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Cough as an adverse effect for inhalation pharmaceutical products
  • +3
  • Rachel Yoon Kyung Chang,
  • Philip Chi Lip Kwok,
  • Sussan Ghassabian,
  • John Brannan,
  • Heikki Koskela,
  • Hak-Kim Chan
Rachel Yoon Kyung Chang
The University of Sydney Faculty of Medicine and Health
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Philip Chi Lip Kwok
The University of Sydney Faculty of Medicine and Health
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Sussan Ghassabian
The University of Sydney Faculty of Medicine and Health
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John Brannan
John Hunter Hospital
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Heikki Koskela
Kuopio University Hospital
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Hak-Kim Chan
The University of Sydney Faculty of Medicine and Health
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Peer review status:ACCEPTED

13 Mar 2020Submitted to British Journal of Pharmacology
14 Mar 2020Submission Checks Completed
14 Mar 2020Assigned to Editor
24 Mar 2020Reviewer(s) Assigned
01 Jun 2020Editorial Decision: Revise Minor
14 Jun 20201st Revision Received
16 Jun 2020Assigned to Editor
16 Jun 2020Submission Checks Completed
16 Jun 2020Reviewer(s) Assigned
20 Jun 2020Review(s) Completed, Editorial Evaluation Pending
21 Jun 2020Editorial Decision: Revise Minor
03 Jul 20202nd Revision Received
06 Jul 2020Submission Checks Completed
06 Jul 2020Assigned to Editor
06 Jul 2020Review(s) Completed, Editorial Evaluation Pending
06 Jul 2020Editorial Decision: Accept

Abstract

Cough is an adverse effect that may hinder the delivery of drugs into the lungs. Chemical or mechanical stimulants activate the transient receptor potential in some airway afferent nerves (C or A fibres) to trigger cough. Types of inhaler device and drug, dose, excipients, formulation characteristics including pH, tonicity, aerosol output and particle size may trigger cough by stimulating the cough receptors. Release of inflammatory mediators may increase the sensitivity of the cough receptors to stimulants. The cough-provoking effect of aerosols is enhanced by bronchoconstriction in diseased airways and reduces drug deposition in the target pulmonary regions. In this article, we review the factors by which inhalation products may cause cough.