COUGHS

INTRODUCTION

There are two basic types of cough Chesty and Dry. A chesty cough is characterized by the presence of mucus or phlegm on the chest; this is absent in a dry cough. The action of coughing is therefore of benefit in the case of a chesty cough, as the mucus needs to be moved from the chest. However in a dry cough there is no benefit to coughing.  Chesty coughs are further divided into Productive and Non-Productive. An individual with a productive chesty cough will notice the presence of the mucus on the chest because they are coughing some of this phlegm off their chest. In the case of a non-productive cough the mucus is not being moved from the chest despite the coughing. If any phlegm coughed up is coloured green/yellow or contains any blood it is important to consult a doctor.  If you are still unsure which type of cough you have talk to your pharmacist about your symptoms, you could use Simple Linctus until you are sure which type of cough you have as it can be safely used in both types of cough, both chesty and dry.

SUMMARY OF COUGH TYPES

Dry  Chesty - Productive  Chesty - Non-productive

GENERAL ADVICE TO RELIEVE SYMPTOMS OF COUGHS

You can help relieve the symptoms of coughs by:  Inhaling steam helps to break up any phlegm on the chest in the case of a chesty cough. It may also soothe the chest in the case of a dry cough. The steam can also be fragranced with menthol or Olbas Oil™ to help breathing. Taking a hot bath or shower will expose your chest to natural steam.  During the night when coughs are often most trouble, use of a vaporiser in the bedroom may help you get a restful nights sleep.

DRY COUGHS

Dry coughs are best treated with a medicine that stops the urge to cough. The cough has no purpose and the irritation on the chest is more nuisance than benefit. There are several medicines available which have just this action. The medical term for a cough suppressant is an antitussive.  Even though you may have a dry cough, it is still difficult to decide which medicine to use, as the choice in this area is so wide. As such, rather that dealing with individual products, we will look at the agents within these products. The main ones are codeine, pholcodine and dextromethorphan. Codeine based medicines- Codeine is not common nowadays due to its potential to abuse, however some chemists may still sell it in the form of a linctus (syrup like medicine) called codeine linctus. It works by suppressing the urge to cough. It is very effective but has some drawbacks. It can cause constipation, however, this is reversible upon discontinuing use of the product.  Pholcodine based medicines- Pholcodine is now the recommended replacement for codeine linctus, it is just as effective but manages to avoid the problems that are encountered with the use of codeine. Again it is usually available in liquid form, but can be taken as tablets and capsules along with other active ingredients. For example, cold and flu remedies often have pholcodine as an ingredient. Dextromethorphan based medicines- Dextromethorphan is less common than the other two ingredients, however it is just as useful. It is available in a liquid form, however it does not usually get used in cold and 'flu products.

CHESTY COUGHS

Productive and Non Productive coughs are very similar and indeed have similar treatments. The best way of dealing with these coughs is to aid the natural coughing process, which is attempting to remove the phlegm from the chest. This is done by use of agents that break the mucus up and therefore make it easier to cough the mucus off the chest. Another ingredient often added to products for chesty coughs is Cetylpyridinium, which has a breath freshening action since catarrh can affect the odour of the breath.  There are four agents available that have expectorant properties:  Ammonium Chloride- This expectorant is used in the more traditional remedies available for chesty coughs. It is still available in generic form. Guaiphenesin- This is the most popular expectorant used in current medicines for productive chesty coughs.  Diphenhydramine- This is also a popular ingredient.  Ipecacuanha- This ingredient is usually added to products containing glycerin. For example glycerin, honey and lemon with ipecacuanha.

COMBINATION PRODUCTS

Nowadays, more and more preparations are manufactured to deal with a variety of symptoms of cold and flu. Cough relief ingredients are found in a number of modern combination preparations. A typical combination preparation may have ingredients to deal with the symptoms of pain, cough and runny nose. It is a good idea to read the ingredients on these types of combination preparations and understand how each ingredient will deal with your symptoms. If you are in doubt, ask your pharmacist.

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