Friday, 17 October 2014

Getting rid of a cough

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When you're sick with a cold, one of the most annoying symptoms is usually a cough. Not only does a cough make it hard for you to relax and focus on recovery, but it can also worsen an already sore throat and contribute to chest pain. As such, getting rid of a cough is often at the top of most people's list when they treat a common cold.


Why does coughing occur?


Coughing primarily occurs due to irritation of the respiratory system from an allergen, illness, or as a result of other irritants. The common cold causes the body to ramp up production of nasal mucus, and this can cause the cough that follows. Getting rid of a cough can often be as simple as treating the congestion. If congestion is contributing to your coughing, decongestants should be the first line of treatment.

Other times, a dry cough can occur with a cold, or can be caused by allergies and environmental irritants. A cough like this occurs because the body's cough reflex has been stimulated, even when congestion is not present. This form of coughing responds best to treatments that decrease the cough reflex at its source. A dry cough isn't the result of congestion, so it won't respond to decongestants.


Treating a congestion cough


Getting rid of a cough that is the result of congestion requires treatment that is tailored towards relieving the excess mucus and clearing up the throat. The medications used for this purpose are called decongestants and some of these medications include:

  • Pseudoephedrine (Sudafed Original)
  • Phenylephrine (Sudafed PE)
  • Oxymetazoline (Nasal sprays)
  • Ephedrine
  • Propylhexedrine (Benzedrex)
  • Levomethamphetamine (Vicks Vapor Inhaler - US only)
Although there is a fairly wide variety of medications used to treat congestion, the most common are phenylephrine in over the counter pills, and oxymetazoline in nasal sprays. Pseudoephedrine is also commonly used, but is often only administered under prescription.





For effective relief of congestion, and for getting rid of a cough that is caused by it, the best form of treatment is a nasal spray containing oxymetazoline. This is because phenylephrine, at least in typical dosages, is not determined to be any more effective than placebo. Unless you have a doctor's prescription for pseudoephedrine, which is the absolute best decongestant, a nasal spray is going to be the most effective product.

One caveat however is that anyone with a heart or blood pressure condition shouldn't use any of these medications because they can all speed up the heart and increase blood pressure. This effect is less likely in the case of a nasal spray, because the effect is localised to the nose, but it is always best to consult your doctor first before using any of these medications if you have a condition like this.

If your cough is a result of congestion, and this is usually the case with a wet cough, getting rid of a cough is as easy as using the decongestant as directed. The excess mucus production will cease, and your cough will ease up as a result. If necessary, you can add in guaifenesin or one of the remedies for a dry cough to completely stop it in its tracks.

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Guaifenesin






Guaifenesin is another medication that can be used for getting rid of a cough. This medication is found in OTC cough medicine and works by breaking up mucus and drawing it out of the airways. If your congestion if particularly bad, you can combine a decongestant with guaifenesin to increase the effects of the decongestant and speed up the elimination of your cough.

This medication is not effective for a dry cough, because this form of a cough isn't caused by mucus. If you're suffering from a dry cough, you will need a different treatment. Neither guaifenesin or decongestants will work.


Treating a dry cough


Getting rid of a cough is slightly more difficult when you have a dry cough, because this kind of cough isn't the direct result of mucus irritating the throat. This cough can be caused from anything from allergens, environmental irritants, viruses, or pre-existing conditions. Treating this kind of cough requires medications that can decrease the central nervous system's cough reflex.

This kind of cough has many potential treatments, and even a few highly effective natural treatments that have similar efficacy to their synthetic counterparts. Some of the medications that are often used to treat a dry cough include:
  • Ginger
  • Theobromine - found in high amounts in chocolate
  • Codeine
  • Dextromethorphan
  • Dihydrocodeine
  • Pholcodine

Many of the above medications are actually natural products. In the case of ginger and theobromine, both of these treatments can be consumed as hot drinks or in a few other forms that are tasty and beneficial. Codeine is also natural because it is derived from the opium poppy. Opiates are the single most effective treatment for a dry cough.

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Codeine and dihydrocodeine


Codeine and dihydrocodeine are both members of the opiate drug class. The main difference is that codeine is completely natural, whereas dihydrocodeine is a semi-synthetic relative that can be formed by modifying codeine.

Both of these medications are often considered the gold standard of antitussive effect and have been used for coughs for around a century. They are the standard that every other cough suppressant is measured against and have been proven safe and highly effective through the millions of people and many years of usage.

Of course, because these drugs are opiates, they should not be taken by anyone who has an allergy to opiates, is overly sensitive to their effects, or by someone who is taking other sedating drugs that could interact. It is best to consult your doctor before using these for the first time, or if you are taking any other medication currently. If you have a dry cough and one of these medications doesn't get rid of it, nothing will.


