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Cough Suppressant

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1. Altering cough reflex sensitivity with aerosolized capsaicin paired with behavioral cough suppression: a proof-of-concept study. Full Text available with Trip Pro

Altering cough reflex sensitivity with aerosolized capsaicin paired with behavioral cough suppression: a proof-of-concept study. The purpose of this prospective, quasi-experimental, single cohort proof-of-concept study was to determine feasibility and proof-of-concept of programmatically decreasing cough sensitivity through use of cough suppression strategies following inhalation of aerosolized capsaicin, in gradually increasing doses, across repeated treatment sessions.Five healthy adults (...) consisted of 5-6 treatment sessions, during which participants were exposed to increasing doses of aerosolized capsaicin while implementing behavioral cough suppression strategies. In phase III, cough sensitivity was re-tested at 1 and 3 weeks post-treatment. Participants were given explicit instructions to not try to suppress their cough. Participants who did not reach the C2 or C5 threshold at 1,000 µmol/L were assigned a score of 1,250 µmol/L.Each participant demonstrated a gradual increase

2019 Annals of Translational Medicine Controlled trial quality: uncertain

2. Quantifying test-retest variability of natural and suppressed citric acid cough thresholds and urge to cough ratings. (Abstract)

Quantifying test-retest variability of natural and suppressed citric acid cough thresholds and urge to cough ratings. The citric acid cough reflex test (CRT) is used to quantify cough sensitivity and evaluate the effects of cough therapies and antitussive medications. This study quantifies the test-retest variability of natural and suppressed citric acid cough thresholds and urge to cough ratings in healthy individuals.Healthy adults (n = 16) inhaled increasing concentrations of citric acid (...) (0.01-3.2 mol/L) on three alternate days (1, 3, 5) until C2 cough thresholds (i.e. two consecutive coughs within 3 s) or the highest concentrations of citric acid was reached. Participants were instructed to "cough if you need to" in the natural cough condition, and "try not to cough" in the suppressed cough condition. Following each inhalation, participants were asked to rate their urge to cough (UTC) using a modified Borg Scale.Natural cough thresholds (NCTs) increased across days 1-3 (0.87

2019 Pulmonary Pharmacology & Therapeutics

3. Impaired cough suppression in chronic refractory cough. (Abstract)

Impaired cough suppression in chronic refractory cough. Functional brain imaging in individuals with chronic cough demonstrates reduced activation in cortical regions associated with voluntary cough suppression. Little is known about the ability of patients with chronic cough to suppress cough. This study aimed to compare the ability to voluntarily suppress cough during inhaled capsaicin challenge in participants with chronic refractory cough with that in healthy controls. This study also aimed (...) to assess the repeatability of capsaicin challenge test with voluntary cough suppression.Participants with chronic refractory cough and healthy controls underwent inhaled capsaicin challenge tests whilst attempting to suppress their cough responses. After 5 days either a conventional capsaicin challenge test with no cough suppression attempt, or a repeat test with an attempt at cough suppression was performed. Threshold capsaicin concentrations required to elicit 1, 2 and 5 coughs were calculated

2019 European Respiratory Journal

4. Comparison of the effects of pretreatment intravenous fentanyl or intravenous lidocaine on suppression of fentanyl-induced cough in children: a randomized, double-blind, controlled clinical trial Full Text available with Trip Pro

Comparison of the effects of pretreatment intravenous fentanyl or intravenous lidocaine on suppression of fentanyl-induced cough in children: a randomized, double-blind, controlled clinical trial The injection of fentanyl usually causes coughing during induction of anesthesia. Based on a few studies about effects of lidocaine and the fact there is no study concerning the effect of fentanyl on fentanyl-induced cough in pediatric patients, the aim of this study was to compare the effectiveness (...) of low dose of fentanyl with lidocaine in prevention of fentanyl-induced cough in children.This randomized double-blind controlled clinical trial study was conducted at Motahari Hospital between February and August 2017 in Urmia (Iran). One hundred patients, aged 2-10 years, of class I or II ASA status who were candidates for elective herniorrhaphy under general anesthesia were enrolled in this study. They were randomly divided into three groups. One minute before the administration of 2 μg/kg

