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At least 811 records · Page 45Linked to original sources
PubMed2001

[Effect of Bakumondo-to on increased sensitivity of the cough reflex in a Sjögren syndrome patient with interstitial lung disease].

A 63-year-old woman had complained of a persistent dry cough. Comparison of chest roentgenograms obtained 3 months earlier and at hospital admission, revealed progressive infiltrative shadows in bilateral middle and lower lung fields and mild volume loss. Hematologic study showed polyclonal hyper-gamma-globulinemia, positive anti-nuclear antibodies, and positive antibodies to Ro (SS-A) antigens. Ophthalmologic study demonstrated keratoconjunctivitis sicca. Parotid sialography showed an apple tree sign. Histopathologic features of labial salivary gland biopsy revealed agglomeration of at least 50 mononuclear cells. Chest CT showed non-segmental dense opacity in outer zones of middle and lower lung fields. Lung function test revealed a restrictive pattern with low diffusion capacity. Blood gas analysis showed hypoxemia (PaO2: 74 Torr, PaCO2: 32 Torr). Bronchoalveolar lavage fluid disclosed increased lymphocytes, and histologic features of a transbronchial lung biopsy included thickening of alveolar walls, infiltration of lymphocytes in the interstitium, and foamy cells in alveolar spaces. Therefore, the patient was diagnosed with primary Sjögren syndrome with interstitial lung disease. Bakumondo-to (Mai men dong tang) was started for the troublesome dry cough. The cough was subjectively relieved, cough scores were decreased, QOL scores improved, and sensitivity of the cough reflex measured by inhalation of capsaicin improved, but the chest roentgenogram was unchanged. Steroid hormone therapy was added, and radiographic abnormalities improved subsequently. Bakumondo-to, a traditional Chinese blended medicine, has notable antitussive activity in bronchitic guinea-pigs and in patients with postinfectious cough. It was concluded that Bakunondo-to may provide effective antitussive activity in some cases of interstitial lung disease with increased sensitivity of the cough reflex.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Angiotensin converting enzyme inhibitor induced cough in Nigerians.

A persistent dry cough is the commonest class of adverse reaction to Angiotensin converting enzyme inhibitors (ACE-I). This ACE-I induced cough appears to exhibit interracial differences being commoner in Chinese subjects as compared to Caucasians. We conducted a cross sectional study of one hundred (100) patients (63 males and 37 females) on ACE-I to determine the prevalence of ACE-induced cough in Nigerians, a Negroid population. Twenty seven patients (27%) had ACE-induced cough and four (4%) had withdrawal of ACE-I therapy on account of cough. The prevalence of ACE-I induced cough was significantly higher amongst females (43%) as compared to males (17%) p < 0.01. The biological basis for the apparent racial and gender differences in ACE-I induced cough requires further study.

Aged↗
PubMed2002

[The effect of bradykinin B(2) receptor antagonist on cough reactivity in a sensitized guinea pig model].

OBJECTIVE: To investigate the effect of bradykinin B(2) receptor antagonist FR173657 on cough response in guinea pigs sensitized and challenged with ovalbumin. METHODS: 40 normal and 40 sensitized guinea pigs were challenged with the aerosol of ovalbumin. 24 hours later, 10 animals from the normal group and 10 from the sensitized group were intraperitoneally injected either with saline or with 0.03 mg/kg, 0.3 mg/kg and 3 mg/kg of FR173657 respectively, and then cough response to inhaled capsaicin was measured. Specific airway resistance was recorded with a noninvasive technique only in normal, sensitized and FR173657 (0.3 mg/kg)-treated sensitized guinea pigs. RESULTS: FR173657 did not influence cough response and airway resistance in normal guinea pigs. Compared with normal animals, sensitized guinea pigs presented an increased cough frequency and specific airway resistance [(21.7 +/- 3.0) times/3 min vs (8.3 +/- 1.4) times/3 min, (9.4 +/- 0.5) cm H(2)O/s vs (7.9 +/- 0.9) cm H(2)O/s], (P < 0.05) after inhalation of 10(-4) mol/L capsaicin. The cough frequency and specific airway resistance were decreased to [(12.2 +/- 1.3) times/1 min and (7.5 +/- 0.9) cm H(2)O/s] after administration of 0.3 mg/kg of FR173657 (P < 0.05). CONCLUSIONS: Bradykinin B(2) receptor antagonist inhibited increased cough response and airway resistance in guinea pigs sensitized and challenged with ovalbumin. Bradykinin may be an important mediator in cough associated with eosinophilic airway inflammation.

