#4 Common Cold

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