Definition and Types of Cough

Cough is one of the common ailments that often occur. Usually, this is self-limiting and will resolve on its own within a week. However, due to the discomfort caused by coughing, majority of individuals will opt for medication to relieve their symptoms.

Cough

Cough on its own is not a disease but merely a symptom to certain diseases. It is actually a normal and good reaction of the body. This reaction is known as a reflex reaction whereby cough automatically occurs to relieve blocked airways or to get rid of irritants.

The two types of commonly occurring coughs are:

1. Cough with phlegm or mucus (productive cough)
2. Cough without phlegm or mucus (non-productive cough)

The cause and the subsequent treatment of these two types of cough differ. Therefore, it is important to identify the type of cough so that the appropriate medicine can be used.

Types of Cough Medicine

It is a common practice whereby some individuals choose to self-treat their coughs by obtaining medicines from pharmacies or other retail shops. There are many types of cough medicines that can be purchased without doctors’ prescriptions. However, there are some cough medicines that contains certain substances that require consultations/ prescriptions before purchasing.

Below are the commonly used cough medicines and their functions:

1. Decongestants (airway reliever): To open up the airway muscles to relieve congestion in the chest. Mainly use for productive cough.

Examples: ephedrine, phenylephrine, oxymethazoline and pseudoephedrine.

1. Expectorants: To relieve congestive chest by thinning the mucus and stimulate cough to remove the phlegm. Mainly use for productive cough.

Examples: ammonium chloride, guaifenesin and ipecac syrup.

1. Cough suppressants (antitussive): To relieve and reduce the frequency of cough, mainly used for unproductive coughs.

Example: codeine, dextromethorphan and diphenhydramine hydrochloride.

Therefore, based on the functions and types of cough listed above, it is recommended to first seek medical advice from doctors or pharmacists before using any cough medicines.

Cough Medicine Abuse and Addiction

Cough medicine abuse is frequently associated with teenagers. However, not all types of cough medicines can cause addiction. By taking the medicine at the prescribed dose and right timing, addiction is very less likely to happen.

Cough medicines containing codeine and dextromethorphan are popular among abusers. If consumed in excess, these types of cough medicines will provide a narcotic effect. These medicines are listed in the Poisons Act 1952 as one of the drugs that can only be obtained from a licensed pharmacist with a doctor’s prescription. However, illegal sales of these medicines have been causing an increase in cough medicine addiction. Dextromethorphan is also one of the cough medicines that are often misused, as it is available in pharmacies or drugstores without a prescription.

The cheap retail price of these medicines is one main contributing factor to abuse. The colour of cough syrup preparations are often indistinguishable from carbonated or soft drinks. The dark brown/ caramel colour of the medication can be mistaken as ‘kopi-O’ or cola. Most cough syrups are sold illicitly by re-packaging them in the form of plastic drink packets or in bottles of carbonated drinks. Abusers normally consume more than what is recommended to get an instantaneous effect.

Effects of Cough Medicine Abuse

Codeine is a type of painkiller and it is more effective when converted into morphine in the body. Excessive codeine intake will reduce mental alertness and thus cause drowsiness, dizziness, nausea and vomiting.

A cough mixture containing codein if taken@used, repeatedly may cause dependence and soon develop tolerance. This is a condition whereby the individual will no longer experience the same effect even though the medicine is given at the same dose. As a result, higher doses will be required and ultimately causing the individual to be addicted to the medicine.

Continuous intake of the medicine at excessive doses will lead to harmful side effects..These effects could be manifested in the form of physical, mental and emotional dependence. Addicts might end up with damages to their lungs, liver, digestive system (due to inadequate nutrients) and kidneys.

Furthermore, muscles of the body will waste away (muscle shrinking), individual will become lethargic and leading to weight loss. Addicts will also tend to always be in a trance, become forgetful and sleeps a lot.

Conclusion

Abuse or addiction to cough medicine leads to a lot of other negative risks. Therefore, patients should be exercise cautioun when taking medicine and should follow instructions from doctors or pharmacists. Prevention is better than cure. Practise the 5R concept when taking any medicine. Ensure RIGHT medicine for the RIGHT patient at the RIGHT time at the RIGHT DOSE and at the RIGHT route of administration.

References:

1. National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm
2. Kesan Menyalahguna Ubat Batuk, Pusat Racun Negara, Universiti Sains Malaysia. 1995.
3. Preventing Teen Over-The-Counter Cough Medicine (Dxm) Abuse: A Parent’s Guide. Consumer Healthcare Products Association (CHPA).
4. knowyourmedicine.gov.my