2018 Electronic physician Controlled trial quality: uncertain

5. Assessing referral and practice patterns of patients with chronic cough referred for behavioral cough suppression therapy. Full Text available with Trip Pro

Assessing referral and practice patterns of patients with chronic cough referred for behavioral cough suppression therapy. The purpose of this exploratory research was to describe current referral and practice patterns for behavioral cough suppression therapy (BCST) throughout the United States, and to assess the need for improving the efficiency of BCST referral patterns. In study I, 126 speech-language pathologists, who treat patients with refractory chronic cough (RCC) in the United States (...) , completed a survey about referral patterns, cough duration, and patient frustration level. In study II, 36 adults with RCC referred for BCST completed a four-part survey about cough symptoms and treatment. The survey included the Leicester Cough Questionnaire (LCQ) before and after BCST. Study I revealed significant patient frustration about the treatment process and the wait-time for BCST. Participants in study II reported average cough duration of over 2 years before BCST. Twenty-seven of 31

2018 Chronic respiratory disease

6. Cough (acute): antimicrobial prescribing

guaifenesin (in people aged 12 and over) over-the-counter cough medicines containing cough suppressants, except codeine, (in people aged 12 and over who do not have a persistent cough, such as in asthma, or excessive secretions). 1.2.2 Be aware that limited evidence suggests that antihistamines, decongestants and codeine-containing cough medicines do not help cough symptoms. See the evidence and committee discussion on self-care. Cough (acute): antimicrobial prescribing (NG120) © NICE 2019. All rights (...) ) that causes cough and mucus production lasting for up to 3 weeks. It is usually caused by a viral infection, but may be caused by a bacterial infection. (NICE clinical knowledge summary on chest infections – adult). Self-care treatments Self-care treatments available for acute cough include honey, herbal medicines and over-the- counter cough medicines (for example, expectorants and cough suppressants [also called antitussives]). Cough (acute): antimicrobial prescribing (NG120) © NICE 2019. All rights

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

7. Altered neural activity in brain cough suppression networks in cigarette smokers. (Abstract)

Altered neural activity in brain cough suppression networks in cigarette smokers. Cough is important for airway defence and studies in healthy animals and humans have revealed multiple brain networks intimately involved in the perception of airway irritation, cough induction and cough suppression. Changes in cough sensitivity and/ or the ability to suppress cough accompany pulmonary pathologies, suggesting a level of plasticity is possible in these central neural circuits. However, little (...) smokers demonstrated significantly higher thresholds for capsaicin-induced urge-to-cough, consistent with a reduced sensitivity to airway irritation. Intriguingly, this was accompanied by increased activation in brain regions known to be involved in both cough sensory processing (primary sensorimotor cortex) and cough suppression, (dorsolateral prefrontal cortex and the midbrain nucleus cuneiformis). Activations in the prefrontal cortex were highest among participants with the least severe smoking

2019 European Respiratory Journal

8. Optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough suppression: a prospective randomized controlled trial. Full Text available with Trip Pro

Optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough suppression: a prospective randomized controlled trial. To investigate the optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough (FIC) suppression.Patients of 180 undergoing elective surgery with general anesthesia, aged 18-65 years, BMI 18.5-30 kg/m2, ASA I or II, were equally randomized into four groups (n = 45) to receive intravenous pretreatment of dexmedetomidine with 0 (group 1), 0.3 (group 2), 0.6 (group (...) 3) and 0.9 (group 4) mcg/kg over 10 mins, respectively. After the pretreatment, all patients were given a 5-s intravenous injection of fentanyl 4 mcg/kg. The symptoms of irritating cough including the severity and onset time were recorded for 1 min after fentanyl injection. General anesthesia induction was completed with midazolam, propofol and cisatracurium, then endotracheal tube or laryngeal mask was inserted and connected to an anesthesia machine. MAP, HR and SpO2 at the beginning

