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Int Arch Otorhinolaryngol 2012; 16(02): 259-268
DOI: 10.7162/S1809-97772012000200016
Review Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Cough: neurophysiology, methods of research, pharmacological therapy and phonoaudiology

Tosse: neurofisiologia, métodos de pesquisa, terapia farmacológica e fonoaudiológica
Aracy Pereira Silveira Balbani
1   PhD in Medicine. Otorhinolaryngologist.
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Publikationsverlauf

13. März 2011

25. Juni 2011

Publikationsdatum:
05. Dezember 2013 (online)

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Summary

Introduction: The cough is the more common respiratory symptom in children and adults.

Objective: To present a revision on the neurophysiology and the methods for study of the consequence of the cough, as well as the pharmacotherapy and phonoaudiology therapy of the cough, based on the works published between 2005 and 2010 and indexed in the bases Medline, Lilacs and Library Cochrane under them to keywords “cough” or “anti-cough”.

Synthesis of the data: The consequence of the cough involves activation of receiving multiples becomes vacant in the aerial ways and of neural projections of the nucleus of the solitary treatment for other structures of the central nervous system. Experimental techniques allow studying the consequence of the cough to the cellular and molecular level to develop new anti-cough agents. It does not have evidences of that anti-cough exempt of medical lapsing they have superior effectiveness to the one of placebo for the relief of the cough. The phonoaudiology therapy can benefit patients with refractory chronic cough to the pharmacological treatment, over all when paradoxical movement of the vocal folds coexists.

Final Comments: The boarding to multidiscipline has basic paper in the etiological diagnosis and treatment of the cough. The otolaryngologist must inform the patients on the risks of the anti-cough of free sales in order to prevent adverse poisonings and effect, especially in children.

Resumo

Introdução: A tosse é o sintoma respiratório mais comum em crianças e adultos.

Objetivo: Apresentar uma revisão sobre a neurofisiologia e os métodos para estudo do reflexo da tosse, bem como a farmacoterapia e terapia fonoaudiológica da tosse, baseada nos trabalhos publicados entre 2005 e 2010 e indexados nas bases Medline, Lilacs e Biblioteca Cochrane sob os unitermos “tosse” ou “antitussígenos”.

Síntese dos dados: O reflexo da tosse envolve ativação de múltiplos receptores vagais nas vias aéreas e de projeções neurais do núcleo do trato solitário para outras estruturas do sistema nervoso central. Técnicas experimentais permitem estudar o reflexo da tosse ao nível celular e molecular para desenvolver novos agentes antitussígenos. Não há evidências de que antitussígenos isentos de prescrição médica tenham eficácia superior à do placebo para o alívio da tosse. A terapia fonoaudiológica pode beneficiar pacientes com tosse crônica refratária ao tratamento farmacológico, sobretudo quando coexiste movimento paradoxal das pregas vocais.

Comentários Finais: A abordagem multidisciplinar tem papel fundamental no diagnóstico etiológico e tratamento da tosse. O otorrinolaringologista deve informar os pacientes sobre os riscos dos antitussígenos de venda livre a fim de prevenir intoxicações e efeitos adversos, especialmente em crianças.

