Cough: some aspects of pathogenesis and therapeutic approaches

Abstract

This article is a literature review on the management of patients with acute cough. The classification of cough, the main causes of acute and subacute cough, the current view on the etiology and pathogenesis of chronic cough are presented. Cough is an important protective mechanism, but in acute and chronic diseases of the bronchopulmonary system cough significantly reduces the quality of life and causes numerous complications. The most common cause of acute and subacute cough is respiratory viruses. Chronic cough is currently explained by the theory of cough hypersensitivity, according to which chronic refractory cough is the result of hypersensitivity of the cough receptors. Before the cause of chronic cough is identified, and when treating patients with acute and subacute cough, symptomatic therapy with cough suppressants that eliminate increased cough reflex activity to normal levels regardless of cough etiology, although not affecting the pathophysiological mechanisms of cough, or with combined drugs with suppressant and expectorant effects, is often required. Peripheral suppressants reduce the activity of peripheral cough receptors of the upper airway mucosa by softening, moistening and enveloping. Central cough suppressants include butamirate. Central non-narcotic cough suppressants in various combinations with muco- and bronchodilators and antihistamines form part of many anti-cough medicines. Butamirate has a non-specific anticholinergic and therefore bronchodilator effect. This article presents a review of clinical studies on the efficacy of butamirate.