Cough integrator

The threshold limit value—time integrated average, TLV—TWA, of chlorine dioxide is 0.1 ppm, and the threshold limit value—short-term exposure limit, STEL, is 0.3 ppm or 0.9 mg /m of air concentration (87,88). Chlorine dioxide is a severe respiratory and eye irritant. Symptoms of exposure by inhalation include eye and throat irritation, headache, nausea, nasal discharge, coughing, wheezing, bronchitis, and delayed onset of pulmonary edema. Delayed deaths occurred in animals after exposure to 150—200 ppm for less than one hour. Rats repeatedly exposed to 10 ppm died after 10 to 13 days of exposure. Exposure of a worker to 19 ppm for an unspecified time was fatal. The ingested systemic effects of low concentration chlorine dioxide solutions are similar to that of chlorite. 

Takahama K, Shirasaki T (2007) Central and peripheral mechanisms of narcotic antitussives codeine-sensitive and -resistant coughs. Cough 3 8 Tominaga M, Caterina MJ, Malmberg AB, Rosen TA, Gilbert H, Skinner K, Raumann BE, Bas-baum Al, Julius D (1998) The cloned capsaicin receptor integrates multiple pain-producing stimuli. Neuron 21(3) 531 3... 

Pratter MR, Brightfing CE, Boulet LP, Irwin RS (2006) An empiric integrative approach to the management of cough ACCP evidence-based clinical practice guidelines. Chest 129 222S-231S... 

The source and conditions under which substance P is released may determine the extent to which the presynaptic and postsynaptic mechanisms are integrated to shape the neuronal output from the NTS to distal synapses in the reflex pathways. Multiple central mechanisms are likely to contribute to the plasticity of cough reflex. In upregulated cough reflex, an increased substance P expression in the vagal neurons may be released at the central terminal in the NTS (Fischer et al. 1996 Chuaychoo et al. 2005). This enhanced substance P release in the NTS... 

In healthy individuals, mucociliary clearance and cough mechanisms are normally effective and efficient for defense on secretion encumbrance, but may become ineffective if these systems malfunction and in the presence of excessive bronchial secretions. Mucus secretion and clearance are extremely important for airway integrity and pulmonary defense. It has been estimated that mucus secretion volume is between 10 and 100 mL/day in healthy subjects (1). 

---