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22681. The effect of anticholinergic bronchodilator therapy on cough during upper respiratory tract infections. (Full text)

The effect of anticholinergic bronchodilator therapy on cough during upper respiratory tract infections. 1. Oxitropium bromide (Oxivent), an anticholinergic bronchodilator, inhibits coughing induced by hypotonic aerosols in both asthmatic and non-asthmatic individuals. We have now extended this work to investigate whether this antitussive activity is reproducible in cough associated with viral infection. 2. The effect of oxitropium bromide (200 micrograms three times daily) on cough (...) and pulmonary function has been studied in 56 non-asthmatic volunteers with upper respiratory tract infections (URTI) in a double-blind, randomised, parallel group, placebo controlled study over 10 days. 3. Lung function, symptom questionnaire and cough response to ultrasonically nebulised distilled water (UNDW) inhalation were initially recorded within 72 h of development of cough and again after the 10 day treatment period. By use of a diary card at home, frequency and severity of cough, nocturnal

1994 British journal of clinical pharmacology Controlled trial quality: uncertain PubMed abstract

22682. ACE inhibitors and their influence on inflammation, bronchial reactivity and cough. (Abstract)

ACE inhibitors and their influence on inflammation, bronchial reactivity and cough. Orally active angiotensin converting enzyme (ACE) inhibitors have been successfully used in the treatment of congestive heart failure and hypertension. However, adverse skin reactions, such as angioneurotic oedema have been reported following such medication. Furthermore, these drugs have been associated with a persistent dry cough in subjects without previous known bronchial hyper-reactivity. There is reason (...) to believe that an ACE inhibitor-induced cough is due to an irritant inflammatory state in the airways of susceptible individuals and that this might have pathophysiological features in common with the cough seen as an early symptom of asthma. All inflammatory responses--wheal and flare reactions, airway reactivity, and infiltration by neutrophils and eosinophils--were enhanced by ACE inhibitors in a dose-dependent manner. Other ACE inhibitors might have different proinflammatory profiles.

1994 European heart journal Controlled trial quality: uncertain

22683. Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects. (Abstract)

Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects. Gastroesophageal reflux (GER) is a common cause of chronic cough. Moreover, chronic cough can be the sole presenting manifestation of GER disease (GERD). It has been suggested recently that GER most often causes chronic cough by stimulating the distal esophagus. To gain further diagnostic and pathophysiologic knowledge, we prospectively evaluated a group of patients with chronic cough likely to be due (...) to GER with extensive gastrointestinal and respiratory studies and then observed their response to antireflux therapy.We prospectively characterized 12 subjects whose chronic cough was likely to be due to GER by chest radiographs, barium esophagography, 24-h esophageal pH monitoring (EPM) with probes in the distal and proximal esophagus, esophagoscopy, and bronchoscopy. Then, prior to instituting antireflux therapy, we objectively counted coughs during the distal esophageal infusion of 0.1 N HCl

1993 Chest Controlled trial quality: uncertain

22684. Children with persistent cough--outcome with treatment and role of Moraxella catarrhalis? (Abstract)

Children with persistent cough--outcome with treatment and role of Moraxella catarrhalis? 52 children with severe cough persisting for more than 10 days were randomized to treatment with amoxycillin/clavulanic acid or placebo in a prospective double-blinded study. Clinically suspected cases of pertussis were excluded, yet 12 (23%) of the children had laboratory verified pertussis infection. The nasopharyngeal colonization showed a predominance of Moraxella catarrhalis which was isolated in 37 (...) (71%) children. Streptococcus pneumoniae and Haemophilus influenzae were isolated in 11 (20%) and 16 (30%) children, respectively. The antibiotic-treated group had a significantly better recovery in both the pediatrician's estimation (p = 0.02) and the independent parental judgement (p = 0.002). These findings are consistent with the view that Moraxella catarrhalis could be directly involved in the pathogenesis of persistent cough in children.

1994 Scandinavian journal of infectious diseases Controlled trial quality: uncertain

22685. Association between cough and angiotensin converting enzyme inhibitors versus angiotensin II antagonists: the design of a prospective, controlled study. (Abstract)

Association between cough and angiotensin converting enzyme inhibitors versus angiotensin II antagonists: the design of a prospective, controlled study. A common adverse experience in hypertensive patients treated with angiotensin converting enzyme (ACE) inhibitors is a tickling dry cough.The aim of the present study was to review clinical observations and mechanisms of cough associated with ACE inhibitors. In addition, since the AT1-type angiotensin II antagonists (represented by losartan (...) , MK954, DuP753) are not expected to influence other systems (kinins, prostaglandins) affected by ACE inhibitors, we explored the hypothesis that antihypertensive therapy with these agents will not be associated with cough at a similar frequency or quality to that seen with ACE inhibitors.Patients with a history of an ACE inhibitor-associated dry cough confirmed by a second challenge with lisinopril were enrolled into an international, multicenter, randomly allocated, double-blind, parallel-group

