Page 126 - Community pharmcy practice E-book 2025

02/11/2025, 00:29

• Cough lasting > 3 weeks (or > 8 weeks for chronic definition) or worsening instead of
improving.
• Cough with haemoptysis (blood in sputum), chest pain, shortness of breath, wheezing,
unexplained weight loss, night sweats (possible serious disease).
• High or persistent fever, signs of pneumonia (e.g., productive cough with purulent sputum,
systemic features), suspected foreign body aspiration.
• Cough in a patient with comorbidities: e.g., severe heart/lung disease,
immunocompromised, recent surgery, cancer.

• Use of ACE inhibitors or other medications known to trigger cough – evaluation required if
suspected.
• In children: very young age especially, or if cough accompanied by breathing difficulty,
dehydration, inability to feed.
• If cough is interfering significantly with daily life, causing syncope/vomiting (e.g., pertussis-
style), suspicion of whooping cough.

Non-Pharmacological Treatment
• Encourage adequate hydration (warm fluids may soothe throat and loosen secretions).
• Use of humidified air or steam (e.g., humidifier, warm shower) to reduce airway irritation
and ease cough.
• Avoid known irritants: smoking, secondhand smoke, strong perfumes/fragrances, cold dry
air, dust.
• Elevate head of bed if cough worsens when lying down (for post-nasal drip or reflux).
• Use of throat lozenges/cough drops, warm honey C lemon (in appropriate age groups) to
help soothe throat irritation.
• Encourage rest, and reduce voice strain, ensure adequate sleep.
• Pharmacist can instruct on cough keeping track (duration, triggers, nature), especially if
suspecting chronic or recurrent cough.

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