Common Cough Research Articles

Pseudobulbar affect in multiple sclerosis: Toward the development of innovative therapeutic strategies

Pseudobulbar affect (PBA), a condition involving involuntary and uncontrollable episodes of crying and/or laughing, occurs frequently in patients with a variety of neurological disorders, including amyotrophic lateral sclerosis (ALS), stroke, traumatic brain injury, dementia including Alzheimer's disease, and multiple sclerosis (MS). Although PBA results in considerable distress for patients and caretakers, it is underrecognized and undertreated. Agents used to treat psychiatric disorders–particularly tricyclic antidepressants and selective serotonin reuptake inhibitors–are useful in alleviating PBA, but act on diffuse neural networks rather than targeting those involved in emotional motor expression. As a result of their nonspecific activity, these agents are associated with a range of unwanted effects that preclude many patients from using them. Dextromethorphan, a common cough suppressant, specifically targets sigma 1 receptors concentrated in the brainstem and cerebellum, thus providing the possibility of targeting regions implicated in emotional expression. When administered in a fixed combination with quinidine, dextromethorphan is effective in treating PBA in patients with ALS, and preliminary results suggest that this therapy also is effective in treating MS-related PBA.

Effect of histamine H1 receptor antagonists on antigen-induced increase of cough sensitivity in guinea pigs

Eosinophilic airway inflammation and increased cough sensitivity without bronchial hyperresponsiveness are the pathologic and physiologic features of bronchodilator-resistant non-productive cough-associated global atopic tendency, abbreviated herein as atopic cough. Histamine H1 receptor antagonists are effective in relieving the cough in nearly 60% of patients with atopic cough. However, there is no direct evidence that histamine H1 receptor antagonists can reduce cough hypersensitivity associated with eosinophilic airway inflammation. The purpose of the present study was to clarify this issue. The number of coughs caused by inhalation of increasing concentrations of capsaicin (10− 8, 10− 6 and 10− 4 mol/L) was counted 24 h after the administration of an aerosolized antigen in actively sensitized conscious guinea pigs and then bronchoalveolar lavage (BAL) was performed. Azelastine (0.1 or 1 mg/kg) or terfenadine (0.2 or 2 mg/kg) was given intraperitoneally 60 min before capsaicin provocation 24 h after the antigen challenge in sensitized guinea pigs. In addition, azelastine (0.1 or 1 mg/kg) was administered 90 min before the capsaicin challenge in naïve guinea pigs. The cough response to capsaicin and the number of eosinophils in BAL fluid (BALF) were significantly increased after antigen challenge. Azelastine and terfenadine significantly reduced the increased cough response after antigen challenge, while azelastine had no effect in naïve animals. In conclusion, histamine H1 receptor antagonists reduce antigen-induced increases in cough sensitivity in sensitized guinea pigs without direct inhibition of a common cough reflex pathway.

The [formula omitted] receptor antagonist dextromethorphan selectively reduces temporal summation of second pain in man

Oral doses of dextromethorphan (DM), a common cough suppressant and N- methyl- d-aspartate (NMDA) receptor antagonist, and their vehicle control were given on a double-blind basis to normal volunteer human subjects who rated intensities of first and second pain in response to repeated painful electric shocks and repeated 52°C heat pulses. Doses of 30 and 45 mg, but not 15 mg, were effective in attenuating temporal summation of second pain, a psychophysical correlate of temporal summation of C afferent-mediated responses of dorsal horn nociceptive neurons, termed ‘wind-up’. By contrast, neither first nor second pain evoked by the first stimulus in a train of stimuli were affected by any of these doses of DM. These results further confirm temporal summation of second pain as a psychophysical correlate of wind-up by providing evidence that DM selectively reduces temporal summation of second pain, as has been shown for wind-up.

Treating the Common Cough in Nonsmokers

Treating the Common Cough in Nonsmokers

Dendrimer electrokinetic capillary chromatography: unimolecular micellar behaviour of carboxylic acid terminated cascade macromolecules

Dendritic (cascade) macromolecules with carboxylic acid terminal moieties are examined as micellar substitutes for the separation of a homologous series of alkyl parabens via electrokinetic capillary chromatography employing aqueous mobile phase conditions; separations using the dendrimers yield excellent efficiency and resolution, while higher generation dendrimers demonstrate enhanced affinity for the parabens relative to lower generation dendrimers and so provide superior separations under identical conditions; the cascades are also shown to be sensitive to solution pH and the technique is extended to the separation of components found in a common cough medicine.

