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Journal of Oncology Pharmacy Practice :... Jun 2020Intractable and persistent cough is experienced by more than a third of patients with advanced cancer, with a significant negative impact on quality of life....
INTRODUCTION
Intractable and persistent cough is experienced by more than a third of patients with advanced cancer, with a significant negative impact on quality of life. Pharmacological treatment has been of little help in some patients. Limited evidence suggests novel agents such as paroxetine may reduce cough severity. This retrospective study aimed to assess effectiveness and tolerability of paroxetine for the treatment of intractable cough in patients with cancer.
METHODS
Single-centre medical record review of paroxetine use in patients with advanced malignancy and cough treated at an Australia tertiary referral cancer centre between 1 October 2012 and 1 October 2017. Data relating to cough type and severity, response and adverse events were extracted from medical records. Cough type was described as non-productive dry cough, productive chesty cough or cough exhibiting both non-productive and productive features (mixed cough).
RESULTS
Overall, 24/34 patients (71%) experienced a major or moderate reduction in their cough severity after treatment with paroxetine. Nearly half (47%) described a major improvement and a quarter (24%) moderate improvement. Of the 34 patients, nearly half had a lung primary cancer (16/34, 47%) and nearly all (17/18) of those without lung cancer had lung metastases from another primary cancer. Patients with dry cough reported greater benefit from paroxetine. Of the 56% (19/34) of patients with non-productive dry cough, 80% (15/19) reported an improvement in symptoms post paroxetine. The remaining 15 patients, 44% of the group, presented with either a productive chesty cough (9/34, 27%) or mixed cough (6/34, 18%). Of these patients, 60% (9/15) reported an improvement in symptoms. Two thirds of patients were commenced on paroxetine 10 mg (22/34, 65%), with the remainder starting at 20 mg (14/34, 35%).
CONCLUSION
Paroxetine may be an effective, novel, off-label treatment for intractable and persistent cough in patients with advanced cancer.
Topics: Adult; Aged; Aged, 80 and over; Australia; Cough; Female; Humans; Male; Middle Aged; Neoplasms; Paroxetine; Quality of Life; Retrospective Studies
PubMed: 31446865
DOI: 10.1177/1078155219870594 -
Internal Medicine (Tokyo, Japan) Sep 1998There are two types of coughs, productive and non-productive; the former is caused by excess airway secretions. The analysis of cough may provide important clues not... (Comparative Study)
Comparative Study
There are two types of coughs, productive and non-productive; the former is caused by excess airway secretions. The analysis of cough may provide important clues not only to aid diagnosis, but also for the selection of drugs for treatment. In this study, cough sounds recorded in a free acoustic field from patients with productive cough and non-productive cough due to chronic airway diseases were compared with those of voluntary cough of healthy subjects and were analyzed by sound spectrogram and time-expanded waveform. All cough sounds could be separated into two or three phases. The implementation of the novel technique to record cough sounds in the free acoustic field and to analyze the sounds of the high frequency range enable recognition of the characteristics of the cough sounds in phase 2 of the cough.
Topics: Acoustics; Adult; Aged; Bronchitis; Cough; Female; Humans; Lung Diseases, Obstructive; Male; Middle Aged; Sound Spectrography; Speech; Sputum
PubMed: 9804079
DOI: 10.2169/internalmedicine.37.732 -
Jornal Brasileiro de Pneumologia :... 2010The aim of this study was to determine the factors associated with nocturnal, productive and dry cough among young adults in Nigeria.
OBJECTIVE
The aim of this study was to determine the factors associated with nocturnal, productive and dry cough among young adults in Nigeria.
METHODS
We evaluated 498 subjects, 20-44 years of age, in Ilorin, Nigeria, using the European Community Respiratory Health Survey (ECRHS) questionnaire, administered by trained interviewers.
