Approach in Diagnosis and Management of Cough
| Dr. Avanish Pratap Shahi
Cough is a prevalent symptom prompting visits to primary care, respiratory, or allergy specialist clinics.1 Based on duration, cough is classified as acute (<3>8 weeks).2 Several factors contribute to cough reflex hypersensitivity and persistence, including age, sex, comorbidities, viral infections, and exposure to irritants or pollutants.3 Evaluation begins with a detailed clinical history focusing on cough characteristics and a physical examination. Sputum characteristics are crucial in diagnosing cough and underlying respiratory conditions, along with chest X-ray, CT scan, PFT, provocation test, CRP, and IgE levels. Treatment options for cough include antitussives, expectorants, mucolytics, antibiotics, bronchodilators, corticosteroids, antihistamines, proton pump inhibitors (PPIs), neuromodulators, and leukotriene receptor antagonists. The Indian Medical Association (IMA) recommends using CDSCO-approved combinations for cough treatment, such as Bromhexine + Guaifenesin + Terbutaline and Levosalbutamol + Ambroxol + Guaifenesin.4
"1. https://www.nature.com/articles/s41572-022-00370-w.pdf
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563099/
3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123091/
4. https://www.ima-india.org/ima/pdfdata/Final-Cough-Algorithm-BookLet-1602.pdf"