Over-the-counter cough syrup not for babies — Expert

A consultant internal disease pharmacist, Solomon Nwanfuru, talks about cough and its treatments with MOTUNRAYO JOEL

What is a cough?

A rapid expulsion of air from the lungs, typically in order to clear the lung airways of fluids, mucus, or other material also known as tussis.

What are the different types of cough?

Broadly speaking, there are two main types of cough; cough which produces excess mucus or phlegm and cough which produces no mucus or phlegm. Based on these two main types of cough, there are four types of cough: chesty, mucus, tickly and wet.

When one has a chesty cough, one feels tightness in one’s chest as if someone is squeezing it hard.  Chesty cough is caused by a build-up of phlegm in the lungs and result in chest congestion. Chest congestion is a common symptom of respiratory tract infections. Sometimes, irritants such as dust, bacteria or viruses can enter one’s lungs and cause an infection. This can result in inflammation of the airways and result in extra phlegm (or mucus) in one’s lungs. The cough mechanism kicks in to try to get rid of it.

Another type of cough is mucus cough. When a wet mucus cough sits on one’s chest, one feels heavy as though something is weighing down on one’s chest. When one gets a cold, more mucus is produced to trap the viruses or bacteria. This mucus can gather in the respiratory system and a cough reflex is triggered to help remove it. Tickly cough can be quite irritating. It makes one feel uncomfortable and can bother one while talking as if someone is tickling one’s throat with a feather.

One feels it in one’s throat rather than in the chest as opposed to the chesty and mucus coughs. The last is dry cough. When one experiences a hacking dry cough, it can be intense and painful. Sometimes, you even want to avoid coughing, because you are afraid it will hurt. A dry cough can be felt in one’s throat rather than in the chest as opposed to the chesty and mucus cough.

What type of cough medicine do you recommend for adults?

A doctor’s recommendation depends on the type of cough. Mucus cough should be treated with an expectorant. However, if the mucus has a flour smell, the person would need to take anti-bacteria medication.  It means the cough is infected and may have originated from dirty environment, contaminated food or poor hygiene. A tickly cough should be treated with demulcent cough syrup that will smoothen the pathway. If a person has a painful cough, he or she needs a cough syrup produced with demoline and codeine. Every type of cough has a different therapy regiment.

Is it safe to take a decongestant if one has high blood pressure?

Decongestants have the tendency to make one’s blood pressure and heart rate rise and it prevents one’s blood pressure medication from working properly. If your blood pressure increases due to decongestant intake, avoid using cough and cold medicine that contains it.

For a child who has persistent cough even after taking antibiotics and cough syrup, what should be the remedy?

If the child does not have tuberculosis, it could be that the child has low immunity. The cough treatment should be backed up with anti-bacterial drugs such as penicillin or cephalaxin, because it has effect in upper respiratory pathway which is the alimentary canal. If it is a condition where both cough syrup and antibacterial are used but the cough still persists, a general blocker will then be used. A steroid could be prescribed because it blocks the paths responsible for the cough, however steroids should not be taken for three to five days.

What is your view on nasal spray for congestion?

Nasal spray is fine, but it should not be used for multiplicity or more frequently.  It has the tendency to cause rebound cough that could block the nasal pathway. If someone has a nasal condition, the person’s condition could be built with good nutrition and multivitamins. Nasal spray should be used only on doctor’s prescription.

What are the benefits of honey as a remedy for cough treatment?

Honey bred with artificial support is different from honey made from the wild (produced by wild bees). The undiluted, natural honey contains materials that work effectively. Artificial honey contains sugar whereas honey from the wild is healthier and good for body system.

What should be the first measure administered to a child having cough or cold?

I do not advise mothers to buy over-the-counter cough syrup, because the syrups are expectorant. And the child cannot cough out the mucus thus its clinical outcome of administering the syrup is defeated.  Rather, they should visit a community pharmacist who will recommend a better therapy.

For children under one year, what should be the ready?

The mother should ensure that exclusive breastfeeding is given to the child. Breast milk contains healthier materials that will boost the child’s immune system.  I also advise mothers to give their children naturally blended food. This is for children above six months.

What cough medicine should one take for a fever and aches?

First, is the person coughing or having pains when the person coughs? It all depends on the type of pain. The primary remedy is paracetamol, and then the person’s mucus sample should be taken to a laboratory for test. In this part of the world, once a person has cold and body aches, antimalarial is prescribed. However, the antimalarial should also be administered based on the person’s body nature. This is because some people react to certain drugs.

How effective are natural cold remedies like zinc, echinacea and vitamin C?

They are antioxidants that are effective in the body. They are immune boosters. They break radicals which then enhances proper blood flow. This guarantees good blood circulating system. There is good evidence that large doses of vitamin C shorten the duration of the common cold by about a day and that symptoms are ameliorated.