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Background |
Risk factors |
Types of the disease |
Causes |
Signs and symptoms |
Diagnosis |
Complications |
Treatment |
Integrative therapies |
Prevention |
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Respiratory Disorders
Respiratory illnesses are conditions affecting the upper respiratory tract, producing symptoms mainly in the nose and throat. Upper respiratory infections include conditions such as colds, laryngitis, pharyngitis, rhinitis, and sinusitis. Additionally, respiratory conditions include infections of the lower respiratory tract, which may affect the windpipe, airways, and lungs. Lower respiratory tract infections include conditions such as asbestosis, asthma, and sarcoidosis.The respiratory system consists of organs that process air in the body, including the nose, throat, and lungs. The nose is the entrance to the respiratory tract. The throat is the hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The lungs are the organs that make it possible for people to breathe; their principal function is to transport oxygen from the atmosphere into the bloodstream and to release carbon dioxide from the bloodstream into the atmosphere.
During a normal day, the average person breathes nearly 25,000 times, taking in large amounts of air. According to the American Lung Association, approximately 342,000 Americans die from lung diseases each year; lung disease is the number three cause of death in the United States, responsible for one in seven deaths.
Many factors, including genetics, pollutants and irritants, and infectious diseases, may affect the health of the respiratory system.
Background
Respiratory illnesses are conditions affecting the upper respiratory tract, producing symptoms mainly in the nose and throat. Upper respiratory infections include conditions such as colds, laryngitis, pharyngitis, rhinitis, and sinusitis. Additionally, respiratory conditions include infections of the lower respiratory tract, which may affect the windpipe, airways, and lungs. Lower respiratory tract infections include conditions such as asbestosis, asthma, and sarcoidosis.The respiratory system consists of organs that process air in the body, including the nose, throat, and lungs. The nose is the entrance to the respiratory tract. The throat is the hollow tube inside the neck that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). The lungs are the organs that make it possible for people to breathe; their principal function is to transport oxygen from the atmosphere into the bloodstream and to release carbon dioxide from the bloodstream into the atmosphere.
During a normal day, the average person breathes nearly 25,000 times, taking in large amounts of air. According to the American Lung Association, approximately 342,000 Americans die from lung diseases each year; lung disease is the number three cause of death in the United States, responsible for one in seven deaths.
Many factors, including genetics, pollutants and irritants, and infectious diseases, may affect the health of the respiratory system.
Risk factors
Smoking is one of the leading risk factors for developing a cough and other respiratory disorders. Additionally, women tend to have more sensitive cough reflexes making them more likely to develop a cough. Exposure to allergens such as dust and pollen may make a person more susceptible to developing a cough.Children who are five years old or younger or who were born prematurely are more likely to develop croup (a disease of infants and young children characterized by harsh coughing, hoarseness, fever, and difficult breathing).
People most at risk for developing asbestosis (scarring of the lungs that results in difficulty breathing) include those who have had at least 10 years of moderate to severe exposure to asbestos, such as workers involved in mining, milling, manufacturing, or installation of asbestos products.
Viral infections are the main cause of colds. They include: rhinoviruses, coronaviruses, adenoviruses, echoviruses, respiratory syncytial viruses (RSV), and coxsackieviruses, which can infect the upper respiratory system. Although over 100 different viruses may cause colds, 30-50% of colds are caused by rhinoviruses.
The majority of patients hospitalized for RSV are under six months of age. For infants and children born prematurely (35 weeks gestation or less), RSV may cause serious respiratory tract disease or even death.
Types of the disease
Asbestosis: Asbestosis is a lung condition caused by breathing in asbestos fibers. Usually, when particles in the air are breathed in, they are filtered out by the nose or the upper airways of the lungs. But asbestos particles are very thin and light and sometimes are not filtered out before they reach the lungs. Asbestos can damage lung tissue and is responsible for causing several serious diseases, including cancer.Asthma: According to the American Lung association, approximately 20 million Americans have asthma, which causes about 5,000 deaths each year. Asthma is a chronic, inflammatory lung disease. The air passages within the lungs are constantly swollen, restricting the amount of air allowed to pass through the trachea. Asthmatics have recurrent breathing problems and a tendency to cough and wheeze.
Common cold: The common cold, or acute viral nasopharyngitis, is an upper respiratory tract infection caused by a virus, which may involve the nose, throat, sinuses, Eustachian tubes (connects the ears to the throat), trachea (windpipe), larynx (voice box), and bronchial tubes (airways). Colds are one of the leading causes of doctor visits and missed days from school and work. According to the Centers for Disease Control and Prevention (CDC), 22 million school days are lost annually in the United States as a result of the common cold. Over the course of a year, people in the United States suffer one billion colds, according to some estimates.
Cough: Coughs can either be classified as acute or chronic. Acute coughs usually begin suddenly and are often due to a cold, flu, or sinus infection. Acute coughs generally go away within two to three weeks. However chronic coughs last longer than two to three weeks.
Croup: Croup is a viral infection that causes the upper part of the windpipe (larynx) to swell and is usually caused by one of the cold viruses.
Laryngitis: Laryngitis is an inflammation of the voice box (larynx) usually associated with hoarseness or loss of voice. Laryngitis may be classified as acute (lasting for a short amount of time) or chronic (long-lasting).
Pharyngitis: Pharyngitis or sore throat is an inflammation of the pharynx, the passageway that connects the oral and nasal cavities. Most cases of pharyngitis occur during the colder months and often spread among family members. Infections of the pharynx usually involve the tonsils (fleshy tissue in the back of the throat that are part of the body's immune defense), and tonsillitis (inflammation of the tonsils) was once a common name for infectious pharyngitis. Infectious pharyngitis accounts for approximately 10 million visits to the doctor's office each year.
Pulmonary hypertension: According to the Pulmonary Hypertension Association, over 100,000 people suffer from pulmonary hypertension. Pulmonary hypertension occurs when there is high blood pressure in the lungs. Pulmonary hypertension results from constriction or tightening of the blood vessels that supply blood to the lungs. As a result, it becomes difficult for blood to pass through the lungs, making it harder for the heart to pump blood forward. This leads to enlargement of the heart and eventually fluid may build up in the liver and tissues, such as the in the legs.
Respiratory distress syndrome (adults): Adult respiratory distress syndrome (ARDS) is a life-threatening lung condition. It is a form of breathing failure that can occur in very ill or severely injured people. It is not a specific disease. It starts with swelling of tissue in the lungs and buildup of fluid in the tiny air sacs that transfer oxygen to the bloodstream. This leads to low blood oxygen levels.
