A 75-year-old man with a history of hypertension, diabetes, environmental allergies, and colon polyps presents to the office with a complaint of persistent dry hacking cough that does not improve with over-the-counter treatment with antitussives and allergy medications. The man reports that he has had the cough for 3 months and is tired of the […]
I would have inquired about the patient’s experience with hyperacidity and heartburn, smoking history, and whether there has been a case of asthma in his family. The patient presents to the facility with a complaint of persistent dry hacking cough that does not improve despite taking antitussives and allergy medications. It would, therefore, be important to assess the patient’s medical history to assess the potential for a respiratory condition. Inquiring about his smoking history and any cases of asthma within his family line would offer insight into behavioral and genetic factors that could have triggered his predisposition to a respiratory condition. Moreover, inquiring about his experience with hyperacidity and heartburn could help establish the potential for excessive acid levels in gastric juices that might have caused discomfort in the patient’s throat (Xu et al., 2018). Pulser, respiratory rate, and lung sounds should have been completed as part of the patient’s physical exam. A physical examination of the chest could also be conducted to rule out chest complications. Completing such physical aspects could allow a caregiver to identify the most likely cause of the symptoms presented.
Based on the medical history and physical exam, lisinopril intake is the most likely cause of the cough. The patient’s medical history reveals that the patient started taking lisinopril six months before this appointment. According to Borghi and Veronesi (2019), lisinopril and other ACE inhibitors cause adverse side effects on a patient’s breathing system, which include a chronic hacking cough. Possible diagnoses that should be considered to alleviate the patient’s condition include bronchitis, asthma, and whooping cough. Other tests that should be completed before producing a diagnosis include a chest x-ray to rule out the presence of mass or fluids in the lungs and a throat swab to rule out strep throat. A sputum culture could also be conducted to rule out any bacterial infection in the patient’s respiratory tract. The treatment strategy could include stopping the Lisinopril regimen and replacing it with an angiotensin receptor blocker. Patient education would focus on improving the client’s information regarding lifestyle changes that could help avoid the symptoms’ recurrence.
Xu, X., Chen, Q., Qiu, Z., Shi, C., Ding, H., Wang, L., … & Yu, L. (2018). Association of cough hypersensitivity with tracheal TRPV1 activation and neurogenic inflammation in a novel guinea pig model of citric acid-induced chronic cough. Journal of International Medical Research, 46(7), 2913-2924. https://journals.sagepub.com/doi/abs/10.1177/0300060518778951
Borghi, C., & Veronesi, M. (2019). Cough and ACE inhibitors: the truth beyond placebo. Clinical Pharmacology & Therapeutics, 105(3), 550-552. https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1002/cpt.1040
Customer's Feedback Review
Published On: 01-01-1970