andre parmonangan panjaitan - 1318011013.pdf

8/10/2019 Andre Parmonangan Panjaitan - 1318011013.pdf

1/10

9 International Journal of Natural Products Research 2011;1 (1): 9-18

Review Article

A REVIEW- COUGH & TREATMENTSMeenakshi Parihar*

1, Ankit Chouhan

1, M.S. Harsoliya

2, J.K.Pathan

1, S. Banerjee

3, N.Khan

1, V.M.Patel

4

1. SVCP, Indore

2. Research Scholar, JJT University, Rajasthan

3. Research Scientist, Ranbaxy

4. APMC, Himatnagar

Coorespondance author: Meenakshi Parihar*([email protected] 9826517280)

Received 10 May 2011; accepted 23 May 2011

Abstract

When cold and flu season rolls around, it can leave you feeling pretty miserable. There is no cure for the common cold, but

there are plenty of herbs out there that will help relieve your symptoms in a natural, gentle way, without any of the side effects

of over the counter medication.Cough is a common problem that everyone often faces. Cough is a natural reflex expulsive

defense mechanism of the body, for clearing excess secretions or mucous or inhaled irritants or toxins or foreign substance inthe respiratory tract. Coughing protects the respiratory system by clearing or cleaning it voluntarily or involuntarily. As long as

cough is helpful in getting rid of infectious material with the help of mucous from the airway, it should not be stopped. The

treatment of coughs is one area where the use of certain herbal remedies remains common today. Herbal drugs play an

important role in the management of various types of cough. Currently available therapies for cough include coughsuppressants. Antitussives provide only symptomatic relief and produce many serious adverse effects like doses respiratory

depression, nausea, vomiting, sedation and drowsiness. These are contraindicated in asthmatics and in patients with diminished

respiratory reserve. Therefore, in recent years much effort has been made to search for natural active plant components withdiminished adverse effects. Many plant species known in folk medicine of different cultures used for treatment of respiratory

complaints such as cough, bronchial affections, pleurisy, pneumonia and expectoration. Due to increasing demand in herbal

therapy, many herbal research laboratories have come forward in successfully launching various herbal products, which are

helpful in the treatment of various types of cough. Different cases, and even the same case at different stages, require different

treatment. 2011 Universal Research Publications. All rights reserved

Key words: cough, herbal treatments of cough, treatments of cough

INTRODUCTION

CoughCough is a common problem that everyone often

faces.Cough is a natural reflex expulsive defense mechanism

of the body, for clearing excess secretions or mucous or

inhaled irritants or toxins or foreign substance in therespiratory tract. Coughing protects the respiratory system byclearing or cleaning it voluntarily or involuntarily. As long ascough is helpful in getting rid of infectious material with the

help of mucous from the airway, it should not be stopped. It

is very important to remember that cough usually manifestsin common cold, but it may be the initial manifestation of

serious illness such as pulmonary hypertension, pneumonia,

tuberculosis or asthma. It can be in various situations

inappropriately stimulated; for example, by inflammation in

the respiratory tract or neoplasia. (Schroeder, K.et al., 2002)In these cases, the cough has a pathological character and it isnecessary to use cough-suppressing agents. Anti-tussiveagents are used mainly to suppress dry and painful coughs

Available online at http://www.urpjournals.com

International Journal of Natural Products Research

Universal Research Publications. All rights reserved
mailto:[email protected]://archives.chennaionline.com/health/pregnancy/index.asphttp://archives.chennaionline.com/health/homearticles/cold.asphttp://archives.chennaionline.com/health/pregnancy/index.asphttp://archives.chennaionline.com/health/homearticles/cold.asphttp://archives.chennaionline.com/health/Homoeopathy/2004/10homoeopathy12.asphttp://www.urpjournals.com/http://www.urpjournals.com/http://archives.chennaionline.com/health/Homoeopathy/2004/10homoeopathy12.asphttp://archives.chennaionline.com/health/homearticles/cold.asphttp://archives.chennaionline.com/health/pregnancy/index.asphttp://archives.chennaionline.com/health/homearticles/cold.asphttp://archives.chennaionline.com/health/pregnancy/index.aspmailto:[email protected]


2/10


(Rang et al., 2003).

Mechanism of CoughCough serves to clear the airways when there are large

amounts of inhaled material, mucus due to excessivesecretions or impaired mucociliary clearance and abnormal

substances such as edema fluid or pus. Each cough involves a

complex reflex arc. The cough reflex has five components:

cough receptors, an afferent nerve (the vagus nerve), thecough center (area in medulla), motor (efferent) nerves

(recurrent laryngeal nerve, phrenic nerve and spinal nerves)

and effector organs (the diaphragm, chest and abdominal wall

muscles)(Chung, K.F. (2003). Cough receptors are located

along the entire laryngo-tracheo-bronchial tree with the

greatest number in the larynx. They are also located in the

nose, paranasal sinuses, diaphragm, pleura, stomach and

pericardium. There are three types of nerve fibres, whichform the sensory (afferent) pathway leading to cough

(i) Myelinated irritant fibres

(ii) Unmyelinated C fibres(iii) Slow adapting stretch receptors

Nerve endings in the larynx, trachea and bronchi are sensitive

to irritation that generates nerve impulses which are

conducted by the vagus nerves to the respiratory centre in the

brain stem. The reflex motor response is deep inspiration

followed by closure of the glottis (Sesuka S, et al 1985) The

internal laryngeal nerve, a branch of the superior laryngeal

nerve, carries the sensory information away from the areaabove theglottis in thelarynx to the CNS viacranial nerve X

(vagus). The receptors report about the excess mucous orforeign substance to the cough center which is located in the

medulla of the brain for inducing cough. The abdominal and

respiratory muscles then contract and suddenly the air is

released under pressure expelling mucus and/or foreign

material from the mouth. Cough receptors are sensitive to:

(Nagendran, 2003).