Respiratory distress syndrome (infants): Respiratory distress syndrome is life threatening and one of the most common lung disorders in premature babies. Additionally, nearly all babies born before 28 weeks of pregnancy develop respiratory distress syndrome. According to the American Lung Association, infant respiratory distress syndrome was the seventh leading cause of death in infants under one year of age in the United States, accounting for 3.2 percent of all infant deaths.
Respiratory syncytial virus (RSV): RSV is a virus that causes infection of the lungs and breathing passages and is most common among infants and children under one year of age.
Rhinitis: Rhinitis affects over 50 million people and is considered one of the most common illnesses in the United States. Rhinitis is the medical term for inflammation of the nose and can be classified as either allergic or non-allergic. Allergic rhinitis occurs when the body's immune system overreacts to an airborne substance (allergen) that is normally harmless, such as mold, pollen, animal dander, or dust mites. Once the allergen is inhaled through the nose, white blood cells of an allergic individual produce an antibody called immunoglobulin E (IgE). This immunoglobulin attaches to the allergen, which triggers the release of histamine and other inflammatory chemicals that cause allergic rhinitis symptoms, such as runny nose and nasal congestion.
There are two types of allergic rhinitis: seasonal allergic rhinitis and perennial allergic rhinitis. Seasonal allergic rhinitis, also called pollinosis, hay fever, or nasal allergies, is characterized by several symptoms, predominantly in the nose and eyes. Symptoms occur after airborne allergens like dust, dander, or pollen are inhaled. When pollens cause the allergic symptoms, the allergic rhinitis is commonly referred to as "hay fever." According to the American Lung association, an estimated 26.1 million Americans have hay fever symptoms each year; 14.6 million Americans have asthma, which often accompanies hay fever. Perennial allergic rhinitis is an allergic reaction to allergens (substances that can cause an allergic reaction) that is not seasonal. Instead, symptoms are persistent and generally less severe than seasonal allergic rhinitis. Non-allergic rhinitis usually affects adults and causes year round symptoms, but the immune system is not involved. Several causes of non-allergic rhinitis include the following: infections, irritants (e.g. dust, secondhand smoke, perfumes), weather changes, emotional or physical stress, hormonal changes, certain foods and beverages, certain medications (e.g. aspirin, ibuprofen ), and long-term use of decongestant nasal sprays.
Sarcoidosis: Sarcoidosis is commonly found in the lungs and is characterized by the presence of granulomas, small areas of inflamed cells. This may lead to loss of lung volume (the amount of air lungs can hold) and abnormal lung stiffness. Sarcoidosis is most common among African Americans and northern European whites. Additionally, the disease usually affects people between the ages of 20 and 40.
Sinusitis: There are three classifications of sinusitis: acute, chronic, and recurrent. Acute sinusitis lasts for less than six months, and it is usually caused by a bacterial infection. Most cases of sinusitis are acute. When symptoms last between four and eight weeks, the condition is considered to be subacute. Symptoms of chronic sinusitis last eight weeks or longer and the severity varies. Symptoms for acute and chronic sinusitis are very similar, except chronic sinusitis symptoms last longer and often cause more fatigue. According to the CDC, chronic sinusitis affects nearly 35 million people in the United States. When an individual suffers from three or more episodes of acute sinusitis per year, the condition is referred to as recurrent sinusitis.
Causes
Asbestosis: Inhaling asbestos fibers may cause scar tissue to develop inside the lungs.Asthma: Individuals who are sensitive to environmental factors (e.g. air pollutants, smoke, chemicals, etc.) and have a family history of asthma are more likely to develop the condition.
Common cold: A cold is caused by a viral infection. Viruses that may cause a cold include rhinoviruses, coronaviruses, adenoviruses, echoviruses, respiratory syncytial viruses (RSV), and coxsackieviruses. Although over a hundred different viruses can cause colds, 30-50% are caused by rhinoviruses.
Cough: Asthma is a common cause of chronic cough in adults and a leading cause in children. Gastroesophageal reflux disease (GERD) is a common condition where stomach acid flows back into the tube that connects the stomach and the throat (esophagus). This causes constant irritation which may lead to chronic coughing. Blood pressure drugs, such as angiotensin converting enzyme inhibitors (ACE inhibitors), have also been known to cause cough in approximately 20% of patients taking them.
Croup: Children may develop croup after breathing respiratory droplets infected with the virus. Croup is usually caused by parainfluenza viruses (viruses causing upper respiratory infections (colds) or lower respiratory infections (pneumonia)).Virus particles may survive on toys or other surfaces.
Laryngitis: Laryngitis is usually caused by a virus. Additionally, laryngitis may also be caused by a bacterial infection or the common cold, bronchitis, flu, or pneumonia.
Pharyngitis: Viruses (such as those that cause the common cold) and bacteria (which can cause many illnesses such as strep throat) may cause a sore throat. The bacteria group A streptococci causes pharyngitis in 5-15% of adults and 15-30% of children. However, approximately 85% of cases of pharyngitis are caused by a virus.
Pulmonary hypertension: Pulmonary hypertension may be caused by diseases of the heart and the lungs, such as chronic obstructive pulmonary disease (COPD) or emphysema, sleep apnea (a sleeping disorder characterized by pauses in breathing), failure of the left heart ventricle, and recurrent pulmonary embolism (blood clots traveling from the legs or pelvic veins obstructing the pulmonary arteries), or underlying diseases such as scleroderma (scar tissue in the organs).
Respiratory distress syndrome: Respiratory distress syndrome results from the absence of the liquid coating inside a baby's lungs (called surfactant) that keeps them open so that he/she can breathe in after birth.
Respiratory syncytial virus: Individuals may develop respiratory syncytial virus by inhaling respiratory secretions from people coughing or sneezing. Additionally, direct contact (e.g. shaking hands) with infected individuals may spread respiratory syncytial virus.
Rhinitis: Airborne substances, known as allergens, may cause allergic rhinitis. These allergens are usually harmless and only cause allergic symptoms in some people.
Sarcoidosis: Research is being done to determine the causes of sarcoidosis. Scientists believe that sarcoidosis may develop when the body's immune system responds to something in the environment, such as bacteria, viruses, dust, or chemicals, resulting in inflammation. In this case, there may be a malfunction in the body's natural defense system causing it not to work properly and overreact.
