- Cough is non-productive (dry cough) if there is minimal clear-white or no phlegm (sputum)
- Cough is productive (wet cough) if there is yellow, green, or brown phlegm (sputum)
Why We Cough - A cough has two important functions:
- It serves to clear the airways of infection, mucus, foreign bodies, and other irritants.
- It protects against aspiration of oral and stomach contents.
Causes of Coughing
- Most common causes: postnasal drip syndrome from a cold, allergic rhinitis, and sinusitis.
- Other common causes: asthma, bronchitis, pneumonia, gastroesophageal reflux, and smoking.
- Less common causes: lung cancer, congestive heart failure, pulmonary embolism, TB, Whooping Cough, and ACE inhibitor drugs
Angiotensin-Converting Enzyme (ACE) Inhibitors can cause a dry chronic cough. Generic and trade name listing:
- Benazepril - Lotensin
- Captopril - Capoten
- Cilazapril - Inhibace
- Enalapril, Enalaprilat - Vasotec
- Fosinopril - Monopril
- Lisinopril - Zestril
- Moexipril - Univasc
- Perindopril - Aceon, Coversyl
- Quinapril - Accupril
- Ramipril - Altace
- Trandolapril - Mavik
Honey for Cough
- Recent Research Study: A recent research study compared honey to either dextromethorphan (DM) or no treatment for the treatment of nocturnal coughing. The study group contained 105 children age 2 to 18 years. Honey consistently scored the best for reducing cough frequency and cough severity. It also scored best for improving sleep. Dextromethorphan (DM) did not score any better than "no treatment" (showing DM's lack of effect).
- How Might Honey Work? One explanation for how honey works is that sweet substances naturally cause reflex salivation and increased airway secretions. These secretions may lubricate the airway and remove the trigger (or tickle) that causes a dry, nonproductive cough.
- Adult Dosage: 2 teaspoons (10 ml) at bedtime
See More Appropriate Topic (instead of this one) If
Should I Call?
WHEN TO CALL YOUR DOCTOR
Call 911 Now (you may need an ambulance) If
- Passed out (fainted)
- Severe difficulty breathing (e.g., struggling for each breath, unable to speak)
- Lips or face are blue
- Wheezing or coughing started suddenly after medicine, an allergic food or bee sting
- Difficulty breathing after exposure to flames, smoke, or fumes
Call Your Doctor Now (night or day) If
- You feel weak or very sick
- Chest pain (Exception: mild chest pain lasting only a few seconds that occurs only when coughing)
- Difficulty breathing
- Wheezing is present
- Coughing up blood and more than a few streaks
- Fever of 103° F (39.4° C) or higher
- Fever of 100.5° F (38.1° C) or higher and you
- Are over 60 years of age OR
- Have diabetes mellitus or a weakened immune system (e.g., HIV positive, cancer chemotherapy, chronic steroid treatment, splenectomy) OR
- Are bedridden (e.g., nursing home patient, stroke, chronic illness, recovering from surgery)
- Increasing ankle swelling
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Coughing up blood
- Coughing has kept you home from school or work for 3 or more days
- Nasal discharge lasts more than 10 days
- Fever returns after being gone for more than 24 hours
- Symptoms of nasal allergy are also present (e.g., itchy eyes, clear nasal discharge, postnasal drip)
- Taking an ACE Inhibitor medication (Including: benazepril/LOTENSIN, captopril/CAPOTEN, enalapril/VASOTEC, lisinopril/ZESTRIL)
- Exposure to TB (Tuberculosis)
- Cough lasts more than 3 weeks
Self Care at Home If
Care at Home
HOME CARE ADVICE
General Care Advice for Mild to Moderate Cough
- Cough Medicines:
- OTC Cough Syrups: The most common cough suppressant in OTC cough medications is dextromethorphan. Often the letters "DM" appear in the name.
- OTC Cough Drops: Cough drops can help a lot, especially for mild coughs. They reduce coughing by soothing your irritated throat and removing that tickle sensation in the back of the throat. Cough drops also have the advantage of portability - you can carry them with you.
- Home Remedy - Hard Candy: Hard candy works just as well as medicine-flavored OTC cough drops. Diabetics should use sugar-free candy.
- Home Remedy - Honey: An old home remedy has been shown to help decrease coughing at night. The adult dosage is 2 teaspoons (10 ml) at bedtime.
- OTC Cough Syrup - Dextromethorphan:
- Caution - Dextropmethorphan:
- Coughing Spasms:
- Drink warm fluids. Inhale warm mist (Reason: both relax the airway and loosen up the phlegm).
- Suck on cough drops or hard candy to coat the irritated throat.
- Prevent Dehydration:
- Avoid Tobacco Smoke: Smoking or being exposed to smoke makes coughs much worse.
- Fever Medication:
- For fevers above 101° F (38.3° C) take acetaminophen or ibuprofen. The goal of fever therapy is to bring the fever down to a comfortable level. Remember that fever medicine usually lowers fever 2 degrees F (1 - 1 1/2 degrees C).
- Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
- Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
- People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
- CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- CAUTION: Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
- Expected Course: Viral bronchitis causes a cough that lasts 1 to 3 weeks. Sometimes you may cough up lots of phlegm (sputum, mucus). The mucus can normally be white, gray, yellow or green.
- Call Your Doctor If:
- Difficulty breathing
- Cough lasts more than 3 weeks
- Fever lasts longer than 3 days
- You become worse
- For a Stuffy Nose - Use Nasal Washes:
- Introduction: Saline (salt water) nasal irrigation is an effective and simple home remedy for treating cold symptoms and other conditions involving the nasal and sinus passages. Nasal irrigation consists of pouring, spraying, or squirting salt water into the nose and then letting it run back out.
- How it Helps: The salt water rinses out excess mucus, washes out any irritants (dust, allergens) that might be present, and moisturizes the nasal cavity.
- Methods: There are several ways to perform nasal irrigation. You can use a saline nasal spray bottle (available over-the-counter), a rubber ear syringe, a medical syringe without the needle, or a Neti Pot.
- Step 1:Lean over a sink.
- Step 2: Gently squirt or spray warm salt water into one of your nostrils.
- Step 3: Some of the water may run into the back of your throat. Spit this out. If you swallow the salt water it will not hurt you.
- Step 4: Blow your nose to clean out the water and mucus.
- Step 5: Repeat steps 1-4 for the other nostril. You can do this a couple times a day if it seems to help you.
How to Make Saline (Salt Water) Nasal Wash: Add 1/2 tsp of table salt to 1 cup (8 oz; 240 ml) of warm water.
- For a Runny Nose With Profuse Discharge: Blow the Nose.
- Medicines for a Stuffy or Runny Nose:
- Nasal Decongestants for a Very Stuffy or Runny Nose:
- Caution - Nasal Decongestants:
- Pain and Fever Medication:
- Expected Course:
- Call Your Doctor If:
And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.
Author and Senior Reviewer: David A. Thompson, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.
Last Review Date: 6/1/2011
Last Revised: 8/13/2010
Content Set: Adult HouseCalls Symptom Checker
Version Year: 2012
Portions Copyright 2000-2012 Self Care Decisions LLC; Copyright LMS, Inc.