RESULTS
Nocturnal cough was associated with asthma (OR = 10.87; p < 0.01), nasal allergy (OR = 6.33; p < 0.01), smoking (OR = 3.10; p < 0.01), skilled manual and non-manual work (OR = 2.86 and 2.10, respectively; p < 0.01 for both) and female gender (OR = 1.33; p = 0.17). Productive cough was associated with skilled manual and non-manual work (OR = 3.82 and 3.03, respectively; p < 0.01 for both), smoking (OR = 3.10; p < 0.01), asthma (OR = 3.27; p < 0.01) and nasal allergy (OR = 5.81; p < 0.01). Dry cough was associated with asthma (OR =5.18; p < 0.01) obesity (OR =1.88; p = 0.19), smoking (OR = 1.77; p = 1.44), nasal allergy (OR = 1.45; p = 0.26) and female gender (OR =1.36; p = 0.33). Age, gender, type of residence and obesity were not significantly associated with any type of cough (p > 0.05).
CONCLUSIONS
Early prevention and treatment of conditions associated with cough, as well as the modification of social factors commonly associated with cough, are needed in order to reduce respiratory morbidity.
Topics: Adult; Cough; Cross-Sectional Studies; Female; Humans; Logistic Models; Male; Nigeria; Young Adult
PubMed: 20625670
DOI: 10.1590/s1806-37132010000300010 -
Clinical and Experimental Allergy :... Jan 2000We have shown that some patients presenting with chronic bronchodilator-resistant non-productive cough have global atopic tendency and airway cough hypersensitivity...
BACKGROUND
We have shown that some patients presenting with chronic bronchodilator-resistant non-productive cough have global atopic tendency and airway cough hypersensitivity without non-specific bronchial hyperresponsiveness, abbreviated as atopic cough. The cough is successfully treated with histamine H1-antagonists and/or glucocorticoids.
OBJECTIVE
This prospective study was conducted to elucidate the histological feature of atopic cough.
METHODS
Tracheal and bronchial mucosa obtained by transbronchoscopic biopsy and bronchoalveolar lavage (BAL) cell component were studied with special emphasis on eosinophils in eight non-smokers diagnosed with atopic cough, all of whom had increased sensitivity of cough response to inhaled capsaicin, normal lung function and bronchial responsiveness to methacholine and normal chest roentgenogram. Their cough completely resolved on histamine H1-antagonists and/or glucocorticoids. Transbronchoscopic tracheal and bronchial biopsy and BAL were also performed in healthy non-smokers as a control.
RESULTS
A small number of eosinophils was detected in subepithelium of trachea in six of seven patients and in subepithelium of bronchi in seven of eight cough patients. The numbers of eosinophils in subepithelium of trachea and bronchi were significantly increased in the patients compared with control subjects. There was no BAL eosinophilia in any patients.
CONCLUSION
It is concluded that eosinophilic tracheobronchitis and cough hypersensitivity are pathological and physiological characteristics of atopic cough.
Topics: Aged; Bronchial Hyperreactivity; Bronchitis; Bronchoalveolar Lavage Fluid; Chronic Disease; Cough; Eosinophilia; Eosinophils; Female; Humans; Hypersensitivity, Immediate; Male; Middle Aged; Prospective Studies; Tracheitis
PubMed: 10606929
DOI: 10.1046/j.1365-2222.2000.00698.x -
Respiratory Medicine 2023Chronic cough is a common troublesome condition, but it is unclear whether dry or productive chronic cough and sex, impacts the burden of cough differently.
BACKGROUND
Chronic cough is a common troublesome condition, but it is unclear whether dry or productive chronic cough and sex, impacts the burden of cough differently.
METHODS
The Canadian Longitudinal Study on Aging is a nationally generalizable, stratified random sample of adults aged 45-85 years. Chronic cough was identified based on a self-reported daily cough in the last 12 months assessed at baseline (2011-2015) and follow-up (2015-2018). Odds ratios (95 % CI) for cough status and change in social participation activities (SPA), healthcare resource utilisation (HCRU), basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were estimated using a weighted generalised estimating equation (WGEE). Results were stratified by sex, and adjusted for age, sex, smoking, body mass index, education, respiratory diseases and retirement status.
