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What Causes Persistent Cough?

Posted on Wed, 2 Nov 2016

Question: Hi Dr,

My father has cough and it is not getting reduced from long. Please some medicine. Dr. told it's allergic bronchitis. Please suggest what needs to be done.

Answered by Dr. Drkaushal85 (9 hours later)

Brief Answer:
There is no chest x ray attached in this question.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Allergic bronchitis needs oral anti allergic, bronchodilators and inhaled bronchodilators and inhaled corticosteroid (ICS).
Oral combination of antihistamine (levocetrizine or fexofenadine) and anti allergic (montelukast) is needed.
Oral bronchodilator like acebrophyllin is also needed.
Inhaled bronchodilators (formoterol or salmeterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone) are must for the treatment.
So please let me names medicines he is taking so that I can guide you better.
Also there is no chest x ray attached in this question. So please attach it.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (28 minutes later)

Thank you Dr. I have attached the documents. Please suggest me what additional things are required required to do. Please suggest me the medication accordingly.
Thanks,
XXXX

Answered by Dr. Drkaushal85 (11 minutes later)

Brief Answer:
Sorry to say but there are no attachments.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry to say but there are no attachments in this question.
I think you are facing technical issues. Better to ask Healthcare Magic team for help.
I will be happy to help you further. Wishing good health to your father. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (4 days later)

Hi Dr,

I have attached the documents. please suggest medication accordingly.

Thanks,
XXXX

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
He should start diuretics.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
I have gone through the attachments you have provided.

He has already given oral and inhaled treatment.
If he is still not improving then we should rule out early heart failure.
Early heart failure can cause cough, pedal edema and it is common in diabetic and hypertensive patients.

So better to get done 2D Echocrdiography. He should definitely take diuretics to see for improvement.
Please let me know
1. Is 2D echo done in the past?
2. Is coughing more at night or in lying down position?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further.

Wishing good health to your father.
Thanks.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Drkaushal85 (7 hours later)

Hi Dr,

It has been done. It has come normal.
Please provide the suggestions

Regards,
XXXX

Answered by Dr. Drkaushal85 (6 minutes later)

Brief Answer:
You should start diuretics and see whether his symptoms are improving or no

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Well, in my opinion, you should give him diuretics and see whether symptoms are improving or not.
Along with other drugs and rota caps, also give him combination of montelukast and fexofenadine (Allegra M) for allergic component.
Hope I have solved your query. I will be happy to help you further. Wishing good health to your father. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (2 days later)

Hi Dr,

I gave him Histafree as per your suggestion. It has a great effect. Can you please tell me what's are dosages. How many per day and when to eat?

Thanks for the help

Regards,
XXXX

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
I don't know what histafree is having.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
It's great that my advice is helping him.
Sorry to say say but I don't know what histafree is having. Actually where I practice, histafree is not available.
So can you please tell me the contents of histafree so that I can guide you the dosage of it?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (17 minutes later)

Hello Dr,

It has the combination of both montelukast and fexofenadine.

Regards,
XXXX

Answered by Dr. Drkaushal85 (9 minutes later)

Brief Answer:
You didn't mention dose.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
You are forgot to mention dose.
Normally montelukast is 10 mg and fexofenadine is 120 mg.
So is this same in histafree?
Also tell me weight of your father because dose also depends on weight of patient.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (9 minutes later)

Hi Dr,

Yes the compositions are same. He had one at night.
His weight is 68Kg.

Now can you please mentions the dosages, so that he can continue the same in a proper dosages.

Thanks,
XXXX

Answered by Dr. Drkaushal85 (18 minutes later)

Brief Answer:
He should take montelukast 10 mg and fexofenadine 180 mg.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
According to his weight, he should take montelukast 10 mg and fexofenadine 180 mg.
He should take this combination for 1 month.
This should be taken at night time before going to sleep.
Hope I have solved your query.
I will be happy to help you further. Wishing good health to your father. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar