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Posts Tagged ‘Cold and flu’

ColdFluMeds

With the cold and flu season approaching, I want to repeat an article I did several years ago about what over the counter medications are available to help alleviate the miserable symptoms of the winter illnesses.  Almost all of the hundreds of products available over the counter contain at least one or a combination of the following ingredients:

  • Tylenol (acetaminophen) or Advil (ibuprofen) for aches and pains
  • Sudafed with either pseudoephedrine or phenylephrine, a decongestant
  • Guaifenesin an expectorant (thins mucus)
  • Dextromethorphan a cough suppressant
  • Antihistamines such as diphenhydramine or chlorpheniramine

We could probably get by with only five different bottles of cold medications on those pharmacy shelves, each containing one of the above medications. I think that taking these drugs individually rather than in combination is better so that one can tailor one’s symptoms to a specific medication and avoid taking something that might not be necessary.  Always read the label on the medication package to check on potential interactions with drugs you may already be taking and to know the possible side effects or warnings.

Here’s how these drugs work.  Tylenol or Advil work equally well for relieving the aches and pains of an illness as well as helping to reduce a fever. Read the directions carefully. The maximum daily dose for acetaminophen is 3000 mg. per 24 hours.

Sudafed, for those who do not have high blood pressure, may be helpful to relieve the swelling of the nasal/sinus passages and to relieve the pressure in the ears due to blocked eustachian tubes. Sudafed with the main ingredient pseudoephdrine, has changed from over the counter to behind the counter and it will need to be signed out for purchase through the pharmacist. It’s probably worth the effort. Sudafed with ingredient phenylephrine can still be purchased over the counter but may be a bit less effective than the pseudoephridine.

Guaifenesin is an expectorant which means it helps to thin out mucous in the nose and sinuses, as well as in the lungs, which makes it easier to either blow out or cough up the mucous.  Dextromethorphan is a cough suppressant which should help at least a little to lessen one’s cough. Honey has also been found to be effective in slowing down a cough. Neither of these remedies is strong enough to actually stop a cough and will not interfere with the healing process.

Antihistamines are really most useful for the symptoms of allergies like hay fever, but they may help colds by slowing down mucous production.  Perhaps they help most by their side effect of drowsiness, thereby helping one to sleep.

Another highly effective way to decongest the nose and sinuses is to perform sinus rinsing using either a netti pot or my preferred method, a Neil Med sinus rinsing kit found at most pharmacies. I have found rinsing to be highly effective to alleviate sinus symptoms and to even treat or prevent sinus infections.

In Summary:

  • For aches and pains from a cold or flu, use Tylenol or Advil.
  • For stuffy nose, sinus congestion or plugged ears use Sudafed.
  • To loosen mucous use guaifenesin such as Mucinex or Robitussin.
  • To help slow down a cough, use a medication with dextromethorphan, such as Robitussin DM or Vicks 44, or try a couple tablespoons of honey in a hot beverage.
  • Get plenty of rest and drink lots of liquids.

Closely follow the directions for proper dosage found on the medication labels.

These are some basic guidelines for choosing medications for the symptomatic relief of common cold and simple flu. I have to admit the effectiveness of these drugs is somewhat limited but worth trying. Adequate rest, liquids, and time still play a major role in recovery from these miserable conditions.

See your health care provider if you have a fever for more than 4-5 days, if you have a fever of more than 103 degrees, or if you have any significant concerns about your illness.

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Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being withdrawn from pharmacy shelves. This is because of unintentional misuse or of overdose of these medications, causing harm and, rarely, death, especially in children younger than 2.

These medications are frequently used in good faith, even though there is no scientific proof that these drugs are actually effective. This is a case where the risks outweigh the benefits.

Health care providers are now asked to advise not using these drugs for children younger than 6. Some of the most commonly used drugs in this category are PediaCare, Triaminic and Dimetapp.

