WELL Duquesne University Mylan School of Pharmacy
UPDATE from the Center for Pharmacy Care
The Common Cold Relief But No Cure
he common cold is an upper respiratory tract infection. Even though symptoms such as runny nose, sneezing, congestion, sore throat and cough are usually mild, the common cold is the leading cause of doctor visits and missed days from work and school.
Transmission and Prevention More than 200 viruses are known to cause the common cold. There is no evidence to support the belief that a person can catch a cold by going outdoors with wet hair, or by getting chilled or overheated. However, research does suggest that stress and allergic diseases that affect the nose or throat may increase the number of colds a person contracts. Transmission of cold viruses occurs by touching germ-containing surfaces, such as telephones or doorknobs, then transferring those germs to the mouth, eyes or nose where they enter the body. To prevent colds, wash hands frequesntly, cough or sneeze into tissues, and avoid close, prolonged contact with anyone who has a cold.
Is it a cold or the ﬂu?
Seek medical advice if…
Symptoms of the common cold usually include nasal congestion, sneezing, sore throat, cough and occasional headache. Typically, recovery from the common cold occurs within a week. On the other hand, the ﬂu (also known as inﬂuenza) exhibits slightly different symptoms, which are illustrated in the chart below.
• You have a fever greater than 102°F, accompanied by aches and fatigue or by sweating and chills • A sore throat persists for several days • Symptoms worsen • Signs and symptoms of bacterial infection develop – thick nasal discharge (that is NOT clear), temperature higher than 101.5°F, chest congestion or signiﬁcant ear pain
Headache General aches, pains Fatigue, weakness Extreme exhaustion Stuffy nose Sneezing Sore throat Chest discomfort, cough
Rare Slight Quite mild Never Common Usual Common Mild to moderate hacking cough
Usually high-grade (102-104°F); last up to four days Prominent Usual; often severe Can last up to three weeks Early and prominent Sometimes Sometimes Sometimes Common; can become severe
(Source: FDA Consumer magazine, October 1996)
Mark Your Calendar WELLNESS MONDAYS • Nov. 14 & 28, Dec. 5 & 19, 2005, 9:00 a.m.-1:00 p.m. BLOOD PRESSURE SCREENING • Nov. 30 & Dec. 14, 2005, 11:00 a.m.-1:00 p.m. Location: Union Concourse, 3rd Floor
All events held in the Center for Pharmacy Care, Room 320 Bayer Learning Center, unless otherwise noted.
ATTENTION LIGHTEN-UP PARTICIPANTS! If you completed Lighten Up in June 2005, you are eligible to participate in the “Maintain Your Weight” Challenge. Please contact x5874 to schedule a weigh-in during Wellness Monday. The ﬁnal weigh-in will be during the week of December 4, 2005.
CENTER FOR PHARMACY CARE — Wellness Mondays
TOBACCO CESSATION PROGRAM
The Center offers the following complimentary screenings on Mondays by appointment: bone density, body composition analysis, facial skin analysis & cholesterol screening. Please call x5874 for an appointment.
The Center for Pharmacy Care offers a ﬁve-week program. Any employee or student interested in joining a group to quit tobacco should call x5874. Dates will be determined after sign-up. www.duq.edu
The Common Cold–Relief but no cure Treatment Options There is no cure for the common cold and preventive vaccines are unavailable because of the difﬁculty in developing individual vaccines for the hundreds of virus strains that can cause a cold. While drinking plenty of ﬂuids, resting in bed, and gargling with warm salt water may provide some relief, there also are pharmacological ways to treat common cold symptoms. Several over-the-counter medications are available. However, they will not prevent or shorten the length of the common cold. In addition, because most of these medications can produce adverse effects such as dizziness, drowsiness, insomnia, and/or upset stomach, they should be taken with care. Mild pain relievers such as acetaminophen (Tylenol®) or ibuprofen (Motrin®) can be taken for fever, sore throat and headache. Oral decongestants such as pseudoephedrine (Sudafed®, Drixoral®, etc.) or topical intranasal products such as oxymetazoline (Dristan 12-hour Nasal®) and phenylephrine (Vick’s Sinus Ultra Fine Mist®) are used to relieve nasal congestion. Phenylephrine also is included in some oral products (e.g. Sudafed PE®), but its efﬁcacy in standard doses is questionable. Patients with hypertension should use these products cautiously. Side effects of pseudoephedrine include dizziness, restlessness, anxiety and insomnia. Antihistamines like diphenhydramine (Benadryl®) may help treat a runny nose and reduce sneezing. Antihistamines are often included in nighttime or “PM” formulations because they frequently cause sedation. The non-sedating antihistamine loratidine (Claritin®) is available without a prescription. However, its beneﬁt in reducing nasal discharge and sneezing is controversial. Combination products that contain the active ingredients mentioned above as well as those used to treat cough are available to combat multiple symptoms. Be sure to check the active ingredients listed in the product to ensure it contains only the medications needed to treat current symptoms. Vitamin C, zinc and a host of dietary supplements, such as Echinacea, have been recommended for treatment and prevention of colds. However, there is still little evidence that these substances provide any consistent beneﬁt.
