Cough Update: Chronic cough: mechanisms and antitussives |
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Cough Update: Chronic cough: mechanisms and antitussives

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An imperative defending reflex of the respiratory tract is cough, which is necessary to clear and protect the upper airways. Cough might become inflated and also inhibit with the quality of life. Although chronic cough can be effectively treated when it is associated with the common causes like asthma, eosinophilic bronchitis, gastroesophageal reflux disease, post-nasal drip syndrome or rhinosinusitis. Progressively, cough with no related cause or idiopathic cough is recognized.


Often, the chronic cough is related with an increased response to tussive agents for instance capsaicin, which is used as an index for the cough reflex. Pliable changes in intrinsic and synaptic excitability at the brain stem, at spinal or ganglionic level might be the mechanism through which the cough reflex is improved in chronic cough. Few airway receptors intercede or influence the cough through activation of vagal afferent pathways that unite on brain stem respiratory networks and on supra-medullary centres. Objective and subjective measurements of cough in the clinic are available, however a major unmet requirement in chronic cough is the accessibility of effective antitussives. Future guidelines in chronic cough consist of the pathophysiological mechanisms of the heightened cough reflex. The outcome of effective antitussives can successfully ease the chronic cough.

Source: Chung KF. Chron Respir Dis. 2007;4(3):159-65.

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