Sinusitis: Bacterial infections are usually the cause of acute sinusitis. When the sinuses are blocked for a long time, a secondary bacterial infection may develop, causing sinusitis.
Signs and symptoms
Asbestosis: The effects of long term exposure to asbestos typically don't show up for at least 20 to 30 years following initial exposure. Symptoms may include the following: shortness of breath, decreased tolerance for physical activity, coughing, and chest pain.Asthma: Symptoms of asthma may include the following: bronchospasm (abnormal contraction of the bronchi causing airway obstruction), coughing, wheezing or whistling sounds when exhaling, shortness of breath or rapid breathing, chest tightness or chest pain, and fatigue.
Common cold: Symptoms of a common cold usually appear about one to three days after exposure to a cold virus. Signs and symptoms of a common cold may include runny or stuffy nose, itchy or sore throat, dry cough, facial pressure due to sinuses (hollow bones in the front of the face), slight body aches or a mild headache, sneezing, itchy watery eyes, low-grade fever (less than 102 degrees Fahrenheit), and mild fatigue (tiredness). Nasal discharge may become thicker as a common cold runs its course. What makes a cold different from other viral infections (such as influenza) is that the individual generally will not have a high fever or colored sputum. They are also unlikely to experience significant fatigue from a common cold. Colds last for approximately one week. Mild colds may last only two or three days while severe colds may last for up to two weeks. Cough due to a cold can last for hours or days.
Cough: Some coughs are dry (nonproductive) while others are considered productive. A productive cough is one that brings up mucus.
Croup: Croup features a cough that sounds like a seal barking. Most children have a mild cold for several days before the barking cough occurs. As the cough becomes more frequent, labored breathing or stridor (a harsh, crowing noise made when breathing in) may occur. Croup is usually worse at night and lasts for five or six nights. In severe cases, the upper airway may become swollen to the point that it is blocked off (airway obstruction). When croup lasts longer than one week, a doctor should be contacted. Children younger than five years of age are more likely to become infected with croup.
Laryngitis: Patients may experience hoarseness, weak voice, sore throat, dry throat, or cough when they have laryngitis. If symptoms last for more than two weeks in an adult or one week in a child, then a doctor should be consulted as this may be a sign of a more serious condition.
Pharyngitis: With pharyngitis, patients may experience sore throat, fever, headache, runny nose, difficulty swallowing, and rarely, difficulty breathing. Pharyngitis usually goes away without complications. However, if the sore throat does not go away after several days, then a doctor should be contacted. Symptoms should go away in approximately one week in patients with viral pharyngitis. In patients with strep throat, symptoms should go away a couple of days after beginning antibiotics. It is important for patients to finish taking their entire antibiotic even if they feel better. Strep throat generally presents as more severe, redder in coloration, more painful, and frequently involves swollen glands.
Pulmonary hypertension: Patients with pulmonary hypertension may experience the following signs and symptoms: chronic fatigue, shortness of breath (dyspnea), chest pain (angina), palpitations, fainting, swollen ankles and legs (edema), and fluid in the abdomen (ascites). These are also symptoms for other diseases such as congestive heart failure; therefore, physicians should rule out other diseases before making a diagnosis of pulmonary hypertension. Unfortunately, these symptoms may affect a person's ability to perform daily tasks such as walking, dressing oneself, and cleaning.
Respiratory distress syndrome: Signs and symptoms of respiratory distress syndrome usually appear at birth or within the next few hours and include the following: rapid, shallow breathing, sharp pulling in the chest below the ribs with each inhale, grunting sounds during exhaling, and flaring of the nostrils during breathing.
Respiratory syncytial virus: Symptoms of respiratory syncytial virus may include cough, stuffy or runny nose, mild sore throat, fever, and irritability. Between 0.5% and 2% of infants and young children require hospitalization. However, most recover from the illness in 8-15 days with oxygen therapy or sometimes mechanical ventilation.
Rhinitis: Symptoms of allergic rhinitis vary greatly among individuals. Common symptoms include: cough, headache, itchy nose, itchy mouth, itchy throat, itchy skin, nosebleeds, impaired smell, watery eyes, sore throat, wheezing, fever, cross-reactivity allergy to some fruits, pink eye (conjunctivitis), nasal congestion, post-nasal drip, runny nose, and swelling of the nasal tissues (may cause headaches). Some patients, especially those suffering from vasomotor rhinitis, sneeze when moving from a cold room to a warmer one.
Sarcoidosis: Patients may experience a dry cough (without sputum), shortness of breath (dyspnea), or chest pain. Additionally, there may be more general symptoms such as fatigue, weakness, fever, and weight loss.
Sinusitis: Patients with sinusitis generally experience symptoms that may affect the nose, eyes, or middle ear including thick nasal drainage, bad-tasting postnasal drip, plugged-up nose, cough, difficulty breathing, head congestion, headache, facial swelling, toothache, constant fatigue, tender cheeks, swollen eyelids, pain between the eyes, neck pain and occasionally fever. Individuals suffering from chronic sinusitis may also have nasal polyps, which are abnormal tissue growths (polypoidal masses) found in the mucous membranes of the nose and paranasal sinuses. Since nasal polyps often block the nasal passages and sinuses, breathing problems may develop.
Diagnosis
Asbestosis: A chest X-ray may be used to diagnose asbestosis. Asbestosis appears as excessive whiteness in the lungs.Asthma: Spirometry is a noninvasive way to evaluate the air capacity of the lungs. Physicians are able to measure the volume of air exhaled before and after a bronchodilator (inhaler) is used.
Cold: Colds are usually diagnosed clinically by the presence of typical symptoms including runny or stuffy nose, itchy or sore throat, dry cough, nasal congestion, facial pressure (sinuses), slight body aches or a mild headache, sneezing, itchy, watery eyes, low-grade fever (less than 102 degrees Fahrenheit), and mild fatigue (tiredness).
Croup: The doctor will look for signs such as a barking cough and stridor (squeaking sound on inhaling). Additionally, the child will be checked for fever and cold symptoms and the doctor will determine whether there is a prior history of croup or airway problems.
Pharyngitis: A rapid strep test can be done within 20 minutes in the doctor's office. If the results are positive, then the doctor will start an antibiotic. If the rapid strep test is negative, then a culture to grow the bacteria should be done to confirm the results. A throat culture is more accurate than the rapid strep test but takes several days to get the results.