Why not use an antibiotic?
The Centers for Disease Control and Prevention (CDC) calls antibiotic resistance “one of the world’s most pressing public health problems.” Antibiotics are only effective for treating disease caused by a speciﬁc bacterial entity – they have no impact on those of viral origin. A culture test is the only way to diagnose a bacterial infection. Antibiotic resistance occurs when these drugs are prescribed for inappropriate indications (such as viral infections) or are not taken for a full course of therapy. This results in bacteria strains that linger and gain resistance to the antibiotic. Annually, tens of millions of antibiotic prescriptions are ﬁlled for viral illnesses, resulting in more treatment-resistant infections and wasteful healthcare expenditures.
Types of Coughs Typically, throat pain and irritation are the ﬁrst symptoms of a cold. Nasal complaints predominate shortly thereafter, followed by cough. During the course of a cold, the cough is usually “productive” — meaning that it helps expel mucus containing the offending agent or virus. The cough may be described as wet or “chesty” and should be permitted to run its course. Conversely, a non-productive cough frequently remains once a cold has ended. Characterized as dry or hacking, this variety is caused by a reﬂex that may be suppressed.
Cough Treatments Hydration is the best way to alleviate a productive cough. Guaifenesin (Mucinex®,
Newsletter Contributors John G. Lech, Pharm.D. Barbara Schmitz, Pharm.D. Candidate Jennifer Huber, Pharm.D. Candidate
For additional information about cold and cough, visit the following Web sites: • www.medlineplus.org
Robitussin®, etc.) is the only product that may provide relief while allowing the cough to serve its purpose. It may be obtained either over the counter or by prescription. With adequate water intake, Guaifenesin acts as an expectorant to thin mucosal secretions and clear pulmonary airways. Dryness increases mucus viscosity, so room humidiﬁers also may be beneﬁcial. Antitussives, which are available without a prescription, all contain dextromethorphan. This substance relaxes the reﬂex that stimulates nonproductive cough. Some examples include: Robitussin Extra Strength®, Delsym® and Vicks 44 Cough Relief®. Narcotic cough suppressants may be prescribed by your doctor, but should be used cautiously, as they can exacerbate breathing problems or initiate mood disturbances. Another common antitussive available by prescription, benzonatate (Tessalon®), is a nonnarcotic alternative that is chemically related to local anesthetics.
See a doctor if a cough is… • Experienced by any child younger than two years old • Persistent (lasting more than seven days) or recurrent cough • Accompanied by a fever • Producing yellowish/greenish sputum • Chronic (e.g. smokers, asthma/chronic obstructive pulmonary disease/bronchitis/ emphysema sufferers) • Exacerbated by the use of an ACE inhibitor (e.g. Capoten®, Vasotec®, etc.) to lower blood pressure, as dry coughs are a common side effect
A publication of the Duquesne University Mylan School of Pharmacy Center for Pharmacy Care & Pharmaceutical Information Center Additional information may be obtained from the Pharmaceutical Information Center by calling x4600 or sending an e-mail to email@example.com. Questions about screenings or programs: Christine O’Neil, Pharm.D, B.C.P.S. , x6417 11/05 307799 CG