Pharmacist focus- February 2007
Patient Education Series February 2007
Cough and Cold
How long do colds normally last?
Cold symptoms generally last about a week or two. Rest and liquids are the best treatment for a cold; however nonprescription medications help relieve cold symptoms, such as nasal congestion and cough.
How can I tell if I have a cold or the flu? Which symptoms belong to which disease?
Influenza has fairly predictable symptoms. In the beginning it starts off something like a cold with upper respiratory symptoms, like a runny nose, and a non-productive cough and scratchy throat but very rapidly and suddenly progresses to high fever and very prominent headache, chills, and muscle aches. The fever lasts about three days or so, and the whole thing usually only lasts about five to eight days. Colds tend to come on gradually and are usually distinguished by a runny nose and sneezing.
What can I do to ward off colds?
- Wash your hands
- Limit exposure to infected people
- Practice healthy habits such as eating a balanced diet, getting enough sleep, and exercising regularly
- Drink plenty of water and rest
What are the different cold remedies and how do I know which to take?
Decongestants:
Decongestants make breathing easier by shrinking swollen mucous membranes in the nose, allowing air to pass through. They also help relieve runny nose and postnasal drip, which can cause a sore throat.
Expectorants:
Expectorants help thin mucous and make it easier to couch mucus up when you have a productive cough. Look for expectorants containing guaifenesin.
Suppressants:
Suppressants control or suppress the cough reflex and work best for a dry, hacking cough that keeps you awake. Look for suppressant medications containing dextromethorphan.
Antihistamines:
Antihistamines dry up nasal secretions and are commonly used to treat allergy symptoms and itching.
Should I take a decongestant or an antihistamine?
This depends on your symptoms. If you have nasal or sinus congestion, then a decongestant can be helpful. If you have drainage – either a runny nose or postnasal drip or itchy watery eyes -- then an antihistamine may be helpful. Over-the-counter antihistamines often make people drowsy; decongestants can make people hyper or keep them awake. Antihistamines can make secretions thick, which can be a problem for people with asthma. Keep in mind that both these medications may interact with other drugs you may be taking for conditions such as heart disease, and they may worsen some conditions. Discuss with your doctor or pharmacist which cold medication may be best for you.
Is it safe to take a decongestant if I have high blood pressure?
Decongestants can increase blood pressure and heart rate, and increase the risk of heart attacks and strokes. Pseudoephedrine is the primary oral decongestant available. In general, if your blood pressure is well controlled with medications, then a decongestant shouldn't be a problem as long as you monitor your blood pressure. This may not be true with certain types of blood pressure medications such as beta-blockers. In these cases, consider nasal sprays. Check with your doctor or pharmacist about what may be best for you.
How often should I use nasal spray?
Nasal decongestants work fast to open breathing passages. But if you use them for more than three days in a row, you may suffer a "rebound effect," and end up more congested than you were at the start. Some doctors suggest using a saline spray instead of a medicated spray. Saline spray works more slowly but has no rebound effect.
What's the deal with cough medicine?
An occasional cough may clear the lung of pollutants and excess phlegm. A persistent cough should be diagnosed and treated specifically. On the shelf you'll find numerous cough medicines with various combinations of decongestants, antihistamines, analgesics/antipyretics, cough suppressants, and expectorants. Ask your pharmacist which combination, if any, would be right for you.
What should I take for fever and aches?
Fever may be a good thing. It helps the body fight off infection by suppressing the growth of bacteria and viruses and activating the immune system. Doctors no longer recommend suppressing fever for most people, except perhaps for the very young, the very old, and those with heart disease or lung disease. However, if you are uncomfortable then it's fine to take medications. Young people (including those in their early 20s) should avoid aspirin. Acetaminophen or the numerous other medicines like ibuprofen are your best choices. Each has their own risks, so check with your doctor or pharmacist as to which may be best for you. Be careful not to overdose! These drugs are often mixed in with other cough and cold and flu remedies you may also be taking. Your pharmacist can help you make the right choice.
What's best for my sore throat?
Medicated lozenges and gargles can temporarily soothe a sore throat. An FDA advisory panel has said that these ingredients are safe: benzocaine, hexylresorcinols, menthol, and phenol and sodium phenolate compounds. The panel suggests you avoid aspirin chewing gum. There's insufficient evidence that topically applied aspirin relieves pain, and it may irritate mucus membranes. Don't use lozenges or gargles for more than a few days. The medications could mask signs of strep throat, a bacterial infection that should be treated with antibiotics.
If you have specific questions, contact your doctor or pharmacist