1994 Journal of hypertension. Supplement : official journal of the International Society of Hypertension Controlled trial quality: uncertain

22686. Effects of inhaled lignocaine and adrenaline on capsaicin-induced cough in humans. (Full text)

Effects of inhaled lignocaine and adrenaline on capsaicin-induced cough in humans. The hypothesis that adrenaline can augment and/or prolong the antitussive effect of nebulised lignocaine was examined.The effect of inhaled lignocaine alone (20 mg) and in combination with adrenaline (400 micrograms) was studied on capsaicin-induced cough in 10 healthy subjects.Cough was significantly reduced between five and 25 minutes by lignocaine. Adrenaline alone had no inhibitory effect and it neither (...) augmented nor prolonged the antitussive effect of lignocaine. The subjective anaesthesia by lignocaine was short lasting (less than 15 minutes) and not altered by adrenaline, suggesting different sensory mechanisms for anaesthesia and cough suppression. Plasma concentrations of lignocaine were low (< 30 ng/ml), not altered by adrenaline, and did not correlate with the local anaesthetic or the antitussive effect.Lignocaine acts locally in the oropharynx and airways and adrenaline does not alter

1994 Thorax Controlled trial quality: uncertain PubMed abstract

22687. Female preponderance for lisinopril-induced cough in hypertension. (Abstract)

Female preponderance for lisinopril-induced cough in hypertension. In a double-blind double-dummy multicenter study, patients with mild to moderate essential hypertension were randomized to receive either nifedipine (n = 416, 47.6% women) or lisinopril (n = 412, 50% women), and side effects were registered by specific questioning, by spontaneous reports, and by use of visual analog scales. Cough was spontaneously reported to occur in 8.5% with lisinopril compared to 3.1% with nifedipine. Women (...) treated with lisinopril reported cough spontaneously three times more often than men, 12.6% v 4.4%, whereas no differences between the sexes were observed during the placebo period or during nifedipine treatment. Similar gender differences were observed during specific questioning. Furthermore, nonsmokers reported an increase in cough more often than did smokers.

1994 American journal of hypertension Controlled trial quality: uncertain

22688. Voluntary suppression of cough induced by inhalation of capsaicin in healthy volunteers. (Abstract)

Voluntary suppression of cough induced by inhalation of capsaicin in healthy volunteers. The aim of the present study was to investigate the voluntary suppression of cough in response to capsaicin inhalation in healthy volunteers, and to determine if the dose-response curve to capsaicin was significantly altered when volunteers were asked to suppress their cough response. The quantification of the degree of voluntary suppression of induced cough could provide a new methodology for screening (...) antitussive agents as antitussives may act by influencing voluntary control of cough. Cough was induced by inhalation of capsaicin. Two challenges were given 5 min apart, each comprising five ascending concentrations of capsaicin (1 x 10(-5) M-3.33 x 10(-4) M). During one of these challenges the volunteer was allowed to cough when required, and during the other they were asked to suppress cough. These two conditions were given in random order. The cough response was recorded by means of a microphone

1993 Respiratory medicine Controlled trial quality: uncertain

22689. Airway inflammation in nonasthmatic subjects with chronic cough. (Abstract)

Airway inflammation in nonasthmatic subjects with chronic cough. The physiopathology of chronic cough remains obscure. We evaluated the possibility that chronic cough in nonasthmatic subjects is associated with airway inflammation, and if this is so, what the relationship between this inflammation and the possible etiology of cough might be, as well as its response to inhaled steroids. Nineteen nonsmoking, nonasthmatic subjects referred for a persistent cough (mean: 3.8 yr) were evaluated (...) ) and a placebo for 1 mo each. Four groups of subjects were identified according to the presence of postnasal discharge (n = 4), gastroesophageal reflux (n = 6), both conditions (n = 5), or neither (n = 4). Subjects with chronic cough had an increased number of inflammatory cells in their bronchoalveolar lavage fluid (BALF), but there was no significant difference between the four subgroups of coughers. As compared with control subjects, the bronchial biopsies of subjects with chronic cough showed increased

1994 American journal of respiratory and critical care medicine Controlled trial quality: uncertain

22690. Effects of doxycycline in patients with acute cough and purulent sputum: a double blind placebo controlled trial. (Full text)

