Padma L
Depatment of Pharmacology, Dr. BR Ambedkar Medical College, Bangalore.
J Assoc Physicians India. 2013 May;61(5 Suppl):9-13.
Cough is one of the commonest symptoms of respiratory tract infections and is a frequent problem encountered in general practice as well as in hospital practice. A wide range of disease processes may present with cough and definitive treatment depends on identifying the cause and diagnosis. Specific treatment of the cause should control the cough, but this may not occur in all cases and in a sizeable proportion of patients, no associated cause can be found. An increased sensitivity of the cough reflex can be observed in patients with dry cough. Symptomatic relief must be considered when the cough interferes with the patient's daily activities and this is effectively treated with antitussive preparations which are available as combinations of codeine or dextromethorphan with antihistamines, decongestants and expectorants Antitussives are used for effective symptomatic relief of dry or non-productive cough. First generation antihistamines like chlorpheniramine and centrally acting opioid derivatives like codeine are often used alone or in combination in the management of nonspecific cough. Sedation caused by these is valuable, particularly if the cough is disturbing the sleep. Although there is extensive experimental data on single agent antitussives and antitussive combinations, there is a major paucity of published literature on these combinations in nonspecific cough. Treatment of dry cough remains a challenge in some patients and this article reviews the scope of the current drugs and combination of Codeine and Chlorpheniramine in the effective management of dry cough.
咳嗽是呼吸道感染最常见的症状之一,在全科医疗和医院医疗中都是经常遇到的问题。多种疾病过程都可能表现为咳嗽,而确切的治疗取决于病因的识别和诊断。针对病因的特异性治疗应能控制咳嗽,但并非所有情况都是如此,而且在相当一部分患者中,找不到相关病因。干咳患者可观察到咳嗽反射敏感性增加。当咳嗽干扰患者日常活动时,必须考虑对症缓解,可使用镇咳制剂进行有效治疗,这些制剂有可待因或右美沙芬与抗组胺药、减充血剂和祛痰剂的组合。镇咳药用于有效缓解干咳或无痰咳嗽的症状。第一代抗组胺药如氯苯那敏和中枢性阿片类衍生物如可待因在非特异性咳嗽的治疗中常单独使用或联合使用。这些药物引起的镇静作用很有价值,尤其是当咳嗽干扰睡眠时。尽管有大量关于单一镇咳药和镇咳药组合的实验数据,但关于这些组合在非特异性咳嗽中的已发表文献却非常匮乏。干咳的治疗在一些患者中仍然是一项挑战,本文综述了当前药物以及可待因和氯苯那敏组合在有效治疗干咳方面的应用范围。