reasons for a cough. In addition to illness, drugs can also cause coughing. It's called a drug-induced cough. The following medicines can easily cause coughing.
Angiotensin-converting enzyme inhibitors.
Angiotensin-converting enzyme inhibitors such as captopril and enalapril increase prostaglandins. The increase in prostaglandins can make coughing easier. In addition, they increase the amount of bradykinin and cell fiber stimulators such as substance P in the lungs. These substances induce bronchoconstriction leading to a severe dry cough. Such dry coughs are generally irritating and persistent in character. No secretions are excreted when coughing. Sometimes it appears paroxysmal. Symptoms can be worsened by lying down and at night. This can affect the patient's sleep. Symptoms of dry cough usually appear within 3 to 7 days of taking an angiotensin-converting enzyme inhibitor. It will get worse over time. This cough cannot be cured with cough suppressants or antibiotics. It usually resolves gradually with discontinuation of the drug.
Antiarrhythmic drugs.
Among the antiarrhythmic drugs that most commonly cause dry cough is amiodarone. It is mainly used to prevent or treat ventricular arrhythmia, atrial fibrillation, etc. Its most common side effect is pulmonary toxicity-related symptoms, occurring in approximately 1 to 17%. Generally, hypersensitivity pneumonitis or interstitial pneumonitis will occur after continuous use for 3 to 12 months. In patients with lung disease, excessive doses or prolonged courses of amiodarone are more likely to develop pulmonary toxicity. Its most common clinical manifestation is dry cough. Therefore, monitoring of lung function is recommended within 3 to 6 months of taking amiodarone. In addition, it is necessary to pay attention to the adjustment of the drug dosage when using it.
Diuretic drugs.
Diuretics such as hydrochlorothiazide can increase urine output and lower blood pressure. One of its common side effects is a dry cough. Most coughs are induced within a few hours of taking the medicine. In severe cases, it can even lead to asthma. The cough usually gets better after the drug is stopped.
Nitroimidazole antibiotics.
Among the nitroimidazole antibiotics, nitrofurantoin is the most likely to induce cough. Its most common side effect is acute pneumonia injury. If the patient has pneumonia or is allergic, it will be more likely to induce pneumonia damage. Its clinical manifestations are mainly dry cough. Most acute pneumonia injuries occur within 1 month of taking nitrofurantoin. If a dry cough develops after more than 6 months of use, it should be considered as possible pulmonary toxicity. Symptoms usually get better when the drug is stopped. If the symptoms do not improve after stopping the drug, oral antihistamines and glucocorticoids can be used to relieve the symptoms.
Antituberculosis drugs.
Among the anti-tuberculosis drugs, para-aminosalicylic acid is the most likely to cause dry cough. Most of the irritating coughs it causes appear within 3 weeks of taking the drug and usually get better when the drug is stopped.
Anti-cancer drugs.
Among the anticancer drugs, bleomycin is one of the drugs that is more likely to cause lung damage. It produces reactive oxidative products that cause direct damage to lung tissue. This results in massive infiltration of leukocytes, increased release of proteases, proliferation of fibroblasts, and pulmonary fibrosis. The common clinical symptom is dry cough. It occurs in about 2 to 4 percent. Lung damage can still occur weeks, months, or even years after the drug is stopped. If lung injury occurs while taking the drug, the drug should be discontinued immediately. If symptoms do not improve after stopping the drug, intravenous glucocorticoids should be administered to inhibit fibroblast activity. Patients can also supplement with oxygen to improve the symptoms of dyspnea.
Antibiotics.
Antibacterial drugs such as penicillins, cephalosporins, macrolides, etc. can cause cough. Patients with allergies are more likely to induce cough. Symptoms generally improve when the drug is stopped.
Anticoagulant drugs.
The most common adverse effect of anticoagulant drugs is bleeding. If the bleeding is in the chest cavity or lung parenchyma, it can damage lung tissue and cause coughing. Therefore, it is recommended to observe whether there is bleeding during taking the medicine, and adjust the dose in time. It is recommended to start with a low dose and then gradually increase the dose.
Sodium cromoglycate
Sodium cromoglycate can be used to prevent asthma attacks and the prevention and treatment of allergic symptoms. However, inhaled sodium cromoglycate tends to irritate the mucous membranes of the airways and cause coughing when used. Coughing may occur a few minutes after taking the medicine. Symptoms can be improved with dose reduction or discontinuation.
Aspirin.
Aspirin can increase the production of leukotrienes. It irritates the mucous membranes of the airways causing coughing. Cough usually occurs within 30 minutes of taking the medicine. Symptoms will gradually relief after the drug is discontinued.
Drug-induced cough usually improves when the drug is discontinued. If it does not improve, it should be promptly treated according to the patient's condition.
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