Airway Resistance↗
PubMedDate not supplied

[Comparative study of two antitussive drugs in the treatment of acute dry cough of infectious origin (prospective, randomized, single blind study)].

The objective was to compare, during a 5-day therapy, the efficacy and tolerability of an antihistaminic antitussive syrup, oxomemazine, combining a small quantity of guaifenesine (T), with a centrally acting antitussive, clobutinol (S), in adult patients aged from 18 to 70 years and presenting with a dry cough of infectious origin. This study was performed by 22 general practitioners and 130 ambulatory patients were enrolled. The primary criterion of this multicenter, randomized, single blind study was to compare the evolution of cough intensity using a Visual Analog Squale (VAS) graduated from 0 to 10 cm. Nine secondary criteria including tolerability were also assessed. With regard to cough intensity, the treatments were not equivalent. A greater reduction was observed with T (-5.2 +/- 2.3 versus -4.3 +/- 2.3). This result was confirmed by a further reduction in cough intensity at days: 2 (p = 0.04), 4 (p = 0.05), and 5 (p = 0.02). The frequency of cough disappearance before the end of the study was significantly greater for T than for S: 46% versus 29% (p = 0.05). The time before disappearance of the cough was 4.0 + 1.1 days for both medicines. Induction of sleep and the frequency of nocturnal wakening were significantly better for T from day 4 (p = 0.02). The drowsiness induced by T meant that diurnal quality of life was better with S on days 1 (p = 0.002) and 2 (p = 0.01). Tolerability was similar for both medicines. In conclusion, as a symptomatic treatment of dry cough, T is efficient and well tolerated. Moreover, we have observed a tendency towards superior efficacy of T than S. T is therefore a useful alternative in the therapeutic armamentarium available to the general practitioner.

Adolescent↗
PubMed1992

Effects of nifedipine and indomethacin on cough induced by angiotensin-converting enzyme inhibitors: a double-blind, randomized, cross-over study.

Prostaglandins (PG) have been suggested to play a role in the genesis of cough induced by angiotensin-converting enzyme inhibitors (ACE-I) and that inhibition of PG synthesis can reduce or abolish the incidence of this side effect. Moreover, experimental and clinical data suggest that nifedipine, a dihydropyridine Ca antagonist, can inhibit PG synthesis. Therefore, we wished to determine whether nifedipine can reduce cough induced by ACE-I as compared with indomethacin, a known inhibitor of PG synthesis. Fourteen hypertensive patients who developed cough during captopril chronic therapy randomly received slow-release nifedipine 20 mg twice daily (b.i.d.), indomethacin 50 mg b.i.d., and placebo b.i.d. for 1 week in a double-blind, cross-over design. At the end of each treatment phase, cough was evaluated by a self-administered questionnaire containing an ordinal scale for daily cough intensity and frequency. Indomethacin abolished or markedly reduced cough induced by ACE-I, whereas nifedipine reduced it but to a lesser degree. These findings suggest that PG can play a role in cough caused by ACE-I, and a dihydropyridine Ca antagonist can reduce the occurrence of this side effect.

Adult↗
PubMed1992

Complete spontaneous remission of cough induced by ACE inhibitors during chronic therapy in hypertensive patients.

The files of 172 consecutive hypertensive patients who received captopril or enalapril have been reviewed and the patients questioned on the development of chronic dry cough, persisting for at least two months. Forty patients had cough that was attributed to the drugs. Thirteen of them discontinued the drugs because of this adverse effect. In 15 of the 27 patients (55%) who continued receiving ACE inhibitors (7 males, 8 females, aged 65.4 +/- 9.9 years) the cough had spontaneously disappeared after 3.9 +/- 1.9 months of continued unaltered administration of these drugs and without any treatment aimed against this symptom. All patients were followed for at least four months after disappearance of cough, without recurrences. This finding may discourage withdrawal of ACE inhibitors from many patients who develop cough. Continuation of ACE inhibitors for at least several months, despite cough, (if the cough is not too severe) is probably justifiable.

Aged↗
PubMed1992

[Chronic cough].

