Page 125 - Community pharmcy practice E-book 2025

02/11/2025, 00:29

Cough

Etiology
• A cough is a sudden, forceful expulsion of air from the lungs, usually triggered by irritation
in the airway (upper or lower respiratory tract) and serving a protective reflex function.
Causes vary by duration: Acute (< 3 weeks): most commonly a viral upper respiratory tract
infection (URTI).
Sub-acute (3-8 weeks): post-infectious cough, lingering irritation.
Chronic (> 8 weeks): may reflect underlying conditions (e.g., asthma, COPD, GERD, ACE inhibitor-
induced cough).

Additional triggering/causative factors: irritants (smoke, dust), post-nasal drip/allergic rhinitis,
environmental exposures, medications (e.g., ACE inhibitors).
Pharmacist’s role: perform initial screening (history, duration, nature of cough), assess whether
self-care is appropriate, identify potential underlying causes, and determine if referral is needed.

Symptoms
• The characteristic symptom is the cough itself — dry (non-productive/tickly) or productive
(with sputum).
• Accompanying symptoms might include throat irritation, tickle in throat, chest / airway
irritation, sputum production, sometimes post-nasal drip, shortness of breath (especially if
underlying pathology).
• Duration: For acute viral cough often less than ~2-3 weeks; persistent beyond ~3 weeks
raises concern.
• The cough may worsen at night, interfere with sleep, be triggered by cold air, lying down,
talking or irritants.

Referral Cases (Red Flags)
Pharmacists should refer or advise medical evaluation if any of the following are present:

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