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Pharmacy preregistration guide

Coughs

Coughs may seem innocent but there may be serious underlying factors which could cause chronic distress to the patient if left untreated for long. Usual common symptoms associated with cough are fever, runny nose, fatigue, headache, these are signs of the "common cold, and should usually disappear or improve over 2-3 weeks.

Coughs can be easily treated for symptomatic relief by cough mixtures, which will usually contain an expectorant (for chesty coughs) to help loosen mucus and sputum and make the cough more comfortable, or a cough suppressant (for dry tickly coughs) which acts to stop the cough.

When to refer to GP/doctor:

bulletBlood in sputum, could indicate a serious lung disease
bulletYellow/green sputum, could indicate a bacterial infection
bulletChronic dry cough induced by ACE inhibitors (e.g ramipril). The ACEI's may inhibit the same enzyme that metabolises bradykinin (a chemical released as part of the immune response), the build up of bradykinin may induce a dry cough. In this case the ACEI should be replaced by a angiotensin-II receptor antagongonist (e.g losartan).
bulletWheezing, and difficulty in breathing
bulletPersistent night time cough in children. This should be checked out as the child may be an undiagnosed asthmatic.
bulletSevere symptoms of infection: Fever, diarrhoea, sore throat, headache, extreme malaise.
bulletsmokers cough: if lung cancer is suspected or long term use (i.e more than2-3 weeks) of OTC cough medicines, a smokers cough should be referred
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