RESULTS
Overall, chronic cough was associated with less SPA, greater HCRU and impaired ADL/IADLs. Productive chronic cough in males was associated with SPA limited by health, ED visits and hospitalisation. Females with productive chronic cough was associated with reduced frequency of SPA and ED visit. Dry chronic cough in females was associated with SPA limited by health and ED visits. Both types of cough was associated with at least 1 impaired basic ADL, but only in females with productive chronic cough was there an association with any impairment in IADLs.
CONCLUSION
Chronic cough is associated with a greater burden on social participation, healthcare use and personal care.
Topics: Male; Female; Humans; Longitudinal Studies; Activities of Daily Living; Social Participation; Cough; Canada; Aging; Patient Acceptance of Health Care
PubMed: 37879447
DOI: 10.1016/j.rmed.2023.107431 -
The Journal of Allergy and Clinical... Nov 2021Chronic cough is a common complaint but there are little population-based data on its burden in the United States.
BACKGROUND
Chronic cough is a common complaint but there are little population-based data on its burden in the United States.
OBJECTIVE
To determine the prevalence of chronic cough and its burden on individuals and the health care system.
METHODS
This was a survey of respondents who completed the 2018 National Health and Wellness Survey and questions about sleep and health care resource use. Chronic cough was defined as having a daily cough for 8 or more weeks. Respondents without chronic cough were selected through propensity score matching. Chronic cough prevalence was estimated using poststratification sampling weights calculated using U.S. Census data and post-data Horvitz-Thompson sampling weights to adjust for sampling bias.
RESULTS
Of 74,977 National Health and Wellness Survey respondents, 3,654 had experienced chronic cough in the previous 12 months, for a weighted prevalence of 5.0%. Respondents with chronic cough were older and more predominantly female than respondents without chronic cough (both P < .001). Compared with matched respondents without chronic cough, those with chronic cough had lower mean scores on the Medical Outcomes Study 36-item Short Form Survey v2 physical (P < .001) and mental (P < .001) component summary scores. More respondents with chronic cough than matched controls experienced severe anxiety and severe depression in the past 2 weeks, work productivity impairment, impaired sleep quality and daytime sleepiness, as well as more emergency department visits and hospitalizations in the past 6 months (P < .001 for all comparisons).
CONCLUSIONS
The burden of chronic cough manifests itself as reduced health-related quality of life, increased anxiety and depression, impaired sleep and work productivity, and greater health care utilization.
Topics: Cost of Illness; Cough; Cross-Sectional Studies; Female; Health Surveys; Humans; Prevalence; Quality of Life; Sleep Quality; United States
PubMed: 34333189
DOI: 10.1016/j.jaip.2021.07.022 -
Journal of Cardiovascular Pharmacology 1989The therapeutic inhibition of angiotensin converting enzyme (ACE) is associated with the production of a dry cough, which occurs more commonly in women than men and... (Review)
Review
The therapeutic inhibition of angiotensin converting enzyme (ACE) is associated with the production of a dry cough, which occurs more commonly in women than men and appears to be unrelated to concurrent illness. At present the exact incidence of ACE inhibitor cough and the substrate of ACE responsible for this effect is unknown. Cough challenge by inhalation of aerosols of tussive agents such as citric acid and capsaicin may be used to study the effect of drug administration on the cough reflex. In normal subjects, an oral dose of captopril (25 mg) causes a significant shift in the dose-response curve to capsaicin inhalation, but not that to distilled water or citric acid. The exacerbation of artificially induced cough by ACE inhibition may be the result of a local increase in perineuronal substance P or bradykinin concentrations within the lung.
Topics: Angiotensin-Converting Enzyme Inhibitors; Cough; Humans
PubMed: 2474106
DOI: 10.1097/00005344-198900133-00015 -
Archives de Pediatrie : Organe Officiel... Aug 2001The medical approach of chronic cough suffers from the lack of a standardised definition. The most frequently encountered criterion is a recurrent cough observed during... (Review)
Review
The medical approach of chronic cough suffers from the lack of a standardised definition. The most frequently encountered criterion is a recurrent cough observed during several consecutive months, each episode lasting at least 1 week. The link between recurrent cough and asthma is still discussed. Cough-related asthma diagnosis is facilitated when wheezing is clearly confirmed, or may be reminded by a nonproductive middle night cough, or an exercise-triggered cough, or the presence of personal or familial atopy. Conversely, an early morning and productive cough associated with tobacco exposure do not suggest asthma.
