Cold Season.

It’s that time of year again, the sun has gone away, the pools are closed, and the kids are back in school.  Rhinovirus and Coronavirus are making their way into our nasal passages and onto our hands and spreading rapidly.  I’m talking about the Common Cold.  The dreaded sore throats, runny noses, and fevers that plague us for anywhere from 7-10 days all the way to 3 weeks in more severe cases.  Sadly there is no cure for the common cold, but there are plenty of over the counter and prescription medications available to ease your suffering.

Antibiotics won’t work on a virus, so unless you have a secondary bacterial infection your Doctor should not be prescribing you antibiotics for the common cold.  Increased antibiotic use can lead to antibiotic resistance in the community, something all of us in healthcare want to prevent.

The signs and symptoms of the Common Cold may be cough, sore throat, runny nose, nasal congestion and sometimes fever.  Fever can also be a sign that you have the flu, but that is another blog for another time.  If your symptoms are severe or you feel that you have the flu, please contact your physician.  If you have a cold or flu it’s best to stay home from work.  If you must work, avoid shaking hands with others, wash your hands regularly, and cover your nose and mouth if you have to sneeze or cough.  Colds are very contagious during the first 3 days after infection and then taper off from there.

The common cold can be caused by over 200 different viral strains and is nearly impossible to gain complete immunity from.

What are the risk factors for getting a cold you may ask?

  • Touching eyes, nose, or mouth with contaminated fingers.
  • Spending time in an enclosed space with infected people.
  • A history of smoking (increases duration of sickness by more than 3 days!)
  • Lack of sleep (you must sleep more than 7 hours a night to increase your resistance to the cold)
  • There is conflicting evidence to suggest that cold weather or getting a “chill” can lead to you getting a cold.  Cold weather does not decrease your immune response.
  • People with stronger immune systems are actually more likely to develop severe symptomatic colds.  This may sound like the opposite of what you would think, but symptoms are due to your bodies response to the infection.  Those with a weak immune system may actually show less severe symptoms due to a weaker immune response.

Prevention of the common cold is relatively straightforward.  Avoid people who are infected and places where infected people have been.  Regular hand washing is critical in preventing the cold and the flu.  When washing hands, any soap will do, it’s actually the action of rubbing the hands together with a soap, rinsing, and drying that removes the virus.  Antibiotic soaps are not a requirement.  Alcohol based sanitizers do little to prevent the common cold.

I remember Paul Harvey on the radio saying around cough and cold season that we should all replace the handshake with a friendly salute.  It would do wonders to prevent the cold and flu from being transmitted person to person.  If you catch me saluting you instead of shaking your hand please don’t be offended, I am just doing my part.

So all this fun stuff aside, you now have the cold, and you feel miserable and you are home from work or school what can you use to treat your symptoms?

Do you have congestion? Then you can use Decongestants, these products relieve the pressure in the sinuses helping you to breath a bit easier.  You can get decongestants in tablet and spray form but the sprays can only be used for 3 days at a time or you may end up with “rebound congestion.”  See your pharmacist or physician if you take medication for high blood pressure, a thyroid condition, and certain antidepressants before taking these medications.  When in doubt about a medication interaction, ask your pharmacist!

Some Examples of Decongestants

Is your nose running or your eyes watering?  Then you most likely need an antihistamine as well.  Antihistamines are the “histamine blockers,” histamine causes the reaction in your body that leads to runny nose and watery eyes.  They are most commonly used to treat seasonal allergies, but may also work for your cold symptoms.  Some antihistamines may cause drowsiness so before you select a product make sure to talk to your pharmacist to determine which one is right for you.  You should not take antihistamines if you have certain bladder conditions or prostate problems.  (Gonna sound like a broken record here) When in doubt about a medication interaction, ask your pharmacist!

Some Example of Antihistamines

If you have a cold you also probably have a cough, your cough may be a dry hacking cough, or a phlegmy moist cough.  Both forms of a cough are treated with dextromethorphan(DM), but the phlegmy cough can also be treated by adding an expectorant along with the DM.  You can also help a phlegmy cough by increasing your consumption of fluids, or running a humidifier at night when you sleep.  Are you taking prescription medications?  Always ask your pharmacist if it is ok before starting a cough suppressant as well, especially if you are taking MAOI inhibitors.

