Management of Acute Cough in Asthmatic Patients with Viral URI

Introduction to Asthma Management

• The American College of Chest Physicians recommends against using albuterol for acute or chronic cough not due to asthma (Grade D recommendation) 3, 4, 5
• Albuterol is effective for cough in asthmatic patients or those with bronchial hyperresponsiveness, with approximately 50% fewer patients reporting cough after 7 days 1, 2

Medication Management

• The American College of Chest Physicians recommends ipratropium bromide as the only inhaled anticholinergic for cough suppression in URI (Grade A recommendation) 4, 6, 7, 8
• First-generation antihistamines may provide modest benefit through anticholinergic effects in the nasal airways 7, 8

Monitoring and Treatment Failure

• Symptoms not improving within the expected timeframe may indicate the need for escalation beyond rescue albuterol 1