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22681. The acute effect of ipratropium bromide bronchodilator therapy on cough clearance in COPD. (Abstract)

The acute effect of ipratropium bromide bronchodilator therapy on cough clearance in COPD. Using radiolabeled, monodispersed aerosols (99mTc-iron oxide) and gamma camera analysis, we measured the efficacy of cough for clearing mucus from the airways of the lung following inhalation of the bronchodilator ipratropium bromide (IB) (Atrovent, Boehringer Ingelheim, Inc), a drug that has been shown to have no effect on mucociliary clearance in COPD. Clearance of radiolabeled aerosol was studied over (...) a 2.5-h period on three separate days, a control day with no coughing, and two study days during which the patient performed controlled cough maneuvers over the course of clearance measurements following IB or placebo therapy (double blind, crossover). Fifteen patients, age > 45 years, with stable moderate-to-severe airway obstruction (mean FEV1/FVC = 0.45) were studied. IB diminished the effectiveness of cough for clearing the radiolabeled particles from the airways. This effect of IB on cough

1993 Chest Controlled trial quality: uncertain

22682. Efficacy of cough suppressants in children. (Abstract)

Efficacy of cough suppressants in children. To test the hypothesis that codeine and dextromethorphan are effective in alleviating the symptoms of acute cough, we conducted a randomized, controlled trial. Eligible patients were children 18 months to 12 years of age, seen in private pediatric practices, with significant night cough of less than 14 days' duration. Study patients were randomly selected to receive codeine, dextromethorphan, or placebo at bedtime for 3 consecutive nights. Outcomes (...) were assessed by the use of a parent questionnaire rating the severity of symptoms at the initiation of therapy, and after each night of the study. Every patient had a cough score (range 0 to 4) and composite symptom score (range 0 to 9) computed for each day of the study. One hundred forty-one doses of study medication were evaluated in 49 patients, including 13 children receiving placebo, 19 dextromethorphan, and 17 codeine. Mean cough and composite symptom scores decreased in each of the three

1993 The Journal of pediatrics Controlled trial quality: uncertain

22683. A multicentre randomized placebo-controlled double-blind study on the efficacy of Ketotifen in infants with chronic cough or wheeze. (Abstract)

A multicentre randomized placebo-controlled double-blind study on the efficacy of Ketotifen in infants with chronic cough or wheeze. The efficacy of Ketotifen was examined in the treatment of 113 infants between 6 and 36 months of age presenting with a history of cough and/or wheeze in a multicentre randomized placebo-controlled double-blind study. A 4 week no-medication baseline phase preceded the 16 week treatment phase in which infants took 2.5 mL twice daily of either placebo or Ketotifen (...) (0.5 mg) syrup; this was followed by a 4 week wash-out phase. Diary card evaluation was performed by the parent or guardian for the duration of the study and recorded wheeze and cough twice daily as well as medication used. The percentage of symptom-free days decreased significantly in both groups (P < 0.005) with placebo-treated infants experiencing significantly more symptom-free days compared with the Ketotifen group (P < 0.01), although this difference was never more than 10% in any 4 week

1992 Journal of paediatrics and child health Controlled trial quality: uncertain

22684. Pathogenesis of chronic persistent cough associated with gastroesophageal reflux. (Abstract)

Pathogenesis of chronic persistent cough associated with gastroesophageal reflux. It was previously shown that unexplained chronic cough is associated with asymptomatic gastroesophageal reflux. The aim of this study was to determine if distal esophageal acid is important in the pathogenesis of this cough. In 22 patients with cough and reflux as determined by 24-h ambulatory esophageal pH monitoring, distal esophageal acid perfusion was performed in a double-blind controlled fashion. Patients (...) received both 0.1 N HCl and 0.9% saline for 15 min, in random order. Cough was recorded with a microphone and then computer analyzed. In 12 matched control subjects, 24-h ambulatory esophageal pH monitoring and distal esophageal acid perfusion studies were also performed. In patients, there was a significant increase in cough frequency, median (range): 36.5 (6 to 111) versus 8.3 (0 to 46)/15 min, p < 0.001, and amplitude, geometric mean (range): 85.2 (78.1 to 92.3) versus 73.1 (0.0 to 87.1) dB, p

