Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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.
A cough is a common symptom of viral respiratory
infections and allergies. A cough can also be caused by
other conditions, some of them serious. For example, a
cough can be a symptom of asthma, acid reflux into the
esophagus (gastroesophageal reflux disease or
GERD), sinusitis, postnasal drip, bronchitis,
cigarette smoking, pneumonia, tuberculosis, hypersensitivity pneumonia (inflammation of
the lung from exposure to certain environmental chemicals),
and even lung cancer. Therefore, a persistent
cough or a cough that is associated with chest pain, fever, weight loss, or
blood-tinged or discolored sputum should be evaluated by a doctor.
There are three types of cough medications available OTC
for the temporary relief of cough due to a cold. They are
oral cough suppressants, oral expectorants, and topical
(externally applied) medicines.
Oral cough suppressants
Codeine and hydrocodone are narcotic oral cough
suppressants that require a doctor's prescription.
Dextromethorphan is an oral cough suppressant that is
available OTC. Dextromethorphan is chemically related to
codeine and acts on the brain to suppress cough, but it does
not have the pain-relieving and addictive properties of
codeine. Diphenhydramine is another non-narcotic medication
that acts on the brain to suppress cough. It is also an
antihistamine.
Dextromethorphan and diphenhydramine can be used to relieve
a dry, hacking cough. They are not generally used to suppress a productive
cough (when sputum is coughed up). Suppressing a productive cough impairs the clearing of secretions and
mucous from
the airways, which is generally undesirable. However,
cough suppressants are sometimes used to suppress even
productive coughs if they are especially bothersome and
prevent restful sleep.
Oral expectorants
Guaifenesin is an oral expectorant
that is believed to increase the leaking of fluid out of the lung tissue and
into the airways. This action thins (liquefies) the thick
mucous in the airways and facilitates the clearing of the
mucous by coughing. Clearing of mucous from the airways
decreases cough.
Topical medications
Camphor and
menthol are topical cough medications. Camphor and menthol ointments are rubbed
on the throat and the chest as a thick layer. The anesthetic action of their
vapors is believed to relieve cough. They are also
available as products for steam inhalation. Menthol is also available as
lozenges and compressed tablets.
Examples of products in the cough category include the following:
Cough suppressants: Benylin Adult Cough Formula,
Buckley's Mixture, Diabe-Tuss DM, and St Joseph Cough
Suppressant for Children and Delsym (effective for 12 hours)
Cough suppressant plus an expectorant and other cold/flu/allergy ingredients:
Alka-Seltzer Plus Cold and Cough, Alka-Seltzer Plus Cold and Flu, Comtrex Deep
Chest Cold & Congestion Relief, Coricidin HBP Cough and Cold
Tablets, Dimetapp Cold and Cough Liqui-Gels Maximum
Strength, PediaCare Cough-Cold Liquid and Chewable Tablets,
Robitussin Maximum Strength Cough and Cold, TheraFlu Flu Cold and Cough
Medicine, and Triaminic AM Cough and Decongestant formula
Since many of these combinations also contain an
antihistamine, a decongestant, and an analgesic in addition
to the cough suppressant and expectorant, they also provide
relief of nasal congestion, sneezing, fever, and aches.
In October 2000, an advisory panel of the U.S. Food and Drug Administration
(FDA) recommended that phenylpropanolamine (PPA), an ingredient contained in many OTC and prescription cold medications as well as weight-loss products, be classified as unsafe because of reports of stroke associated with the this ingredient. Many companies voluntarily chose to reformulate their products to exclude phenylpropanolamine. The FDA
has been taking steps to remove phenylpropanolamine from all drug products and has requested that all drug companies discontinue marketing products containing this ingredient.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
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