"Hey Doc, got something to stop this coughing?"

"So, there was this funeral procession walking out of a church in San Francisco.  One of the six pole bearers stumbled on his shoe laces and the coffin tipped forward.  The coffin slid down the steep church stairs and continued to slide down one of the steep San Francisco streets.  At the bottom of the hill the coffin went sliding through the front door of a pharmacy, slid all the way back to the pharmacy counter and came to a stop as it ran into the pharmacy counter.  At that point, the coffin door flew open and the corpse popped up and said, Hey doc, got something to stop this coffin?"

It seems this time of year we get at least four or five people a day coming into the pharmacy asking what they should take to stop their coughing.  Like I have said before, when someone asks a question in the pharmacy, it is usually not a simple one line answer.  We need to take the time to ask a few questions to help the patient decide what the best course of action should be.

Coughing is a natural process to clear your airways of something.   The cough is the symptom of something else going on.  If you have a fever,  yellow or green sputum, are coughing blood, or are having a difficult time breathing, please see your doctor as soon as possible.

What we are talking about here is an acute cough, something that has started within the last couple days, not a cough that has been pestering you for weeks or months.  A chronic cough can be caused by many different medical or social conditions and may even be caused as an adverse effect of another medication you may be taking. 

In the pharmacy we have two basic options of over the counter medication to treat a cough.  Guaifenesin is used to treat a phlegm and mucus cough, and dextromethorphan is used to treat a dry and hacky cough.

Guaifenesin is an expectorant that is used to help thin the mucus.  Guaifenesin stimulates the respiratory tract to produce more secretions and increase the volume of fluid.  This increase in respiratory fluid thins out the mucus, making it much less sticky and creates a much easier environment to cough out the mucus.  While taking guaifenesin it is imperative to stay hydrated.  Hydration helps keep the mucus thin and loose.  Guaifenesin works best when it is kept in your system on a regular basis for 3-4 days.  Remember; drink plenty of fluids while taking this medication.

Dextromethorphan works in the cough center of your central nervous system to suppress the cough stimulus.  This medication works well if you are having a difficult time sleeping because your dry hacking cough is keeping you up.  To purchase dextromethorphan you need to ask for it at the pharmacy counter.   Dextromethorphan has been shown to give a euphoric dissociative effect when taken at high doses and you need to be 18 years of age to purchase it. 

Before you take any over the counter cough medication, please take the time to read and understand the dosing information on the medication package.  If you have any question as to which over the counter medication you should use, or, if you don't understand the package dosing instructions, please talk with your pharmacist or doctor.  Remember, you can call any pharmacy and ask to speak to the pharmacist.  They will be happy to direct you to the best alternative to help you  with your coughing.

Thanks
Steve

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