Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China; Department of Pulmonary and Critical Care Medicine, Shanghai Putuo District People's Hospital, Shanghai, China.
Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Ann Palliat Med. 2020 Sep;9(5):3562-3570. doi: 10.21037/apm-20-819. Epub 2020 Sep 2.
Chronic cough is defined as a cough lasting for ≥8 weeks with a normal chest radiograph. The common causes of chronic cough are cough variant asthma (CVA), upper airway cough syndrome/postnasal drip syndrome (UACS/PNDs), eosinophilic bronchitis (EB), gastroesophageal reflux-related chronic cough (GERC) and atopic cough (AC). Drug-induced chronic cough, a rare cause of chronic cough, refers to a chronic cough caused by certain drugs. In addition to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), there are cases reporting that some drugs such as omeprazole and leflumide that can cause cough. An important step in the diagnosis and treatment of chronic cough is to determine the history of the patient with regard to any drugs that can induce chronic cough. If the cough occurs after taking the medicine, a suspected diagnosis of drug-induced cough should be established. If the cough resolution occurs within 1 to 4 weeks after drug withdrawal, it would be considered as a side effect of the medication. we should be alert to the possibility of drug-induced chronic cough after excluding CVA, UACS, EB and other common causes of chronic cough. This article reviews the relevant drugs that may cause cough and their possible mechanisms of action.
慢性咳嗽定义为咳嗽持续时间≥8 周，且胸部 X 线正常。慢性咳嗽的常见病因包括咳嗽变异性哮喘（CVA）、上气道咳嗽综合征/鼻后滴注综合征（UACS/PNDs）、嗜酸粒细胞性支气管炎（EB）、胃食管反流相关性慢性咳嗽（GERC）和变应性咳嗽（AC）。药物相关性慢性咳嗽是一种罕见的慢性咳嗽病因，是指由某些药物引起的慢性咳嗽。除血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）外，还有报道称某些药物如奥美拉唑和来氟米特也可引起咳嗽。慢性咳嗽的诊断和治疗的一个重要步骤是确定患者与可诱发慢性咳嗽的药物相关的病史。如果咳嗽发生在服药之后，应怀疑为药物相关性咳嗽。如果停药后 1 至 4 周内咳嗽缓解，则可认为是药物的副作用。在排除 CVA、UACS、EB 等慢性咳嗽常见病因后，我们应警惕药物相关性慢性咳嗽的可能性。本文回顾了可能引起咳嗽的相关药物及其可能的作用机制。
