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
• Low dose oral opioids (oramorph 1.25mg) may also be of benefit
• If secretions are 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