Pharmacology of Cough

Treatment of refractory chronic cough remains a challenge for physicians due to limited therapeutic options. One leading hypothesis regarding the etiology of chronic cough is damage to the vagus nerve, which mediates the cough reflex, after an insult such as a viral infection. This results in hypersensitivity and therefore a reduced cough threshold. Neuromodulators such as gabapentin, pregabalin, and tramadol have been repurposed to treat this hypersensitivity similar to other neuropathic pain conditions. A new class of drugs, P2X3 antagonists, have emerged as another possibility for treating individuals with chronic cough; however, Food and Drug Administration approval is still pending.