Touch of inhaled foreign body like plant

Excessive secretions or mucous innose,throat, sinuses

and lungs Irritant gases like nitric acid, sulphuric acid, ammonia

and sulphur dioxide

Oedema or infection with pus in the airway

Exposure to extreme hot or cold air (Nagendran,

2003).

The mechanism of a cough is as follows:

Coughing is started by stimulation of sensory nerves in

the lining of the respiratory passages - the tubes used to

breathe.

Diaphragm and externalinter-costal muscles contracts,increase the volume of the lungs and makes the pressure

of air within the lungs lower than atmospheric pressure.

Air rushes into the lungs in order to equalize the

pressure. The glottis closes (muscles innervated by recurrent

laryngeal nerve) to prevent air escaping whilst the

diaphragm relaxes and expiratory muscles contract.

This reduces the volume of the lungs, therefore

increasing pressure.

The pressure of air within the lungs is now greater than

atmospheric pressure and so air is trying to escape.

Thus, glottis opens and release air at over 100 mph

(Widdicombe JG. 1995)

Phases of CoughCoughing involves four phases. These are as follows:

1) InspirationThe initial phase of cough is characterized by the inhalation

of gas. During inspiration, the expiratory muscles are

lengthened and strengthened. Thus, inhaling to high lung

volumes will enable the expiratory muscles to generate

greater positive intra-thoracic pressures for a given degree ofneural activation. Although a modest degree of positive intra-

thoracic pressure is needed to generate expiratory flow, an

effective cough can be achieved at pressures much lower thanthe maximal pressure that the expiratory muscles are capable

of producing. Thus, this initial phase of cough is not critical

because an effective cough can be accomplished by inhalingsmall volumes (Mazzone, S.B et al 2002).

2) Compression of air against a closed glottisThe compressive phase of cough follows the initialinspiratory phase. After inhaling a volume of air, the glottis is

closed and an expiratory effort ensues. At the onset of the

expiratory effort, the glottis closes for about 0.2 seconds.

Glottis closure maintains lung volume as intra-thoracic

pressures are building. Glottis closure minimizes expiratory

muscle shortening, thereby promoting contraction of the

expiratory muscles, and allowing the expiratory muscles to

maintain a more advantageous force-length relationship and

to generate greater positive intra-abdominal and intra-thoracicpressures. The high intra-thoracic pressures developed during

glottis closure may be as great as 300 mm Hg. The closed

glottis also creates a pressure drop (high pressure inside, low

pressure outside) so that when the glottis opens, the air is

forcefully expelled to outside (Dicpinigaitis, P.V. 2003)

3) Expression

Once the glottis is opened, the expiratory phase of coughensues, and the high intra-thoracic pressures developed

during the compressive phase of cough promote high

expiratory flow rates. The glottis is opened and the airwayscollapse to expel the cough (and whatever it may carry).Initially, there is a very brief blast of turbulent flow. This

burst of air is due to the additive effects of the gas expired

from the distal parenchymal units and the gas displaced by

the central airways, which are compressed by the high intra-
http://www.answers.com/topic/laryngeal-nervehttp://www.answers.com/topic/glottishttp://www.answers.com/topic/larynxhttp://www.answers.com/topic/cranial-nerveshttp://www.answers.com/topic/vagus-nervehttp://archives.chennaionline.com/health/firstaid/nose.asphttp://www.answers.com/topic/diaphragmhttp://www.answers.com/topic/intercostal-muscle-1http://www.answers.com/topic/glottishttp://www.answers.com/topic/recurrent-laryngeal-nervehttp://www.answers.com/topic/recurrent-laryngeal-nervehttp://www.answers.com/topic/glottishttp://www.answers.com/topic/glottishttp://www.answers.com/topic/recurrent-laryngeal-nervehttp://www.answers.com/topic/recurrent-laryngeal-nervehttp://www.answers.com/topic/recurrent-laryngeal-nervehttp://www.answers.com/topic/glottishttp://www.answers.com/topic/intercostal-muscle-1http://www.answers.com/topic/diaphragmhttp://archives.chennaionline.com/health/firstaid/nose.asphttp://www.answers.com/topic/vagus-nervehttp://www.answers.com/topic/cranial-nerveshttp://www.answers.com/topic/larynxhttp://www.answers.com/topic/glottishttp://www.answers.com/topic/laryngeal-nerve


3/10


thoracic pressures. Although glottis closure enhances this

phase of cough, it is not essential for an effective cough. For

example, individuals with a tracheostomy or endotracheal

tube can produce an effective cough by performing a huffingmaneuver, which is performed with an open glottis.

4) Relaxation

After the cough reflex the expiratory muscles relaxed andthere is a transient bronchodilation (McCool, 2006).

Causes of Cough1) Infection: by bacteria, virus (common cold), and fungus

(Aspergillus infection).

2) External factors: -by dust, cold, pollens, smoking and

other environmental irritants. Also the drugs, which used

in treatment of hypertension and heart diseases (ACEinhibitors and beta-blockers) may cause cough. Foreign

body when enters pharynx, nose, larynx, trachea,bronchus, oesophagus. (Widdicombe, J.G. 2002)

3) Internal factors:as diseases get progressive in: Sinuses - Postnasal drip

Heart - Congestive heart failure Lung - Asthma, chronic bronchitis, cancer, pneumonia,

tuberculosis and pressure on lungs due to a

mass like mediastinal lymphadenopathy.

Ear - Otitis media, and foreign body

StomachGastro-oesophageal reflux

4) Psychogenic factors: habit of clearing mucous, fordrawing attention, etc (Lee, L.Y.et al. 2001).

Symptoms of CoughCough itself is a symptom, usually associated with sore

throat, hoarseness, nose block, breathlessness, heartburn or

chest pain, dizziness, disturbance in sleep, distress on

exercise or running, sometimes even for laughing,

restlessness, general bodyaches, urinary incontinence,

haemoptysis, lack of concentration, stomachache, nausea,

vomiting and swollen glands. It produces white/green/yellow/

discolored or blood-stained phlegm(Eccles R et al.1992).