Ginger and theobromine


  • Other natural antitussives

    This guide can be used if you are searching for a completely natural treatment plan, as it includes some of the many natural foods and herbs that have an antitussive effect.

    If you plan to do this, you need to know that most of these don't have significant proof that they work, or the effect is mild at best. The guide is included as a reference only.

    You will also need to research each individual herb and consult your doctor before use because even natural medicine may be contraindicated because of any health conditions, allergies, or other medications you may be taking.
Ginger and theobromine are rather interesting as treatments for a cough. Theobromine is a stimulant related to caffeine, found in most natural sources of caffeine like tea and coffee. It is most concentrated in cocoa however, and hot chocolate can make a great method for getting rid of a cough. Ginger, on the other hand, is often used for digestive issues and is found in many baked goods, drinks, and candies, as well as plenty of savoury foods like curry.

Both of these natural medications may have an effect that is similar to codeine, without being an opiate themselves, and this is why they are so interesting. They suppress the cough reflex in the central nervous system, just like opiates, but do so through a different mechanism.

This also means that they can be taken together with traditional opiate antitussives like codeine and the cough suppressant effect will be boosted synergistically, but you shouldn't take them if you have an allergy to either medication. You also shouldn't take theobromine if you have a heart of blood pressure problem, a sensitivity to caffeine, or an allergy to either theobromine or chocolate.

Finally, because the research into the antitussive effects of these natural cough suppressants is fairly recent, and they haven't been widely compared to common opiate antitussives as of yet, their efficacy isn't a definite like it is with codeine or dihydrocodeine. The effect may not be real, or it may only work under certain circumstances. More research needs to be concluded before the effects are completely concrete. Until then, you take the risk that the treatment won't work for you if you go this route.

  • Ginger pharmacological study

    (6)-Shogaol is one of the active constituents of ginger, and showed an antitussive effect comparable to dihydrocodeine in this study. It is for this reason that getting rid of a cough with ginger or ginger extract may be possible.


Dextromethorphan


Dextromethorphan is another common cough suppressant found in OTC syrups and cold medicine pills. Whilst it is somewhat related to opiates, it does not share the same effect and is not an opiate medication. For this reason, it can not be used for any of the other purposes where opiates would be used. It also has different side effects.





This medication is most commonly found in Robitussin, and is another medication where you should preferably receive advice from a doctor or pharmacist before using. Do not use this medication for getting rid of a cough if you have an allergy to it, to NMDA antagonists, or are using other medications that could interact. This is especially important if you are taking MAO inhibitors or antidepressants, because it can result in serotonin syndrome from excess serotonin.

When used for a cough, dextromethorphan is probably not effective, based on studies that rate it no better than placebo. It'd be better to just avoid it entirely as it is a waste of money for this purpose because there isn't enough proof that it can treat a cough. It was introduced to the market to replace codeine in much the same way as phenylephrine, without any significant regard to whether it even works.


Pholcodine


Pholcodine is an opiate, but it doesn't share the same effects of codeine and other typical opiates. This is because it selectively affects the cough center of the central nervous system. This means that it can reduce a cough without causing the typical side effects of opiates.

It is nowhere near as effective as standard opiates however, and is only a good option if you are sensitive to common opiates. It can also be mildly sedating and you should consult with a pharmacist prior to use in order to ensure other medications aren't going to interact.


Prescription cough suppressants


Prescriptions cough suppressants are powerful, and not to be taken lightly. These medications are strong opiates like morphine, hydromorphone, and hydrocodone. You will need a prescription for any of these drugs and they must only be taken under the supervision of your doctor. They should also only be taken if other more conservative treatments have failed.


Antihistamines


If your cough is being caused by an allergy, antihistamines are an easy way to treat this, and are also some of the most tolerable medications available. Conditions like allergic rhinitis and asthma, as well as hayfever and other allergies, are able to cause coughing. Getting rid of a cough that is the result of allergies can be achieved with antihistamines like loratadine or fexofenadine.





In this study, loratadine was compared to placebo for the treatment of coughs that are a result of allergic conditions. Loratadine was found to significantly suppress the coughing reflex in those with an allergy, but not in those who did not have an allergy. This means that antihistamines are a highly effective treatment for allergic coughing, but should not be used for other types of coughs. They will only treat allergic conditions.

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Taking any antitussive medication, even if natural, should be done under the consultation of a doctor or pharmacist. You also shouldn't be using them for getting rid of a cough that is chronic and won't seem to go away. This needs to be looked at by a medical professional as it may be something more serious. Antitussives are only for temporary relief of temporary coughs. When used appropriately like this, you ensure that your health is being well looked after and you're getting the relief you need without putting yourself at risk.

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