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Suggest Treatment For Severe Cough

Posted on Tue, 22 Sep 2015

Question: Hello Doctor

My mother, XXXXXXX XXXX, 65.5 yrs old, is suffering from acute cough (just that), accompanied by no fever, since 40 days now. The initial doctor we went to prescribed some medication, nothing happened after intake of his medication, she did self medication or critizine after that for couple of days, nothing happened.

This new lady doctor has precribed three days course of Amoxyclav 625 (thrice in a day), Grilinctus (Before sleep, 5ml) and Histafree (Once before sleep)

Along with the above she is doing regular gargles and having all the precautionary measures. She is not diabetic or any other ailment.

She started the course on from 2nd Sept night.

I can send the X-ray report, Blood Test report to you which she earlier prescribed (along with some normal medication, without antibiotic)

Please let me know how to send the scanned reports to you.

Please advice on to continuation of the prescribed medication or change of doctor again.

Answered by Dr. Abubakar Siddiqh (7 hours later)

Brief Answer:
seems to be allergic bronchitis.

Detailed Answer:

Hi,

I had gone through your question and understand your concerns that your mother is having cough since 40 days. I would like to ask you few more details.

- Is there any belching or post nasal drip (sinus secretions dripping back into throat) ?
- Is there any swelling of limbs (pedal edema) or breathlessness on walking ?

Kindly get back to me with the details.

As per your clinical details, it appears to be allergic or drug related (antihypertensives) or acid peptic disease or acute pulmonary edema (elderly lady with history of cardiac disease).

My suggestions are -

1. Continue augmentin, grinlictus and histafree ( they take care of both allergic as well as infective cough) for couple of days.

2. Start her on ppi inhibitors (pantoprazole + domperidone ) over the counter tab.pan- twice daily before food to prevent cough due to acid peptic disease.

3. First scan the documents, then upload them.

4. In case of persistence, needs ECG and Echocardiogram to rule out the cause (pulmonary edema).

Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Abubakar Siddiqh (16 hours later)

Thank you so much doctor for the response.

We are starting a course on pantoprazole. Though I must tell you that we suspect my mother is an heart related disorder as well. She has been taking some medicines as prescribed by our known Doctor. He had recommended Pantocid (which has pantoprazole) I am not sure whether domperidone is a different salt altogether. Are these two difference medicines or one combo having both the salts?

I have emailed to healthcaremagic her recent Blood report, Chest X-ray report, 2 Lipid Profile reports (one recent and one for Nov'2014), our family doctor's prescription (He not that one who recommended augmentin, grinlictus and histafree for 3 days)

Her 3-day course on augmentin, grinlictus and histafree is ending today evening.

The recent ECG report is not available, the latest one is of year 2014.

Is there any belching or post nasal drip (sinus secretions dripping back into throat)? No
Is there any swelling of limbs (pedal edema) or breathlessness on walking? No, Breathlessness only happens while moving up the stairs unto 2nd floor or so.

Please suggest whether we need to get this ECG done sooner, we will get done.

We generally go in for her regular whole body checkup done after 8-9 months, so the previous reports and x-rays and ECG's are available as well. But new ECG is not available not. I think may be if a new ECG is done you can compare that with previous 3-4 years of ECGs to come to a conclusion.

Please suggest the way out. Thank you so much.

Answered by Dr. Abubakar Siddiqh (58 minutes later)

Brief Answer:
continue the same.

Detailed Answer:

Hello again,

Thanks for considering my answer and for your follow up.

Answers for your queries.

1. Tab. PAN-D, it is a combo, contains two components- pantaprazole + domperidone. Over the counter medication, you can start her with this tab.

2. I can not see your uploaded attachments.

3. Please continue, same medications (augmentin and grinlictus needs to be taken for a week to have best results).

4. Any investigation, validity is 6 months (Ecg). Better to have latest one for safer side.

5. In my opinion, let her continue same prescription for a week. In case of persistent cough you need to redo the tests to know the exact cause.

All the best, take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Abubakar Siddiqh (49 minutes later)

Thank you doctor. Pictures have been emailed to customer care department. I haven't attached them here. They should be directing those to you. I will continue the prescription as suggested. Thanks.

Answered by Dr. Abubakar Siddiqh (5 hours later)

Brief Answer:
take care.

Detailed Answer:

Hello again,

Your mother's investigations (blood tests and x-ray chest) appears to be normal. Kindly follow the instructions, what I have already mentioned.

All the best. Take care.

Above answer was peer-reviewed by : Dr. Prasad