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Cough

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22701. 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

22702. Effect of terbutaline sulphate in chronic "allergic" cough. Full Text available with Trip Pro

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

22703. Inhibition of artificially induced cough in man by bronchodilators. Full Text available with Trip Pro

Inhibition of artificially induced cough in man by bronchodilators. 1. The antitussive properties of bronchodilators were evaluated in a total of 47 normal volunteers. 2. Cough was induced by inhalation of ultrasonically nebulized solutions of distilled water and hypotonic saline. 3. Inhaled fenoterol hydrobromide (360 micrograms; 20 volunteers) and inhaled ipratropium bromide (72 micrograms; 14 volunteers) both significantly reduced couch compared with placebo (P less than 0.01). Oral (...) salbutamol sulphate (4 mg; 11 volunteers) and oral pirenzepine hydrochloride (50 mg; 14 volunteers) had lesser effects. 4. Cough inhibition correlated with a small but statistically significant degree of bronchodilatation as measured by specific airway conductance (sGaw) and forced expiratory volume in one second (FEV1) in six normal subjects studied with each treatment in a placebo controlled, double blind study (r = 0.67, P less than 0.001). 5. Small reductions in airway tone are associated

1987 British journal of clinical pharmacology Controlled trial quality: uncertain

22704. Characteristics of prostaglandin induced cough in man. Full Text available with Trip Pro

Characteristics of prostaglandin induced cough in man. Inhaled PGF2 alpha and PGE2 were evaluated for relative tussive activity to non-prostanoid tussive agents. In addition a comparison was sought between the present observations and those in the cat, the only laboratory animal which consistently coughs to prostanoids. Five healthy volunteers were repeatedly challenged at 90 min intervals with aerosols of PGE2 (100-500 micrograms ml-1) and tussive activity was monitored. In a second separate (...) with regards to the tussive potency and the early and late phases of PGF2 alpha activity no such correlation seems to exist for PGE2. The high tussive potency of the prostaglandins in man suggest that their local release in various respiratory pathophysiological conditions may be responsible for the accompanying coughs/irritancy.

1985 British journal of clinical pharmacology Controlled trial quality: uncertain

22705. Salbutamol in the treatment of whooping cough. (Abstract)

Salbutamol in the treatment of whooping cough. A double blind placebo-controlled study was performed to evaluate the efficacy of salbutamol in the treatment of 25 pertussis patients. The diminishing of paroxysmal cough in the treatment group did not differ significantly from that of the control group.

1986 Scandinavian journal of infectious diseases Controlled trial quality: uncertain

22706. The treatment of acute transient cough: a placebo-controlled comparison of dextromethorphan and dextromethorphan-beta 2-sympathomimetic combination. (Abstract)

The treatment of acute transient cough: a placebo-controlled comparison of dextromethorphan and dextromethorphan-beta 2-sympathomimetic combination. The efficacy of an antitussive-beta 2-sympathomimetic combination (dextromethorphan-salbutamol) was compared with that of a plain antitussive (dextromethorphan) and a placebo in a double-blind trial in 108 out-patients with cough associated with acute respiratory infection. The dextromethorphan-salbutamol combination was superior (...) to dextromethorphan or placebo in the suppression of cough at night, although a spontaneous improvement occurred in all treatment groups during the 4-day treatment period. No statistically significant differences between the treatments were shown in the symptom scores for the cough frequency and severity during the day, sputum quantity or ease of expectoration. A significant improvement in cough during the day was observed in all treatment groups. The results suggest that the use of antitussives is usually

1986 European journal of respiratory diseases

22707. Intratracheal aerosolized etidocaine to attenuate cardiovascular and cough responses to laryngoscopy and intubation. (Abstract)

Intratracheal aerosolized etidocaine to attenuate cardiovascular and cough responses to laryngoscopy and intubation. Forty-five ASA I or II patients scheduled for elective surgery were randomized into one of three groups. Patients in Group 1 (n = 15) received no intratracheal aerosol at laryngoscopy. Patients in Group 2 (n = 15) and Group 3(n = 15) received 50 mg and 75 mg, respectively, of intratracheal aerosolized etidocaine at laryngoscopy. Cardiovascular and respiratory responses were (...) observed at laryngoscopy and intubation and for the first ten minutes following laryngoscopy and intubation (with anesthesia provided by IV thiopental and nitrous oxide [70%] in oxygen). The magnitude and duration of blood pressure and heart rate increases caused by laryngoscopy and intubation were significantly less in the etidocaine-treated patients than in the controls (P less than .05). The incidence of coughing after intubation also was decreased significantly in the etidocaine-treated patients (P

