{"id":1302,"date":"2023-12-07T11:38:08","date_gmt":"2023-12-07T16:38:08","guid":{"rendered":"https:\/\/www.allergy-associates.com\/?p=1302"},"modified":"2023-12-07T11:38:08","modified_gmt":"2023-12-07T16:38:08","slug":"dear-dr-k-15","status":"publish","type":"post","link":"https:\/\/www.allergy-associates.com\/?p=1302","title":{"rendered":"Dear Dr. K;"},"content":{"rendered":"\n<p><em>I\u2019ve seen you and multiple other doctors for what has been called unexplained chronic cough.&nbsp; Now I\u2019ve read about the new drug Gefapixant.&nbsp; Do you think I\u2019m a candidate?<\/em><\/p>\n\n\n\n<p>My answer is a qualified yes. But before I continue my answer let me first give a summary of your own situation that might be of help to other kindred spirits.&nbsp; Your cough is called \u201cunexplained\u201d because despite our best efforts the medical specialists you\u2019ve seen have failed to find a cause.&nbsp; Your primary doctor listened to your lungs (normal) and ordered a chest x-ray (normal) and a CT scan (normal).&nbsp; Your ENT did nasal endoscopy and a sinus CT, both of which were normal.&nbsp; Your allergist (me) did allergy tests that were negative.&nbsp; Your pulmonary doctor did a series of breathing tests and even a methacholine challenge test, all of which were normal.&nbsp; He did have you try some inhalers which did not stop your chronic cough.&nbsp; Your gastroenterologist did an upper GI x-ray and then an endoscopy both of which were normal.&nbsp; Your speech pathologist examined your larynx and vocal cords and found no abnormality.&nbsp; And yet, you continue to cough.&nbsp;<\/p>\n\n\n\n<p>Gefapixant is an antagonist (blocker) of the P2RX3 receptor.&nbsp; This receptor functions as a ligand-gated ion channel for nociceptor activation.&nbsp; I\u2019m sorry for all the big words, but basically a nociceptor is a sensor that tells a nerve that it is being stimulated.&nbsp; This sensor is activated through an entrance doorway called an ion channel.&nbsp;<\/p>\n\n\n\n<p>As it turns out this particular receptor plays a role in sensing pain, sensing the need to empty our bladder and sensing the need to cough.&nbsp; And you might correctly guess the medication is being studied for these applications as well.&nbsp;<\/p>\n\n\n\n<p>Compared to placebo Gefapixant 45mg twice a day reduced cough frequency and cough severity and improved cough-specific quality of life.&nbsp; Its main side effect was causing taste perversion.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I\u2019ve seen you and multiple other doctors for what has been called unexplained chronic cough.&nbsp; Now I\u2019ve read about the new drug Gefapixant.&nbsp; Do you think I\u2019m a candidate? My answer is a qualified yes. But before I continue my answer let me first give a summary of your own situation that might be of help to other kindred spirits.&nbsp; Your cough is called \u201cunexplained\u201d because despite our best efforts the medical specialists you\u2019ve seen have failed to find a&#8230;<\/p>\n<p class=\"read-more\"><a class=\"btn btn-default\" href=\"https:\/\/www.allergy-associates.com\/?p=1302\"> Read More<span class=\"screen-reader-text\">  Read More<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[636],"class_list":["post-1302","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-gefapixant"],"_links":{"self":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts\/1302","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1302"}],"version-history":[{"count":1,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts\/1302\/revisions"}],"predecessor-version":[{"id":1303,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=\/wp\/v2\/posts\/1302\/revisions\/1303"}],"wp:attachment":[{"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.allergy-associates.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}