I know this may sound discouraging when caring for a sick child, but there are very useful non-drug treatments for cold and cough symptoms:

  • Encourage the child to drink plenty of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus. The fat in milk does combine with saliva in the mouth, causing a slimy sensation, but that’s not harmful.
  • Fever or pain can be controlled using either acetaminophen (Tylenol) or ibuprofen (Advil), giving accurate and consistent doses every six hours.
  • Saline irrigations: For infants, use rubber bulb suction with saline nose drops to remove mucus. A saline nose spray can be used for older children.
  • Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water should be replaced daily and the machine cleansed regularly according to the manufacturer’s recommendations. Keep indoor relative humidity at about 40 percent to 50 percent
  • If a medication such as Tylenol or Advil is given, I do not advise the use of household silverware spoons to measure doses of medication. Common teaspoons can vary, holding anywhere from 2 to 10 milliliters (mLs) of liquid, which could cause either an under- or overdose of a medication. Proper measuring devices using units of milliliters usually come with the medicine or can be obtained from the pharmacist.
  • Honey can relieve coughs by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, 1 teaspoon for children 6 to 11 years, and 2 teaspoons for children 12 years and older. Do not give honey to a child younger than 1 year old.

See your health care provider immediately for any of the following cases:

  • A child younger than 2 months of age with any fever
  • A child younger than 2 years with a fever that lasts longer than two or three days
  • A child who complains of an earache or a severe sore throat
  • A child who has thick green nasal discharge for more than 2 weeks
  • Mild symptoms that fail to improve after 10 to 14 days
  • Any child who seems very ill to you

By the way, for children who have been appropriately prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated. The two most commonly prescribed antibiotics, Amoxicillin (which tastes like bubblegum or occasionally is fruit-flavored) and Zithromax (which has a cherry-vanilla-banana taste), can be kept at room temperature for as long as 10 days. Refrigeration may improve the taste, but it isn’t needed to maintain potency.

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I recently walked into one of our local pharmacies and I was amazed to see the tremendous number of cold and flu medications filling the shelves. It made me realize how confusing it must be for anyone to decide which of the medications to use.

In this article, I would like to help simplify the selection process. Almost all of these hundreds of products contain at least one of the following ingredients:

  • Acetaminophen or ibuprofen, for aches and pains
  • Pseudoephedrine, a decongestant
  • Guaifenesin, an expectorant
  • Dextromethorphan, a cough suppressant
  • Antihistamines, such as diphenhydramine or chlorpheniramine

We could probably get by with only five different bottles of cold medications on those pharmacy shelves, each containing one of the above medications. I think that taking these drugs individually rather than in combination is better so that one can tailor one’s medications to specific symptoms and avoid taking something that might not be necessary. Always read the label on the medication package to check on potential interactions with drugs you might already be taking and to know the possible side effects or warnings.

Here’s how these drugs work. Acetaminophen or ibuprofen work equally well for relieving the aches and pains of an illness as well as helping to reduce a fever.

Pseudoephedrine, for those who do not have high blood pressure, is fairly effective as a decongestant to help relieve swelling of the nasal and sinus passages and to relieve pressure in the ears due to blocked eustachian tubes. Sudafed has changed from over the counter to behind the counter and will need to be signed out for purchase through the pharmacist. It’s probably worth the effort. Guaifenesin is an expectorant, which means it helps to thin out mucus in the nose and sinuses as well as in the lungs, which makes it easier to either blow out or cough up the mucus.

Dextromethorphan is a cough suppressant, which should help a least a little to slow down one’s cough. It is not strong enough to stop a cough and will not interfere with the healing process. Antihistamines are really most useful for allergies like hay fever but they may help colds by slowing down mucous production. Perhaps they help most due to their side effect of drowsiness, which can help one get to sleep. I will discuss the newest guidelines for treating routine upper respiratory infections in infants and children in the near future. The following information restates the advice I gave in my prior article on Influenza.

In summary:

  • For aches and pains from a cold or flu, use Tylenol or Advil.
  • For stuffy nose, sinus congestion or plugged ears, use Sudafed.
  • To loosen mucus, use guaifenesin such as Mucinex or Robitussin.
  • To help suppress a cough, use a medication with dextromethorphan, such as Robitussin DM or Vicks 44.
  • Get plenty of rest and drink lots of liquids.

These are some basic guidelines for choosing medications for symptom relief of the common cold and simple flu. See your health care provider if you have a fever for more than four or five days, if you have a fever of more than 103 degrees, or if you have any significant concerns about your health.

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