Cough is a powerful physiological reflex mechanism that causes central airways to be cleared of foreign material and excess secretions. Chronic cough is a very common presenting symptom in general practice with a prevalence in the population of about 5%. As a general rule, persistent cough represents organic disease of the upper and lower airways, the lung parenchyma, the pulmonary circulation, the pleural space, the mediastinum and the upper gastro-intestinal tract. The most common cause is cigarette smoking, but virtually any chronic lung disease may be occasionally associated with cough. Complications of coughing are tussive syncopes, rib fractures, rupture of respiratory muscles and eventually hernias. Based on a detailed clinical history and physical examination, the investigation includes a chest radiograph, spirometry, and sputum smears. Radiography of the sinuses, bronchoscopy and upper gastro-intestinal endoscopy may be added. If the treatment of an underlying disease is successful, chronic cough may disappear. There are few 'antitussive' drugs with proven suppression of the cough reflex.

Antitussive Agents↗
PubMed2003

Activity of the laryngeal abductor and adductor muscles during cough, expiration and aspiration reflexes in cats.

We studied the temporal relationships and the patterns of electromyographic activities of the posterior cricoarytenoid and thyreoarytenoid muscles (laryngeal abductor and adductor), the diaphragm and abdominal muscles in anesthetized cats during mechanically induced tracheobronchial and laryngopharyngeal coughs, expiration and aspiration reflexes. The posterior cricoarytenoid muscle activity reached the maxima just before the peak of diaphragmatic activity in both types of cough and aspiration reflexes and slightly before the top of abdominal muscle activity in coughs and the expiration reflex. Thus, this muscle contributes to the inspiratory phase of coughs and aspiration reflex and also to the expulsive phase of coughs and the expiration reflex. The thyreoarytenoid muscle presented strong discharges in the compressive phase of coughs and expiration reflex (during the rising part of the abdominal muscle activity) and in the subsequent laryngoconstriction (following the diaphragmal and/or abdominal muscle activity) in all four reflexes. This muscle was also slightly activated at the beginning of the aspiration reflex. The existence of four phases of the cough reflex is also discussed.

Abdominal Muscles↗
PubMed2003

[Etiological diagnosis of chronic cough with unknown causes].

OBJECTIVE: To explore the spectrum and frequency of causes for chronic cough in Chinese patients. METHODS: 86 patients with chronic cough were enrolled in the study. The diagnostic procedure was based on the anatomical protocol for diagnosing chronic cough designed by Irwin, and additional cytological assay was performed for sputum induced by hypertonic saline aerosol inhalation. The efficacy of therapy specific to the diagnosis was evaluated. RESULTS: Definite diagnosis was made in 77 (89.5%) out of the 86 patients with chronic cough. The most common causes included cough variant asthma (CVA) (24/86, 27.9%), postnasal drip syndrome (PNDs) (22/86, 25.6%), eosinophilic bronchitis (EB) (13/86, 15.1%), and gastroesophageal reflux (GER) (12/86, 14.0%). After active management based on the diagnosis, cough improved in 72 patients (93.5%). CONCLUSIONS: In addition to CVA, PNDs and GER, eosinophilic bronchitis is also an important cause of chronic cough. A positive response to the specific therapy is essential to a definite diagnosis.

Adolescent↗
PubMed2003

Clinical observation between chronic sustained cough with asthma and childhood inguinal hernia.

Inguinal hernias are common and cause problems for the health services. Several factors are thought to influence their development. Patients under 16 years old who had received hernioplasty at National Taiwan University Hospital were enrolled in a study to analyze the correlation between preceding recurrent cough with asthma and later hernia development. Patients aged 5 and 6 years old (when admitted for hernioplasty in 2000) were particularly focused. This entailed further analysis of their birth history, family atopic history, specific allergic diseases (allergic rhinitis, atopic dermatitis, asthma), hernia type (direct or indirect), the onset of chronic cough and asthma. One hundred and sixty three patients (2.66%) from a total hernioplasty population of 6130 were found to have had preceding asthma with recurrent cough before having the hernioplasty intervention. One hundred twenty-five patients were aged 5 to 6 years old, among whom 8 (6.4%) patients were found to have asthma, and 20 (16%) patients were noted to have recurrent sustained cough. All the hernia types were indirect and were received with high suture ligation. In conclusion, the incidence of asthma was not significantly higher in the group of individuals receiving hernioplasty. However, a higher incidence of recurrent sustained cough was noted, which could be a relatively important factor for the hernia development. Further reliable cough measurements would be needed to evaluate the severity of recurrent sustained cough as the potential risk for the hernia development.

