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Your Medicine May Be Making You Cough

Angiotensin-Converting Enzyme (ACE) Inhibitors found in some prescription medications can be associated with Chronic Cough.  It is important to never stop a medication without first discussing the consequences with the ordering physician.  But a Cough Doctor can precisely diagnose the cause(s) of your Chronic Cough and the role of ACE Inhibitor medication in your situation.

A persistent, dry, tickling cough is a relatively common result of ACE inhibitors, such as lisinopril, which are used to treat hypertension, heart and kidney diseases. Cough may occur within hours of the first dose of medication, or its onset can be delayed for weeks to months after the initiation of therapy. Treatment with ACE inhibitors may sensitize the cough reflex, thereby potentiating other causes of chronic cough.

The mechanism of ACE inhibitor induced cough is not fully understood but probably is associated with increases in bradykinins that activate the cough reflex. Although cough usually resolves within 1 to 4 weeks of the cessation of therapy with the offending drug, in a subgroup of individuals cough may linger for up to three months. A different drug class, angiotensin receptor blockers (ARBs), do not cause cough, even in those patients with a history of ACE inhibitor-induced cough.

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Cough Treatment

Did you know that not all coughs are created equal? Different types of cough require different diagnostic approaches and different cough treatments.  So, when it comes to cough treatment, there is no universal solution.

To be effective, cough treatment must target the specific cause(s) and trigger(s) of your unique cough.  Do not waste time and money and expose yourself to risks or side effects with the wrong cough treatment.

Dr. Mandel Sher is a Cough Doctor.  He understands the debilitating impact of Chronic Cough on living life to the fullest.  As a Chronic Cough specialist, he and the Center for Cough team offer people suffering with Chronic Cough a comprehensive diagnostic and cough treatment approach.  At Center for Cough, Dr. Sher balances innovation with evidence-based medicine.  All his services are recognized by Medicare and other major insurance companies and are covered medical services.  Contact Dr. Mandel Sher if you or someone you know has a cough that won’t go away:  727-393-8067. 

Chronic Cough is a complex medical condition with multiple contributing factors.  Cough treatment for Chronic Cough involves medical detective work upfront to establish an individualized profile of your unique cough.  Then, a choreography of prescription and over-the-counter medications and voice exercises and therapy can begin.

A common cause of Chronic Cough is an overly sensitive cough mechanism that is easily irritated to produce cough.  This syndrome is called “hypersensitive cough reflex” in the medical literature.  The cough reflex has three components: neurogenic, inflammatory, and behavioral. Generally, medication aimed at cooling down the cough reflex is part of the cough treatment plan.

The importance of beginning with a precise diagnosis of the cause(s) and trigger(s) of your cough cannot be overstated.  A sequential, trial and error approach to cough treatment is often ineffective, wastes time and money, and includes unnecessary risks and side effects of the medication.  A comprehensive cough treatment approach expedites relief from cough and is based on each unique patient’s situation.

 

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Chronic Cough and Triggers

Our body’s cough mechanism is stimulated by irritants that produce cough.  These irritants are also known as Chronic Cough and its triggers.  Upon learning about Chronic Cough and Triggers, a Center for Cough patient declared, “I’m trigger happy.”

Dr. Sher and Center for Cough team identify the precise Chronic Cough cause and Chronic Cough triggers.  Each person has a unique cough profile.  Understanding your cough profile is the first and most important step toward effective cough treatment.  Chronic Cough can be triggered by a variety of medical conditions.  Below are the  most common Chronic Cough triggers.

Persistent cough that does not go away can be an indication of an underlying serious medical problem. Only precise diagnosis of your cough’s cause and its triggers can reveal if cough is a symptom or if cough is THE problem.

If you or someone you know has Chronic Cough, contact Dr. Mandel Sher at Center for Cough.  A comprehensive cough diagnostic approach and cough treatment plan is the first step toward measurable and lasting cough relief.  Please call:  727-393-8067.

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What’s Making Me Cough?

Sequence of Actions in the Cough Reflex Pathway Resulting in Cough

The chronic cougher tends to have an increased urge to cough. It can be described as a tickle in the back of the throat. Sometimes it can be a feeling that something is stuck there. Often, there is a feeling of post nasal drip, but rarely any is produced. A hypersensitive or heightened cough reflex requires less stimuli, such as nasal secretions, airborne irritants, acid or gastroesophageal reflux, to trigger a chronic cough. What creates these feelings?

  • Cough receptors in the upper airway (nose), larynx (voice box), lung, and esophagus are activated by direct irritation such as throat infection, post nasal drip or gastric acid (which has contact with the receptors in the larynx/voice box)
  • The receptors send a signal to the cough center in the lower brain area
  • The cough center then decides if there is enough stimulus to set off a cough
  • The cough center becomes hyperactive by repeated stimulation from the peripheral cough receptors
  • The cough center is also influenced by higher brain function which can result in a voluntary and habit cough
  • Stimulation of the upper airway, esophagus, and lung can heighten or sensitize the cough reflex without actually triggering off a cough. For example, acid or even food entering the esophagus from the stomach can send signals to the cough center to become more sensitive or irritable. Allergic nasal symptoms also send signals to the cough center and increase sensitivity.