2019 BMC Anesthesiology Controlled trial quality: uncertain

9. A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial. Full Text available with Trip Pro

A small dose of remifentanil pretreatment suppresses sufentanil-induced cough during general anesthesia induction: a randomized, double-blind, placebo-controlled trial. Intravenous use of sufentanil can elicit cough. This study aimed to evaluate the inhibitory effect of pre-injection of a mall dose of remifentanil on sufentanil-induced cough during the induction of general anesthesia.This prospective, randomized, controlled trial was conducted from January 10, 2019 to March 01, 2019. A total (...) . Then, sufentanil 0.5 μg/kg was injected within 5 s and the number of coughs that occurred within 1 min after sufentanil injection were recorded. One minute after sufentanil injection, etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given for general anesthesia induction irrespective of the presence or absence of cough. The mean arterial pressure (MAP) and heart rate (HR) at time points just before remifentanil pretreatment administration (T0), 3 min after administration (T1), 1 min after intubation (T2

2019 BMC Anesthesiology Controlled trial quality: predicted high

10. Efficacy of Single-Dose Dexmedetomidine Combined with Low-Dose Remifentanil Infusion for Cough Suppression Compared to High-Dose Remifentanil Infusion: A Randomized, Controlled, Non-Inferiority Trial. Full Text available with Trip Pro

Efficacy of Single-Dose Dexmedetomidine Combined with Low-Dose Remifentanil Infusion for Cough Suppression Compared to High-Dose Remifentanil Infusion: A Randomized, Controlled, Non-Inferiority Trial. Background: Combination of dexmedetomidine and opioid may be an alternative to high-dose opioid in attenuating cough during emergence from anesthesia, while also reducing the adverse effects of high-dose opioid. We tested the hypothesis that a single-dose of dexmedetomidine combined with low-dose (...) DR. Conclusion: A single-dose of dexmedetomidine (0.5 μg/kg) combined with low-dose remifentanil infusion at 1 ng/mL of Ce during emergence from sevoflurane-remifentanil anesthesia was not inferior to high-dose remifentanil infusion alone at 2 ng/mL of Ce with regard to suppressing cough.

2019 International journal of medical sciences Controlled trial quality: uncertain

11. Translating cough mechanisms into better cough suppressants. (Abstract)

Translating cough mechanisms into better cough suppressants. Chronic cough is a significant problem, and in many patients cough remains refractive to both disease-specific therapies and current cough-suppressing medicines, creating a need for improved antitussive therapies. Most patients with chronic cough also display heightened sensitivity so that they experience a persistent sense of the need to cough, and often innocuous stimuli can trigger their coughing. This hypersensitivity underpins (...) the newly described concept of cough hypersensitivity syndrome (CHS), a term that encapsulates the notion of common underlying mechanisms producing neuronal activation, sensitization and/or dysfunction, which are at the core of excessive coughing. Understanding these mechanisms has been a focus of recent research efforts in the field in the hope that new therapies can be developed to selectively target sensitized unproductive cough while maintaining the reflexive cough essential for airway protection

2017 Chest

12. Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children

features of tics that include suppressibility, distractibility, suggestibility, variability, and the presence of a premonitory sensation whether the cough is single or one of many tics (Grade 1C) . 4. In adults and children with chronic cough, we suggest against using the diagnostic terms habit cough and psy chogeni c co ug h (Ungraded Consensus-Based Statement) . 5. In adults and children with chronic cough, we suggest substituting the diagnostic term tic cough for habit cough to be consistent (...) and gastroesophageal refl ux disease, is unlikely to occur once patients fall asleep. 11 , 12 Although the biologic explana- tions are poorly understood, this is most likely due to the observed suppression eff ect that sleep has on cough. 13 Although the potential diagnostic usefulness of other clinical criteria to assist in making the diagnosis of psychogenic cough is not known, the literature in adults suggests that the mere presence of depression and/or anxiety in patients with chronic unexplained cough