The high intra-abdominal and intra-thoracic pressures

developed during compressive phase of cough can betransmitted to the CNS and mediastinum, and underlie some

of the adverse cardiovascular, GI, genitourinary,

musculoskeletal, and neurologic complications associated

with cough. Some effects of cough on the body organs during

coughing are as follows:

Pressure in abdomen is increased - so hernia may occur

in diaphragm or the muscle of the abdomen (umbilicalhernia, incision hernia) or into the scrotal sac.

The anus will get tightly closed - so it may aggravate

piles or fissure in the anus. Due to pressure in chest - air emphysema may develop.

Due to violent cough, bursting type of headache may

occur. (Feldman JI et al. 1993.)

Types of CoughCough mainly classified as:

1) Productive CoughIt is also termed as an effective cough and wet cough, since it

effectively expels secretions, mucous or foreign materialfrom the respiratory tract. This type of cough is mostly acute

in nature and often caused by bacterial or viral or fungal

infection. This type of cough should not be suppressed or

otherwise recurrent or constant infection will be there, since

the purpose of the cough (to remove mucus) is suppressed.

Productive cough should be allowed to serve its purpose and

suppressed only when it is exhausting the patient or is

dangerous, e.g. after eye surgery (Karlsson, J.A.1996).

2) Non-productive CoughIt is also named as an ineffective cough since it wont bring

any secretions or mucous from the lungs. It is a dry, irritating

cough without phlegm. Mostly, this type of cough is chronic

in nature and caused by dry irritation or dust or smoke orfumes, or due to edema and mild secretion in the resolving

stage of illness. Dry cough is mainly useless and persistent in

nature, thus it should be stopped. Asthma, rhinosinusitis,esophageal reflux or combination of the last two is the

commonest underlying reason for persistent cough. It may be

also due to weakness of the muscles of respiration, thickviscid mucus and in diseases of the cilia which helps mucoustransportation in the airway. The overall approach to the

persistent cough must involve attention to underlying factors

(Bennett and Brown, 2003).

Cough can also be classified as:

Acute - not more than three weeks duration - for

example, infective coughs

Chronic - more than three weeks duration - for

example, smokers cough

Dry cough - no mucous or secretions

Wet cough - with mucous or secretions

Cough from chest and cough from throat - productive ornon-productive

Paroxysmal cough - spasmodic and recurrent

Bovine cough - soundless cough due to paralysis of

larynx

Psychogenic cough - self-conscious activity of the

patient to draw attention

RECENT DRUGS USED FOR TREATMENT OFCOUGH

Treatments of cough depend on the types of cough. Dry

coughs are treated with cough suppressants (antitussives) that

suppress the urge to cough, while productive coughs (those

that produce phlegm) are treated with expectorants that

loosen mucus from the respiratory tract. Apart from specific
http://archives.chennaionline.com/health/Homoeopathy/2004/10homoeopathy12.asphttp://archives.chennaionline.com/health/Homoeopathy/2004/10homoeopathy12.asphttp://archives.chennaionline.com/health/Homoeopathy/2004/10homoeopathy12.asphttp://archives.chennaionline.com/health/Homoeopathy/2004/10homoeopathy12.asp


4/10


Table 1:Some importance herbal drugs used in cough and other than cough also

Sl.No. NAME BIOLOGICAL SOURCE FAMILY

ACTIVE CHEMICAL

CONSTITUENT THERAPEUTIC USES

1. Flaxseed / Linseed Seeds of Linum

usitatissimumLinaceae -linolenic acid

Cough1, wall putty, paint binder, wood

finish, Nutritional Supplement and food.

2. Fenugreek/MethiDried ripe seeds and

aerial parts of Trigonella

foenum-graecum

Fabaceae Steroidal saponins,

Alkaloids (Trigonelline)

Anorexia, fever,gastritis, gastric ulcer,Common coldand Cough

2.

3.

Garlic/Lahsun Bulb ofAllium sativum Alliaceae Allicin

Antibiotic, digestive, anticoagulant,

antioxidant, blood thinner, stomachic,

carminative, Expoctorentand in Cough3.

4. Fennel

Seeds, leaves and roots

of Foeniculum vulgare Umbellifereae Anethol, Fenchone

Carminative, chronic Coughs,aromatic,

antispasmodic, galactogogue, stomachic,

anti-inflammatory, anti-bacterial.

5. Clove

Flower buds of Eugenia

Caryophyllata

Myrtaceae Eugenin, Caryophyllin

Aromatic, nausea emesis, Carminative,

Stimulant, aphrodiasiac, Expectorentand

in Cough4.

6. Cardamom/ Cardamon

Dried ripe seeds of

Elettaria cardamomum Zingiberaceae

Terpenes (terpineol,

cineol)

Carminative, stimulant, aromatic,

indigestion, flatuelence, Cough5.

7. Ginger Rhizomes ofZingiberofficinale Zingiberaceae Sesqueterpenoids((-)-Zingiberene)

Adjuvant, appetizer, aromatic,

carminative, diaphoretic, cough

6

,expectorant, sialagogue, rubefacient.

8. Cinnamon Bark of Cinnamomum

zeylanicum

Lauraceae Cinnamic aldehyde

Antiseptic, aphrodiasiac, aromatic,

astringent, blood purifier, carminative,

digestive, common coldand Cough1.

9. Poppy/Opium Poppy Capsules of Papaver

somniferum

Papaveraceae Morphine, thebaine,

codeine

Hypnotic, sedative, astringent,

expectorant, Cough1, diaphoretic,

antispasmodic.

10. Saffron Flower of Crocus sativus Iridaceae -crosin, carotinoids

Carminative, diaphoretic, emmenagogue,

depression, Cough2, antihistaminic.

11. Sesame

Cold compression of

seeds of Sesamum

indicum

Pedaliaceae Oleic acid, linileic acid

Antioxidant, rheumatoid arthritis,

osteoporosis, migraine, antidepressant,

dysmenorrhea, irritating Cough7, cracking

joints, hard stools.

12. Tulsi Dried leaves of Ocimum

sanctumLinn.

Labiatae Eugenol, Carvacrol

Antibacterial, insecticidal, stimulant,

aromatic, anticatarrhal, spasmolytic,

diaphoretic, antiperiodic, Cough8.

13. Elderberry

Berries of Sambucus

nigra Caprifoliaceae

Sanbucine,

sambunigrin

Laxative, anti-inflammatory, arthritis,

Cold, Cough5, influenza, asthma,

bronchitis, sore throat, alterative, diuretic,

.

14. Hyssop Herbs of Hyssopus

officinalis

Labiateae -pinene, camphene

Jaundice, rheumatism, asthma, bronchitis,

Cough6due to cold, sinusitis, anti-

inflammatory, vermifuge, sudorific.

15. Liquorice

Dried root and stolon of

Glycyrrhiza glabra Leguminosae

Glycyrrhizinic acid,

carbenoxolone

Expectorant, demulcent,Cough3, peptic

ulcer, antispasmodic, arthritis,

inflammations, addisions disease,

flavouring agent.

16. Mullein

Leaves of Verbascum

thapsus scrophulariaceae

Gum, resin, fatty

acids, mucilage

Demulcent, emollient, astringent, Cough8,

asthma, sore throat.

17.Marsh Mallow Leaves and Roots of

Althea officinalis Malvaceae Asparagin, mucilage,

tannins

Demulcent, emollient, Cough5,

inflammation, irritation of alimentarycanal, urinary and respiratory organs.

18. Slippery Elm Inner bark of Ulmus fulva Urticaceae Mucilage,tannins,

starch

Demulcent, diuretic, expectorant, Cough6,

nutritive, emollient, pectoral, laxative,

dysentery, enteritis, cystitis.


5/10


19. Goldenseal Roots of

Hydrastiscanadensis

Ranunculaceae

Berberine, canadine,

hydrastine

Tonic, stomachic, soothing agent,

muscle stimulant, laxative, emollient,

diuretic, Cough7.

20. Echinacea

rootstock of Echinacea

angustifolia, E.purpure Compositae

Betain, caryophylene,

tannins, glycoside

Cold, slow healing wounds, respiratory

and urinary tract in fection, alterative,

antibiotic, Wooping Cough9(with

Goldenseal).

21. Thinleaf Milkwort

Dried Roots of Polygala

tenuifoliaor Polygala

sibirica

Polygalaceae

Onjisaponine,

tenuifoliside

Insomnia, dream-disturbed sleep,

forgetfulness, palpitation, Cough10

with

sputum difficult to expectorate, breast

pain.

22. Lungwort Whole herb of Sticta

pulmonaria

Lichens Stictic acid, gyrophoric

acid

Bronchial catarrh, pulmonary

tuberculosis, Cough11

, rheumatism,

hysteria, healing.

23. Turmeric

Dried and fresh rhizomes

of Curcuma longa Linn. Zingiberaceae Curcumin, turmerone

Condiment, coloring agent, anti-

inflammatory, antiarthritic, Cough12

,

cervical cancer.

24. Honey

Sugar secretion deposited

in honey comb by bees

Apis mallifera, Apis

dorsataand other species

of Apis

Apidae Glucose, fructose,

sucrose

Demulcent, sweetening agent,

antiseptic, ingredient of Cough13

mixture, cough drops and vehicle for

ayurvedic formulation.

25. Thyme

Whole herb of Thymus

vulgaris Labiatae

Phenols(thymol,

carvacrol, etc)

Antiseptic, tonic, antispasmodic,carminative, barking Cough

14, anemia,

insomnia, wooping Cough, sore throat.

26. Amalaki/Amla Fruits of Emblica

officinalis

Euphorbiaceae Phyllemblin, tannins,

vitamin c

Antioxidant, immunomodulator,

hypoglycemic, hypolipidemic,

hypotensive, antacid, tonic, mild

laxative, common cold, Cough15

,

gastritis.

27.

Lobelia Dried flowering herb and

seeds of Lobelia inflate Lobeliaceae

Lobeline, lobelic acid

Expectorant, diaphoretic, antiasthmatic,

Cough12

, counterirritant, epilepsy,

tetanus, diphtheria, tonsillitis.

28.

Peppermint

Flowering tops of Mentha

piperita Labiatae

Menthol, pulegone,

menthone

Carminative, stimulant, flavouring

agent, mild antiseptic, Cough13

and

Cold, bronchitis, nasal catarrh, chest

complaint, lumbago.

29.

Eucalyptus

Fresh leaves of

Eucalyptus globules Myrtaceae

Cineole, camphene,

phellandrene

Counter-irritant, antiseptic,

expectorant, Cough11

, chronic

bronchitis, flavouring agent.

30. Plantain Roots, leaves and flower

of Plantago major

Plantaginaceae Aucubin

Epilepsy, headache, dysentery,

jaundice, asthma, cold, Cough12

,

arthritis, gout, leucorrhea.

31.

Anise

Seeds of Pimpinella

anisum

Umbelliferae Anethol, choline

Antiseptic, spasmodic, carminative,

Cough14

, expectorant, digestive,

pectoral, epilepsy, insomnia.

32. Coltsfoot Flower of Tussilago

farfara

Compositae Faradial, phytosterol

Astringent, demulcent, emollient,

unproductive Cough1, expectorant,

tonic, persistent Cough, tuberculosis,

wheezing, pneumonia, pleurisy.

33. Fritillary

Bulbs of Fritillaria

meleagris Liliaceae

Songbeinone,

songbeinine

Chinese Cough3

remedy,

hyperthyroidism.

34. Loquat Fruit and leaves of

Eriobotrya japonica

RosaceaeEriobotrin,

isoeriobotrin,

xylopyranoside

Chinese Cough15remedy, demulcent,expectorant, sedative, making pies or

tarts.

35. Ladybell

Roots ofAdenophora

tetraphylla, Adenophora

stricta

Campanulaceae Saponins, xanthotoxin,

ammoidin

Chinese Cough16

remedy, anorexia, dry

mouth, red tongue, antitussive,

expectorant.


6/10


36. Poria Cocos Sclerotium of fungus

Wolfiporia extensa

Polyporaceae Polysaccharides,

triterpenoids

Chinese Cough17

remedy, insomnia,

restlessness, fatigue, sleep disorder,

tension, nervousness.

37. Pomelo Peels of Citrus maxima Rutaceae Octanal, citral, decanal

Chinese Cough18

remedy, motion

sickness, vomiting, pain due to

indigestion in children.

38.

Bellflower

Roots of Platycodon

grandiflorus

Campanulaceae Triterpene saponins

Expectorant, antitussive that treat

Cough19, tonsillitis, pertusis, asthma,

anti inflammatory, anti ulcer, anti

cholestraenemia.

39. Pinellia

Rhizomes of species

Pinellia (P. browniana,

P.cordata, etc)

Araceae

Cycloartenol, -

monpalmitin, -

sitosterol

Chinese Cough20

remedy, nausea,

vomiting, phlegm.

40.

Schisandra Seeds of Schisandra

chinensis

Schisandriaceae

Dibenzocyclooctad-

iene

Chinese Cough21

remedy, tonic,

restorative adaptogen,

hepatoprotective, immunomodulator.

41. Trichosanthes

Seeds of Trichosanthes

kirilowii Curcubitaceae

Triterpene saponin

alcohols

Chinese Cough20

remedy, diabetes,

chest pain, expectorant.

42.

Banaphsa Flowers and roots of Viola

odorata

Violaceae Gaultherin, violutoside,

saponins

Healing, anti-inflammatory, diuretic,

emetic, expectorant, Cough19

, laxative,

demulcent, astringent, eczema

diaphoretic, flu, emollient, fever.

43. Kantkari Roots and rhizomes of

Solanum xanthocaroum

Solanaceae

Carpesterol,

solanocarpine,

solanine

Diuretic, expectorant, febrifuge,

anodyne, Coughs17

, dysuria, stone,

hypotensive.

44. Talispatra

Leaves ofAbies webbiana

Pinaceae

Monoterpenes,

phytosterol, flavonoids

Asthma, bronchitis, astringent,

carminative, blood purifier,

antispasmodic, aromatic, chronic

Cough22

, anorectic.

45. Shati Roots and rhizomes of

Hedychium spicatium

Zingiberaceae Limonene, cineol,

terpinolene

Antiseptic, poultice, inflammation,

nausea, vomiting, asthma, chronic

Cough15

, carminative, stimulant, brain

tonic, reduce excess weight,

hypotensive, hypoglycemic

36. Poria Cocos Sclerotium of fungus

Wolfiporia extensa

Polyporaceae Polysaccharides,

triterpenoids

Chinese Cough17

remedy, insomnia,

restlessness, fatigue, sleep disorder,

tension, nervousness.

37. Pomelo Peels of Citrus maxima Rutaceae Octanal, citral, decanal

Chinese Cough18

remedy, motion

sickness, vomiting, pain due to

indigestion in children.

38. Bellflower

Roots of Platycodon

grandiflorus

Campanulaceae Triterpene saponins

Expectorant, antitussive that treat

Cough19

, tonsillitis, pertusis, asthma,

anti inflammatory, anti ulcer, anti

cholestraenemia.

39. Pinellia

Rhizomes of species

Pinellia (P. browniana,

P.cordata, etc)

Araceae

Cycloartenol, -

monpalmitin, -

sitosterol

Chinese Cough20

remedy, nausea,

vomiting, phlegm.

40. Schisandra Seeds of Schisandra

chinensis

Schisandriaceae

Dibenzocyclooctadiene

Chinese Cough remedy, tonic,

restorative adaptogen,

hepatoprotective, immunomodulator.

41. Trichosanthes

Seeds of Trichosanthes

kirilowii Curcubitaceae

Triterpene saponin

alcohols

Chinese Cough20

remedy, diabetes,

chest pain, expectorant.

42. Banaphsa Flowers and roots of Viola

odorata

Violaceae Gaultherin, violutoside,

saponins

Healing, anti-inflammatory, diuretic,

emetic, expectorant, Cough19

, laxative,

demulcent, astringent, eczema

diaphoretic, flu, emollient, fever.

43. Kantkari Roots and rhizomes of

Solanum xanthocaroum

Solanaceae

Carpesterol,

solanocarpine,

solanine

Diuretic, expectorant, febrifuge,

anodyne, Coughs17

, dysuria, stone,

hypotensive.


7/10


44. Talispatra Leaves ofAbies

webbiana

Pinaceae

Monoterpenes,

phytosterol,

flavonoids

Asthma, bronchitis, astringent,

carminative, blood purifier,

antispasmodic, aromatic, chronic

Cough22

, anorectic.

45. Shati Roots and rhizomes of

Hedychium spicatium Zingiberaceae

Limonene, cineol,

terpinolene

Antiseptic, poultice, inflammation,

nausea, vomiting, asthma, chronic

Cough15, carminative, stimulant, brain

tonic, reduce excess weight,

hypotensive, hypoglycemic

remedies cough may be treated as a symptom with

following drugs:

1) Pharyngeal demulcents:these sooth the throat and reduceafferent impulses from inflamed/irritated pharyngeal

mucosa. Examples are lozenges, cough drops and

linctuses congaing syrup, glycerin and liquorice.

2) Expectorants: these are drugs believe to increase

bronchial secretion or reduce its viscosity thus facilitating

its removal by coughing. These are of two types:

(i) Bronchial secretion enhancers: e.g. sodium potassiumcitrate, potassium iodide, squill and guaiphenesin etc.

(ii) Mucolytics: these reduce viscosity of phlegm. e.g.

bromhexine and cysteine (Canning, B.J. et al. 2004)

3) Antitussives:these are drugs that act in the CNS to raise

the threshold of cough center or act peripherally in the

respiratory tract to reduce tussal impluses or both these

actions. Because they aim to control rather than eliminate

cough antitussives should be used only for dryunproductive cough or if cough is unduly tiring, disturb

sleep or is hazardous (hernia, piles, cardiac, diseases and

ocular surgery). These drugs are broadly classified into

two groups based on their site of action:(i) Peripheral antitussive: these drugs act outside the CNS to

inhibit cough by suppressing the responsiveness of one or

more vagal sensory receptors that produce cough. e.g.

noscapine and benzonatate.

