COUGH

Ordinary dry cough with throat pain - aris­ing from pharyngitis, laryngitis and bron­chitis is one of the commonest symptom seen in General Practice.
Instructions :
1. Steam inhalations 2-3 times/day. Addto water Tine. Benzoin, Vicks orAmrutanjan.
2. Warm salt water Gargles.
3. Take hot drinks like hot tea, coffee,milk or soups,5-6 times/day.
4. If cough is severe, advise Rest at home,and voice rest if laryngitis.
5. If smoker, advise to stop smoking
6. Instruct to cover the mouth whilecoughing (using hand or handkerchief)to prevent spread of infection to otherfamily members.

Drug Treatment :
1. Cap Terramycin 500 mg. tds x 5 (anti­biotic = 7A) Read the note below.
2. Suprcssa 1-2 tsp tds or Linctus Co­deine I tsp tds3.

If associated with fever, Add :
Tab Crocin 1 tds and if fever

4. If associated with common colds,Add anti histaminic :
Tab Rinoslat Vi - 1 tds

5. If associated with Body ache, AddNSAID :
Tab Disprin 1 tds, or Tab Combiflam 1 tds
If associated with occasional rhonchii, Add Bronchodilator :
i) Tab Asthalin 4 mg. x tds ii) Tab Wysolon 5 mg. tds x 3

If associated with expectoration,
Give :
i) Avil expectorant tsp tds ii) Tab Bromhexeine 8 mg. tds
There major points in deciding treat­ment of cough are its duration, pres­ence of expectoration and presence of wheezing.
The Choice of the antibiotic will vary from doctor to doctor, and from locality to locality.
In General, for mild infections use milder antibiotics like Tetracyclins, Septran, Erythromycin, Ampicillin-Amoxycillin, Gentamycin.
If the infection is severe start with peni­cillin, Roxithromycin, Cefalosporins or Pefloxacin.
If infection is not controlled in 3 days,
1. Cap. Nufex 500 mg. or Inj. Penicillin 10 lacs IM x A.T.D. x OD 6 (penicillin is one of the most effective drugs in Respiratory tract in­fections)

2. Tab Wysolone 5 mg. tds x 5 (Predniso­lone =9A-1)
3. Auscultate carefully for wheezing &rhonchii.
4. If no response, ask for investigations :i) Hb%, WBC for eosinophil. ii) X-ray Chest for TB, pneumonia etc. iii) If other investigations are normal, HIV Test.
5. If Eosinophilia, i.e. Tropical Eosino-philia.
1. T. Hetrazan 1 tds x 21 days

2. T. Wysolone 1 bd x 10-15 days

Indications for immediate X-ray ;
1. Cough > 15 days.
2. Chest pain on breathing, high feveror dyspnoea
3. Rales, cavity or abnormal breathsounds
4. Loss of weight or gross emaciation
5. Hemoptysis
6. No response to antibiotics for 1 wk.