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

22685. Thickened feedings as a cause of increased coughing when used as therapy for gastroesophageal reflux in infants. (Abstract)

Thickened feedings as a cause of increased coughing when used as therapy for gastroesophageal reflux in infants. To determine whether thickening of infant formula feedings with rice cereal increases coughing, we studied 25 infants from birth to 6 months of age, referred for evaluation of gastroesophageal reflux. Coughing was blindly quantified after each of a pair of isocaloric meals (one thickened and one unthickened). Coughing was more frequent after thickened feedings than after unthickened

1992 The Journal of pediatrics Controlled trial quality: uncertain

22686. Clinical trial of the efficacy and safety of moguisteine in patients with cough associated with chronic respiratory diseases. (Abstract)

Clinical trial of the efficacy and safety of moguisteine in patients with cough associated with chronic respiratory diseases. This completely randomised, double-blind, placebo-controlled, multicentre trial was carried out to evaluate the antitussive activity and safety of a 200 mg t.i.d. regimen of moguisteine (20 mg/ml ready-to-use suspension) during four days in patients with cough associated to chronic respiratory disorders. A total of 87 patients were enrolled, 42 on moguisteine and 45 (...) on placebo. All had persistent dry or slightly productive coughs associated with chronic respiratory disorders. Seventy three were submitted to per protocol efficacy analyses, and eighty-three to intention-to-treat efficacy analyses. All the patients who were administered the study drug were analysed for safety. The underlying disorders reported as being associated with the target symptom were chronic obstructive pulmonary disease, cough of unknown aetiology, respiratory tract malignant neoplasms

1993 Drugs under experimental and clinical research Controlled trial quality: predicted high

22687. 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

22688. Effects of glycopyrrolate on capsaicin-induced cough in normal volunteers treated with captopril. (Abstract)

Effects of glycopyrrolate on capsaicin-induced cough in normal volunteers treated with captopril. The effects of inhibition of angiotensin converting enzyme (ACE) and glycopyrrolate on cough caused by inhaled capsaicin were investigated in a double-blind, randomised cross-over study in twelve normal volunteers. The capsaicin challenge was performed before and 2 h after dosing with 75 mg captopril or matched placebo given orally, and 20, 40 and 60 min after giving 1 mg glycopyrrolate i.v (...) . to each subject. Captopril and placebo did not alter the cough response when compared to baseline. Glycopyrrolate, however, caused a significant increase in the threshold sensitivity (D2) from baseline, and a significant decrease in the total cough response at 40 and 60 min both after captopril and placebo. The D2-baseline and D2-40 min after glycopyrrolate (mean SD), respectively, were 3.2 (1.0); 17.9 (4.2) after placebo and 2.5 (8.5); 23.6 (6.9) after captopril. Elimination of vagal influences

1994 European journal of clinical pharmacology Controlled trial quality: uncertain

22689. Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. Full Text available with Trip Pro

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

22690. Alfentanil suppresses coughing and agitation during emergence from isoflurane anesthesia. (Abstract)

Alfentanil suppresses coughing and agitation during emergence from isoflurane anesthesia. To evaluate the effectiveness of alfentanil in suppressing coughing and agitation during emergence from isoflurane anesthesia.Randomized, double-blind, placebo-controlled study.Operating rooms at a university medical center.34 healthy ASA physical status I and II adult patients scheduled to undergo oral surgical procedures.During emergence from anesthesia, patients received either alfentanil 15 micrograms (...) /kg (in 10 ml) or saline (10 ml) when the end-tidal isoflurane concentration reached 0.3%.Hemodynamic variables were measured at one-minute intervals following administration of the study medication. A blinded observer recorded the time for patients to spontaneously open their eyes and to follow commands after discontinuing the isoflurane. The occurrence of coughing and agitation prior to extubation was noted. Patients in the alfentanil treatment group exhibited a reduced incidence of coughing

1995 Journal of clinical anesthesia Controlled trial quality: uncertain

22691. The effect of inhaled and oral dextromethorphan on citric acid induced cough in man. Full Text available with Trip Pro