Effects of doxycycline in patients with acute cough and purulent sputum: a double blind placebo controlled trial. Acute cough with purulent sputum is a common complaint presented to general practitioners.A randomized, double blind, placebo controlled clinical trial was undertaken to determine the efficacy of doxycycline in persons aged 18 years and over presenting to 22 general practices in the Netherlands with acute cough and purulent sputum.Patients were excluded if they were pregnant, had (...) an allergy or intolerance to tetracyclines, had severe dyspnoea and fine crackles on auscultation, purulent rhinitis together with maxillary tenderness, chronic airways disease, or had taken antibiotics in the previous two weeks. Patients entered in to the study were given oral doxycycline for 10 days, 200 mg on the first day, followed by 100 mg on the next nine days, or placebo.Duration of frequent daytime cough after entry was a mean of 1.5 days shorter in the group of 71 patients receiving doxycycline

1994 British Journal of General Practice Controlled trial quality: predicted high PubMed abstract

22691. Effect of frusemide on cough responses to chloride-deficient solution in normal and mild asthmatic subjects. (Abstract)

Effect of frusemide on cough responses to chloride-deficient solution in normal and mild asthmatic subjects. We studied the tussive effects of a chloride-deficient solution (1.26% sodium bicarbonate). Nine normal volunteers and 10 mild asthmatic subjects were studied. In two double-blind, placebo-controlled, cross-over studies, we assessed the profile of any inhibitory effects that inhaled frusemide had over these responses. Baseline cough challenge was followed by inhalation of either (...) frusemide (40 mg), or 0.15 M NaCl control. Cough was then induced at 0.5, 2, 4 and 6 h after treatment. Forced expiratory volume in one second (FEV1) was measured before and after each challenge. Changes from the baseline cough response due to drug or control were compared nonparametrically at each time point. There was no difference in the sensitivity of normal and asthmatic subjects to the cough challenge (median cough response 15 and 14.5 on control day, 12 and 15 on frusemide day). Frusemide caused

1993 The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Controlled trial quality: uncertain

22692. Effects of systematic patient education about cough on the consulting behaviour of a general practice population. (Abstract)

Effects of systematic patient education about cough on the consulting behaviour of a general practice population. In four general practices the effects of systematic patient education on cough were compared with four control practices. Intended and unintended contacts for cough were defined. In two successive autumn-winter periods, in 62% of 5890 contacts for cough the intervention could be applied. In spite of the better baseline situation in the experimental practices, the percentage

1993 Patient education and counseling Controlled trial quality: uncertain

22693. Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. (Full text)

Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. In vitro studies have suggested that both the viscoelastic properties of lung secretions and the peak flow attained during simulated cough influence clearance. This study examines the possible association of the viscoelastic properties of sputum and maximum expiratory flow with measured effectiveness of mucus clearance induced by instructed cough and by forced expiration technique (...) (FET) in patients with airways obstruction.Nineteen patients (11 men and eight women) of mean (SE) age, % predicted FEV1, and daily sputum wet weight of 64 (2) years, 52 (6)%, and 37.5 (7.9) g respectively participated in the study. Mucus movement from proximal and peripheral lung regions was measured by an objective non-invasive radioaerosol technique. Each patient underwent three assessments: control, cough, and FET. During cough and FET, maximum expiratory flow was measured at the mouth level

1994 Thorax Controlled trial quality: uncertain PubMed abstract

22694. The effect of chest radiographs on the management and clinical course of patients with acute cough. (Abstract)

The effect of chest radiographs on the management and clinical course of patients with acute cough. The authors studied 2018 consecutive patients with a cough of less than 1 month's duration, presenting for medical care with this problem for the first time. Chest films were taken of all of the last 1819 of these patients. After physicians had specified diagnoses and patient management plans for the last 1531 of these 1819 patients, 98 per cent of the 1531 were randomized either to a group whose (...) in the management of patients with acute cough are needed.

1983 Medical Care Controlled trial quality: uncertain

22695. Effect of terbutaline sulphate in chronic "allergic" cough. (Full text)

Effect of terbutaline sulphate in chronic "allergic" cough. The effects of terbutaline sulphate were studied in 30 patients who presented with chronic cough at an allergy clinic. After a three week baseline period terbutaline and its placebo were given for two periods of three weeks each in a randomised, double blind, crossover manner. Patients kept a daily record of day and night cough scores and peak expiratory flow readings. Twenty one patients responded to terbutaline; placebo produced (...) no significant effect. Both day and night cough scores (p less than 0.001) and peak expiratory flow rates were significantly improved (p less than 0.05) by the end of the first week of treatment with terbutaline. This improvement was achieved with only a fairly small change in airway calibre.