1985 Annals of Emergency Medicine Controlled trial quality: uncertain

22708. Chemical specificity of coughing in man. (Abstract)

Chemical specificity of coughing in man. The purpose of this study was to test whether cough response to inhaled ultrasonically nebulized fluid is dependent on the ionic content of the fluid. Coughing was recorded in human volunteers during inhalation of aqueous solutions in a series of double blind randomized experiments. The occurrence of cough was found to be dependent on the concentration of chloride ions in the inhaled fluid, cough frequency progressively increasing as chloride ion (...) concentration was reduced. It is proposed that the ion composition of the surface lining fluid of the airway may moderate the cough response by means of a chemo-receptor, although tonicity may also be important.

1986 Clinical science (London, England : 1979) Controlled trial quality: uncertain

22709. Cough and wheezing from beclomethasone dipropionate aerosol are absent after triamcinolone acetonide. (Abstract)

Cough and wheezing from beclomethasone dipropionate aerosol are absent after triamcinolone acetonide. To test the hypothesis that patients with asthma who develop cough and wheezing after the use of beclomethasone aerosol would have a better tolerance for triamcinolone aerosol.Randomized, double-blinded, crossover trial.Pulmonary function laboratory.Volunteer sample of 24 patients attending an asthma clinic who had developed cough, with or without wheezing, after inhaling beclomethasone aerosol (...) of one aerosol on one day and three of the other on the next.Forced expiratory volume in one second (FEV1) was measured before and after each aerosol application. The FEV1 decreased a mean of 17.7% from baseline after inhalation of beclomethasone, and 0.8% after triamcinolone (difference, 16.9; 95% confidence limits, 12.36 to 21.34; p less than 0.001). Coughs were counted after each puff. The mean number of coughs after beclomethasone aerosol inhalation was 35.8, and after triamcinolone, 0.5

1987 Annals of internal medicine Controlled trial quality: uncertain

22710. Taste preference for cough syrups: a comparative study of three codeine-containing medications. (Abstract)

Taste preference for cough syrups: a comparative study of three codeine-containing medications. Unpleasant taste is a common feature of cough syrups, particularly those containing codeine. An antitussive compound of codeine sulfate and chlorpheniramine maleate was formulated in a coated drug-resin complex, which prevents release of the active ingredients until they reach the stomach and small intestine. Thus patients do not taste the bitterness of the codeine. A three-way crossover taste test (...) was conducted in 175 volunteers who tasted each of three cough syrups in random sequence, rated the taste of each, and ranked their preferences. The cough syrups used in the study were the aforementioned formulation (CM), promethazine hydrochloride with codeine (PH), and iodinated glycerol with codeine phosphate (IG). Tastes were rated on a scale from +2 (very good) to -2 (very poor). Mean rating scores for each product were 0.97 for CM, 0.14 for PH, and -1.5 for IG. Pairwise comparisons showed

1986 Clinical therapeutics Controlled trial quality: uncertain

22711. Autonomic mechanisms in the heart rate response to coughing. (Abstract)

Autonomic mechanisms in the heart rate response to coughing. To differentiate between the possible reflex and mechanical components in the heart rate response to cough, eight healthy subjects performed a standardized cough test before and after pharmacological autonomic blockade; to test the clinical usefulness of the cough manoeuvre two groups of diabetic patients (without and with autonomic neuropathy) were compared with a group of age-matched normal subjects. Because of the use of abdominal (...) and expiratory muscles during cough, the cardioacceleratory response was compared with that induced by an intense contraction of the arm muscles (handgrip). The cardioacceleratory response was completely abolished by atropine while propranolol failed to affect it. The diabetic patients with autonomic neuropathy showed a response similar to that after cholinergic blockade. The response was similar to that induced by muscular contraction for 4 s, after which it differed showing a continued cardioacceleration