Asthma↗
PubMed2004

Effects of inhaled corticosteroids on cough in awake guinea pigs with experimental allergic rhinitis--the first experience.

Allergic rhinitis is a common cause of chronic cough. Topical corticosteroids are regarded as the most effective first-time treatment in allergic rhinitis. In this study we evaluated the cough sensitivity during the early and late allergic responses in guinea pigs with experimental allergic rhinitis. Another aim of the study was to follow up the effect of inhaled beclomethasone dipropionate on the cough in guinea pigs with allergic rhinitis. 31 guinea pigs were sensitized with ovalbumin (OA). Animals were intranasally challenged with OA (experiment) or saline (control) in 7-day intervals for 9 weeks. Cough was induced by inhalation of citric acid aerosols in gradually increasing concentrations for 30 s and was evaluated 1 h after the 8(th) nasal challenge (NCH) and 17 h after the 9(th) NCH. Cough was significantly increased only during an early allergic response, 1 h after repeated NCH [18 (14-23) vs. 8 (3-10); P<0.001]. Five experimental animals were inhaling aerosol of beclomethasone dipropionate seven days between the 8(th) and the 9(th) NCH and cough was evaluated 1 h after the 9(th) NCH. Inhaled corticosteroids significantly inhibited the enhanced allergic rhinitis related cough [4 (1-9) vs.19 (9-37) vs. 6 (3-9); P<0.05].

Administration, Inhalation↗
PubMed1992

Cough receptor sensitivity and bronchial responsiveness in normal and asthmatic subjects.

We examined whether airway cough receptor sensitivity correlates to nonspecific bronchial responsiveness. We measured cough threshold, the lowest concentration of inhaled tartaric acid eliciting five or more coughs, and the provocative concentration of methacholine producing a 20% fall in forced expiratory volume in one second (PC20FEV1) in 38 normal and 11 asthmatic subjects. All subjects were nonsmokers. The geometric mean value of PC20FEV1 was 25.7 mg.ml-1 (GSEM1.29) and 0.63 mg.ml-1 (GSEM1.29) and the geometric mean value of the cough threshold was 115 mg.ml-1 (GSEM1.20) and 95.5 mg.ml-1 (GSEM1.35) in normal and asthmatic subjects, respectively. The PC20FEV1 was significantly (p less than 0.01) lower in asthmatics than in normals but the cough threshold did not differ between them. No significant correlation was observed between the cough threshold and the PC20FEV1 in normal subjects or in asthmatics. These results indicate that cough sensitivity does not directly correlate to bronchial responsiveness in normal and asthmatic subjects.

Administration, Inhalation↗
PubMed2003

Cough sensitivity in localized scleroderma with no clinical symptoms from lower airways.

Cough sensitivity is increased in patients with atopic dermatitis, although they have no clinical symptoms from the lower airways. In the present study we examined the cough sensitivity to capsaicin in patients, who had no clinical respiratory symptoms, with sclerodermia localized to the skin. Cough sensitivity was defined as the lowest capsaicin concentration, which evokes 2 or more coughs. Twelve patients and 12 healthy matched volunteers, as a comparison group, inhaled deep breaths (2 L) of a capsaicin aerosol in doubled concentrations (from 0.02 to 200 micromol/L). Cough sensitivity, expressed as a geometric mean (95% CI) of capsaicin concentration, was 0.15 micromol/L (0.04 to 0.56) in the patients with localized sclerodermia and 4.96 micromol/L (2.50 to 9.85) in controls, which made a significant difference towards higher cough sensitivity in sclerodermia, respiratory symptom-free patients. Thus, disease processes localized outside the respiratory tract may have surreptitious pulmonary manifestation that is brought to light by the capsaicin cough test.

Adult↗
PubMedDate not supplied

Gastroesophageal reflux disease and sinusitis: their role in patients with chronic cough.