2015 American College of Chest Physicians

13. Effects of age on effect-site concentration of remifentanil for suppressing anesthetic emergence cough in male patients undergoing laparoscopic cholecystectomy Full Text available with Trip Pro

Effects of age on effect-site concentration of remifentanil for suppressing anesthetic emergence cough in male patients undergoing laparoscopic cholecystectomy Remifentanil infusion during emergence lowers cough. Effect-site concentration (Ce) of remifentanil using target-controlled infusion (TCI) has been evaluated in previous studies. Recent studies revealed the existence of sex-related differences in remifentanil Ce in young and elderly patients. Thus, there was the need to re-evaluate (...) the effect of age in single sex. We investigated the remifentanil Ce for suppressing emergence cough in young and elderly male patients and evaluated the age-related differences.In total, 25 young (ages between 20 and 50 years) and 24 elderly (ages between 65 and 75 years) male patients undergoing laparoscopic cholecystectomy were enrolled. Anesthesia was implemented with remifentanil using TCI and sevoflurane. The remifentanil Ce for suppressing emergence cough was estimated for each group using Dixon's

2018 Clinical interventions in aging

14. Assessment of chronic cough

/S0012-3692(17)32918-5/fulltext http://www.ncbi.nlm.nih.gov/pubmed/29080708?tool=bestpractice.com Sub-acute cough is most often self-limiting, but chronic cough may provide significant challenges for effective evaluation and management. Non-targeted cough suppressant therapy is rarely effective for chronic cough. However, the difficulty is in determining the cause of cough, because some 'aetiologies' are syndromes without accurate diagnostic tests. The cause is determined instead by typical (...) Assessment of chronic cough Assessment of chronic cough - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of chronic cough Last reviewed: February 2019 Last updated: June 2018 Summary Cough is the most common presenting symptom in primary practice. Schappert SM, Burt CW. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02. Vital

2018 BMJ Best Practice

15. Symptomatic treatment of the cough in whooping cough. (Abstract)

to 30 January 2014) and LILACS (30 January 2014). We searched Current Controlled Trials to identify trials in progress.We selected randomised controlled trials (RCTs) and quasi-RCTs of any intervention (excluding antibiotics and vaccines) to suppress the cough in whooping cough.Two review authors (SB, MT) independently selected trials, extracted data and assessed the quality of each trial for this review in 2009. Two review authors (SB, KW) independently reviewed additional studies identified (...) Symptomatic treatment of the cough in whooping cough. Around 16 million cases of whooping cough (pertussis) occur worldwide each year, mostly in low-income countries. Much of the morbidity of whooping cough in children and adults is due to the effects of the paroxysmal cough. Cough treatments proposed include corticosteroids, beta2-adrenergic agonists, pertussis-specific immunoglobulin, antihistamines and possibly leukotriene receptor antagonists (LTRAs).To assess the effectiveness and safety

2014 Cochrane

16. Efficacy of Dexmedetomidine for Cough Suppression in Patients Undergoing Thyroid Surgery

Efficacy of Dexmedetomidine for Cough Suppression in Patients Undergoing Thyroid Surgery Efficacy of Dexmedetomidine for Cough Suppression in Patients Undergoing Thyroid Surgery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Efficacy of Dexmedetomidine for Cough Suppression in Patients Undergoing Thyroid Surgery (EDCSTS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03312413 Recruitment Status : Recruiting First Posted

2017 Clinical Trials

17. Effect of propofol combined with opioids on cough reflex suppression in gastroscopy: study protocol for a double-blind randomized controlled trial. Full Text available with Trip Pro

