Many people diagnosed with pulmonary fibrosis (PF) complain of acute or chronic cough. Cough and shortness of breath are two of the main symptoms associated with this condition. Even though people with PF may experience a persistent cough, it is important to note that pulmonary fibrosis may not be the only reason; it can also be caused by a number of other medical conditions, such as the common cold, post-nasal drip, heartburn, or gastroesophageal reflux disease (GERD). Low oxygen levels can also trigger coughing in PF patients.
Treating persistent cough in pulmonary fibrosis is often a major challenge for physicians because cough associated with this condition often does not respond to medication. However, there are treatment options that can help manage coughing. These treatments are the same as the ones used to treat persistent cough in other conditions and are mostly palliative in nature or aimed simply at relieving the symptoms and do not address the underlying cause of the cough.
Treating cough in pulmonary fibrosis involves addressing the possible comorbidities (other illnesses that occur at the same time) such as post-nasal drip or GERD. A physician can prescribe a variety of drugs, including benzontate, N-acetyl cysteine (NAC), and even some simple over-the-counter remedies such as cough drops. Other types of treatment that physicians may consider include administration of amitriptyline, baclofen, gabapentin, and nebulized lidocaine.
Efforts to understand the development of cough, as well as the testing of drugs that may decrease the frequency and severity of cough in PF patients, are underway. For example, Johns Hopkins University School of Medicine sponsored a small Phase 3 clinical trial (NCT00600028), completed in 2011, that showed promise for the drug thalidomide in helping decrease the frequency and severity of constant, disabling cough in PF patients. But it has not been approved by the FDA for this indication.
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