Keywords

anti-cough - codeine - dextromethorpha - expectorants - cough

Palavras-chave

antitussígenos - codeína - dextrometorfano - expectorantes - tosse
 

  • Bibliographic References

  • 1 Fiess E. II Diretrizes brasileiras no manejo da tosse crônica. J Bras Pneumol 2006; 32 (Suppl. 06) S403-46
    CrossrefGoogle Scholar
  • 2 Bouajaoude ZC, Pratter MC. Clinical approach to acute cough. Lung 2010; 188 (Suppl. 01) S41-6
    CrossrefGoogle Scholar
  • 3 Schaefer MK, Shehab N, Cohen AL, Budnitz DS. Adverse events from cough and cough medications in children. Pediatrics 2008; 121: 783-7
    CrossrefGoogle Scholar
  • 4 Smith SM, Schroeder K, Fahey T. Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev 2008; (1) CD001831
    Google Scholar
  • 5 Shefrin AE, Goldman RD. Use of over-the-counter cough and cold medications in children. Can Family Phys 2009; 55: 1081-3
    Google Scholar
  • 6 Boehringer Ingelheim. Retirada do mercado do Cloridrato de Clobutinol (Silomat® e Silomat® Plus). [2007] Encontrado em URL: http://portal.anvisa.gov.br/wps/wcm/connect/96a21d804237610cbd70fd01cce3dc94Carta+da+empresa+Boehringer+Ingelheim+sobre+a+retirada+do+ mercado+dos+medicamentos+Silomat%C2%AE+e+Silomat%C2%AE+Plus_.pdf?MOD=AJPERES
    Google Scholar
  • 7 Reis AMM, Figueras A. Analysis of the evidence of efficacy and safety of over-the-counter cough medications registered in Brazil. Braz J Pharm Sci 2010; 46: 135-45
    CrossrefGoogle Scholar
  • 8 Gupta D, Verma S, Vishwakarma SK. Anatomic basis of Arnold́s ear-cough reflex. Surg Radiol Anat 1986; 8: 217-20
    CrossrefGoogle Scholar
  • 9 Tekdemir I, Aslan A, Elhan A. A clinico-anatomic study of the auricular branch of the vagus nerve and Arnold́s ear-cough reflex. Surg Radiol Anat 1998; 20: 253-7
    Google Scholar
  • 10 Undem BJ, Carr MJ. Targeting primary afferent nerves for novel antitussive therapy. Chest 2010; 137: 177-84
    CrossrefGoogle Scholar
  • 11 Kollarik M, Ru F, Undem BJ. Acid-sensitive vagal sensory pathways and cough. Pulm Pharmacol Ther 2007; 20: 402-11
    CrossrefGoogle Scholar
  • 12 Hamamoto T, Takumida M, Hirakawa K, Takeno S, Tatsukawa T. Localization of transient receptor channel vanilloid subfamilies in the mouse larynx. Acta Otolaryngol 2008; 128: 685-93
    CrossrefGoogle Scholar
  • 13 Geppetti P, Pattachine R, Nassini R, Materazzi S. Cough: the emerging role of tge TRPA-1 channel. Lung 2010; 188 (Suppl. 01) S63-8
    Google Scholar
  • 14 Takahama K, Shirasaki T. Central and peripheral mechanisms of narcotic antitussives: codeine-sensitive and - resistant coughs. Cough 2007; 3: 8
    CrossrefGoogle Scholar
  • 15 Plevkova J, Antosiewicz J, Varechova S, Poliacek I, Jakus J, Tatar M , et al. Convergence of nasal and tracheal neural pathways in modulating the cough response in Guinea pigs. J Physiol Pharmacol 2009; 60: 89-93
    Google Scholar
  • 16 Mazzone SB, Mori N, Canning BJ. Synergistic interactions between airway afferent nerve subtypes regulating the cough reflex in guinea pigs. J Physiol 2005; 569: 559-73
    CrossrefGoogle Scholar
  • 17 Canning BJ. Central regulation of the cough reflex: therapeutic implications. Pulm Pharmacol Ther 2009; 22: 75-81
    CrossrefGoogle Scholar
  • 18 Canning BJ. Encoding the cough reflex. Pulm Pharmacol Ther 2007; 20: 396-401
    CrossrefGoogle Scholar
  • 19 Veras TN, Pinto LA. Tosse psicogênica em criança: relato de caso. Sci Med 2008; 18: 54-7
    Google Scholar
  • 20 Thach BT. Maturation of cough and other reflexes that protect the fetal and neonatal airway. Pulm Pharmacol Ther 2007; 20: 365-70
    CrossrefGoogle Scholar
  • 21 Dragomir A, Akay Y, Curran AK, Akay M. Investigating the complexity of respiratory patterns during the laryngeal chemoreflex. J Neuroeng Rehab 2008; 5: 17
    CrossrefGoogle Scholar
  • 22 Dicpinigaitis PV. Experimentally induced cough. Pulm Pharmacol Ther 2007; 20: 319-24
    CrossrefGoogle Scholar
  • 23 Sitkauskiene B, Dicpinigaitis PV. Effect of smoking on cough reflex sensitivity in humans. Lung 2010; 188 (Suppl. 01) S29-32
    CrossrefGoogle Scholar
  • 24 Morice AH. The cough hypersensitivity syndrome: a novel paradygm for understanding cough. Lung 2010; 188 (Suppl. 01) S87-90
    Google Scholar
  • 25 Bolser DC. Pharmacologic management of cough. Otolaryngol Clin North Am 2010; 43: 147-55
    CrossrefGoogle Scholar
  • 26 Minamizawa K, Goto H, Ohi Y, Shimada Y, Terasawa K, Haji A. Effect of d-pseudoephdrine on cough reflex and its mode of action in Guinea pigs. J Pharmacol Sci 2006; 102: 136-42
    CrossrefGoogle Scholar
  • 27 Leconte S, Ferrant D, Dory V, Degryse J. Validated Methods of Cough Assessment: A Systematic Review of the Literature. Respiration 2010; , DOI: 10.1159/000321231