Some Cough Suppressants and Expectorants

Having body aches, sore throat, or a sinus headache associated with your cold?  Then you can also use pain relievers like acetaminophen or ibuprofen.  These products also help to lower a fever as well.  Children under 13 years of age should avoid aspirin and aspirin related products when treating flu like symptoms due to the risk of Reye’s Syndrome.  The best choice for children is still acetaminophen in these situations.  Anti-inflammatory products like ibuprofen or naproxen may also slightly help in situations of congestion because they can help to decrease inflammation in the nasal passages.

Pain Relievers

There are also many non-medicated products available over the counter for the treatment of the common cold.  Nothing can cure the cold but there is some science behind vitamin C and zinc.

Vitamin C has fallen out of favor among most healthcare practitioners for speeding healing of the common cold.   Vitamin C is water soluble, and therefore very hard to overdose on.  We don’t recommend you try that though, keep your doses below 2000mg a day to prevent stomach upset, diarrhea, and cramps.  Vitamin C can interact with some medications as well, so check with your pharmacist if you take anticoagulants, aspirin, barbiturates, sulfa drugs, salicylates or tetracyclines.  You should also watch your consumption of vitamin C if you suffer from gout, kidney stones, sickle cell anemia, or iron storage disease.

Zinc is believed to help speed the healing of the common cold, but there are studies that also show that it is no more effective than a placebo (sugar pill).  Zinc is best taken in a lozenge form as the tablets can lead to stomach upset and nausea, zinc nasal sprays have mainly been removed from the market due to the risk of permanent loss of smell.  For zinc to work correctly you need to take 9-24mg of elemental zinc every 2 to 3 hours.  Zinc products should not be used for longer than 5 days, the most common side effects are temporary loss of taste, metallic taste in the mouth, stomach upset, and mouth irritation.  Long term use of zinc can lead to a copper deficiency, so please keep your usage to 5 days.  Zinc is not recommended for use in children.  Zinc can be toxic if taken incorrectly or in too high of a dose, remember to ask your pharmacist if you have any questions!

Some Examples of Zinc and Vitamin C Products

There are also many combination cold and flu products over the counter that combine many of the more popular medications into one convenient dose.   Since many of these products contain multiple ingredients it is always best to ask your pharmacist which product best suits your collection of symptoms.  Don’t have ready access to your pharmacist?  Make a list of your symptoms and find the product that covers them.  If you don’t have congestion, don’t take a product that has a decongestant, since there is no reason for you to medicate yourself for that symptom.  Many people just prefer to use single symptom products and combine them as necessary to treat their particular mix of symptoms.

Some Examples of Combination Cold Products.

Everyone who has a cold should get plenty of rest, drink plenty of fluids (water, gatorade, juice, etc-dehydration can put you in the hospital), and eat regular meals.  Hang in there, colds can last on average up to 10 days!  If the symptoms last longer than 7 to 10 days or become severe you should make an appointment to see your doctor.

Some facts from the NIH (National Institutes of Health)

  • Colds lead to 75-100 million physician visits annually at a cost of over $7.7 billion a year!!
  • Americans alone spend over $2.9 billion on over the counter drugs, and another $400 million on prescription medicines for symptomatic relief.
  • More than 1/3 of patients who saw a doctor received an antibiotic prescription, this has implications for antibiotic resistance from overuse of these drugs.
  • 22-189 million school days are missed annually due to a cold, this can lead to 126 million lost workdays for parents who stay home to take care of their children.
  • 150 million workdays are missed by employees suffering from a cold!
  • The total economic impact is believed to be over $20 billion per year!  This number accounts for 40% of time lost from work.

My best advice is to practice good hygiene, wash your hands, avoid contact with seriously sick individuals and get plenty of sleep!  Nothing is truly going to prevent you from getting a cold but I hope you don’t get one!

Be Well,

Ron

Blog disclaimer:

Reasonable effort and care have been taken to prepare this blog, and the information provided is believed to be accurate at the time of posting. However, this information is not intended to constitute and “authoritative statement” under food and drug administration rules and regulations. When in doubt please make sure to contact your pharmacist or physician when making dietary changes, or regarding medical treatment and other related issues. This blog is meant to be informative, Spartan Pharmacy asks that you please use this information as a reference and not a replacement for proper medical treatment. Please, leave that to the professionals!

All Photos unless otherwise noted are copyright protected and owned by Ronald P Obringer, any unauthorized use without permission of the owner is strictly forbidden.©Ronald P. Obringer

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