Pulmonary hypertension: An echocardiogram may be used to determine whether a patient has pulmonary hypertension. This test is noninvasive and uses harmless sound waves so that the doctor may see the heart without making an incision. A picture of the heart is recorded, and the doctor may determine the size and thickness of the heart muscle.
Respiratory distress syndrome: Blood samples are taken to determine whether a baby has enough oxygen in the blood, which may help diagnose respiratory distress syndrome.
Respiratory syncytial virus: The doctor will usually listen to the lungs with a stethoscope to check for signs of wheezing. Additionally, fluid may be taken from the nose with a cotton swab to identify the virus.
Rhinitis: An allergen-specific immunoglobulin E (IgE) test, commonly often referred to as radioallergosorbent test (RAST®), is a type of blood test that can help determine if a patient who experiences allergy symptoms, such as runny nose, watery eyes, and hives, is allergic to particular substances called allergens. The in vitro test (performed outside of the body in a laboratory setting) exposes a blood sample to suspected allergens (like dust mites, pollen, or animal dander) to determine whether the patient has developed allergen-specific immunoglobulin E (IgE) antibodies. Antibodies are proteins that recognize and bind to specific antigens. During the procedure, a sample of blood is taken from the patient. The blood is then sent to a laboratory that performs specific IgE blood tests. An allergen-antigen complex is bound to a paper disc called an allergosorbent and the patient's blood is added. If the blood contains antibodies to the specific antigen, it will bind to the "tagged" immunoglobulins. RAST® is less accurate than a skin test. However, if the patient has a severe skin disease (such as eczema or psoriasis) that is present on large areas of skin on the arms or back, a skin test may not be possible. This is because the skin test may only be performed on the arms and back, and there may not be enough unaffected skin to perform a conclusive test. For these patients, an allergen-specific IgE test is the preferred diagnostic method.
Sarcoidosis: When enlargement of the lymph glands in the center of the lungs is seen on X-ray, sarcoidosis is suspected.
Sinusitis: Allergy testing may be conducted to detect specific allergens that might be causing sinusitis. Computerized tomography (CT) scans, which produce detailed images of the sinus cavities, may be used to identify inflamed areas. Cultures (blood tests) may be used to detect a bacterial or fungal infection. An endoscopic examination may be performed. During this procedure, a narrow, flexible fiber-optic scope is inserted into the nasal cavity through the nostrils. The physician is then able to see where the sinuses and middle ear drain into the nose. Blood tests may be conducted to rule out other conditions that may be associated with sinusitis, like an immune deficiency disorder or cystic fibrosis.
Complications
Bronchitis and pneumonia: The common cold poses a risk for bronchitis and pneumonia in nursing home patients and other people who may be susceptible to infection. Some experts believe that the rhinovirus may play a more significant role than the flu in causing lower respiratory infections in such individuals.Bronchiolitis: Bronchiolitis is an infection of the airways of the lungs and usually occurs in young children between three and six months of age. RSV causes more than half of all bronchiolitis cases.
Cough complications: Patients may develop headache, dizziness, and fractured ribs from a chronic cough.
Lung cancer: Patients may have an increased risk of developing lung cancer if they have asbestosis. Additionally, both asbestosis and smoking put patients at an even higher risk for cancer.
Untreated strep throat: Untreated strep throat may lead to serious complications such as glomerulonephritis (kidney disorder) and rheumatic fever (a potentially life-threatening illness that may damage the heart valves).
Treatment
Antibiotics: The doctor will prescribe a 10-day treatment of penicillin or amoxicillin (Amoxil®, Trimox®) to treat strep throat. Patients allergic to penicillins may be given erythromycin, azithromycin (Zithromax®), or clarithromycin (Biaxin®). Patients should finish all of the medication even if they start to feel better.Cough medicines: Over-the-counter medicines such as Robitussin DM®, which includes the two medications dextromethorphan and guaifenesin, may be used to relieve cough symptoms. However, according to the American College of Chest Physician's guidelines, over the counter cough syrups contain drugs in too low a dose to be effective. Additionally, patients may delay treatment for more serious coughs. An antihistamine with a decongestant is the recommended treatment.
Combined therapy medicine: Combined therapy involves both a controller (e.g. corticosteroids or long acting beta agonists) and a reliever (e.g. corticosteroids or short acting beta agonists such as Albuterol®). This therapy is used to manage asthma symptoms for long-term therapy.
Corticosteroids: Doctors may prescribe corticosteroids such as dexamethasone or prednisone to reduce the upper airway swelling that may occur with croup. Additionally, corticosteroids may be prescribed to keep the lungs working and relieve symptoms in patients suffering from sarcoidosis.
Endothelin receptor antagonist (ERA): Letairis® (ambrisentan) was recently approved in 2007 for the treatment of pulmonary hypertension. Ambrisentan works by blocking the effects of a substance called endothelin, which is made by the body in increased amounts in patients with pulmonary hypertension. Endothelin causes blood vessels to narrow (constrict). It also causes overgrowth of the muscle in the walls of the blood vessels in the lungs. By blocking the action of endothelin, ambrisentan can reduce blood pressure in the lungs and improve activity level and well-being in patients. Common side effects of ambrisentan include the following: swelling of the lower extremities, nasal congestion, sinusitis, flushing, palpitations, abdominal pain, and constipation.
Medication change: Patients who develop a cough from ACEIs may be switched to other blood pressure medications, such as angiotensin receptor blockers (ARBS), which have a lower incidence of cough and work in a similar way.
Nasal decongestants: Nasal decongestants are useful medications for the common cold. Nasal decongestants help dilate (open) swollen mucous membranes of the nasal passages so the individual can breathe easier. Nasal decongestant dosage forms include tablets, sprays, inhalers, and nose drops. Nasal decongestants include the oral decongestant pseudoephedrine (Sudafed®), the nasal sprays oxymetolazone (Afrin®) and phenylephrine (Neo-Synephrine®), and the nasal inhalers propylhexedrine (Benzedrex®) and levmetamfetamine (Vicks Vapor Inhaler®). Nasal sprays containing a decongestant should be used for no longer than 72 hours due to the risk of rebound congestion (nasal spray addiction). They are safe for most patients, but they do have many side effects and conditions in which they should not be used, including in people with heart disease, high blood pressure, thyroid disease, glaucoma (increased pressure in the eyes), diabetes, seizure disorders, enlarged prostate, or by individuals using a monoamine oxidase inhibitor (MAOI, a type of antidepressant). Stinging, burning, sneezing, increased nasal discharge, drying of the nostrils, and altered taste may occur. If these effects continue or become bothersome, a doctor should be consulted. Other side effects include rapid or pounding heartbeat, dizziness, trouble sleeping, shaking of the hands, and tremors. Healthcare professionals recommend not using decongestants while pregnant or breastfeeding. If symptoms get worse, a doctor may need to evaluate the situation.