(ii) Central antitussive: these drugs act within the CNS at the

level of the brain stem, where the basic neural circuitry

responsible for cough is located. Centrally acting

antitussives work by depolarization, or a dulling of the

vagus nerve, the nerve leading from the brain stem and

serving the chest area. e.g. codeine and dextromethorphan.

Codeine is more selective for cough centre and is used asthe standard antitussive (Mazzone, S.B. 2003).

4) Adjuvant antitussives:these include bronchodilators andsalbutamol (Tripathi, 2008).

HERBAL TRATMENT FOR COUGH

The treatment of coughs is one area where the use of certainherbal remedies remains common today. Herbal drugs play

an important role in the management of various types of

cough. Currently available therapies for cough include cough

suppressants. Antitussives provide only symptomatic relief

drowsiness. These are contraindicated in asthmatics and in

and produce many serious adverse effects like doses

respiratory depression, nausea, vomiting, sedation and

patients with diminished respiratory reserve. Therefore, inrecent years much effort has been made to search for natural

active plant components with diminished adverse effects.

Many plant species known in folk medicine of different

cultures used for treatment of respiratory complaints such as

cough, bronchial affections, pleurisy, pneumonia and

expectoration. Due to increasing demand in herbal therapy,

many herbal research laboratories have come forward insuccessfully launching various herbal products, which are

helpful in the treatment of various types of cough. Different

cases, and even the same case at different stages, require

different treatment. The addition of appropriate remedies to a

standard cough syrup base is an appropriate means of using

the syrup as a vehicle without becoming unduly reliant on a

particular preformulated remedy. Following herbal treatments

are used (Mohmed Sohel Harsoliya. et al.2011)

1) Cough SuppressantsSince productive coughs are a necessary means of removing

the infectious and obstructive material, cough suppressants

called antitussives should only be used for dry coughs..Licorice (Glycyrrhiza glabraLinn.) extract is usually thought

of as simply a demulcent with a pleasant flavor, but its

derivatives have been shown to have a central antitussive

effect similar to codeine. Licorice is also considered to be asedative expectorant. An antitussive that works by reducing

irritation of the respiratory membrane at or below the voice

box is wild cherry bark (Prunus). Wild cherry bark is

effective for nervous coughs and is often used in short-term

infectious cases. The compound prunasin in wild cherry bark

can be toxic in large amounts but in smaller quantities

relieves the irritation of the mucosa and thereby alleviatescoughing.

2) Demulcents and ExpectorantsDemulcents contain mucilaginous components that are used

for their soothing effect on irritations of the membrane lining

the throat. For this purpose cough syrups are commonly

employed, in addition to acting as a vehicle for other

antitussives or expectorants. Besides sugar in syrups and

lozenges, other commonly used demulcents are honey,

glycerin, licorice, and gum arabic, since they also sweeten

medicinal preparations. Coughs due to acute inflammation or


8/10


from phases of increased irritability in chronic bronchitis can

be treated with mucilaginous herbs in the dose necessary to

gain relief. The soothing effects of these herbs are only

present when prepared as extracts by soaking in water at

room temperature. The juice of plantain (Plantago ovate

Linn.) has demulcent mucilage as well as antibacterialcomponents (McLeod RL.et al.2007)

Expectorants, cough remedies that increase the amount of

respiratory fluid secretions, can be used for both dry and

productive coughs. Those known as sedative expectorants are

used for dry coughs to increase respiratory fluid which

produces a demulcent effect on the respiratory membranes.

Stimulant expectorants help decrease the thickness of thesecretions in productive coughs, thus aiding their expulsion,

and inhibit bacterial growth by their antiseptic effects.

Expectorants provide no direct benefit for coughs arising

from irritation in the throat or to the pleural membrane

outside of the lungs. These remedies have an antitussive

action by increasing the amount of respiratory fluid, therebyproducing a soothing effect on the bronchial membranes, and

by decreasing the thickness of membrane secretions, thus

facilitating their removal.

Ipecac is used both to liquify thick, tenacious mucus from the

airways and to relieve spasms of the respiratory tubes,

particularly spasms from croup. It reduces bronchial swelling

and distress, and the coughing becomes easier. The main

application for ipecac is in bronchial congestion with a dry,

irritable cough. Ipecac is especially indicated when there is

irritation with a continued effort to clear the larynx. It may be

the best expectorant for acute conditions when taken in small,frequent doses insufficient to cause nausea. Peppermint oil

and its component menthol act as a local anesthetic to relieveirritation and are therefore useful in throat lozenges, as well

as being mildly antiseptic. Volatile aromatic antiseptics arealso taken internally as expectorants.

3) Stimulant ExpectorantsVolatile antiseptics taken internally are generally as stimulant

expectorants. They do not act as nervous system stimulants,

but rather their tonic and antiseptic actions help to stimulaterepair and diminish fluid secretions due to inflammation.They are eliminated by the lungs when taken orally. These

volatile compounds increase sputum expulsions by

stimulating normal respiratory fluid secretions through their

mild irritant effects directly on the bronchial glands. Besides

peppermint oil, commonly used stimulant expectorantscontaining aromatic oils include eucalyptus, garlic, and

thyme. Eucalyptus oil and its component eucalyptol are

common antiseptic flavoring ingredients in throat lozenges

for coughs. Taken internally eucalyptus reduces

inflammatory respiratory secretions by its antiseptic actionand facilitates expulsion of the sputum.

4) Aromatic RelaxantsSeveral stimulant expectorant herbs contain a combination of

volatiles with resinous components. In addition to havingthese antiseptic expectorant components, these herbs are also

antispasmodic to the bronchial airways. Elecampane root

(Inula) is used in short-term and persistent coughs where

there is abundant expectoration, for chronic bronchitis, or

after protracted colds or influenza.

