China
Africa
Explore chapters and articles related to this topic
Diagnostic tests in respiratory medicine
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
Cough initiates with a deep inspiration that fills the thoracic cavity with air. The external costal muscles are stimulated, the diaphragm flattens and the glottic area opens to let the air in. Next, the vocal cords are closed, creating pressure in the thoracic cavity. A high-speed expiration is stimulated by the contraction of the abdominal wall muscles, the diaphragm returns to a convex shape, the internal costal muscles contract and, finally, the glottic area opens. Since the higher cortical centres influence the cough centre, it is possible to voluntarily produce or suppress a cough. A complex reflex arc is stimulated for each cough (Table 5.3).
Drug Therapy in Laryngology and Head and Neck Surgery
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
These are divided into cough suppressants and the expectorant and demulcent cough preparations. After excluding an underlying cause of a cough, such as asthma and gastro-oesophageal reflux, cough suppressants may be used. It is thought that these drugs act by an ill-defined central action in the nervous system and may depress the ‘cough centre’ in the brain stem. The narcotic analgesics are effective as antitussives in subanalgesic doses. Codeine phosphate is useful for dry or painful coughs but it also inhibits the secretion and mucociliary clearance of sputum, is constipating and dependence can develop. Pholcodine (related to codeine) and dextromethorphan (a non-narcotic, nonanalgesic) have lesser side effects. Over the counter preparations include sedating antihistamines, such as diphenhydramine, and may work by causing drowsiness.
The pharmacology of pain control
Published in Nan Stalker, Pain Control, 2018
Three major therapeutic uses for opioids are as follows. Analgesia, particularly in severe acute and chronic pain: for example, in myocardial infarction, traumatic injury, surgery or terminal illness.Controlling diarrhoea: however, a drug such as loperamide, which acts locally in the intestine, may be preferred. (Loperamide is poorly absorbed so it produces constipation without analgesia, respiratory depression or drug dependency).Cough suppression: morphine and its derivatives are the most potent drugs known to suppress the cough centre in the medulla oblongata. It is also possible to separate the cough suppression activity of the opioid drugs from their analgesic action and potential to produce dependence. Codeine effectively suppresses cough at blood concentrations lower than those required to suppress pain. The synthetic drug dextromethophan suppresses cough but has no analgesic, respiratory depressant or central nervous system stimulating activity.
Premedication with Oral Midazolam Suppress Fentanyl- Induced Cough in Children: A Randomized Double-Blind Trial
Published in Egyptian Journal of Anaesthesia, 2023
Mohamed said mostafa elmeligy, Neveen A. Kohaf, Reda K. Abdelrahman
FIC is commonly caused by fentanyl during the induction of general anesthesia, especially in pediatrics [14]. Fentanyl was classified as a cough-suppressant medicine due to its antagonistic effect on the mu receptor in the lung’s periphery and inhibition of the cough center in the medulla oblongata’s central region [15]. However, paradoxically, it commonly induces coughing shortly after its administration [3]. FIC’s precise mechanisms have not been exactly elucidated. However, there are several suggested mechanisms, including pulmonary chemoreflex: FIC may be regulated by irritant receptors or vagal C-fiber receptors (juxta-capillary receptors). These receptors may trigger a cough reflex when stimulated [16]. Also, fentanyl-induced constriction of the tracheal smooth muscle leads to triggering of pulmonary mucosal irritant receptors and cough induction [3]. Also, fentanyl may cause the production of histamine by the mast cells in the lungs, which can induce cough [17]. In addition, muscle rigidity generated by fentanyl can cause abrupt adduction of the vocal cords or supraglottic blockage by soft tissue, resulting in cough [18].
The diagnostic utility of the frequency scale for the symptoms of gastroesophageal reflux disease questionnaire (FSSG) for patients with subacute/chronic cough
Published in Journal of Asthma, 2021
Ryota Kurokawa, Yoshihiro Kanemitsu, Kensuke Fukumitsu, Norihisa Takeda, Jennifer Maries Yap, Motohiko Suzuki, Yuta Mori, Satoshi Fukuda, Takehiro Uemura, Tomoko Tajiri, Hirotsugu Ohkubo, Ken Maeno, Yutaka Ito, Tetsuya Oguri, Masaya Takemura, Akio Niimi
@@This is a post-hoc analysis of our previous study of the epidemiology of subacute/chronic cough in a tertiary cough center in Japan (4). Four hundred and fourteen patients visited the asthma and chronic cough clinic of Nagoya City University Hospital between April 2012 and March 2018 due to subacute or chronic cough without other respiratory symptoms (4). Subacute/chronic cough was defined as cough persisting for 3 weeks or longer. Patients underwent diagnostic and therapeutic trials by cough specialists (Y.K., M.T., and A.N.). Exclusion criteria of this study were as follows, as were in our original study (1,4) patients with current or former smoking history of more than 10 pack-years or those who quitted smoking within 6 months prior to the first visit, (2) abnormal chest radiograph findings that may explain cough symptoms, and (3) symptoms of chest tightness, shortness of breath or wheezing that may suggest typical asthma rather than CVA. In the previous report, we excluded 102 patients due to smoking history of >10 pack-years (n = 35) or the presence of wheezes on auscultation (n = 67) (4). Among the remaining 312 patients, 56 patients did not undergo blood analysis. Therefore, 256 patients were analyzed in the present study.
Carob extract attenuates brain and lung injury in rats exposed to waterpipe smoke
Published in Egyptian Journal of Basic and Applied Sciences, 2018
Mona Abdel-Rahman, Amira A. Bauomy, Fatma Elzahraa H. Salem, Mona Ahmed Khalifa
The waterpipe smokers had increased cough and biologic abnormalities in several anatomic components in the lung compared to nonsmokers [35]. The cough reflex can be initiated by a wide variety of stimuli [36]. The vagal fibers for cough enter the brainstem (cough center) and relay in the nucleus of the solitary tract with connections to second-order neurons [37,38] . Afferent impulses travel to the dorsal medulla where the reflex is subject to cortical control where cerebral cortex has a role in influencing cough. The brain then sends signals back to the lungs and respiratory muscles [39,40] . Neurotransmitters which involved in the central cough complex are tachykinins, glutamate, g-aminobutyric acid, N-methyl-D-aspartate, 5-HT and DA [37,38,41] . Increased release of substance P is involved in the development of cough and inflammation of the airway, and its production is regulated by dopaminergic neurons in the brainstem.