Products containing pseudoephedrine can be purchased without a prescription. However, the products are placed behind the pharmacy counter with limits to the amount that may be purchased in a single day and month. These efforts were established since there is widespread abuse of pseudoephedrine as a drug to make methamphetamine.
Pain relievers: Throat pain may be relieved by taking over-the-counter medications such as ibuprofen (Advil®, Motrin®), acetaminophen (Tylenol®), or aspirin (in adults only). Acetaminophen may also be used in patients who have the croup to lower fever, which may improve the child's breathing.
Saline nasal drops: Isotonic saline nasal drops are recommended for infants. Healthcare professionals recommend 1-2 drops in each nostril 15 to 20 minutes before feeding and bedtime and repeated 10 minutes later. Adults and children may also use saline nasal drops (Ocean® nasal spray) to relieve dry and inflamed nasal passages.
Surfactant replacement therapy: Surfactant may be given right after birth in the delivery room to prevent or treat respiratory distress syndrome. Surfactant is a liquid that coats the inside of the lungs and keeps them open so that the baby can breathe in air once he or she is born. The baby is given surfactant through a tube attached to a breathing machine until the lungs have developed enough to start making their own surfactant.
Integrative therapies
Strong scientific evidence:Andrographis: Andrographis (Andrographis paniculata) has been widely used in Indian (Hindu) folk medicine and Ayurvedic forms of medicine. A combination of andrographis with Siberian ginseng or eleuthero (Eleutherococcus senticosus) called Kan Jang® may be effective in the treatment of acute upper respiratory tract infections including sinusitis (inflammation of the sinuses), a common symptom of colds. The treatment was for five days, and improved fever, muscle soreness, cough, sore throat, and headache.
Good scientific evidence:
Boswellia: Boswellia has been proposed as a potential chronic asthma therapy. Future studies are needed to assess the long-term efficacy and safety of boswellia and to compare the efficacy of boswellia to standard therapies. Boswellia should not be used for the relief of acute asthma exacerbations. Boswellia is generally believed to be safe when used as directed, although safety and toxicity have not been well studied in humans. Avoid if allergic to boswellia or similar herbs or if pregnant or breastfeeding.
Bromelain: It is proposed that bromelain may be a useful addition to other therapies used for sinusitis (such as antibiotics) due to its ability to reduce inflammation/swelling. Studies report mixed results, although overall bromelain appears to be beneficial for reducing swelling and improving breathing. Better studies are needed before a strong recommendation can be made. There are multiple reports of allergic and asthmatic reactions to bromelain products, including throat swelling and difficulty breathing. Allergic reactions to bromelain may occur in individuals allergic to pineapples or other members of the Bromeliaceae family, and in people who are sensitive/allergic to honeybee venom, latex, birch pollen, carrot, celery, fennel, cypress pollen, grass pollen, papain, rye flour or wheat flour. Few serious side effects have been reported with the use of bromelain. Avoid if pregnant or breastfeeding.
Choline: Choline is possibly effective when taken orally for asthma. Choline supplements seem to decrease the severity of symptoms, number of symptomatic days and the need to use bronchodilators in asthma patients. There is some evidence that higher doses of 3 grams daily might be more effective than lower doses of 1.5 grams daily. Choline is generally regarded as safe and appears to be well-tolerated. Pregnant or breastfeeding women should not take doses that exceed adequate intake (AI) levels.
Coleus: There is a lack of sufficient data to recommend for or against the use of coleus in the treatment of bronchial asthma. Preliminary data appears to be promising. However, larger, randomized, controlled trials are needed to confirm the safety and efficacy of coleus in bronchial asthma. Coleus is generally regarded as safe, as very few reports have documented adverse effects. However, only a few short-term trials have assessed its safety in a small sample size of patients. Avoid if allergic to Coleus forskohlii and related species or with bleeding disorders. Avoid if pregnant or breastfeeding.
Ephedra: Ephedra contains the chemicals ephedrine and pseudoephedrine, which are bronchodilators (expand the airways to assist in easier breathing). It has been used and studied to treat asthma and chronic obstructive pulmonary disease in both children and adults. However, the U.S. Food and Drug Administration (FDA) has collected thousands of reports of serious toxicity linked to ephedra (including over 100 deaths). Other treatments such as beta-agonist inhalers (for example, albuterol) are more commonly recommended due to safety concerns with ephedra or ephedrine. Ephedra products are banned from dietary supplements because of serious health risks, including heart attack, heart damage, breathing difficulties and fluid retention in the lungs. Avoid ephedra if pregnant or breastfeeding.
Nasal irrigation: There is good evidence from randomized controlled trials, case series and equivalence trials to recommend the use of nasal irrigation in the treatment of chronic sinusitis. Nasal irrigation is generally well tolerated with few and transient adverse effects (like nasal irritation, discomfort, otalgia or pooling of saline in the paranasal sinuses) reported from clinical trials. Avoid if pregnant or breastfeeding.
Probiotics: Good scientific evidence supports the use of probiotic Enterococcus faecalis bacteria to treat hypertrophic sinusitis (sinus inflammation). This treatment may reduce frequency of relapses and the need for antibiotic therapy. Probiotics are generally regarded as safe for human consumption. Long-term consumption of probiotics is considered safe and well tolerated.
Psychotherapy: Family psychotherapy may slightly improve wheezing and thoracic gas volume for children with asthma, according to several studies.
Sage: Sage mouthwashes and gargles have been approved for use against sore throat in Germany by the German Commission E. Additional study is needed comparing sage to standard therapies.
Vitamin C: Scientific studies generally suggest that vitamin C does not prevent the onset of cold symptoms. However, in a subset of studies in people living in extreme circumstances, including soldiers in sub-arctic exercises, skiers, and marathon runners, significant reductions in the risk of developing colds by approximately 50% have been reported. This area merits additional study, and may be of particular interest to elite athletes or military personnel.
