Postnasal drip

There is some controversy as to whether cough in conditions usually associated with the production of mucus such as COPD or bronchiectasis should be suppressed as this could lead to mucus accumulation with increased risk of lung infections. In both COPD and bronchiectasis, an enhanced cough reflex has been demonstrated (Doherty et al. 2000 Torrego et al. 2006), and therefore part of the excessive cough which has been reported in COPD patients with the use of cough counters (Coyle et al. 2005) may be related to an enhanced cough reflex. In these conditions, it is difficult to reverse the previous condition with effective treatments. 

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Pharyngitis is an acute throat infection caused by viruses or bacteria. Other conditions, such as gastroesophageal reflux, postnasal drip, or allergies, also can cause sore throat and must be distinguished from infectious causes. Acute pharyngitis is responsible for 1% to 2% of adult physician visits and 6% to 8% of pediatric visits but generally is self-limited without serious sequelae.41,42 Antibiotics are prescribed in 50% to 70% of cases in adults and children because of the inability to... 

Symptoms include clear rhinorrhea, sneezing, nasal congestion, postnasal drip, allergic conjunctivitis, and pruritic eyes, ears, or nose. 

Patients may complain of loss of smell or taste, with sinusitis or polyps the underlying cause in many cases. Postnasal drip with cough or hoarseness can also be bothersome. 

PO Rash, abdominal pain, arthralgia, nausea, insomnia nfialation Bronchospasm, hoarseness, lacrimation Nasal Cough, headache, unpleasant taste, postnasal drip Opfitfialmic Lacrimation and itching of eye Rare... 

A temperature scale that never quite caught on was formulated by the Austrian chemist Johann Sebastian Farblunget. The reference points on this scale were 0 FB, the temperature below which Farblunget s postnasal drip began to bother him, and 1000 FB, the boiling point of beer. Conversions between C and °FB can be accomplished with the expression... 

The best antitussive of all is removal of the cause of the cough itself, e.g. treatment of underlying conditions such as asthma, postnasal drip or gastro-oesphageal reflux. In patients with hypertension or cardiac failure, a common cause of a dry cough is treatment with an ACE inhibitor. 

As always, it is necessary to have a clear idea of the underlying problem before Starting to any therapy. For example, the approach to cough due to invasion of a bronchus by a neoplasm differs from chat due to postnasal drip from chronic sinusitis or to chat due to chronic bronchitis.The following are general recommendations ... 

There may be sore throat and cough due to irritation of the pharynx and mucus dripping down from the nasopharynx into the bronchus (postnasal drip)... 

He found that inhalation of the vapor was useful for sinus congestion, postnasal drip, and bronchial catarrh. He also suggested that the berries be used as a general bladder tonic to strengthen function and tonicity. 

Symptoms affecting the head, ears, and nose headache with vertigo, pain in the temples and the top of the head, inflammation of the middle ear, sneezing, constant postnasal drip with coughing and gagging. 

Not only is allergic rhinitis aggravating, it also frequently leads to further complications, particularly if the patient does not receive adequate treatment. Symptoms of untreated rhinitis may lead to inability to sleep, chronic malaise, fatigue, and poor work or school efficiency. Patients often are plagued by loss of smell or taste, with sinusitis or polyps underlying many cases of allergy-related hypos-mia. Postnasal drip with cough, hoarseness, and even vocal polyps also can be bothersome. 

Azelastine is an ophthalmic antihistaminic preparation. It is indicated in the treatment of symptoms of seasonal allergic rhinitis, such as rhinorrhea, sneezing, and nasal pruritus treatment of symptoms of vasomotor rhinitis, such as rhin-orrhea, nasal congestion, and postnasal drip (nasal inhalation) treatment of itching of eye associated with allergic conjunctivitis (ophthalmic). 

Poe RH, Harder RV, Israel RH, KaUay MC (1989) Chronic persistent cough. Experience in diagnosis and outcome using an anatomic diagnostic protocol. Chest 95 723-728 Pratter MR (2006) Chronic upper airway cough syndrome secondary to rhinosinus diseases (previously referred to as postnasal drip syndrome) ACCP evidence-based clinical practice guidelines. Chest 129 63S-71S... 

Wise SK, Wise JC, DelGaudio JM (2006) Association of nasopharyngeal and laryngopharyngeal reflux with postnasal drip symptomatology in patients with and without rhinosinusitis. Am J Rhinol 20 283-289... 

Irwin RS, Madison JM. Diagnosis and treatment of chronic cough due to gastroesophageal reflux disease and postnasal drip syndrome. Pulm Pharmacol Ther 2002 15 261-266. 

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