Plasticity of Vagal Afferent Fibres Mediating Cough

Kollárik, Marián; Undem, Bradley J.

doi:10.1002/9780470755846.ch18

Cited by 4 publications

(3 citation statements)

References 51 publications

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“…Patients with CC have increased cough reflex sensitivity so that their cough is evoked by stimuli that are normally subthreshold for initiating the cough reflex. 32 Continuous coughing reduces the cough threshold and sensitizes the cough so that it is triggered by smaller and smaller amounts of stimuli. 20,22 Consciously suppressing the cough changes the sensitivity of the cough receptors and desensitizes the cough reflex thereby raising the cough threshold so that the cough occurs when the afferent input from sensory receptors summates to the new threshold.…”

Section: Pathophysiological Basis For Improvement In Cough Following Behaviour Modification Therapiesmentioning

confidence: 99%

REVIEW SERIES: Chronic cough: Behaviour modification therapies for chronic cough

et al. 2007

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Chronic cough (CC) can be refractory to medical treatment and newer strategies are required for these patients. Behaviour modification therapies are a potential approach for management of cough that does not respond to medical management. Behaviour modification therapy for CC involves an individually tailored programme teaching individuals to increase control over cough symptoms and includes education, specific strategies to suppress the cough, vocal hygiene training and psychoeducational counselling. Several case series have described speech pathology treatment for CC and a recent randomized control trial has demonstrated a significant improvement in symptoms. Possible mechanisms for this improvement include reduced cough reflex sensitivity, increased voluntary control of the cough and reduced stimulation of cough receptors. Respiratory retraining used by physiotherapists may also have potential for use in CC. The validity of psychological therapeutic approaches to CC rests on concepts of CC as a disorder with a psychogenic component, and the ability of cognitive therapies to modify the cough pathway. This work outlines current literature into behavioural management of CC and suggests new directions for practice and research in adults with this condition.

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Section: Pathophysiological Basis For Improvement In Cough Following Behaviour Modification Therapiesmentioning

confidence: 99%

REVIEW SERIES: Chronic cough: Behaviour modification therapies for chronic cough

et al. 2007

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“…receptors in the airway mucosa, and analysed their And if their effectiveness is small and close to that membrane properties. [101,117,118,134] This research has of a placebo, this lessens the likelihood of adverse led to development of a number of novel drugs effects including addiction. which are active in suppressing induced cough in experimental animals, but which have not been adequately assessed in human patients as yet.…”

Section: Extensive Work With Experimental Animals Hasmentioning

confidence: 99%

Acute Cough in the Elderly

Widdicombe

Kamath²

2004

Drugs & Aging

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Although the frequency of physician consultations and the sale of over-the-counter remedies establish the high prevalence of acute cough in the elderly, epidemiological studies have tended to be imprecise. However, respiratory tract infections in nose, larynx and/or bronchi, either viral or bacterial or both, are by far the commonest cause of acute cough. These are especially frequent and hazardous in the elderly, and community living and institutionalisation may aggravate this problem. A variety of viruses and bacteria have been incriminated, with rhinovirus, influenza and respiratory syncytial viruses, and Streptococcus pneumoniae, Haemophilus influenza and Bordetella pertussis being especially important. Viral infections can readily lead to community-acquired pneumonia. Successful diagnosis should point to successful treatment, and in this respect clinical examination and patient history are paramount, supplemented by chest X-ray, viral and bacterial culture and serological testing. Depending on the results of these tests, specific antibacterial therapy may be called for, although there is dispute as to the merits of antibacterial therapy in cases of uncertain diagnosis. Prevention and prophylaxis for influenza and S. pneumoniae infections are now commendably routine in the elderly, especially those in communities. Treatment, as well as the use of antibacterials, may also be directed against the inflammatory and infective processes in the airways. Non-specific antitussive therapy is common and usually highly desirable to prevent the adverse effects of repeated coughing. There have been few advances in antitussive therapy in recent years, opioids and dextromethorphan being the most commonly used agents; they act centrally on the brainstem, but also have a large placebo effect. However they work, they are much appreciated by patients and their partners. Moreover, striking advances in our understanding of the peripheral sensory and central nervous pathways of the cough reflex in recent years should soon lead to a new and more specific choice of agents to inhibit cough.

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“…The mechanisms by which these conditions produce persistent cough are unclear, though it is likely that there is a common pathway linking these associated causes with the occurrence of an enhanced cough reflex. This points towards an increase in the general excitability of the nervous pathways of cough, a process that may occur both at the cough receptor level or centrally at the level of the central coordination of the cough reflex [2, 3]. Treating the associated cause of chronic cough sometimes, but not always, leads to significant relief of the symptom.…”

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confidence: 99%

H⁺/K⁺‐ATPase (proton pump) inhibitors dampen increased cough reflex: more than gastric acid suppression

Chung¹

2005

Clin Experimental Allergy

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Plasticity of Vagal Afferent Fibres Mediating Cough

Cited by 4 publications

References 51 publications

REVIEW SERIES: Chronic cough: Behaviour modification therapies for chronic cough

REVIEW SERIES: Chronic cough: Behaviour modification therapies for chronic cough

Acute Cough in the Elderly

H⁺/K⁺‐ATPase (proton pump) inhibitors dampen increased cough reflex: more than gastric acid suppression

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Plasticity of Vagal Afferent Fibres Mediating Cough

Cited by 4 publications

References 51 publications

REVIEW SERIES: Chronic cough: Behaviour modification therapies for chronic cough

REVIEW SERIES: Chronic cough: Behaviour modification therapies for chronic cough

Acute Cough in the Elderly

H+/K+‐ATPase (proton pump) inhibitors dampen increased cough reflex: more than gastric acid suppression

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Product

Resources

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H⁺/K⁺‐ATPase (proton pump) inhibitors dampen increased cough reflex: more than gastric acid suppression