Chung K Fan
National Heart & Lung Institute, Dovehouse Street, London, SW3 6LY, UK.
IDrugs. 2003 Aug;6(8):781-6.
Cough is an important defensive reflex of the airway and a common symptom of respiratory disease. After an upper respiratory tract virus infection, cough is transient, but is more persistent with conditions such as asthma, rhinosinusitis, gastroesophageal reflux, chronic obstructive pulmonary disease (COPD) and lung cancer. Treatment directed at these conditions may improve cough, but there remains a need to control cough directly. The most effective antitussives are opioids, such as morphine, codeine or pholcodeine, but they produce side effects including drowsiness, nausea, constipation and physical dependence. Opioids such as k- and d-opioid receptor agonists, non-opioids such as nociceptin, neurokinin and bradykinin receptor antagonists, vanilloid receptor VR(1) antagonists, blockers of sodium-dependent channels, and maxi-K calcium-dependent channel activators of afferent nerves may all represent novel antitussives and this needs to be confirmed in clinical trials.
咳嗽是气道的一种重要防御反射，也是呼吸系统疾病的常见症状。上呼吸道病毒感染后，咳嗽是短暂的，但在哮喘、鼻窦炎、胃食管反流、慢性阻塞性肺疾病（COPD）和肺癌等疾病中更为持久。针对这些疾病的治疗可能会改善咳嗽，但仍需要直接控制咳嗽。最有效的镇咳药是阿片类药物，如吗啡、可待因或福尔可定，但它们会产生副作用，包括嗜睡、恶心、便秘和身体依赖。κ和δ阿片受体激动剂等阿片类药物、孤啡肽、神经激肽和缓激肽受体拮抗剂等非阿片类药物、香草酸受体VR(1)拮抗剂、钠依赖性通道阻滞剂以及传入神经的大电导钙依赖性钾通道激活剂都可能代表新型镇咳药，这需要在临床试验中得到证实。