Yoga: Multiple human studies report benefits of yoga (such as breathing exercises), when added to other treatments for mild-to-moderate asthma (such as standard drug therapy, diet, or massage). Better research is needed before a firm conclusion can be drawn.
Unclear or conflicting scientific evidence:
Acupressure: Preliminary research suggests that patients with chronic asthma who receive acupressure may experience improved quality of life. Further well-designed studies are needed before firm conclusions can be drawn.
Andrographis: Based on clinical evidence, andrographis may prevent upper respiratory tract infection during the winter months if taken on a daily basis. Additional high quality clinical study is needed to reach a conclusion on whether andrographis may be effective in prevention of upper respiratory tract infections.
Aromatherapy: Despite widespread use in over-the-counter agents and vapors, there is not enough scientific evidence to recommend the use of eucalyptus oil as a decongestant-expectorant (by mouth or inhaled form). The available studies have been poor quality. Further studies are needed before a conclusion may be drawn.
Black tea: Research has shown caffeine to cause improvements in airflow to the lungs (bronchodilation). However, it is not clear if caffeine or tea use has significant clinical benefits in people with asthma. Better research is needed in this area before a conclusion can be drawn.
Boneset: Boneset (Eupatorium perfoliatum) is native to eastern North America and was used by Native Americans to treat fevers. Boneset is used homeopathically in very dilute amounts. Homeopathic boneset was found in one study to decrease the symptoms associated with a cold. Homeopathic medicines do not have side effects due to the very small amount of substance, such as boneset, used in their preparation.
Butterbur: Historically, butterbur has been used to treat asthma. Pre-clinical studies report anti-inflammatory and leukotriene inhibitory properties, which may lead to clinical effects. Initial human research suggests possible benefits. However, controlled trials with adequate sample sizes are necessary in order to clarify whether there are true benefits in humans.
Chiropractic: Several studies report the effects of chiropractic spinal manipulative therapy on breathing indices and quality of life in children and adults with asthma. Results are variable, and in the studies with positive results, mostly subjective but not objective (lung function test) changes are reported. Due to methodological problems and variable results, no clear conclusions can be drawn in this area.
Echinacea: Echinacea (Echinacea angustifolia, Echinacea purpurea, Echinacea pallida) is one of the most widely used herbal supplements in the world. Echinacea seems to improve the body's natural immune system during colds and flu. However, preliminary studies have mixed results in using Echinacea for preventing the common cold in adults. Although multiple low quality studies have previously suggested that adults taking Echinacea by mouth when cold symptoms begin may reduce the length and severity of symptoms, a clinical trial in July 2005 did not demonstrate any clinical benefit. Recent meta-analyses are conflicting; one suggested that standardized extracts of Echinacea were effective in the prevention of symptoms of the common cold after clinical inoculation, compared with placebo, whereas the other reported no such benefit. Further research is needed. Also, initial research suggests that Echinacea may not be helpful in children for treatment of upper respiratory infections. Additionally, development of rash has been associated with Echinacea use, and therefore the risks may outweigh the potential benefits in this population. Caution is advised when taking Echinacea supplements, as adverse effects including drug interactions are possible. Echinacea supplements should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.
Elder: Elder (Sambucus nigra) has been reported to have antiviral and antibacterial activity in laboratory studies. There is a small amount of research on the combination herbal product Sinupret®, which is a German product that contains elder and several other herbs in patients with bronchitis. This formula contains elder flowers (Sambucus nigra) as well as gentian root, verbena, cowslip flower, and sorrel. Although benefits have been suggested, due to design problems with this research, no clear conclusion can be drawn either for Sinupret® or elder in the management of bronchitis. Sinupret® has also been reported to have beneficial effects when used with antibiotics to treat sinus infections, although the majority of this evidence is not high quality and requires confirmation with better research.
Euphorbia: One short clinical trial involving senior patients with chronic bronchitis with Euphorbia helioscopia showed a significant effect on patients. However, this is only one short trial done in a specific population of senior patients; longer and larger trials are needed to evaluate the effect of Euphorbia helioscopia in a wider range of patients.
Garlic: Garlic (Allium sativum) supplements may reduce the severity of upper respiratory tract infections, including colds. However, this has not been demonstrated in well-designed human studies. Garlic may improve the immune system's ability to fight off infection, such as a cold virus. Caution is advised when taking garlic supplements, as adverse effects including an increase in bleeding and drug interactions are possible. Garlic supplements should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.
Goldenseal: Goldenseal (Hydrastis canadensis) has become a popular treatment for the common cold and upper respiratory tract infections, and is often added to Echinacea in commercial herbal cold remedies. Animal and laboratory research suggests that the goldenseal component berberine has effects against bacteria and inflammation. However, due to the very small amount of berberine in most goldenseal preparations, it is unclear whether goldenseal contains enough berberine to have the same effects. Caution is advised when taking goldenseal supplements, as adverse effects including drug interactions are possible. Goldenseal supplements should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.
Green tea: Research has shown caffeine to cause improvements in airflow to the lungs (bronchodilation). However, it is not clear if caffeine or tea use has significant benefits in people with asthma. Better research is needed in this area before a conclusion can be drawn.
Guided imagery: Therapeutic guided imagery may be used to help patients relax and focus on images associated with personal issues they are confronting. Experienced guided imagery practitioners may use an interactive, objective guiding style to encourage patients to find solutions to problems by exploring their existing inner resources. Biofeedback is sometimes used with imagery to enhance meditative relaxation. Interactive guided imagery groups, classes, workshops, and seminars are available, as well as books and audiotapes. Preliminary research in children suggests that stress management and relaxation with guided imagery may reduce the duration of symptoms due to upper respiratory tract infections, including colds. Additional research is needed to confirm these results.
Hydrotherapy: Hydrotherapy is broadly defined as the external application of water in any form or temperature (hot, cold, steam, liquid, ice) for healing purposes. It may include immersion in a bath or body of water (such as the ocean or a pool), use of water jets, douches, application of wet towels to the skin, or water birth. These approaches have been used for the relief of various diseases and injuries, or for general well being. There is preliminary evidence that daily showers with warm water followed by cold water, or cold water alone, may reduce the duration and frequency of common cold symptoms. Additional research is needed in this area before a clear conclusion can be drawn.
Hypnotherapy, hypnosis: Preliminary research for the use of hypnosis for the management of asthma symptoms does not provide clear answers. Anxiety associated with asthma may be relieved with hypnosis. Additional research is needed before a firm conclusion can be drawn.
