Cough is annoying sometimes, but we should know what is cough. How is my cough different from others? What are the possible causes? How can I treat my cough with a specific medicine apart from taking tons of medicines? These are the questions that come into our minds when we suffer from this annoying ailment. Let’s find answers to these questions from a pharmacist’s point of view.
What is cough?
Cough is a natural, protective reflex action that our body produces to clear the mucous and irritants (dust, allergens, or smoke) from the airways. There are two types of coughs: productive (wet) and non-productive (dry) cough. A productive cough produces mucous and phlegm from the airways and the lungs. Non- productive cough, also called dry cough, does not produce mucous or sputum.
What are the common causes of cough?
It can be a symptom of many diseases like
a. Flu or cold
b. Asthma
It is a health condition that involves airways constriction. It includes shortness of breath, tightness of the chest, chest pain, coughing attacks, etc. Cough, in this case, can be productive and non-productive. Most asthmatic patients have a non-productive (dry) cough.
c. Gastroesophageal reflux disease (GERD)
It happens when the oesophagal lining is irritated by the backflow of the acid in the stomach. The inflammation and irritation can trigger your cough reflex.
d. Allergies, Coronavirus, and Bronchitis
These conditions can trigger the cough reflex and, if treated properly, can be diminished within a week or 2.
A drug that can cause cough
Lisinopril and enalapril belong to ACE inhibitors, are used to lower blood pressure, and can activate the cough reflex.
How can you tell if your cough is productive or non-productive?
When you hear a rattling sound while breathing due to an infection, arises yellowish or greenish mucous or sputum, it is called productive (wet) cough. Non-productive produces a scratchy and tickling sensation in the throat and does not produce mucous and phlegm (sputum).
Treatment for the relief of wet and dry cough
Two types of treatment can be helpful for the relief of cough.
1. Over-the-counter drugs
OTC (over-the-cough) drugs are those drugs that are available in pharmacies without a doctor’s prescription.
Two types of drugs can be used to suppress productive and non-productive cough.
a. An antitussive drug like, dextromethorphan is used to treat non-productive (dry) cough.
b. An expectorant like guaifenesin is used to treat productive (wet) cough.
Brands of Dextromethorphan in Pakistan:
| Brand name | Company name | Active ingredients | Uses | Price 60ml and 120ml |
| Corex-D | Pfizer laboratories LTD. | Chlorpheniramine, Dextromethorphan, Ephedrine, and Sodium Citrate | Anti-allergen, anti-tussive, and nasal- decongestant | Rs.22.86 (60ml) Rs.37.29 (120ml) |
| Cosome | Merck Private LTD. | Chlorpheniramine, Dextromethorphan, and Pseudoephedrine | Anti-allergen, anti-tussive, and nasal- decongestant | Rs.33.00 for 120ml |
| RONDEC | Abbott Laboratories (Pakistan) Limited. | Chlorpheniramine, Dextromethorphan, Phenylephrine, Ephedrine, and Ammonium Chloride | Anti-allergen, anti-tussive, and nasal- decongestant | Rs.38.12 (120ml) Rs.19.05 (60ml) |
| DELSYM | Global Pharmaceuticals | Dextromethorphan and Pseudoephedrine | Anti-tussive and nasal decongestant | Rs.10 (60ml) |
Brands of Guaifenesin in Pakistan:
| Brand names | Company name | Active ingredients | Uses | Price |
| GLYCODIN | Lahore chemical & pharmaceutical Works (PVT) LTD. | Chlorpheniramine, Dextromethorphan, Ephedrine, and guaifenesin | Anti-allergen, anti-tussive, nasal-decongestant, and expectorant | Rs.32.21 (120ml) Rs.18.50 (60ml) |
| TRIAMINIC-E | Novartis Pharma (Pak) LTD. | Pseudoephedrine and Guaifenesin | Nasal- decongestant and expectorant | Rs.25 (60ml) |
| TUSSIVIL | Pfizer Laboratories LTD. | Guaifenesin, Dextromethorphan, and Phenylephrine. | Expectorant, anti-tussive, and nasal-decongestant | Rs. 34.08 (120ml) |
2. Home remedy and alternative medicine
Natural expectorants like honey, menthol, oral hydration, ginger tea, and steam are used as an alternative treatment for the relief of cough. Children over the age of 12 months and under 12 years should not recommend using dextromethorphan and guaifenesin due to their side effects. Therefore, 1.5-2 teaspoons of honey 30 minutes before bedtime are usually advised to minimize cough and reduce the stickiness of the mucus in case of a wet cough. However, adults can use warm honey water to minimize sore throat and cough. Lozenges, including menthol, are also used to relieve sore throat and irritation. Ginger tea, steam, and oral hydration are used in wet coughs to minimize the stickiness of the mucus in the throat.
Pharmacist Note
Cough syrups combined with antihistamines, nasal decongestants, and pain relievers suppress a cough and cold, flu, allergies, or other associated conditions. Patients should seek medical help if the cough continues for 3 weeks. The adverse effects associated with the use of anti-tussive and expectorants are dizziness, drowsiness, nervousness, stomach pain, constipation, headache, nausea, and vomiting (if taken in high doses). Cough syrups should not be given to children under the age of 12 years.
Who is Miss Sumaira Faiz?
Sumaira Faiz is a known pharmacist by profession and has done M.Phil. in Pharmaceutics. She has an experience in industry and retail setup. She loves writing articles and blogs about public health and issues produced by the misuse and polypharmacy in Pakistan. Through her blogs, she has involved herself in generating public awareness about medicines; their right uses, right time, and right doses; their equivalents (counterparts), their alternatives, and their generics under the guidance of her respected teacher, Sir Syed Kazim Ali.
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