5) Inhalation TherapyIn treating bacterial infections below the voice box inhaling

volatile antiseptics in steam is the most common method of

using many stimulant expectorants. To achieve the bestmucus-dissolving and antiseptic effects, volatile compounds

should be inhaled and not just taken orally. The steam also

helps liquify the sputum so that it can be more easilyexpelled. Volatile antiseptics include both essential oils and

balsams. The aromatic vapors of the major volatile

constituents have shown antiseptic activity. Volatile

antiseptic expectorants derived from conifers are often usedas inhalants. These include dwarf pine needle or Scotch pine

needle oils and cedar leaf oil.(Karlsson, J.A. 1996)

6) Topical TreatmentsApplied topically to the chest, neck and upper back and

covered with a flannel binder, the combination of eucalyptol,

menthol, thymol, and camphor act as counterirritants in a dry

chest pack to relieve pulmonary congestion (Mohmed SohelHarsoliya. et al.2011).

CONCLUSIONAs long as cough is helpful in getting rid of infectious

material with the help of mucous from the airway, it should

not be stopped. But coughs causes severe irritation of thethroat and entire respiratory tract. The herbs are best to treatthis condition that will soothe the mucous membranes and

expel any phlegm that is causing congestion. Herbs can also

help coat the mucus membranes of the respiratory tract,

helping relieve any itchiness that may cause a coughing

spasm. Some herbs also have a high mucilage content thathelps soothe the throat and is gentle enough that it won't

trigger you to cough more, some are a nutritive herb and

some herbs are helping you restore your immune system to

fight your respiratory tract infection. Some herbs are

especially beneficial when there is also asthma present in the

disorder. It is safe enough to use with children. There are

plenty of herbs out there that will help relieve your symptomsin a natural, gentle way, without any of the side effects of

over the counter medication.

REFERENCES

1. Benett PN, Brown MJ. 2003. Clinical Pharmacology, 9th

Ed. ELBS Publications, Churchill


9/10


Livingstone, Edinburgh: 279-288, 319-343, 549-552.

2. Canning, B.J. et al. (2004) Identification of the trachealand laryngeal afferent neurones mediating cough in

anaesthetised guinea-pigs. J. Physiol. 557, 543558

3. Chung, K.F. (2003) Current and future prospects for

drugs to suppress cough. IDrugs. 6, 7817864. Dicpinigaitis, P.V. (2003) Current treatment of cough. In

Drugs for the Treatment of Respiratory Diseases (Spina,

D. et al., eds), pp. 565578, Cambridge UP

5. Eccles R, Morris S, Jawad M. 1992; Lack of effect of

codeine in the treatment of cough associated with acute

upper respiratory tract infection. J Clin Pharm Ther

17:17580.

6. Feldman JI, Woodworth WF. 1993: Cause of intractablechronic cough: Arnold's nerve. Arch Otoloryngol Head

Neck Surg; 119:1042.

7. Karlsson, J.A. (1996) The role of capsaicin-sensitive C-

fibre afferent nerves in the cough reflex. Pulm.

Pharmacol. 9, 3153218. Karlsson, J.A. (1996) The role of capsaicin-sensitive C-fibre afferent nerves in the cough reflex. Pulm.

Pharmacol. 9, 315321

9. Lee, L.Y. and Pisarri, T.E. (2001) Afferent properties

and reflex functions of bronchopulmonary C-fibers.

Respir. Physiol. 125, 476510. Mazzone, S.B. (2003) Sensory pathways for the cough

reflex. In Cough: Causes, Mechanisms and Therapy

(Chung, K.F. ed.), pp. 161171,

11. Mazzone, S.B. and Canning, B.J. (2002) Central nervous

system control of the airways: pharmacological

implications. Curr. Opin. Pharmacol. 2, 220228

12. McCool FD. 2006. Global physiology and

pathophysiology of cough. Chest. 129:48S-53S.13. McLeod RL, Jia Y, McHugh NA, Fernandez , Mingo

GG, Wang X, Parra LE, Chen J, Brown D, Bolser DC,Kreutner W. Hey JA. 2007. Sulfur-dioxide exposure

increases TRPV1-mediated responses in nodose gangliacells and augments cough in guinea pigs. Pul.

Pharmacol. Ther.20:750-757.

14. Mohmed Sohel Harsoliya, Mohmed Jamal Sabugar, Patel

Vishnu M., Singh sarika and PathanJaved Khan, 2011

The New Multifunctional Plant Selected Cough Syrup:

An OverviewJournal of Pharmacy Research,4(2),411-

412

15.Nagendran T. 2003. Management of acute and chronic

cough in the ambulatory care setting.Hospital Physician.49-54.

16. Rang HP, Dale MM, Ritter JM, Moore PK. 2003.Pharmacology, 5thEd. Churchill Livingstone, New York:

217-241

17. Schroeder, K. and Fahey, T. (2002) Systematic review of

randomized controlled trials of over the counter cough

medicines for acute cough in adults. Br. Med. J. 324,

32933118. Sesuka S, Kaneko Y. 1985;Cough associated with the

use of captopril. Arch Intern Med 145:1524.

19. Tripathi KD. 2008. Essentials of Medical Pharmacology,

6th Ed. Jaypee Brothers Medical Publishers, New Delhi,

India: 184-216.

20. Widdicombe J G. 1995;Neurophysiology of the cough

reflex. Eur Resp J 8:1193202.

21. Widdicombe, J.G. and Undem, B.J. (2002) Summary:

central nervous pharmacology of cough. Pulm.