The effect of inhaled and oral dextromethorphan on citric acid induced cough in man. 1. Dextromethorphan is a widely used antitussive agent which is a non-narcotic codeine analogue. We have investigated whether inhaled administration of dextromethorphan provides antitussive activity in a citric acid induced cough model. 2. Twenty normal subjects underwent repeated cough challenge with 5% citric acid. Subjects were studied on six occasions. Study medication consisted of oral dextromethorphan 30 (...) mg or oral matched placebo or 1, 3 and 30 mg inhaled dextromethorphan or matched inhaled placebo. Cough challenge was administered 10 min after study medication and hourly thereafter up to 250 min. 3. No significant differences were seen between baseline cough responses. Oral dextromethorphan (30 mg) produced a mean percentage reduction in cough of 38% (P < 0.002), which remained significant at 250 min. Inhaled dextromethorphan had no clinically significant effect although activity at later time

1995 British journal of clinical pharmacology Controlled trial quality: uncertain

22692. Effect of dose adjustment on enalapril-induced cough and the response to inhaled capsaicin. Full Text available with Trip Pro

Effect of dose adjustment on enalapril-induced cough and the response to inhaled capsaicin. 1. In nine hypertensive patients with enalapril-induced cough the effect of altering the dose of enalapril on subjective cough and the cough response to inhaled capsaicin was examined in a random single-blind balanced cross-over study. They received three doses of enalapril, each for 3 weeks; the dose at entry (mean 10 mg daily); double this dose (mean 20 mg daily); and half this dose (mean 5 mg daily (...) ). 2. The cough response to inhaled capsaicin was also measured in two control groups: hypertensive patients on long-term enalapril treatment with no cough (n = 18), and hypertensive patients taking nifedipine (n = 17). 3. In patients with enalapril-induced cough there were significant dose-responses for enalapril as regards severity of cough (P < 0.05) and night time waking by cough (P < 0.05), but not for frequency of cough. Although the cough was less severe (P < 0.02) and caused less night time

1995 British journal of clinical pharmacology Controlled trial quality: uncertain

22693. 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

22694. 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

22695. Efficacy and tolerability of levodropropizine and dropropizine in children with non-productive cough. (Abstract)

Efficacy and tolerability of levodropropizine and dropropizine in children with non-productive cough. The antitussive efficacy and tolerability of dropropizine and of its enantiomer levodropropizine were evaluated in children with non-productive cough; 258 were evaluable for tolerability and 254 for efficacy. Patients randomly received either 1 mg/kg dropropizine or 2 mg/kg levodropropizine orally, three times daily for 3 days. There were statistically significant decreases in the frequency (...) of coughing spells and nocturnal awakenings after both levodropropizine and dropropizine treatments (P < 0.001). Gastro-intestinal symptoms were mild in the two groups; somnolence was twice as frequent in the dropropizine group (10.3% vs 5.3%) and the difference is clinically relevant, though not statistically significant. Levodropropizine is as effective as an antitussive as dropropizine, but appears to carry a lower risk of daytime somnolence.

1995 The Journal of international medical research Controlled trial quality: uncertain

22696. High prevalence of persistent cough with angiotensin converting enzyme inhibitors in Chinese. Full Text available with Trip Pro

High prevalence of persistent cough with angiotensin converting enzyme inhibitors in Chinese. 1. Angiotensin converting enzyme (ACE) inhibitors are in common use for the treatment of hypertension and heart failure. Whereas they are, in general, well tolerated, a dry cough can develop which, on occasion, requires termination of therapy. The reported prevalence of cough with ACE inhibitor therapy has varied from 0.2 to 25%, depending upon methods of data collection, analysis and symptom reporting (...) . 2. To evaluate the prevalence of cough in Chinese patients receiving ACE inhibitors, interviews were carried out in 191 patients in Hong Kong who were taking therapy which included captopril or enalapril for hypertension or heart failure, and 382 patients matched for sex and age receiving alternative medications which excluded an ACE inhibitor (controls). Patients and controls were interviewed in a blinded manner by the same interviewer using a common adverse-effect questionnaire. 3. Persistent