The causes of coughing are multiple. Research into the physiology of coughing has established that interactions amid C-fibers and rapidly activating receptors in humans have the most significant effect on stimulation of coughing. Precipitants of coughing include gastroesophageal reflux and sinusitis. Stimulation of vagal afferents by esophageal irritation and aspiration of acidic gastric contents or vapors are the most frequently cited causes of cough associated with gastroesophageal reflux or laryngopharyngeal reflux. Sinusitis may precipitate coughing from other mechanisms including aspiration of postnasal drainage and sinopulmonary reflex. Taking a lesson on how these conditions affect asthmatic patients, this article will review how these two conditions may also influence cough in normal patients.

Bronchial Hyperreactivity↗
PubMed1991

Prevalence of persistent cough during long-term enalapril treatment: controlled study versus nifedipine.

The prevalence and severity of cough during long-term enalapril treatment were examined by comparing a cohort of 136 hypertensive patients who started treatment with enalapril with consecutive age and sex-matched patients who commenced nifedipine therapy during the same period. Cough and other symptoms were assessed by a questionnaire designed to avoid bias towards reporting cough. After a mean of 27 months' treatment patients on enalapril had an excess of persistent cough (16 per cent, 95 per cent CI 7-25, p less than 0.01), voice change (14 per cent, 95 per cent CI 2-27, p less than 0.05) and sore throat (10 per cent, 95 per cent CI -0.1 to 20.3 per cent, p less than 0.01) when compared to nifedipine-treated patients. The cough was usually dry, moderate or severe, paroxysmal, and troublesome at night. Cough tended to be more common in women (23 per cent vs. 7.2 per cent), non-smokers, and at higher doses of enalapril, but was not related to age, duration of treatment, or chronic respiratory disease. Dry cough commonly persists as a troublesome side-effect during long-term enalapril treatment, and is often associated with voice change and sore throat.

Cough↗
PubMed1991

[Cough caused by angiotensin-converting enzyme inhibitors. A series of cases collected by spontaneous notification of adverse reactions].

Cough is one of the possible untoward adverse drug effects of angiotensin converting enzyme inhibitors. We describe the available information on 50 cough episodes attributable to captopril and 18 episodes attributable to enalapril reported to the Spanish Drug Surveillance System. Cough represented 37% and 39% of the reports of side effects of captopril and enalapril, respectively. There was a remarkable female predominance among the patients with cough. Cough developed at very low doses (15 mg of captopril and 5 mg of enalapril daily), although the patients on captopril who developed cough were receiving higher doses than those who presented other side effects. A high proportion of patients (29%) continued with the drug for more than six months after cough had developed, suggesting the need for a wider knowledge of this side effect.

Aged↗
PubMedDate not supplied

[Bronchial reactivity and cough due to ACE inhibitors].

The occurrence of a dry, nonproductive cough during ACE inhibitors therapy has been described in several reports. However, the mechanism of this effect is still unknown. In order to clarify whether ACE inhibitor-induced cough is a symptom of an asthmatic disturbance, six patients (age 54-68) with cough related to captopril or enalapril were rechallenged with ACE inhibitors after an adequate washout period. Baseline airway function and bronchial reactivity to metacholine were measured at the end of the washout period and on the fourth day of rechallenge which was accompanied by the reappearance of cough without wheezing. Rechallenge did not cause changes in dynamic lung function; a low and not significant (p less than 0.1) increase in metacholine dose causing a 15% and a 20% reduction in baseline FEV 1 was observed. It is concluded that cough and bronchoconstriction are likely to be mediated through different nervous pathways and that ACE inhibitor-induced cough is not a variant of asthmatic cough.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1990

[Relationship between cough threshold to inhaled tartaric acid and sex, smoking and atopy in humans].

It has been reported that angiotensin converting enzyme inhibitor (ACE-I) elicits dry cough more frequently in women than in men. This study was designed to evaluate whether airway cough receptors are more sensitive in women than in men. Cough threshold to inhaled tartaric acid was measured in 33 men and 29 women. In non-atopic and non-smoking subjects, geometric mean value of cough threshold in women was 10.0 (GSEM, 1.29) %, which was significantly (p less than 0.02) lower than that in men, 22.5 (GSEM, 1.30) %. In non-atopic men, the cough threshold was significantly (p less than 0.05) lower in smokers (9.3 (GSEM, 1.57) %) than in non-smokers. In non-smoking women, the cough threshold was significantly (p less than 0.02) lower in atopic subjects (4.2 (GSEM, 1.33) %) than in non-atopic subjects. These results demonstrated that airway cough receptors may be more sensitive in women, smoking men and atopic women.

Administration, Inhalation↗