Cough and respiratory secretions

Abstract

Cough is both an important defense mechanism for the lungs and a -troublesome symptom. Treatment is first directed at the underlying mechanisms giving rise to cough. Codeine or strong opioids can help to relieve cough although their use is limited by adverse effects such as sedation and constipation. Patients with ineffective cough due to neuromuscular diseases, such as motor neurone disease, are vulnerable to retained airway secretions and pneumonia. Physiotherapy techniques and cough assist devices may enhance clearance of respiratory secretions under these circumstances. Anticholinergic drugs such as hyoscine or glycopyrronium are effective in controlling secretions and a death rattle at the end of life.