidocaine suppressed the cough reflex significantly (P less than 0.01). Coughing was suppressed completely by 2 mg/kg of intravenous lidocaine. In study 2, 108 patients received 2 mg/kg lidocaine intravenously or a placebo 1, 3, 5, 7, 10, or 15 min before intubation. The same criteria for determining whether a patient did or did not cough during tracheal intubation were used as in study 1. The incidence of coughing decreased significantly (P less than 0.01) when 2 mg/kg of lidocaine was injected intravenously between 1 and 5 min before our attempting intubation. Cough reflex was suppressed completely by plasma concentrations of lidocaine in excess of 3 micrograms/ml.

Adolescent↗
PubMedDate not supplied

Cough induced by changes of ionic composition of airway surface liquid.

Coughing is one of the most common of respiratory systems, and yet few anti-tussives are wholly effective and safe. Centrally acting anti-tussives not only inhibit coughing, but also depress ventilation. As an alternative approach, therapies acting on the afferent limb of the cough reflex are explored. Coughing can be reflexly induced in man by reducing the chloride ion content of airway surface lining liquid (ASL). This can be achieved by inhaling aerosols of hypochloride aqueous solutions nebulized ultrasonically. The cough reflex so provoked may be an important protective mechanism to prevent wide excursions of ionic content of ASL. We have demonstrated that pretreatment with inhaled beta-sympathomimetic and anti-muscarinic drugs inhibit this cough reflex whilst oral beta-sympathomimetics and anti-muscarinics have less effect. It is unlikely that either group of drugs directly affect the vagal epithelial receptors responsible for the cough reflex induced by hypochloride solutions. We hypothesize that these agents may act by limiting the communication between the ASL and the paracellular channels, where the receptors lie between the epithelial cells, by tightening the junctions between cells. This may also explain why beta-sympathomimetic agents inhibit the cough of viral infections and the cough of asthma.

Adrenergic beta-Agonists↗
PubMed1993

A comparison of the cough stress test and single-channel cystometry with multichannel urodynamic evaluation in genuine stress incontinence.

OBJECTIVE: To assess the predictability and accuracy of a simplified approach--the cough stress test and single-channel cystometry--in the diagnosis of genuine stress incontinence (GSI) by comparing these tests to the more complex multichannel cough urethral pressure profile and urethrocystometry. Conversely, we assessed the predictability and accuracy of the multichannel approach--the cough urethral pressure profile and urethrocystometry--in GSI by comparing these tests to the cough stress test and single-channel cystometry. METHODS: Prospectively, 145 women with complaints of urinary incontinence underwent a complete urogynecologic evaluation. All patients underwent single-channel cystometry with cough stress test and multichannel urethrocystometry with cough urethral pressure profiles in the erect position. Genuine stress incontinence was diagnosed if 1) the patient was seen to spurt urine per urethra with cough at full cystometric capacity in the absence of vesical instability as determined by single-channel cystometry, or 2) the cough urethral pressure profile demonstrated pressure equalization in the absence of vesical instability as determined by multichannel urethrocystometry. Statistical values were calculated for both the simplified and the multichannel methods, and measures of validity were compared statistically. RESULTS: For the diagnosis of GSI, the simplified method had a positive predictive rate of 87.2% and a negative predictive rate of 80.6%. The multichannel method had a positive predictive rate of 84.0% and a negative predictive rate of 84.4%. CONCLUSION: For the diagnosis of GSI, the simplified method of the cough stress test and single-channel cystometry is as accurate and predictive as the multichannel method.

Cough↗
PubMed1995

Prostanoids and cough response to capsaicin in asthma and chronic bronchitis.