Kiwi: Kiwi (Actinidia deliciosa, Actinidia chinensis) may be beneficial in lung conditions such as upper respiratory infections (including colds). However, scientific data is lacking. One survey study suggests that kiwi, and other fruits high in vitamin C, may have a protective effect on lung conditions in children, especially wheezing. However, properly controlled studies are lacking at this time.
Lactobacillus acidophilus: Lactobacillus acidophilus has been suggested as a possible treatment for asthma. However, further research is necessary before a firm conclusion can be made.
Massage: Promising initial evidence suggests that massage therapy may improve lung function in children with asthma. Additional research is necessary before a firm conclusion can be drawn.
Meditation: Preliminary research of transcendental meditation® for asthma reports benefits. However, due to unclear design or study description, these results cannot be considered definitive.
Sahaja yoga, which incorporates meditation techniques, may have some benefit in the management of moderate to severe asthma. Further studies of meditation alone are needed before a firm conclusion can be drawn.
Melatonin: Based on preliminary research, melatonin may improve sleep in patients with asthma. Further studies that evaluate the long-term effects of melatonin on airway inflammation and bronchial hyper-responsiveness are needed before a firm conclusion can be made.
Mistletoe: Iscador® (a preparation of mistletoe, Viscum album, whole extract) has been reported to improve clinical symptoms and markers of immune function in children with recurrent respiratory disease (RRD) exposed to the Chernobyl nuclear accident. There is insufficient evidence to recommend for or against mistletoe therapy for RDD in general. Caution is advised when taking mistletoe supplements, as adverse effects including drug interactions are possible. Mistletoe supplements should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor. Mistletoe should not be used with seizure disorders, glaucoma (increased pressure in the eyes), diabetes, or hyperthyroidism (high thyroid hormone).
Moxibustion: Moxibustion is widely used in China for respiratory tract infections in children. However, there is insufficient evidence to make recommendations.
Omega-3 fatty acids, fish oil, alpha linolenic acid: Several studies investigating use of omega 3-fatty acids for asthma do not provide enough reliable evidence to form a clear conclusion, with some studies reporting no effects, and others finding benefits. Because most studies have been small without clear descriptions of design or results, the results cannot be considered conclusive.
Peppermint: Peppermint (Mentha piperita) is a flowering plant that grows throughout Europe and North America. Peppermint is widely cultivated for its fragrant oil. Peppermint oil has been used historically for numerous health conditions, including common cold symptoms, cramps, headache, indigestion, joint pain, and nausea. Menthol, a constituent of peppermint oil, is sometimes included in inhaled preparations for nasal congestion, including "rubs" that are applied to the skin and inhaled. High quality research is lacking in this area. Use of essential oils is not for internal use.
Perilla: Preliminary evidence suggests some benefit of perilla oil for symptoms of asthma. Further clinical trials are required before a definitive conclusion can be reached.
Physical therapy: Chest physical therapy and physiotherapy breathing retraining have been studied in both children and adults to improve quality of life and improve lung function in severe and acute asthma. Early evidence is mixed. Studies often include combination treatment with drug therapy or are not well-designed, which make it difficult to assess the magnitude of benefit, if any, of physical therapy alone. More research is warranted.
Pycnogenol®: Pycnogenol® may offer clinical benefit to both children and adults with asthma. Additional study is needed before a strong recommendation can be made.
Relaxation therapy: Preliminary studies of relaxation techniques in individuals with asthma report a significant decrease in asthma symptoms, anxiety and depression, along with improvements in quality of life and measures of lung function. Further large trials in humans are needed to confirm these results.
Selenium: Preliminary research reports that selenium supplementation may help improve asthma symptoms. Further research is needed to confirm these results.
Slippery elm: Slippery elm (Ulmus fulva) is commonly used to treat sore throats, most typically taken as a lozenge. While anecdotally reported to be effective, supporting evidence is largely based on traditional evidence and the fact that components of slippery elm appear to possess soothing properties for the throat. Scientific evidence is necessary in this area before a clear conclusion can be drawn. Slipper elm throat lozenges are safe in recommended dosages.
Tylophora: Methodologically weak trials using tylophora make extrapolation to clinical practice difficult. Available studies of Tylophora for asthma show conflicting results. Therefore, efficacy remains unproven.
Vitamin B6: Preliminary research suggests that children with severe asthma might have inadequate pyridoxine status. Theophylline, a prescription drug used to help manage asthma, seems to lower pyridoxine levels. Studies of pyridoxine supplementation in asthma patients taking theophylline yield conflicting results. Further research is needed before a conclusion can be drawn.
Vitamin C: It has been suggested that low levels of vitamin C (or other antioxidants) may increase the risk of developing asthma. The use of vitamin C for asthma has been studied since the 1980s (particularly exercise-induced asthma), although the evidence in this area remains inconclusive. Additional research is necessary before a clear conclusion can be drawn.
Vitamin E: Daily supplementation with oral vitamin E does not appear to affect the incidence, duration, or severity of pneumonia (lower respiratory tract infections) in elderly nursing home residents or alter patterns of antibiotic use, although there may be a protective effect against colds (upper respiratory tract infections). Additional research is warranted. Caution is advised when taking vitamin E supplements, as adverse effects including an increase in bleeding and drug interactions are possible. Vitamin E supplements should not be used if pregnant or breastfeeding, unless otherwise directed by a doctor.
Zinc:There are contradictory results regarding the efficacy of zinc formulations in treating duration and severity of common cold symptoms. Although zinc might be beneficial in the treatment of cold symptoms, more studies are needed to clarify the zinc formulations that may be most effective, the rhinoviruses affected by zinc, and if nasal sprays provide a useful alternative application route for zinc treatment. A recent study found no significant differences between zinc nasal spray and placebo. Negative results may be caused by using doses of zinc that are too low or the presence of compounds like citric or tartaric acid, which may reduce efficacy due to chelating of the zinc ion.
Fair negative scientific evidence:
Echinacea: Initial research suggests that echinacea may not be helpful in children for treatment of upper respiratory tract infections and cold symptoms, possibly because parents are not able to recognize the onset of common cold symptoms soon enough to begin treatment, or because the dose of echinacea for use in children is not clear. There are fundamental differences in causes of upper respiratory tract infection symptoms in children versus adults (bacterial versus viral causes; different viruses; different sites of infection; etc). Until additional research is available, echinacea cannot be considered effective in children for the treatment of upper respiratory infections. Furthermore, development of rash has been associated with echinacea use, and therefore the risks may outweigh the potential benefits for children.