1987 Clinical science (London, England : 1979) Controlled trial quality: uncertain

22712. Antitussive properties of inhaled bronchodilators on induced cough. (Abstract)

Antitussive properties of inhaled bronchodilators on induced cough. We have studied the antitussive effects of two anticholinergic agents, oxitropium bromide (200 micrograms) and ipratropium bromide (80 micrograms), and a combined beta-agonist and anticholinergic preparation containing fenoterol hydrobromide (200 micrograms) and ipratropium bromide (80 micrograms), in 16 normal and ten asthmatic volunteers in a double-blind, randomized, placebo-controlled crossover trial. Cough was induced (...) by inhalation of ultrasonically nebulized distilled water and hypotonic saline solution. All treatments significantly reduced the cough response to inhaled distilled water aerosol when compared with placebo (p less than 0.001). There was no difference between oxitropium bromide and ipratropium bromide (p greater than 0.05), but the combination preparation displayed a greater antitussive effect than either oxitropium bromide (p less than 0.05) or ipratropium bromide (p less than 0.025). Cough frequencies

1988 Chest Controlled trial quality: uncertain

22713. Attenuation of bronchofiberscopy-induced cough by an inhaled beta 2-adrenergic agonist, fenoterol. (Abstract)

Attenuation of bronchofiberscopy-induced cough by an inhaled beta 2-adrenergic agonist, fenoterol. We investigated the antitussive effect of fenoterol in 40 patients (34 males) undergoing bronchofiberscopy for diagnostic purposes. The patients were randomly allocated into two groups, one receiving two puffs (400 micrograms) of fenoterol and the other two puffs of placebo, from a metered-dose inhaler in a double-blind fashion. The following procedure was used: premedication with 0.5 mg atropine (...) sulfate and 100 mg hydroxyzine administered intramuscularly; 50 min later, aerosol administration; 10 min after aerosol administration, a standardized topical anesthesia was performed. As soon as the bronchofiberscope had entered the trachea, sounds were recorded for a 5-min period, while the tracheobronchial tree was systematically inspected. Additional lidocaine (2% solution, 2 ml boluses) was injected into the airways if troublesome cough occurred. The two groups did not differ significantly

1988 The American review of respiratory disease Controlled trial quality: uncertain

22714. Cough and the common cold. (Abstract)

Cough and the common cold. To determine whether the cough of the common cold arises from upper respiratory stimuli and whether antihistamine-decongestant therapy is an effective treatment for this cough, we prospectively evaluated volunteers with uncomplicated common colds in a randomized, double-blind, placebo-controlled study. After completing a standardized questionnaire and undergoing a physical examination, throat-culturing, and pulmonary function testing, subjects took the active drug (...) or identical-appearing placebo for 7 days while they kept a diary in which they ranked the severity of 17 symptoms for 14 days. Pulmonary function testing was repeated, on average, on Days 4, 8, and 14. Forty-six percent of the variation in cough severity could be explained by throat-clearing and 47% of the variation in throat-clearing severity by postnasal drip. FIF50%, the only physiologic parameter that significantly correlated with cough, rose as cough severity fell. Antihistamine-decongestant therapy

1988 The American review of respiratory disease Controlled trial quality: uncertain

22715. Evaluation of directed coughing in cystic fibrosis. (Abstract)

Evaluation of directed coughing in cystic fibrosis. Supervised directed coughing was compared to conventional physiotherapy (postural drainage, vibration and/or percussion and coughing) in 38 patients with cystic fibrosis aged 9-18 years admitted to hospital with an exacerbation of their pulmonary symptoms. Assessment included objective measures of pulmonary function and sputum characteristics. Both treatment groups showed significant improvement at the end of the 2-week period. When (...) the patients were graded according to their pulmonary disease, those with mild-moderate disease demonstrated a significant improvement in both treatment groups whereas those with severe lung disease showed little improvement with either treatment. Directed coughing is as effective as conventional physiotherapy in the management of patients with cystic fibrosis admitted to hospital for treatment of an exacerbation of their pulmonary symptoms.