    Google Scholar
  • 28 Schönffeldt PG, Céspedes JG, Sepúlveda R, Salamanca ME. Aumento del umbral tusígeno en sujetos sanos con el uso de levodropropizina. Rev Chil Enf Respir 2005; 21: 165-70
    Google Scholar
  • 29 Mutschler J, Koopmann A, Grosshans M, Hermann D, Mann K, Kiefer F. Dextromethorphan withdrawal and dependence syndrome. Dtsch Arztebl Int 2010; 107: 537-40
    Google Scholar
  • 30 Rimsza ME, Newberry S. Unexpected Infant Deaths Associated With Use of Cough and Cold Medications. Pediatrics 2008; 122: e318
    CrossrefGoogle Scholar
  • 31 Takahara A, Sasaki R, Nakamura M, Sendo A, Sakurai Y, Namekata I , et al. Clobutinol delays ventricular repolarization in the guinea pig heart: comparison with cardiac effects of HERG K+ channel inhibitor E-4031. J Cardiovasc Pharmacol 2009; 54: 552-9
    CrossrefGoogle Scholar
  • 32 Seitz CS, Bröcker EB, Trautmann A. Allergy evaluation after emergency treatment: anaphylaxis to the over-the-counter medication clobutinol. Emerg Med J 2007; 24: e19
    CrossrefGoogle Scholar
  • 33 Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA. Gastro-oesophageal reflux treatment for prolonged non-specific cough in children and adults. Cochrane Database Syst Rev 2005; (2) CD004823
    Google Scholar
  • 34 Hunt J, Yu Y, Burns J, Gaston B, Ngamtrakulpanit L, Bunyan D , et al. Identification of acid reflux cough using serial assays of exhaled breath condensate pH. Cough 2006; 2: 3
    CrossrefGoogle Scholar
  • 35 Soni S, Anandjiwala S, Patel G, Rajani M. Validation of Different Methods of Preparation of Adhatoda vasica Leaf Juice by Quantification of Total Alkaloids and Vasicine. Indian J Pharm Sci 2008; 70 (1) 36-42
    CrossrefGoogle Scholar
  • 36 Gupta PR. Ambroxol - Resurgence of an old molecule as an anti-inflammatory agent in chronic obstructive airway diseases. Lung India 2010; 27: 46-8
    CrossrefGoogle Scholar
  • 37 Chang CYC, Sachs HC, Lee CE. Unexpected Infant Deaths Associated With Use of Cough andCold Medications [carta]. Pediatrics 2009; 123: 2:e359
    Google Scholar
  • 38 Chang AB, Halstead RA, Petsky HL. Methylxanthines for prolonged non-specific cough in children. Cochrane Database Syst Rev 2005; (3) CD005310
    Google Scholar
  • 39 Chang AB, Peake J, McElrea MS. Anti-histamines for prolonged non-specific cough in children. Cochrane Database Syst Rev 2008; 2: CD005604
    Google Scholar
  • 40 Chang AB, Winter D, Acworth JP. Leukotriene receptor antagonist for prolonged non-specific cough in children. Cochrane Database Syst Rev 2006; 2: CD005602
    Google Scholar
  • 41 Chang CC, Cheng AC, Chang AB. Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults. Cochrane Database Syst Rev 2007; (4) CD006088
    Google Scholar
  • 42 Warren MD, Pont SJ, Barkin SL, Callahan ST, Caples TL, Carroll KN , et al. The effect of honey on nocturnal cough and sleep quality for vhildren and their parents. Arch Pediatr Adolesc Med 2007; 161: 1149-53
    CrossrefGoogle Scholar
  • 43 Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin Jr CM. Arch Pediatr Adolesc Med 2007; 161: 1140-6
    Crossref
  • 44 Shadkam MN, Mozaffari-Khosravi H, Mozayan MR. A comparison of the effect of honey, dextromethorphan, and diphenhydramine on night cough and sleep quality in children and their parents. J Altern Compl Med 2010; 787-93
    Google Scholar
  • 45 Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE. Honey for acute cough in children. Cochrane Database Syst Rev 2010; 1: CD007094
    Google Scholar
  • 46 Vertigan AE, Theodoros DG, Gibson PG, Winkworth AL. Efficacy of speech pathology management for chronic cough: a randomised placebo controlled trial of treatment efficacy. Thorax 2006; 61: 1055-69
    Google Scholar
  • 47 Murry T, Branski CK, Yu K, Cukier-Blaj S, Duflo S, Aviv JE. Laryngeal sensory deficits in patients with chronic cough and paradoxical vocal fold movement disorder. Laryngoscope 2010; 120: 1576-81
    CrossrefGoogle Scholar
  • 48 Gibson PG, Vertigan AE. Speech pathology for chronic cough: a new approach. Pulm Pharmacol Ther 2009; 22: 159-62
    CrossrefGoogle Scholar
  • 49 Lee JK, Mintz S. Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment. Ann Otol Rhinol Laryngol 2006; 115: 871
    Google Scholar
  • 50 Halum SL, Sycamore DL, McRae BR. A new treatment option for laryngeal sensory neuropathy. Laryngoscope 2009; 119: 1844-7
    CrossrefGoogle Scholar
  • 51 Norris BK, Schweinfurth JM. Management of recurrent laryngeal sensory neuropathic symptoms. Ann Otol Rhinol Laryngol 2010; 119: 188-91
    Google Scholar