Cyclooxygenase products are released by chronic airway inflammation. Our working hypothesis for the present study was that prostanoids augment airway cough sensitivity. The effects of a cyclooxygenase inhibitor, indomethacin (100 mg.day-1 for 4 days), and a thromboxane synthesis inhibitor, OKY-046 (400 mg.day-1 for 4 days), on cough response to inhaled capsaicin were examined in eight patients with asthma, 10 patients with chronic bronchitis, and 10 normal subjects. Capsaicin cough threshold, the lowest concentration of capsaicin eliciting five or more coughs, was measured as an index of airway cough sensitivity. In asthmatics, the cough thresholds with indomethacin treatment (15.7 (GSEM 1.38) microM) and OKY-046 (10.2 (GSEM 1.20) microM) were significantly greater than the value with placebo (6.05 (GSEM 1.25) microM). In patients with chronic bronchitis, the cough threshold was significantly greater with indomethacin (5.94 (GSEM 1.50) microM) than with placebo (3.41 (GSEM 1.33) microM and OKY-046 2.97 (GSEM 1.43) microM). In normal subjects, the capsaicin cough threshold was not altered by indomethacin or OKY-046 treatment. These results support our hypothesis and suggest that thromboxane A2 may be one of the cyclooxygenase products augmenting airway cough sensitivity in asthma, but not in chronic bronchitis.

Adult↗
PubMedDate not supplied

Inhalation of phosphoramidon, a neutral endopeptidase inhibitor, induces cough in awake guinea-pigs.

In the present study, we explored whether or not a neutral endopeptidase inhibitor provokes cough in awake guinea-pigs. Inhalation of phosphoramidon at a concentration of 10(-6) M did not cause cough, but increasing the concentration to 10(-5) M caused cough with a latency of about 10 to 12 min. Inhalation of enalapril, an angiotensin-converting enzyme inhibitor, did not cause cough, even at high concentrations of 10(-5) M and 10(-4) M. Pretreatment with phosphoramidon (10(-5) M) significantly increased the number of coughs caused by substance P and capsaicin. Capsaicin-induced coughs were more easily produced in bronchitic guinea-pigs than in normal guinea-pigs. However, there was no significant difference in the number of phosphoramidon-induced coughs between normal and bronchitic guinea-pigs. Phosphoramidon-induced coughs were significantly depressed by codeine (20 mg/kg, p.o.) and CP96345 (2 mg/kg, i.v.). The present results provide new evidence for the proposed idea that neutral endopeptidase may regulate the occurrence of cough.

Administration, Inhalation↗
PubMed1998

[Effects of oxatomide, H1-antagonist, on postinfectious chronic cough; a comparison of oxatomide combined with dextromethorphan versus dextromethorphan alone].

H1 antihistamines have been shown to have antitussive effects in patients with asthma and postnasal drip. In Japan, no study has been performed to determine whether orally administered oxatomide, H1 antihistamine, can reduce the chronic cough seen in patients with post-upper-airway infection (postinfection). Patients who had chronic cough of more than three weeks' duration and a history of post-upper-airway infection took part in the study. None had any history of nasal disease, gastroesophageal reflux, bronchial asthma, or other chronic pulmonary disease. All patients were non-smokers, and none used ACE inhibitors. They had normal CRP concentrations, peripheral white blood cell and eosinophil counts, serum IgE concentrations, titers of cold agglutinins and antibodies to Mycoplasma pneumoniae, chest roentgenograms, and respiratory function tests. A prospective randomized, open design was used. The effect of one week of treatment with dextromethorphan (D) or with D plus oxatomide (D + O) on the severity of cough, as estimated by cough diary, were examined. Twenty-two patients entered the study, and 20 were eligible for efficacy and side-effect analyses. Nine patients receiving D and 11 receiving D + O completed the protocol. Patients' characteristics before the start of the study, such as severity and duration of cough, and laboratory data, were not significantly different between the two groups. From trial day 5 to 7, improved rates of cough were significantly higher with D + O than with D alone (p < 0.05). Combination therapy with oxatomide and dextromethorphan reduces subjective perception of cough as estimated by cough diary. These results suggest that oxatomide, H1 antihistamine may improve chronic cough in patients with post-upper-airway infection.

Adult↗