American Board of Internal Medicine (ABIM) Certification Practice Exam

What medication do the American College of Chest Physicians recommend for patients with unexplained chronic cough?

1. Gabapentin

2. Cough suppressants

3. Antihistamines

4. Bronchodilators

The correct answer is: Gabapentin

The American College of Chest Physicians (ACCP) recommends gabapentin for patients with unexplained chronic cough, particularly when the cough is thought to be related to irritation or neuropathic pain. Gabapentin, a medication primarily used for neuropathic pain and seizure disorders, has been shown to help reduce cough frequency and severity in patients where traditional treatments may not be effective. In cases of unexplained chronic cough, it's important to consider non-traditional medications such as gabapentin, especially when cough suppressants, antihistamines, or bronchodilators may not address the underlying issue or if the cough is not due to an obvious allergen or respiratory condition. Cough suppressants, while helpful in alleviating symptoms, do not target the underlying pathophysiological mechanisms behind chronic cough. Similarly, antihistamines tend to be more applicable to coughs associated with allergy-related symptoms rather than unexplained chronic cough, and bronchodilators are typically indicated for conditions like asthma or COPD rather than chronic cough without identifiable causes.