Med. Pro Praxi 2008; 5(10): 358-361

Kašel v primární praxi

MUDr. Petr Papoušek1, MUDr. Vladimír Koblížek2, MUDr. Tereza Dobešová2, et al
1 Katedra patofyziologie, LF UK, Hradec Králové
2 Plicní klinika, Ušní, nosní a krční klinika, Neurologická klinika, Psychiatrická klinika, Hradec Králové

Přístup k pacientovi s kašlem začíná anamnézou a vyšetřením. Ačkoliv má časový průběh a charakter kašle malou diagnostickou hodnotu, anamnesticky je důležité určit, zda pacient užívá ACE inhibitor, zda je kuřák nebo má vážné projevy život ohrožující nebo systémové choroby. Potom se u akutního kašle rozliší, zda je příčina život ohrožující, nebo méně nebezpečná. U chronického kašle se nejdříve vyloučí nejčastější příčiny. Lékař doporučí nekouřit, je-li to aktuální. První linii léčby chronického kašle představuje antihistaminikum 1. generace a lokální dekongescens na „zadní rýmu“. Specialista vyloučí CHOPN, astma a bronchitis s eozinofilií sputa. Nedostatečná odpověď si vyžádá žaludeční antisekreční léčbu na gastroezofageální reflux. Při přetrvávající neúspěšné léčbě vyšetří pacienta specialista.

Keywords: akutní a chronický kašel, příčiny, diagnostika a léčba

Published: December 19, 2008  Show citation

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Papoušek P, Koblížek V, Dobešová T, al E. Kašel v primární praxi. Med. praxi. 2008;5(10):358-361.
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