So i’ll be talking about medications you can use, so first the over-the-counter medications, unfortunately these are for the cough and cold therapy and cough suppressant medications, these are not recommended for children under six years old and they’re not encouraged for children under 12 years old either, they’re not encouraged for acute or chronic cough and this is because research has shown that they are not much more effective than doing nothing or placebo and there are many reports of toxic side effects like nausea, dizziness, seizures, short pauses, problems breathing and there have been cases of overdose and death so because of all those things again we’re weighing the risks and benefits of all the therapy, we use risks of using these medications with side effects versus the benefits which might not be as high so they’re not recommended in young children and even for older children who can take the medicine, there’s still these considerations of side effects so if your child’s using the medicine and they have any side effects or it’s not working, please stop the medication immediately and also a quick note on the medications that suppress cough, this would be such as dextromethorphan that’s found in robitussin or delsum or some brand names, we often don’t recommend those either because of the side effects but also again we really encourage cough suppressant because that’s what’s helping to clear the mucus and if mucus is stuck down in the throat or in the airway, it can actually lead to more problems and infections so we do want people to clear the mucus and so there are there are medications that are very targeted towards certain causes of chronic cough and that’s what i’ll talk about next, the first one is asthma and asthma is a condition that’s often under diagnosed and under-treated so if with the chronic cough, if your child has any other signs that suggest asthma, wheezing triggers that are common for asthma or lung function testing that suggests it, they will be started on a trial of asthma controller medication and usually by the time they end up at the pediatric pulmonologist, the symptoms have been going on long enough and are often enough that they will need that daily control or medication and this is the inhaled corticosteroid which is the inhaler slow acting medication to help calm down the inflammation in the airways and prevent it from becoming worse with triggers or illness and other medication, there are medication by mouth that are asthma controller medications as well or the oral steroids, if the cough is very bad and affecting your child greatly there will be put on a five-day course of oral steroids to help calm down the symptoms and the important thing to remember if you have an inhaler for asthma, if you have an asthma medication inhaler to always use the chamber or spacer with it because this helps the particles be delivered properly down into the lungs instead of without it, it’s oftentimes squirted more into the mouth and swallowed so the spacer is very important because you’re using medications but we have to make sure they’re being used properly. Another condition is allergies, there are specific treatment for them and these medications are called antihistamines, some brand names are zyrtec claritin allegra and they help block this molecule called histamine which causes all the allergic response in the body and there’s also some nasal corticose steroid sprays that can be used every day, they’re slow acting and they also help to calm down the inflammation such as flonase or nasonex and those might be trialled as well, the other condition that has specific treatment is gastroesophageal reflux or gerd and this is mentioned before when the food comes up or the acid can trigger cough and wheezing and so there are medication like zantac or prilosec that can help suppress or block the stomach acid, there’s also medication that helps the gut move so the food stays down and doesn’t come up towards the airway but both of these conditions, you may have a trial of the treatment or you may be referred to a specialist for treatment and further medication choices or testing or evaluation and then lastly a specific condition that might be causing the cough and has a treatment would be bacterial infections and the treatment for this is antibiotics and there are many different types of infections out there so sometimes the recommendation will be a certain type of antibiotic for days and sometimes it will be months so the key is to have close guidance with your physicians and to come up with the proper diagnosis and we really want to avoid over-prescribing of antibiotics so before you’re started on the antibiotics there might be other testing that’s done first and the key is if you are prescribed the antibiotic make sure that you complete the whole course and then next up under treatment, i’m putting prevention because that’s always number one, if you can prevent getting a cough that’s the best or if you can prevent irritating your cough that is great too, the first one on the list is to avoid the triggers that worsen cough such as tobacco smoke or allergens, if you have allergies or asthma also important is not catching a cough or sharing germs with others so always remember the good cough hygiene, to cover your mouth not with your hand which you touch people and things with your hand after you sneeze but cover your mouth with your elbow and also remember good hand washing and also there are options available in terms of vaccines for some conditions that are known to cause chronic cough such as pertussis which causes the whooping cough and also the flu vaccine can prevent influenza and that’s more known to cause long-term lung damage so if we can prevent that, that is wonderful too and lastly when and why to visit the pediatric pulmonologists, if your child’s cough or your cough is lasting more than a month, please come see your pulmonologist, if the cough has been less than a month but the cough is worsening or if there are any red flag symptoms or other symptoms that are going along with the cough that seems more than a viral illness and that would be if your child has any weight loss, also poor growth or any other concerns that you may have, visit your pulmonologist.

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