Topics: Asthma; Child; Child, Preschool; Cough; Diagnosis, Differential; Exercise; Humans; Hypersensitivity; Infant; Infant, Newborn; Recurrence; Tobacco Smoke Pollution
PubMed: 11683085
DOI: 10.1016/s0929-693x(01)80017-8 -
Otolaryngology--head and Neck Surgery :... Dec 2002The differential diagnosis and treatment of patients with chronic cough, paradoxical vocal fold motion, and disordered breathing can be a challenge to most practicing... (Review)
Review
OBJECTIVES
The differential diagnosis and treatment of patients with chronic cough, paradoxical vocal fold motion, and disordered breathing can be a challenge to most practicing otolaryngologists. Tracheobronchial (ie, asthma, bronchitis, and tracheal stenosis), laryngeal (ie, vocal fold paralysis and neoplasms), and rhinologic (ie, allergies and rhinosinusitis) etiologies are commonly diagnosed and treated effectively. However, occasionally one is faced with patients who are refractory to medical treatment and have no obvious rhinologic, laryngeal or pulmonary cause.
STUDY DESIGN AND SETTING
We conducted a review of the literature.
METHODS
We present a thorough review of the current medical literature exploring the complex neurologic mechanisms involved in the production of cough and the relationship between gastroesophageal reflux disease, vagal neurapathy, and paradoxical vocal fold motion.
RESULTS
The diagnosis and successful treatment of chronic cough can be complex. It requires a thorough understanding of the neurologic mechanisms behind cough excitation and suppression. Successful treatment strategies include aggressive management of the patient's reactive airway disease, gastroesophageal reflux disease, and, in select cases, paradoxical vocal fold motion. This may involve a well-coordinated effort among pulmonologists, otolaryngologists, gastroenterologists, and speech pathologists.
CONCLUSION
Gastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion are additional causes of chronic cough and disordered breathing that need to be considered, in the absence of obvious laryngotracheal and/or rhinologic pathology. A high index of suspicion is essential in making the diagnosis and formulating an effective multidisciplinary treatment plan for these patients.
Topics: Chronic Disease; Cough; Diagnosis, Differential; Female; Gastroesophageal Reflux; Humans; Laryngoscopy; Male; Risk Assessment; Vagus Nerve Diseases; Vocal Cord Paralysis; Vocal Cords
PubMed: 12501100
DOI: 10.1067/mhn.2002.127589 -
The Journal of International Medical... Aug 2023Cough is a frequent symptom accompanied by lung cancer. More potent antitussive treatment for this complex and distressing symptom is required, but anti-cancer...
Cough is a frequent symptom accompanied by lung cancer. More potent antitussive treatment for this complex and distressing symptom is required, but anti-cancer chemotherapy cannot fully manage the cough. Inhibition of vagal nerves might control coughing in patients with troublesome lung cancer-related cough and P2X inhibitory therapy may be useful for targeting neuronal function. We report the case of a woman in her late 70s who never smoked and had advanced lung cancer. She visited our hospital complaining of serious deterioration of a non-productive cough. She was diagnosed with relapse of lung cancer, but she requested 2-week anti-tussive therapy before second-line chemotherapy. Gefapixant (P2X antagonist) add-on at a dose of 90 mg/day (45 mg twice daily as the usual dosage in Japan) improved her cough as indicated by an improvement in the visual analog scale for cough from 70 to 20 mm and in the Japanese version of the Leicester Cough Questionnaire from 8.2 to 16.3, despite a deterioration in lung cancer after 2 weeks. There are no current guidelines for cough accompanied by lung cancer; however, our findings suggest that P2X inhibition is a potent therapeutic option for lung cancer-related cough.
Topics: Humans; Female; Cough; Lung Neoplasms; Sulfonamides; Antitussive Agents
PubMed: 37641866
DOI: 10.1177/03000605231194890