Monitoring of Drug Prescriptions for Children in the County of Jämtland and in Sweden as a Whole in 1977–1987

One individual-based (Jämtland) and one population-based (Sweden) monitoring system provided information on the prescription sales of drugs for children in ambulatory care. The overall prescription rate decreased between 1977 and 1987 and it was 20-25% lower in Jämtland than in Sweden as a whole. Antibiotics, drugs for ear, nose and throat diseases and respiratory drugs accounted for three out of four prescriptions. Penicillin V dominated among antibiotics and the prescription rate was stable whereas that of other antibiotics increased. During their first year of life one out of ten children in Jämtland had at least one prescription of antibiotics, during their first five years three out of four children. Prescribing of decongestants, especially systemic, decreased during the study period whereas that of anti-asthmatics increased, partly due to the non-approved use of these drugs for common cough. The results from our study underline the need for pharmaco-epidemiological studies linking prescription data to clinical data in order to answer questions on the rational of present drug treatment practices.

Common cold with cough on the day of examination: a factor that should be taken into account in epidemiological studies on pulmonary function.

Epidemiologists using pulmonary function tests agree that a number of factors have to be taken into account. In a study carried out among 912 men aged 22 to 54 we found that those having a common cold and cough on the day of examination had lower pulmonary function values. So we suggest that these symptoms should also be considered as a potential confounding factor.

Play materials and toys in the education of young children

A survey on the prescribing pattern of H1-antihistamine preparations was carried out in four socio-economic areas in Liverpool: the City Centre, an Affluent Area, a Poor area and a Council Estate. The purpose of this study was to find out which H1-antihistamines were prescribed from the wide range available; to discover if there was a trend in the use of these agents over a 12-month period and to suggest possible explanations for these findings. The majority of H1-antihistamine preparations were prescribed in the Affluent Area followed by the City Centre, Poor Area and the Council Estate. In all four areas, over 7.0% of all total items dispensed in a year contained H1-antihistamine drugs, and the lowest use (3.7-9.2%) fell in the summer months while the highest use was in January (8.2-14.1% of items containing H1-antihistamine dispensed per month). Thus the general trend in the use of these drugs may not follow the trend of the hay fever season and it is probably true that H1-antihistamines were more frequently prescribed for treatment of other conditions (common cough and cold) than rhinitis alone. The most widely prescribed classes of H1-antihistamines were alkylamines and ethanolamines, followed by the phenothiazines and ethylenediamines while the piperazines were not prescribed. Triprolidine, diphenhydramine, promethazine and brompheniramine were the top four most widely prescribed drugs.

WHOOPING COUGH IS FIRST DESCRIBED AS A DISEASE SUI GENERIS BY BAILLOU IN 1640

Guillaume de Baillou (1536—1616), often called "the Sydenham of France," gave the first detailed description in his Epidemiorum et Ephemeridum Libri (duo) of an epidemic of whooping cough which occurred in 1578: Fevers attacked children of four months, ten months, and a little older, and carried off an enormous number. Especially that common cough which is popularly called Quinta or Quintana, of which mention has been made before. The symptoms of this are severe. The lung is so irritated that in its struggle to drive out by utmost effort the cause of irritation, it can neither inspire, nor with any ease expire. The patient seems to swell up, and as if on the verge of suffocation with his breathing obstructed in midthroat. Why it is popularly called Quinta, is not altogether clear. Some think the word is a made-up term of onomatopoeic origin, from the sound and noise which they make when they cough like this. Others do not derive it from this source, but think the cough is called in Latin ‘Quintana,’ because it repeats at certain hours: and experience shows this is true, for they are free from this distress of coughing sometimes for an interval of four or five hours, then the paroxysm of coughing repeats, sometimes so distressing that blood is driven out by its violence, through nose and mouth. Very frequently the stomach empties it contents. I have never yet read any author who gives any account of this cough.1