1995 British journal of clinical pharmacology Controlled trial quality: uncertain

22697. Loratadine in the treatment of cough associated with allergic rhinoconjunctivitis. (Abstract)

Loratadine in the treatment of cough associated with allergic rhinoconjunctivitis. Antihistaminic treatment of allergic asthma or cough-type asthma, including cough associated with allergic rhinocojunctivitis, has been recently reconsidered prospectively since new very potent compounds, nonsedating with anti-allergic properties, are available.The possible effectiveness of loratadine in the treatment of allergic cough was assessed in 20 patients with allergic rhinoconjunctivitis and cough due (...) to Parietaria judaica during the pollen season (April to July 1993).Allergic patients were enrolled in a double-blind, placebo-controlled, parallel-group, randomized study, and received loratadine 10 mg/d or placebo in oral tablets for 4 weeks. Occurrence and severity of conjunctival and nasal symptoms, severity and frequency of cough attacks were assessed daily by the patients together with peak expiratory flow evaluation performed twice a day, ie, in the morning and in the evening. Physicians evaluated

1995 Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Controlled trial quality: uncertain

22698. Modulation of the renin-angiotensin-aldosterone system and cough. (Abstract)

Modulation of the renin-angiotensin-aldosterone system and cough. To review the clinical features of the cough related to angiotensin-converting enzyme (ACE) inhibitor therapy, and to suggest from a prospective controlled study that angiotensin II (Ang II) receptor antagonists are not associated with this particular side effect to the same extent as observed with ACE inhibitors.All pertinent data from reports published between 1972 and 1994 were identified through a comprehensive medical (...) literature search. Additionally, results are presented from an international multicentre study examining the occurrence of cough in 135 patients with mild to moderate hypertension, with a history of ACE inhibitor-related cough, who were randomly given either losartan (a type I Ang II receptor antagonist), lisinopril (an ACE inhibitor), or hydrochlorothiazide (a thiazide diuretic).More than 500 articles were identified; those reporting frequency, characterization, mechanism and treatment of ACE inhibitor

1995 The Canadian journal of cardiology Controlled trial quality: uncertain

22699. The efficacy and safety of moguisteine in comparison with codeine phosphate in patients with chronic cough. (Abstract)

The efficacy and safety of moguisteine in comparison with codeine phosphate in patients with chronic cough. We conducted a multicentre, double-blind, parallel group study to compare the clinical efficacy of a new antitussive drug, moguisteine (100 mg t.i.d.), to that of a reference standard, codeine (15 and 30 mg, t.i.d.). Both drugs were given orally for a period of two days. A group of 119 patients (mean age 54 yrs; 61 females and 58 males) with chronic, dry or slightly productive cough (...) , associated with various respiratory disorders (including chronic obstructive pulmonary disease, respiratory malignancies and pulmonary fibrosis) were enrolled at six participating centres. The percentage reduction in the number of morning coughs over a period of 6 h after the first administered dose compared to baseline assessment, was 21% with moguisteine (n = 39), 28% with codeine 15 mg (n = 38), and 29% with codeine 30 mg (n = 36). Differences between treatments were not significant. The percentage

1995 Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo Controlled trial quality: uncertain

22700. Effect of an NK1 receptor antagonist (CP-99,994) on hypertonic saline-induced bronchoconstriction and cough in male asthmatic subjects. (Abstract)

Effect of an NK1 receptor antagonist (CP-99,994) on hypertonic saline-induced bronchoconstriction and cough in male asthmatic subjects. To investigate the role of NK1 receptors in the pathogenesis of bronchoconstriction and cough in asthma, we performed a randomized, double-blind, crossover study on the effects of a selective non-peptide tachykinin NK1 receptor antagonist (CP-99,994) on baseline measures of lung function and on hypertonic saline-induced bronchoconstriction and cough in 14 male (...) % or 20 units, whichever was greater. Throughout the challenge cough was counted from a taped record made from two microphones placed close to the subject's larynx. We found that CP-99,994 did not significantly affect SRaw or spirometric measures of lung function during the first hour of infusion. Although CP-99,994 infusion markedly attenuated the bronchoconstrictor response to the saline challenge in two subjects, it did not significantly decrease the area under curves obtained for SRaw and cough

1995 American journal of respiratory and critical care medicine Controlled trial quality: uncertain

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