Treating Cough
The best treatment for a cough is to treat the responsible underlying condition. A cough can also be treated with medications that either:
- Make the cough more productive
- Suppress the cough
In a Public Health Advisory, the Food and Drug Administration (FDA) recommends that over-the-counter (OTC) cough and cold products should not be used to treat infants or children less than two years old. Rare but serious side effects have been reported, including death, convulsions, rapid heart rates, and decreased levels of consciousness. OTC cough and cold products include decongestants, expectorants (to make cough more productive), antihistamines, and antitussives (cough suppressants). The FDA is still reviewing data concerning the safety of these products in children aged 2-11 years. There have been serious side effects reported in this age group as well. * 1
A wet cough, which produces sputum, is an important way for your body to clear secretions from the airways. Wet coughs should not be suppressed, but may need to be made more productive. They may be treated with expectorant medications. These medications help thin bronchial secretions and make them looser and easier to cough up.
Guaifenesin is the best known expectorant and is found in a variety of over-the-counter cough and cold products (Robitussin, for example).
Moisture therapy also helps make secretions looser and easier to cough up. This therapy involves adding moisture to air with a steam vaporizer or cool-mist humidifier.
Medications are used to suppress a cough when it is:
- Dry (producing little or no sputum)
- Wet, but causes severe chest pain or interferes with sleep
Examples of cough suppressants include:
- Local anesthetics in the form of lozenges, sprays, and pills
- Dextromethorphan (eg, Robitussin Cough Suppressant, Vicks Cough Relief)
- Narcotics such as codeine
Honey has also been studied. This natural remedy appears to improve nighttime cough and sleep disruption in children. Note: Do not give honey to infants younger than 12 months because of the risk of infant botulism. * 2
In January 2006, new guidelines for treatment of cough from the American College of Chest Physicians were issued. Emphasis is now placed on prevention of whooping cough , including use of a newly approved vaccine. In addition, use of expectorants and suppressants is now discouraged; in their place, use of antihistamines is now emphasized. Identifying the underlying cause is the primary focus for intervention.