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Posts Tagged ‘Medications’

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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pain relief medications

Does your back ache? Do you have a headache, toothache or sprained ankle? What medication should you choose for pain relief?

In most cases these types of pain are common and can be treated with over the counter pain medications which make up a $2 billion a year industry. The few basic medications available to treat your pain must be chosen wisely and you must be aware of the possible side effects of these drugs so that they don’t cause more harm than good.

The potential for harm rises with increasing doses of the medication and in taking it for long periods of time. The elderly and those with chronic medical conditions face a greater chance of experiencing troublesome side effects.

In spite of the pharmacy shelves being filled with a mind boggling combination of available pain relieving drugs, they are really all made up of any one of the following types of drug:

Acetaminophen (Tylenol)

This is probably the safest of the drugs when taken at the recommended doses. It is classified as an analgesic (pain reliever) as well as a fever reducer. It can be used by all ages, except infants under 3 months old. It can have a toxic effect on the liver and should be used very cautiously, if at all, by those with liver disease or those who drink more than three alcoholic beverages a day. A big advantage of acetaminophen over the others is its tendency not to irritate or harm the stomach. It can be taken if one is also taking a blood thinning medication. Follow the dosing directions carefully.

Ibuprofen (Advil, Motrin IB)

This is called an anti-inflammatory analgesic because it acts not only on most any type of pain but also on inflammation. Many people use this medication for relief of soft tissue aches and pains associated with vigorous exercise or hard physical labor. Like acetaminophen, it is very effective as a fever reducer for young and old. Do not use in infants under six months of age without consulting your doctor.

Unlike acetaminophen, it does not harm the liver in recommended doses, but, it can be very irritating to the stomach possibly leading to bleeding and/or stomach ulcers. Long term high dose usage has been linked to increase risk of heart and kidney disease. It should not be taken while taking a blood thinning drug.

Naproxen Sodium (Aleve)

This is also an anti-inflammatory drug taken for the same indications as ibuprofen. It can be taken less frequently than ibuprofen and still achieve the same benefit. It causes similar side effects to ibuprofen with perhaps less likelihood of stomach and kidney problems.

ASPIRIN (Bayer, Excedrin)

This time-honored drug is also an anti-inflammatory, analgesic, and fever reducer. Under the care of a physician, it is now being used in a low dose to help prevent heart disease. It’s cheap and plentiful, but has more potential side effects compared to the others. It is more frequently associated with stomach irritation and bleeding. It is not recommended in children less than 16 years old. Because of the potential side effects, I personally would not take aspirin to treat routine pain unless there was no other choice.

The bottom line is that if you have mild pain for whatever reason, any of the above drugs could be helpful, but results vary for each individual. Pay close attention to the various side effects which I have listed and which can be found on the medication label. Be sure to see your doctor if you get no pain relief from these commonly used mentioned medications or if your pain lasts more than a few days.

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Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being largely withdrawn from pharmacy shelves. This is because of unintentional misuse or 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 in which the risks outweigh the benefits.

Health care providers are now asked not to advise the use of such drugs for children younger than 6. Some of the most common are PediaCare, Triaminic and Dimetapp.

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

• Encourage the drinking of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus formation.

• Control high fever or pain with either acetaminophen (Tylenol) or ibuprofen (Advil), giving doses once every six hours.

• Saline irrigation can be helpful for a congested or drippy nose. For infants, use rubber bulb suction to remove nasal secretions after applying saline nose drops or spray, or try sinus rinsing for older children.

• Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water inside should be replaced daily and the machine should be cleansed regularly according to the manufacturer’s recommendations. If possible, maintain indoor relative humidity between 40 percent and 50 percent.

• If a medication such as Tylenol or Advil is given, I do not advise the use of household kitchen spoons to measure doses of medication. Measuring devices that use units of milliliters (mLs,) usually are packaged with the medicine or can be obtained from a 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, one teaspoon for children 6 to 11 years, and two teaspoons for children 12 and older. Do not give honey to a child younger than 1.

Sometimes, a visit to a doctor is called for. See your health care provider immediately for the following cases:

• A child younger than 2 months of age with any fever

• A child younger than 2 years of age with a fever lasting more than two or three days

• A child who complains of an earache or a severe sore throat

• Thick green nasal discharge that continues for more than seven to 10 days

• Mild symptoms that do not improve after 10 to 14 days

• A child who seems very ill to you

By the way, for children who have appropriately been prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated.

The two most commonly prescribed antibiotics — amoxicillin, which tastes like bubble gum or occasionally is fruit-flavored, and azithromycin (Zithromax), which has a cherry/vanilla/banana taste — can be kept at room temperature for up to 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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