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Posts Tagged ‘guaifenesin’

Sinuses are air pockets found in the bones of the skull. There are seven sinuses which are located on both sides of the nose, in between the eyes, and one deep behind the nose. Their true function is not well understood, but some have suggested that sinuses serve to lighten the weight of the skull, to humidify the air we breathe and to create resonance in our voices.

Acute sinusitis is an inflammation of the sinuses. This in turn causes the lining of the sinuses to become swollen. The swelling interferes with drainage of sinus fluid, thus filling up the space, which causes the typical pain. It is usually triggered by the common cold virus and less often by seasonal allergies (hay fever).

Sinus infections affect more than 30 million adults in the U.S. every year and cost the health care system about $3 billion to diagnose and treat.

Those who experience hay fever or any allergic condition that affects the sinuses are more at risk for sinusitis. Risk factors also include exposure to pollutants, such as cigarette smoke, and nasal passage abnormalities, such as a deviated septum or nasal polyps.

Common symptoms of a sinus infection are:

* Nasal obstruction with drainage of thick yellow or green mucus

* Pain, tenderness, swelling and pressure around the eyes or aching in the upper teeth

* Reduced sense of smell and taste

* A cough, often worse at night

If the above symptoms are combined with a fever greater than 100.5 degrees Fahrenheit, unbearable facial pain, or swelling and redness around the eyes and nose, that’s a reason to see a doctor immediately for a possible sinus infection.

Recommendations for treatment to relieve the symptoms include:

* Saline nasal irrigation: Over the past few years, since I have become familiar with this treatment, I have seen countless patients with sinus infections that might have needed antibiotics cure their infections with saline irrigation. “Neil Med” sells a rinsing system for less than $15 and can be found at all pharmacies.

* Decongestants: This includes over-the-counter medication, such as Sudafed. (Have the pharmacy tech help you find the generic alternative with the ingredient “pseudoephedrine.”) There are also nasal sprays, such as Neo-Synephrine or Afrin, either of which should be used for no more than one week. Remember to always read the labels on medications before using them.

* Nasal steroids:. These medications, which can be obtained with a doctor’s prescription, include Flonase and Nasonex, among others, and are used to prevent and treat nasal inflammation.

Because sinusitis is usually caused by a virus, my advice for those who have symptoms of a sinus infection is to treat the symptoms as outlined above for a week or two. Then, if symptoms worsen or do not improve, see a doctor.

When you do so, don’t expect or ask to be prescribed antibiotics. Just tell the doctor your symptoms and let him or her examine you and offer the treatment he or she feels is in your best interest. This might or might not include antibiotics. Trust your doctor’s advice.

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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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