Home' Australian Pharmacist : Australian Pharmacist June 2015 Contents Australian Pharmacist June 2015 I ©Pharmaceutical Society of Australia Ltd.
Jill Malek is a professional practice pharmacist working
in the PSA NSW office.
This article is supported
through an unrestricted
grant from inova.
After reading this article, pharmacists should be
Recognise the signs and symptoms of coughs
Differentiate between chesty and dry coughs,
and recommend appropriate treatment options
Differentiate between the common cold
and influenza, and recommend appropriate
Identify treatment options for coughs and cold
for children less than six years of age
Discuss the efficacy of treatments for coughs
Competency standards (2010) addressed: 1.3, 6.1,
6.2, 7.1, 7.3 .
Accreditation number: CAP150606H
A cough is a symptom of many conditions. As well as being a way of
clearing blockage from the airways, cough is associated with viral and
bacterial infections, asthma, gastro-oesophageal reflux disease, rhinitis
and sleep apnoea.
Patient history and symptoms need to
be thoroughly explored in an attempt
to determine the aetiology of the
cough before symptomatic treatment
Colds are self‐limiting viral
infections with no specific treatment.
Management of a cold focuses on
providing symptomatic relief.
Types of cough
Coughs are generally either productive
or non‐productive. A productive (wet
or ‘chesty’) cough produces sputum
and expels secretions from the lower
Clear or white sputum is
considered normal whereas thick yellow,
green or brown sputum may be due to a
lower respiratory tract infection such as
bronchitis (although this is not considered
a reliable diagnostic indicator).3,4
An acute non‐productive (dry) cough is
dry, tight, tickly and irritating.
It may be
due to a recent cold or influenza (post‐viral
cough) or caused by dry atmosphere, air
pollution or a change in temperature.
This type of cough has no obvious
physiological purpose and produces
A patient presenting with
a chronic (i.e. longer than 2–3 weeks)
non‐productive cough should be referred
for further examination as it may be due to
an underlying condition such as gastro‐
oesophageal reflux disease (GORD) or be
coughs caused by upper airways cough
syndrome (post‐nasal drip) can be
managed by a pharmacist.
Symptoms of a common cold
Cold symptoms typically include
a sore throat, occasionally a fever
(a temperature of 38.5 °C or higher),
sneezing, nasal discharge, nasal
congestion and a cough.
loss of taste and smell, mild burning of
the eyes, and a feeling of pressure in
the ears or sinuses (due to obstruction
and/or mucosal swelling) may also
occur. Thirty percent of colds also
feature a cough that starts after nasal
symptoms lessen. A mild increase
in body temperature may occur and
infants and young children are more
likely to develop higher temperatures.
Infants may be irritable, have a blocked
nose may cause difficulty feeding, and
Pharmacists are often asked by
consumers to differentiate between a
cold and ‘the flu’. Both are caused by viral
infections however, influenza presents
with more severe symptoms that appear
See Table 1.
General treatment for coughs and colds
focuses on providing symptomatic
relief. Offering the most appropriate
treatment for coughs and colds relies
on differentiating between symptoms
of an underlying condition such as
influenza, bronchitis, allergic and chronic
rhinitis and those of a self‐limiting upper
respiratory tract viral infection.
The initial treatment of cough is to
specifically manage the cause of the
cough. Once this has been addressed,
cough treatment involves managing
cough symptoms by8:
avoiding exposure to environmental
factors that can cause coughing
practising vocal hygiene measures
(e.g. adequate hydration, avoiding
vocal strain, smoking cessation,
Coughs and colds
BY JILL MALEK
reducing alcohol, reducing caffeine
intake)9 and using steam inhalations
using medicines such as short‐
term cough suppressants, sedating
antihistamines, high‐dose proton
pump inhibitors (PPIs), low‐dose
inhaled corticosteroids, or a trial of
nebulised lignocaine in severe cases.
An acute non‐productive or
productive cough is often self‐limiting.
Non‐prescription over‐the‐counter (OTC)
medicines are frequently recommended
however, there is little evidence for
or against their efficacy in either
adults or children.
of evidence‐based medicine and the
potential for adverse effects should be
considered before recommending OTC
cough preparations.3 If a cough lasts
longer than two weeks, refer the patient
for further examination.3
Many OTC cough preparations for
non‐productive cough contain
demulcents, suppressants and sedating
antihistamines. A demulcent may
suppress coughing by forming a
protective layer over the pharynx and
relieving the irritation that triggers a
dry cough especially at night.
preparations include cough syrups
that contain sugar, glycerol or honey.
Honey is considered to have bactericidal
Links Archive Australian Pharmacist May 2015 Australian Pharmacist July 2015 Navigation Previous Page Next Page