Effect of propofol combined with opioids on cough reflex suppression in gastroscopy: study protocol for a double-blind randomized controlled trial. The best methods for inducing analgesia and sedation for gastroscopy are still debated but finding an adequate regimen of sedation/analgesia is important. Stimulation of the larynx under sedation can cause reflex responses. Propofol with opioids has been recommended for gastroscopy sedation but the effects on cough reflex suppression remain unclear (...) . This trial will evaluate the effects of propofol combined with small doses of dezocine, oxycodone, sufentanil or fentanyl for gastroscopy. We hypothesise that better performance may be obtained with a combination of propofol and oxycodone. We will observe the incidence and degree of reflex coughing and gagging under sedation when using propofol combined with one of the above drugs or propofol alone.This will be a prospective, randomised, double-blind, controlled trial. ASA I-II level patients aged 18-65

2017 BMJ open Controlled trial quality: predicted high

18. Role of the dorsomedial medulla in suppression of cough by codeine in cats Full Text available with Trip Pro

Role of the dorsomedial medulla in suppression of cough by codeine in cats The modulation of cough by microinjections of codeine in 3 medullary regions, the solitary tract nucleus rostral to the obex (rNTS), caudal to the obex (cNTS) and the lateral tegmental field (FTL) was studied. Experiments were performed on 27 anesthetized spontaneously breathing cats. Electromyograms (EMG) were recorded from the sternal diaphragm and expiratory muscles (transversus abdominis and/or obliquus externus; ABD (...) and the FTL to reduce cough in the cat, 2) the neuronal circuits in these target areas have unequal sensitivity to codeine and/or they have differential effects on spatiotemporal control of cough, 3) the cNTS has a limited role in the cough suppression induced by codeine in cats.Copyright © 2017. Published by Elsevier B.V.

2017 Respiratory physiology & neurobiology

19. Blocking voltage-gated sodium channels as a strategy to suppress pathological cough. (Abstract)

Blocking voltage-gated sodium channels as a strategy to suppress pathological cough. Pathological cough is thought to be secondary to inappropriate activation of vagal sensory nerves. Sensory nerves can be activated by a large number of disparate stimuli. The most relevant stimuli to block for effective anti-tussive therapy likely depend on the specific underlying pathology that is leading to the coughing. Blocking voltage-gated sodium channels (NaV) will prevent action potential initiation (...) and conduction and therefore prevent sensory communication between the airways and brainstem. In so doing, they would be expected to inhibit evoked cough independently of the nature of the stimulus and underlying pathology. There are nine subtypes of NaVs each with distinct pore-forming alpha subunits referred to NaV1.1-1.9. Among these channels, based on functional and genetic analysis of cough causing vagal afferent nerve subtypes, we hypothesize that targeting NaV1.7 and NaV1.8 is a rational strategy

2017 Pulmonary Pharmacology & Therapeutics

20. Classification of Cough as a Symptom in Adults and Management Algorithms

(Treatment of GERD should not be limited to acid suppression) Investigate and treat A cause of cough is suggested or concern for Life- threatening condition History to include: • Red ?ags • Occupational / Environmental Issues • Travel Exposures Physical Exam Chest radiograph Chronic Cough Hemoptysis Smoker > 45 years of age with a new cough, change in cough, or coexisting voice disturbance Adults aged 55-80 years who have a 30 pack-year smoking history and currently smoke or who have quit within the past (...) not be limited to acid suppression. Remember to routinely assess cough severity or quality of life before and after treatment and routinely follow patients4to6weeksaftertheinitialvisit.Considerreferraltoarecognizedcoughclinicforpatientswithrefractoryunexplainedchroniccough.ACEI¼ angiotensin-converting enzyme inhibitor; A/D¼ antihistamine/decongestant; BD¼ bronchodilator; HRCT¼ high-resolution CT; ICS¼ inhaled corticosteroid; LTRA¼ leukotriene antagonist; PPI¼ proton pump inhibitor. See Figure 3 and 4 legends

2018 American College of Chest Physicians

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