Cough

Coughing is a mechanism the body uses to protect the airway. When coughing feels excessive to an individual it can become a distressing and exhausting symptom. Assessment of the cause and provoking factors of a cough should pay close attention to potentially reversible issues such as allergy or acute infection.

Non-drug treatment

• Positioning
• Chest physiotherapy to optimise coughing technique

Drug treatment

• Mucolytics if the patient has an effective cough will aid clearance of phlegm/secretions (carbocisteine, nebulised saline)
• Cough suppressants such as simple linctus or codeine linctus may have some benefit in those with an ineffective wet cough, or a pure dry cough
• Low dose oral opioids (Oramorph 1.25mg) may also be of benefit
• If secretions are the main driver of cough and the patient is no longer strong enough to effectively clear these, then antisecretory medications (hyoscine, glycopyrronium) may be more beneficial than other measures