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Coughing Up Phlegm. Taking Methotrexate, Plaquenal, Losartan. Suggset Medication

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Posted on Mon, 29 Apr 2013
Question: I am coughing up phlegm, it is the form of a small tootsie roll, about 1/2"x1". I am on methotrexate and plaquenal, also losartan for high blood pressure
doctor
Answered by Dr. Michelle Gibson James (2 hours later)
Hi, thanks for using healthcare magic

Productive coughing can be due to a number of conditions such as : (1) bronchitis which can be viral or bacterial, this is associated with a persistent cough and there would be symptoms of infection such as fever, history of nasal congestion or discharge, sore throat. Most cases are viral and respond to symptomatic therapy such as mucolytics, increasing oral fluids and cough suppressants

(2) Rhinosinusitis- this is inflammation of the nasal passages and sinuses.It results in a post nasal drip, this post nasal drip can result in a cough , in some persons it would be productive. There would be a history of a sinus symptoms such as post nasal drip, intermittent symptoms. It is treated by avoiding the allergen, using topical nasal sprays and antihistamines. Most of these are available over the counter

(3) infection of the lung- pneumonia. Pneumonia is common cause of reproductive cough, it would be differentiated from bronchitis by examination (different sounds would be heard by the doctor) and by history. The fever may be prolonged and a general feeling of malaise

(4) COPD- if there is a history of smoking,this is also an option. COPD consists of emphysema or chronic bronchits. Chronic bronchitis is diagnosed in the presence of a persistent productive cough.

If you are feeling generally unwell with symptoms such as fever that may suggest an infection it would be best to visit your doctor for an evalaution. It is important to remember that with the immunosuppresants you are taking for RA, you may not experience the typical fever with an infection because fever is an inflammatory response.

i hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (10 minutes later)
Is it common for phlegm to congregate into a log style tootsie roll type thing? I did have actinomyces in 209. thanks
doctor
Answered by Dr. Michelle Gibson James (29 minutes later)
HI, it implies it is taking the shape of one of the airways that it was expelled from.

Actinomyces can present with a productive cough as well. Other symptoms such as fever, loss of appetite, fatigue and weight loss may occur.
It is diagnosed by obtaining an appropriate specimen from the lungs.

With a history of previous infection, you may want to speak to your doctor about evaluation for this.

Please feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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Coughing Up Phlegm. Taking Methotrexate, Plaquenal, Losartan. Suggset Medication

Hi, thanks for using healthcare magic

Productive coughing can be due to a number of conditions such as : (1) bronchitis which can be viral or bacterial, this is associated with a persistent cough and there would be symptoms of infection such as fever, history of nasal congestion or discharge, sore throat. Most cases are viral and respond to symptomatic therapy such as mucolytics, increasing oral fluids and cough suppressants

(2) Rhinosinusitis- this is inflammation of the nasal passages and sinuses.It results in a post nasal drip, this post nasal drip can result in a cough , in some persons it would be productive. There would be a history of a sinus symptoms such as post nasal drip, intermittent symptoms. It is treated by avoiding the allergen, using topical nasal sprays and antihistamines. Most of these are available over the counter

(3) infection of the lung- pneumonia. Pneumonia is common cause of reproductive cough, it would be differentiated from bronchitis by examination (different sounds would be heard by the doctor) and by history. The fever may be prolonged and a general feeling of malaise

(4) COPD- if there is a history of smoking,this is also an option. COPD consists of emphysema or chronic bronchits. Chronic bronchitis is diagnosed in the presence of a persistent productive cough.

If you are feeling generally unwell with symptoms such as fever that may suggest an infection it would be best to visit your doctor for an evalaution. It is important to remember that with the immunosuppresants you are taking for RA, you may not experience the typical fever with an infection because fever is an inflammatory response.

i hope this helps, feel free to ask any other questions