John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The treatment of cough is directed toward the particular by the cause. However, patients may get
symptomatic relief from over-the-counter cough medicines containing guaifenesin
and/or dextromethorphan, drinking lots of water, inhaling steam, and using cough
lozenges. In severe cases a doctor may prescribe codeine, which is an effective
Asthma: Inhaled bronchodilators and inhaled steroids are given to
decrease inflammation of the airways, and reduce wheezing. In some cases, short-term oral steroids are
Gastroesophageal reflux disease (GERD): Treatment includes avoiding foods that increase
reflux, avoiding meals before lying down, elevating the head while sleeping, and
taking medication such as famotidine (Pepcid), cimetidine (Tagamet), or
ranitidine (Zantac) to decrease stomach acidity.
Sinus problems and postnasal drip: Use of decongestants such as
pseudoephedrine (Sudafed) or antihistamines such as diphenhydramine (Benadryl)
may improve symptoms of post nasal drip. Inhaled nasal steroids are very
effective in treating allergic rhinitis (hay fever), a common cause of cough.
Additionally, other nasal inhalers like
ipratropium bromide (Atrovent) can
relieve post nasal drip. Antibiotics may be prescribed if the cause is
determined to be sinusitis.
Infections: Bacterial pneumonia and bronchitis is typically treated with
antibiotics such as cephalosporins and azithromycin (Zithromax). If the
pneumonia is close to the chest wall inflammation of the surface of the lung can
cause pain, known as pleurisy and analgesics can be helpful. Cough suppressants
are used with caution in these situations because clearing the lung of the
infected mucus by coughing helps clear the infection.
Most bronchitis in adults
is from virus infections. Therefore, treatment is much the same as that of the
common cold including rest, fluids, analgesics, and humidification. Some people
find expectorant cough medicines containing guaifenesin helpful in alleviating
their discomfort. Sometimes it is hard to differentiate a viral bronchitis from
a bacterial bronchitis, and antibiotics are prescribed. In some cases,
asthmatics can produce green mucus that looks infected. Your doctor can have the
mucus examined to determine if an infection is present.
Medications: Patients taking blood pressure medicines called ace
(angiotensin converting enzyme) [for example, enalapril (Vasotec),
lisinopril (Zestril, Prinivil), etc.]
should talk to their doctor about switching medications. They should not stop
their medicines on their own because a marked elevation in blood pressure can
result from discontinuation. A newer generation of ace inhibitor like medicines
called ARB's (Angiotensin receptor blockers),
(for example, valsartan [Diovan],
losartan [Cozaar], etc.) can be alternatives that have less potential to cause chronic coughing. There are a
host of other medicines available to manage blood pressure.
Reviewed by George Schiffman, MD, FCCP on 7/12/2011