1988 British journal of diseases of the chest Controlled trial quality: uncertain

22716. Effects of pH and osmolarity on aerosol-induced cough in normal volunteers. (Abstract)

Effects of pH and osmolarity on aerosol-induced cough in normal volunteers. 1. The chemosensitivity of cough receptors stimulated by inhalation of aqueous aerosols was evaluated in 21 normal volunteers in three experiments. 2. The pH of isotonic saline was altered using small amounts of phosphate or glycine buffers to produce solutions with a pH range of 2.6-10.0. These solutions were nebulized ultrasonically and breathed for 1 min periods by seven subjects in random order and on separate days (...) . Cough frequency during each 1 min inhalation was recorded. Only the two solutions of extreme pH (2.6 and 10.0) caused cough. 3. The effect of altering the osmolarity of the inhaled aerosol on cough was assessed using D-glucose over a range of 77-1232 mosmol/l. Saline solutions over the same range of osmolarity were also tested. The pH of D-glucose was raised to match that of saline by adding small amounts of sodium hydroxide. All solutions were nebulized and inhaled by seven subjects as described

1988 Clinical science (London, England : 1979) Controlled trial quality: uncertain

22717. Assessment of the antitussive effect of vadocaine hydrochloride using citric acid-induced cough in healthy volunteers. (Abstract)

Assessment of the antitussive effect of vadocaine hydrochloride using citric acid-induced cough in healthy volunteers. Vadocaine hydrochloride (2',4'-dimethyl-6'-methoxy-3-(2-methylpiperidyl)propionanilide+ ++ hydrochloride, OR K-242-HCl; INN: vadocaine) is a novel compound with potent antitussive and local anaesthetic action. The antitussive profile of this compound was evaluated in 40 healthy volunteers in double-blind, placebo-controlled cross-over study design using inhaled citric acid (...) a cough inducer. In Part I, vadocaine was compared in 20 healthy volunteers at two dose levels (10 and 30 mg) with codeine phosphate (50 mg) and a placebo. In part II, vadocaine (30 mg) and a placebo were compared in 20 healthy volunteers. In Part I, no statistically significant differences were found between the 3 compounds tested. However, statistically significant rises from the pre-dose value in the cough threshold stimulus level were observed following 10 and 30 mg doses of vadocaine. Neither

1988 Arzneimittel-Forschung Controlled trial quality: uncertain

22718. The effect of unproductive coughing/FET on regional mucus movement in the human lungs. (Abstract)

The effect of unproductive coughing/FET on regional mucus movement in the human lungs. The study was designed to ascertain the movement of mucus from proximal and peripheral regions within the human lungs during cough and the forced expiration technique (FET). Mucus movement was measured using a radioaerosol technique. Seven patients (mean +/- SEM age: 63 +/- 3 years) with airways obstruction (% predicted FEV1: 44 +/- 4) participated in the study. Each patient underwent three assessments (...) in a randomized manner: control/cough/FET. Peak expiratory flow rate (PEFR) was measured at the mouth during cough and FET. None of the patients produced sputum during the assessment periods. Both cough and FET compared with control increased, on average, mucus clearance from all regions; statistical significance was achieved only for central lung regions with cough (P less than 0.05). There was no significant correlation between PEFR during cough/FET and regional lung clearance.

1991 Respiratory medicine Controlled trial quality: uncertain

22719. Comparative study of the effects of three angiotensin converting enzyme inhibitors on the cough reflex. (Abstract)

Comparative study of the effects of three angiotensin converting enzyme inhibitors on the cough reflex. To compare the effects of three different angiotensin converting enzyme (ACE) inhibitors on the cough reflex, capsaicin and citric acid challenge tests were done in normal subjects and hypertensive patients before and after administration of delapril, captopril, or enalapril. Two groups of 7 normal subjects (single dose study: 15 mg delapril v 18.75 mg captopril or 2.5 mg enalapril (...) ) and a group of 6 mildly hypertensive patients (1 week study: cross-over administration of 30 mg/day delapril, 37.5 mg/day captopril, or 5 mg/day enalapril) were studied. Another group of 6 patients with essential hypertension was treated with three ACE inhibitors for 4 weeks in a randomized order, with a 2 week washout period between active therapies. Aerosols of 1 mumol/L and 3 mumol/L capsaicin and 0.68% citric acid in 0.9% NaCl were generated by an ultrasonic nebulizer, and the frequency of cough

1991 American journal of hypertension Controlled trial quality: uncertain

22720. Effect of sulindac on the cough reflex of healthy subjects. Full Text available with Trip Pro

Effect of sulindac on the cough reflex of healthy subjects. The effects of a single dose of sulindac 200 mg and placebo on the capsaicin-induced cough reflex were studied in a two-phase double-blind crossover study in 18 healthy subjects. Sulindac increased the threshold for capsaicin cough response significantly, but did not alter D5, peak response, or the total cough response when compared with placebo values.

1991 British journal of clinical pharmacology Controlled trial quality: uncertain

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