Sneezing and Coughing

A sneeze is a sudden, forceful, uncontrolled burst of air from the lungs. The soft palate and uvula are depressed, the tongue elevates to partially close the passage to the mouth, and the air ejected from the lungs is expelled mostly through the nose. Sneezing typically occurs when irritants and foreign particles reach the nasal mucosa and trigger the release of histamine that initiates the sneeze reflex by activating sensory fibers of the trigeminal nerve.

Coughing is an explosive respiratory maneuver, which reflexively or deliberately is intended to clear irritants, foreign particles, and secretions from the airway.16,17 It consists of three sequential phases: inhalation; forced exhalation against a closed glottis; and, following opening of the glottis, violent release of air from the lungs. Common causes of acute cough include upper respiratory tract infections, exacerbation of COPD and asthma, and pneumonia.16

Common causes of chronic cough include chronic bronchitis and gastroesophageal reflux disease, treatment with an angiotensin-converting enzyme inhibitor, and obstructive sleep apnea.16,17 When persistent and excessive, cough can seriously impair quality of life and lead to vomiting, muscle pain, rib fractures, urinary incontinence, tiredness, syncope, and depression.16,17 It also has psychosocial effects, such as embarrassment and negative impact on social interactions.16,17

Symptomatic treatment may include the administration of guaifenesin or guaifenesin w/codeine.2,3,17 Guaifenesin, an expectorant, promotes or facilitates the removal of secretions from the respiratory tract by increasing sputum volume and making sputum less viscous. Codeine phosphate, an antitussive agent, temporarily controls cough due to minor throat and bronchial irritation that may occur with the common cold or inhaled irritants.