Brrrrr it's cold outside, common cold that is! Josh and Jennifer, the mom on drugs, tackle a brisk topic as they delve into the world of the virus and why these pesky bugs tend to come around this time of year!
- Intro
- 1 billion cases occur in United States annually
- One of top five illnesses in U.S.
- Adults: 2-3 colds/year; children: 6 or more/year
- Colds may occur at any time of year but more common in winter months
- What it is
- Viral infection of upper respiratory tract
- Most caused by rhinoviruses but may also be caused by coronavirus and adenovirus
- Represents 60% of all disorders with nasal stuffiness/discharge as primary complaint (Patient Assessment in Pharmacy – chapter 7)
- Onset is typically slow – symptoms progress over 12-36 hours and last 5-9 days (Patient Assessment in Pharmacy)
- Transmission due to contact with nasal secretions/saliva of infected people (Am Family Physician) through direct contact, coughing, sneezing, or talking (Postgrad Med)
- Symptoms (Patient Assessment, Handbook of OTC Drugs
- Sore throat
- Nasal symptoms
- Low-grade fever not common; may occur more in children – typically not higher than 100.4 degrees F orally
- General malaise
- What to do about it
- Treatment goals (Handbook of Nonprescription Drugs)
- No cure, so goals are to reduce symptoms and prevent transmission to others
- Antibiotics ineffective against viral infections
- Preventive measures (American Family Physician)
- Good hand hygiene
- Preventive practices with little or no effectiveness:
- Ginseng
- Echinacea
- Vitamin C or D
- Probiotics
- Water gargles
- Recommended Treatment
- Nonpharmacologic therapy (evidence of efficacy lacking)
- Vaporizers/humidifiers
- Breathe Right nasal strips
- Aromatic oils (e.g., Vicks VapoRub) – may ease nasal congestion – use cautiously in children as oils can irritate eyes and skin and accidental ingestion can lead to toxicity
- Nasal aspirators/bulbs for babies and young children who cannot blow nose (4 years and younger)
- Analgesics
- No aspirin use in children
- Acetaminophen
- NSAIDs
- Local anesthetics
- Benzocaine (not in children < 2 – causes methemoglobinemia), dyclonine
- Lozenges, sprays for sore throat – temporary relief
- Intranasal ipratropium
- Decongestants with or without antihistamines
- Oral decongestants
- Phenylephrine
- Pseudoephedrine (behind the counter)
- Nasal decongestants
- Topical efficacy
- Limited use to 3 days due to risk for rebound congestion
- Zinc
- High zinc concentrations may block adhesion of human rhinovirus to nasal epithelium and blocking viral replication but in vitro data may support only modest antiviral effect