Evening primrose oil: Small studies do not show evening primrose oil to be useful in the treatment of asthma. Further research is needed to confirm this conclusion.
Vitamin C: Many studies have examined the effects of taking daily vitamin C for cold prevention or treatment. Overall, no significant reduction in the risk of developing colds has been observed. In people who developed colds while taking vitamin C, no difference in severity of symptoms has been seen overall, although a very small significant reduction in how long colds last has been reported (approximately 10% in adults and 15% in children). Laboratory experiments in which volunteers are infected with respiratory viruses while taking vitamin C have shown differing results. However, overall, they report small or no significant differences in symptom severity following infection. At this time, the scientific evidence does not support the use of vitamin C for prevention or treatment of the common cold.
Vitamin E: There is preliminary evidence that vitamin E does not provide benefits in individuals with asthma.
Strong negative scientific evidence:
L-arginine: Although it has been suggested that arginine may be a treatment for asthma, studies in humans have actually found that arginine worsens inflammation in the lungs and contributes to asthma symptoms. Therefore, taking arginine by mouth or by inhalation is not recommended in people with asthma.
Prevention
The diphtheria, Haemophilus influenzae (Hib), and measles vaccines protect children from some of the most dangerous forms of croup.Individuals should not smoke and should stay away from second hand smoke to prevent developing a cough.
People working with asbestos products should monitor their exposure levels and wear protective gear, such as face masks.
Children and adults need to understand the importance of hand washing. Healthcare professionals recommend carrying a bottle of alcohol-based hand rub containing at least 60% alcohol for times when soap and water are not available. These gels kill most germs and are safe for older children to use themselves. Use cautiously as the overuse of antibacterial cleansers can cause damage to normal bacteria that live on the skin.
Synagis® (palivizumab) is used to prevent serious lower respiratory tract diseases caused by respiratory syncytial virus in high risk children. A recent study showed that Synagis® may reduce recurrent wheezing in premature infants by almost half.
Patients may also receive the flu vaccination, which is effective for one year. It may be injected into the patient or sprayed into the nose. A prescription is needed for both types of flu vaccines. They are available at a doctor's office or at a flu clinic in the local area. The flu shot is an inactivated vaccine (containing killed virus) that is given with a needle. The flu shot is approved for use in people six months of age and older, including healthy people and people with chronic medical conditions such as diabetes, asthma, and heart disease. The flu shot is recommended in children ages six months to five years, adults that are in close contact with children ages six months to five years (such as teachers and daycare workers), people 50 years of age and older, healthcare workers, all care givers of high risk people (such as those with HIV/AIDS or cancer), and people with chronic health conditions (e.g. asthma), as well as pregnant women. The nasal-spray flu vaccine (FluMist/LAIV®) is a vaccine made with live, weakened flu viruses that does not cause the flu (sometimes called LAIV for "Live Attenuated Influenza Vaccine"). The nasal flu vaccine is approved for use in healthy people 5- 49 years of age who are not pregnant. Patients who have weakened immune systems (e.g. HIV patients or chemotherapy patients) should not receive the nasal spray vaccine because it contains a weakened form of the live influenza virus. Although rare, it is possible for the weakened virus to cause an infection in immunocompromised patients.
Author information
Natural Standard is an international research collaboration that aggregates and synthesizes data on complementary and alternative therapies. Using a comprehensive methodology and reproducible grading scales, information is created that is evidence-based, consensus-based, and peer-reviewed, tapping into the collective expertise of a multidisciplinary Editorial Board. The mission of this collaboration is to provide objective, reliable information that aids clinicians, patients, and healthcare institutions to make more informed and safer therapeutic decisions. Natural Standard is widely recognized as one of the worlds premier sources of information in this area.Bibliography
American Academy of Family Physicians. www.aafp.org. Accessed August 25, 2007.
American Lung Association. www.lungusa.org. Accessed August 25, 2007.
MedlinePlus.www.nlm.nih.gov. Accessed August 25, 2007.
Neumours Foundation. www.kidshealth.org. Accessed August 28, 2007.
National Heart Lung and Blood Institute. www.nhlbi.gov. Accessed August 28, 2007.
Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com. Copyright 2008. Accessed August 26, 2007.
Pulmonary Hypertension Association. www.phassociation.org. Accessed August 25, 2007.
Simoes EA, Groothuis JR, Carbonell-Estrany X, et. al. Palivizumab prophylaxis, respiratory syncytial virus, and subsequent recurrent wheezing. J Pediatr. 2007 Jul;151(1):6-7. View Abstract.
Barrett B, Harahan B, Brown D, et. al. Sufficiently important difference for common cold: severity reduction. Ann Fam Med. 2007 May-Jun;5(3):216-23. View Abstract.
Simasek M, Blandino DA. Treatment of the common cold. Am Fam Physician. 2007 Feb 15;75(4):476, 479, 482. View Abstract.
Williams PR, Phelka AD, Paustenbach DJ. A review of historical exposures to asbestos among skilled craftsmen (1940-2006). J Toxicol Environ Health B Crit Rev. 2007 Sep-Oct;10(5):319-77. View Abstract.
Barst RJ. A review of pulmonary arterial hypertension: role of ambrisentan. Vasc Health Risk Manag. 2007;3(1):11-22. View Abstract.
Bolser DC. Cough suppressant and pharmacologic protussive therapy: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):238S-249S. View Abstract.
Related Terms
ACE inhibitor-associated cough, acute respiratory distress syndrome, airway obstruction, asbestosis, asthma, bronchial congestion, bronchiolitis, chest X-ray, common cold, congestion, cough, croup, decongestant, dyspnea (shortness of breath), eucalyptus aromatherapy, expectorant, FBD, functional breathing disorder, hypoxia, laryngitis, lower respiratory infection, lung cancer, lung infections, nasal congestion, nasopharyngitis, pharyngitis, pulmonary conditions, pulmonary hypertension, recurrent sneezing, respiration, respiratory disease, respiratory distress, respiratory infection, respiratory problems, respiratory syncytial virus, respiratory tract infection, rhinitis, rhinopharyngitis, runny nose, sarcoidosis, sinus congestion, sore throat, strep throat, stuffy nose, tonsillitis, upper respiratory tract infection, vasodilator.
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