Effect of codeine on objective measurement of cough in chronic obstructive pulmonary disease.

Access to files

Full-text and supplementary files are not available from Manchester eScholar. Use our list of Related resources to find this item elsewhere. Alternatively, request a copy from the Library's Document supply service.

Abstract

BACKGROUND: Codeine is the standard antitussive treatment to which novel agents are compared.Little is known about the objective effect of any treatments on cough in chronic obstructive pulmonary disease (COPD).OBJECTIVE: To quantify the effect of codeine on objective cough frequency (quantified as time spent coughing: cough seconds, cs/h), citric acid cough threshold, and subjective measures in a double-blind, placebo-controlled crossover study in COPD.METHODS: We studied 21 patients with physician-diagnosed, stable disease who complained of cough (76.9% male; mean age, 67.7 years; mean predicted FEV(1), 53.4%; median smoking history, 43.5 pack-years).Each subject performed a cough challenge (single breath, citric acid), 10-hour daytime ambulatory and overnight cough recordings, subjective cough scores, and visual analog scales at baseline and on 2 study days, 1 week apart.Codeine phosphate 60 mg or matched placebo were given, in random order, at the start of each cough recording (0 and 12 hours).RESULTS: Median time spent coughing at baseline was 8.27 cs/h (interquartile range [IQR], 5.94-11.67); after placebo treatment, 7.22 cs/h (IQR 4.42-10.40); and after codeine treatment, 6.41 cs/h (IQR 3.86-9.10).Codeine treatment had a significant effect on time spent coughing compared with baseline (P = .02) but not compared with placebo (P = .52).There were no significant differences in cough challenge thresholds (log concentration of tussive agent causing 2 coughs or log concentration of tussive agent causing 5 coughs) or subjective cough measures for codeine compared with placebo.CONCLUSION: In this study, codeine was no more effective than placebo in patients with COPD complaining of cough.CLINICAL IMPLICATIONS: Codeine is the antitussive agent to which we compare new treatments; however, in a group of stable patients with COPD, it had no effect on cough frequency over placebo.

Keyword(s)

Aged; Cross-Over Studies; Double-Blind Method; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Research Support, Non-U.S. Gov't; administration & dosage: Citric Acid; drug effects: Reflex; drug therapy: Cough; drug therapy: Pulmonary Disease, Chronic Obstructive; therapeutic use: Antitussive Agents; therapeutic use: Codeine

Bibliographic metadata

Institutional metadata

Record metadata