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Approach to chronic cough, References: 1) American Academy of Family…

- - - - Rx: Rule out red flags. Smoking cessation.
    - - Spirometry, metacholine test suggestive of asthma
        
        Rx: Avoid potential triggers, inhaled bronchodilators, high dose inhaled corticosteroids, leukotriene receptor antagonists ((montelukast)
        
        If symptoms still persist then oral steroid (prednisone) 40 to 60mg for 5 to 10 days
    - - Rx: Antacids, PPIs therapy for 8 weeks, lifestyle changes, dietary changes, weight loss, H2 receptor antagonist
    - - Rx: Discontinue the drug, resolution of the cough should
        occur within one week to three months. Angiotensin receptor blockers (ARBs) are a good alternative to
        ACE inhibitors
    - - Rx:
        
        decongestant
        
        first-generation antihistamine. Intranasal corticosteroids, saline nasal rinses, nasal anticholinergics
        
        antihistamines
    - - Rx: Avoidance of occupational exposures, inhaled corticosteroids, montelukast
    - - Rx: Avoid exposure. Wear a mask.
    - - Rx: Treatment includes an inhaled bronchodilator, inhaled anticholinergic, inhaled corticosteroid and a one-to-two-week course of oral corticosteroids(with or without antibiotics)
  - - - Chest Radiograph
        
        Abnormal
        
        Treat accordingly
        
        Cough persists
        
        Cough resolves
        
        Normal
        
        Sequentially treat (or evaluate) for the most common causes of chronic cough:
        -UACS (allergy skin testing, sinus CT)
        -Asthma (PFTs)
        -Non-asthmatic eosinophilic bronchitis (sputum eosinophilia)
        -GERS (esophageal pH monitoring)
        
        Cough persists
        
        Evaluate for less common conditions (e.g. sputum tests, HRCT scan. esophageal pH probe monitoring, esophagoscopy, flexible bronchoscopy, cardiac studies, bronchoscopy, obstructive sleep apnea studies)
        
        Treat accordingly
        
        2 more items...
        
        Cough resolved