Pharmacol. Ther. 15, 251252

WEB-LIOGRAPHY

1. http://www.tonicfoodclub.com/ayurvedic-herbs-coughs/

2. http://www.livestrong.com/article/119832-herbs-dry-

cough/

3. http://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/

4. http://www.himalayahealthcare.com/abouthimalaya/cprofile.htm

5. http://naturalremediesforcough.com/

6. http://globalherbalsupplies.com/herb_information/

7. http://www.fzrm.com/herbextracts.htm

8. http://www.hkjcicm.org/cm_database/plants/detail_e.asp

x?herb_id=62

9. http://autonopedia.org/healing/Herbs/LungMoss.html

10. http://ayurveda-foryou.com/ayurveda_herb/amalaki.html

11. http://www.mountainroseherbs.com/learn/coltsfoot.php

12. http://pubs.acs.org/doi/abs/10.1021/bk-2003-0859.ch022

13. http://www.tcmtreatment.com/herbs/00-shashen.htm

14. http://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htm

15. http://findmeacure.com/2010/02/19/ladybells/

16. http://www.drugs.com/npp/poria.html

17. http://www.foodsnherbs.com/pomelo_peel.htm

18. http://www.naturalelixir.com/schisandra.html
http://www.tonicfoodclub.com/ayurvedic-herbs-coughs/http://www.livestrong.com/article/119832-herbs-dry-cough/http://www.livestrong.com/article/119832-herbs-dry-cough/http://www.livestrong.com/article/119832-herbs-dry-cough/http://www.livestrong.com/article/119832-herbs-dry-cough/http://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/http://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/http://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/http://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/http://www.himalayahealthcare.com/abouthimalaya/cprofile.htmhttp://www.himalayahealthcare.com/abouthimalaya/cprofile.htmhttp://www.himalayahealthcare.com/abouthimalaya/cprofile.htmhttp://www.himalayahealthcare.com/abouthimalaya/cprofile.htmhttp://naturalremediesforcough.com/http://globalherbalsupplies.com/herb_information/http://www.fzrm.com/herbextracts.htmhttp://www.hkjcicm.org/cm_database/plants/detail_e.aspx?herb_id=62http://www.hkjcicm.org/cm_database/plants/detail_e.aspx?herb_id=62http://www.hkjcicm.org/cm_database/plants/detail_e.aspx?herb_id=62http://www.hkjcicm.org/cm_database/plants/detail_e.aspx?herb_id=62http://autonopedia.org/healing/Herbs/LungMoss.htmlhttp://ayurveda-foryou.com/ayurveda_herb/amalaki.htmlhttp://www.mountainroseherbs.com/learn/coltsfoot.phphttp://pubs.acs.org/doi/abs/10.1021/bk-2003-0859.ch022http://www.tcmtreatment.com/herbs/00-shashen.htmhttp://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htmhttp://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htmhttp://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htmhttp://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htmhttp://findmeacure.com/2010/02/19/ladybells/http://www.drugs.com/npp/poria.htmlhttp://www.foodsnherbs.com/pomelo_peel.htmhttp://www.naturalelixir.com/schisandra.htmlhttp://www.naturalelixir.com/schisandra.htmlhttp://www.foodsnherbs.com/pomelo_peel.htmhttp://www.drugs.com/npp/poria.htmlhttp://findmeacure.com/2010/02/19/ladybells/http://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htmhttp://taoism.about.com/od/herbsthattonifytheyin/g/Nan_Sha_Shen.htmhttp://www.tcmtreatment.com/herbs/00-shashen.htmhttp://pubs.acs.org/doi/abs/10.1021/bk-2003-0859.ch022http://www.mountainroseherbs.com/learn/coltsfoot.phphttp://ayurveda-foryou.com/ayurveda_herb/amalaki.htmlhttp://autonopedia.org/healing/Herbs/LungMoss.htmlhttp://www.hkjcicm.org/cm_database/plants/detail_e.aspx?herb_id=62http://www.hkjcicm.org/cm_database/plants/detail_e.aspx?herb_id=62http://www.fzrm.com/herbextracts.htmhttp://globalherbalsupplies.com/herb_information/http://naturalremediesforcough.com/http://www.himalayahealthcare.com/abouthimalaya/cprofile.htmhttp://www.himalayahealthcare.com/abouthimalaya/cprofile.htmhttp://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/http://www.livestrong.com/article/143250-herbs-help-you-stop-coughing/http://www.livestrong.com/article/119832-herbs-dry-cough/http://www.livestrong.com/article/119832-herbs-dry-cough/http://www.tonicfoodclub.com/ayurvedic-herbs-coughs/


10/10


19. http://www.naturopathydigest.com/nutrition_herbs/herbs

/trichosanthes_seed.php

20. http://ayurveda.astrologytutorials.com/tag/banaphsa/

21. http://www.altavaltrebbia.net/v/english/herbs/sweetviolet

.htm

22. http://prakrutiremedies.com/talasipatra.php

Source of support: Nil; Conflict of interest: None declared
http://www.naturopathydigest.com/nutrition_herbs/herbs/trichosanthes_seed.phphttp://www.naturopathydigest.com/nutrition_herbs/herbs/trichosanthes_seed.phphttp://www.naturopathydigest.com/nutrition_herbs/herbs/trichosanthes_seed.phphttp://www.naturopathydigest.com/nutrition_herbs/herbs/trichosanthes_seed.phphttp://ayurveda.astrologytutorials.com/tag/banaphsa/http://www.altavaltrebbia.net/v/english/herbs/sweetviolet.htmhttp://www.altavaltrebbia.net/v/english/herbs/sweetviolet.htmhttp://www.altavaltrebbia.net/v/english/herbs/sweetviolet.htmhttp://www.altavaltrebbia.net/v/english/herbs/sweetviolet.htmhttp://prakrutiremedies.com/talasipatra.phphttp://prakrutiremedies.com/talasipatra.phphttp://www.altavaltrebbia.net/v/english/herbs/sweetviolet.htmhttp://www.altavaltrebbia.net/v/english/herbs/sweetviolet.htmhttp://ayurveda.astrologytutorials.com/tag/banaphsa/http://www.naturopathydigest.com/nutrition_herbs/herbs/trichosanthes_seed.phphttp://www.naturopathydigest.com/nutrition_herbs/herbs/trichosanthes_seed.php

andre parmonangan panjaitan - 1318011013.pdf

Documents