UACS is often treated with a combination of a first-generation decongestant/antihistamine and other nasal corticosteroids, nasal ipratropium bromide, or nasal cromolyn.
Newer generation, non-sedating antihistamines such as Claritin, Zyrtec, and Allegra, which circumvent drowsiness because they don’t pass the blood-brain barrier, are ineffective for treating UACS-associated cough.
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An oral leukotriene receptor antagonist known as zafirlukast has in some cases been more effective than steroids in reducing asthma-associated cough, possibly because it more effectively suppresses the interaction of eosinophils (white blood cells that fight concomitant infection during asthmatic reaction) with cough receptors.
Non-asthmatic eosinophilic bronchitis, a condition characterized by chronic cough without the airway remodeling common to asthma, is often misdiagnosed as cough-variant asthma because it responds similarly to inhaled corticosteroids.
“It’s easy to underestimate the tremendous quality of life issue that cough is, not only for the patient but for the family.
Some of our patients have been coughing every single day for ten, twenty, even thirty years,” said Dr.
Numerous potential novel antitussive agents are now being studied, including antagonists to eosinophil, tachykinin receptor, 5-HT receptor, and TRPV1 receptor; agonists to the delta-opioid receptor, NOP receptor, and GABA-B; endogenous cannabinoids, and large conductance Ca 2-activated K -channel openers.
The idiopathic (unexplained) cough remains a mystery.
Chronic cough can also result from laryngopharyngeal reflux (LPR), a subtype of GERD in which reflux reaches the upper airways.
People with LPR often cough when eating, drinking, laughing, talking on the telephone, or getting up in the morning, and may experience hoarseness or other voice change.
The cough mystery presents a particular challenge to those who attempt to diagnose and treat it.