COUGH
Symptom Definition
Cough is non-productive (dry cough) if there is minimal clear-white or no phlegm (sputum).
Cough is productive (wet cough) if there is yellow, green, or brown phlegm (sputum).
Why We Cough - A cough has two important functions:
It serves to clear the airways of infection, mucus, foreign bodies, and other irritants.
It protects against aspiration of oral and stomach contents.
Common Causes
Most common cause: postnasal drip syndrome from a cold, from allergic rhinitis, or from sinusitis.
Other common causes: asthma, bronchitis, pneumonia, gastroesophageal reflux, smoking.
Call 911 Now If you Have:
Passed out
Severe difficulty breathing (e.g. struggling for each breath, unable to speak)
Lips or face are bluish now
Wheezing started suddenly after medicine, an allergic food or bee sting
Difficulty breathing after exposure to flames, smoke, or fumes
Call Your Doctor Now (night or day) If
You feel weak or very sick
Chest pain (EXCEPTION: mild chest pain lasting only a few seconds that occurs only when coughing)
Difficulty breathing
Wheezing is present
Coughing started suddenly after bee sting
Coughing up blood and more than a few streaks
Fever of 103 F (39.4 C) or higher
Fever of 100.5 F (38.1 C) or higher and you
o Are over 60 years of age:
o Have diabetes mellitus or a weakened immune system (e.g. HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy)
o Are bedridden (e.g. nursing home patient, stroke, chronic illness, recovering from surgery)
Increasing ankle swelling
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
You think you need to be seen
Sinus pain or pressure (around cheekbone or eyes)
Fever present for more than 3 days
Earache is present
Call Your Doctor During Weekday Office Hours If
You have other questions or concerns
Coughing up blood
Coughing has kept you home from school or work for 3 or more days.
Nasal discharge lasts more than 10 days
Fever returns after being gone for more than 24 hours
Symptoms of nasal allergy are also present (e.g. itchy eyes, clear nasal discharge, postnasal drip)
Taking an ACE Inhibitor medication (Including: benazepril/LOTENSIN, captopril/CAPOTEN, enalapril/VASOTEC, lisinopril/ZESTRIL)
Exposure to TB (Tuberculosis)
Cough lasts more than three weeks
Self Care at Home If
Cough with no complications and you don't think you need to be seen
HOME CARE ADVICE FOR COUGH
1. Mild Coughs: Use cough drops.
2. Cough Medications: In cough and cold medications, there is either a "cough suppressant" to reduce the cough or a "cough expectorant" to thin thick phlegm. Some medications contain both a cough suppressant and an expectorant. Generally, medications containing a cough suppressant should be avoided if you are coughing up phlegm.
3. Cough Suppression Medications: The most common cough suppressant in over the counter cough medications is dextromethorphan. An example is Robitussin DM. Do not try to suppress coughs that produce mucus and phlegm. Dextromethorphan is best used in the late stages of a respiratory infection when the cough is dry and hacking.
4. Cough Expectorant Medications: To loosen and cough up thick phlegm, try using a cough medication that contains guaifenesin (e.g. plain Robitussin).
5. Coughing Spasms: Drink warm fluids. Inhale warm mist. (Reason: both relax the airway and loosen up the phlegm) Suck on cough drops or hard candy to coat the irritated throat.
6. Hydration: Drink plenty of liquids (6-8 glasses of water daily). If the air in your home is dry, use a humidifier
7. Avoid Tobacco Smoke: Smoking or being exposed to smoke makes coughs much worse.
8. Fever Relief: For fever relief, take acetaminophen every 4-6 hours (Adults 650 mg) OR ibuprofen every 6-8 hours (Adults 400 mg).
o Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
o Do not take acetaminophen if you have liver disease.
o Read the package instructions thoroughly on all medications that you take.
9. Expected Course:
10. Viral bronchitis causes a cough that lasts 1 to 3 weeks. Sometimes you may cough up lots of phlegm (sputum, mucus). The mucus can normally be white, gray, yellow or green.
11. Call Your Doctor If:
Difficulty breathing
Cough lasts more than 3 weeks
You become worse or develop any of the "Call Your Doctor" symptoms.
Dr. Alex Franko III 9/6/2007 11:18 AM
WWW.ALEXFRANKO.COM