1983 British medical journal (Clinical research ed.) Controlled trial quality: uncertain PubMed abstract

22696. [Objectivation of the effect of antitussive agents using tussometry in patients with chronic cough]. (Abstract)

[Objectivation of the effect of antitussive agents using tussometry in patients with chronic cough]. The antitussive effect of several antitussive agents has been objectively evaluated in patients with chronic stable cough due to bronchial carcinoma, pulmonary tuberculosis or chronic obstructive lung disease. The patients received the active antitussive drugs or placebo in a double-blind, randomized crossover design. The preparations were administered at 10 p.m. and 2 a.m. on 7 consecutive (...) nights and no antitussive was given for the following 20 hours. Cough frequency and intensity were recorded from 10 p.m. until 6 a.m. The active medications were noscapine (30 mg), dextromethorphan (20 mg), dihydrocodeine (30 mg) and codeine (20, 30 and 60 mg) at 10 p.m. and 2 a.m. Cough frequency and intensity were objectively assessed with a pressure transducer placed over the trachea and recorded on a chartrecorder. Statistical analysis was performed with analysis of variance and multiple range

1985 Schweizerische medizinische Wochenschrift Controlled trial quality: uncertain

22697. Dextromethorphan and codeine: objective assessment of antitussive activity in patients with chronic cough. (Abstract)

Dextromethorphan and codeine: objective assessment of antitussive activity in patients with chronic cough. Dextromethorphan, the most widely used cough suppressant in the U.S.A., was compared with codeine, the traditional European antitussive, in a double-blind, crossover trial using both an objective and subjective assessment of efficacy in sixteen patients with chronic, stable cough. Both preparations, at a dose of 20 mg, were similarly effective in reducing cough frequency. Dextromethorphan (...) lowered cough intensity to a greater degree than codeine (p less than 0.0008) and was considered the better antitussive by the majority of patients (p less than 0.001). In view of its lack of side-effects, its safety even in overdose and its non-narcotic status, the increasing trend in Europe to use dextromethorphan as a substitute for codeine in the treatment of cough is to be welcomed.

1983 The Journal of international medical research Controlled trial quality: uncertain

22698. Lidocaine given intravenously as a suppressant of cough and laryngospasm in connection with extubation after tonsillectomy. (Abstract)

Lidocaine given intravenously as a suppressant of cough and laryngospasm in connection with extubation after tonsillectomy. The preventive effect of lidocaine against coughing in the recovery period after general anaesthesia was observed. The study was carried out as a double-blind sequential trial. At the same time the incidence of laryngospasm was registered. Lidocaine or placebo was given intravenously just before extubation. Nineteen patients for tonsillectomy, all of them over the age (...) of 15, randomly received a 2% solution of lidocaine 2 mg/kg body weight or placebo (saline) 2 min prior to expected extubation. We found that lidocaine in this dose given prophylactically just before extubation was able to inhibit and prevent coughing in the recovery period after general anaesthesia. None of the patients included in this study got laryngospasm, and none of the patients developed serious side-effects.

1983 Acta Anaesthesiologica Scandinavica Controlled trial quality: uncertain

22699. Depressive effect of coughing on spinal monosynaptic reflexes in conscious man. (Abstract)

Depressive effect of coughing on spinal monosynaptic reflexes in conscious man. 1. The relationship between coughing and spinal monosynaptic reflexes (SMR) in extensors and flexors was investigated in eight healthy subjects by using the Hoffmann technique. Coughing exerted major depression (81% in extensor and 83% in flexor SMR). This depressant effect began simultaneously with the first cough and lasted through the coughing phase. Complete recovery to initial values occurred an average of 40 s (...) thereafter. 2. In comparison, mental tasks induced only a slight decrease in SMR amplitude. In contrast, the Mueller and Valsalva manoeuvres induced facilitation. 3. During coughing, large variations in extensor amplitudes were observed that were coupled with the ventilatory cycle. Slight facilitation was observed during inspiration, but expiration induced pronounced depression, occurring 0.20 s after the beginning of the expiratory period. Experiments performed during baseline breathing failed to show

1983 Clinical science (London, England : 1979) Controlled trial quality: uncertain

22700. Stroke associated with sympathomimetics contained in over-the-counter cough and cold drugs. (Full text)

Stroke associated with sympathomimetics contained in over-the-counter cough and cold drugs. Phenylpropanolamine (PPA) and pseudoephedrine are sympathomimetics contained in over-the-counter cold preparations. A case-control study linked PPA use with hemorrhagic stroke in women. Twenty-two patients with stroke associated with use of these drugs are described.In a consecutive stroke registry since 1988, 22 patients had stroke associated with over-the-counter sympathomimetics. Sympathomimetic

2003 Stroke PubMed abstract

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