throat or lung cancer. A doctor should evaluate
chronic cough in smokers on a regular basis to
monitor for more significant health problems.
SMOKING CESSATIONmay end the cough; cough that
continues longer than six months beyond smoking
cessation may indicate another health condition
and requires a doctor’s assessment.
Treating Cough
Treatment focuses first on eliminating any under-
lying reasons for cough. Antibiotic medications are
helpful only when there is a bacterial infection.
The most effective cough suppressant medications
are those which contain DEXTROMETHORPHAN, ben-
zonatate, or NARCOTICS such as codeine and
hydrocodone. Products containing benzonatate (a
non-narcotic) or narcotics require a doctor’s pre-
scription and are not generally appropriate for
chronic cough. Products containing dextromethor-
phan are numerous and available over the
counter; extended-release products can provide
relief for 10 to 12 hours per DOSE.
Expectorants help thin mucus and secretions so
the coughing mechanism can more easily bring
them out of the airways. Doctors do not agree on
whether expectorants are truly helpful, and there
are few clinical research studies that have investi-
gated their effectiveness. The most common
expectorant in cough products sold in the United
States is guaifenesin. Manufacturers recommend
drinking plenty of water when taking products
containing guaifenesin; some health experts
believe increased water intake alone is adequate
to thin mucus.
Most cough products, both prescription and
over the counter, combine ingredients, so it is
important to read product labels carefully. Prod-
ucts may include a cough suppressant and an
expectorant as well as a decongestant, an antihis-
tamine, and other substances. Maintaining ade-
quate moisture in the air (as with a cool
humidifier), drinking plenty of liquids, and avoid-
ing substances that irritate the throat and airways
are effective nonmedication methods for manag-
ing cough, especially chronic cough.
See also ALLERGIC RHINITIS; ALLERGY; PERTUSSIS;
PULMONARY EMBOLISM; SMOKING AND HEALTH.croup A viral INFECTIONof the upper respiratory
tract that produces a characteristic barking COUGH,
most commonly in children under age three.
Other symptoms include rapid BREATHING, a high-
pitched noise with inhalation (stridor), and FEVER.
In many children, the top of the airway at the
back of the THROAT becomes swollen and con-
gested, reducing the flow of air. The barking
cough results from air being forced through this
narrowed passage as the body attempts to clear
the congestion of the infection. Croup often fol-
lows COLDSand its symptoms tend to worsen at
night. The most effective treatment is prompt
exposure to moist air. Parents often find that as
soon as they get the child buckled into the car seat
for the late-night trip to the hospital emergency
room, coughing lessens and breathing eases. The
cool night air helps open the airways. Often it
brings the child relief to sit, wrapped in a blanket
for warmth, with a parent in the night air for a
few minutes. An alternative method is to turn on
a hot shower and close the bathroom door so the
bathroom fills with steam, then sit with the child
in the steam.
The child needs immediate medical attention
when symptoms- last longer than three days
- include a fever higher than 102ºF
- suggest that the child is not getting enough
oxygen, such as CYANOSIS(blue lips) - include excessive drooling
Though frightening for parents, croup is most
often self-limiting and has few complications.
Because croup is viral, ANTIBIOTIC MEDICATIONSdo
not bring about any improvement in symptoms.
And, being viral, croup is contagious, spread
through droplets in the air from coughing as well
as by hand contact.
See also BREATH SOUNDS; EPIGLOTTITIS; PERTUSSIS.croup 19