Cold, Flu and cough

types of humidifier

- Ultrasonic humidifiers - Impeller humidifiers - Evaporative humidifiers - Steam humidifiers (vaporizer)

treat what sx of cold

-nasal -sore throat -cough -fever

SX of common cold

1-3 post viral contact day 2: sneezing, followed by rhinorrhea fever- low grade days 4/5 infrequent symptom 20% non productive tiredness, shivering, fever

Special populations Diabetics Pediatrics

Diabetics - avoid products with sugar and alcohol - Sugarfree-Naldecon®SeniorDXorEX;diabetictussin - Alcohol free - numerous; Delsym® • Pediatricpatients-dosingbasedonweight - All pediatric cough and cold products voluntarily withdrawn from the OTC market - Less than 2 years, always refer to MD - > 2 yo, nasal congestion can be treated best with a nasal aspirator, saline drops, head elevation, vaporizer/humidifier - Avoid alcohol-containing products

Cool mist humidifier evaporative

Evaporative (wick) humidifier - use a wick, filter, belt to absorb water - fan allows water to evaporate and disperse

Alternatives

Hypotonic Sodium Chloride solutions • 0.65% drops/sprays (AYR®, Ocean®) • Rehydrate nasal mucosa and liquefy dry secretions for easier removal of dry nasal crusting during dry seasons • Drug of choice for pregnant women

Pseudoephedrine

Immediate release vs. extended release • Dosed up to 240mg daily • Caution - used in illegal manufacturing of methamphetamine and methcathinone

Homeopathy

Large doses of drugs that produce symptoms of a disease in healthy people will cure the same symptoms when given in extremely small doses - Oscillococcinum® - contains extremely diluted constituents of autolysed duck heart and liver, with literally no "active" ingredient detectable - Place pellets under tongue = sublingually - Dissolve one tubule every 6 hours up to 3 times a day; do not use for longer than 3 days

prevention of cold/flu getting sick

Proper hand washing - avoid rubbing eyes or placing in nose or mouth Lysol kills >99% of rhinovirus after 1 minute - antiviral tissues - no prophylactic treatment or cure for colds exists

Vitamin C

Proposed mechanism - antioxidant properties neutralize the large amounts of oxidizing compounds released by neutrophils • Some studies have shown that large doses 1-4 grams/day can decrease the duration and severity of symptoms by 10-29%

what is one virus we should know that causes the common cold

Rhinovirus

Decongestants

Sympathomimetic amines that activate alpha-adrenergic receptors in nasal blood vessels to cause contraction of the smooth muscle of the nasal blood vessels, facilitating breathing • Reduces blood supply to the nose • Dry up postnasal drip - may alleviate sore throat Use • Treat sinus and nasal congestion

Cool mist humidifier ultrasonic

Uses high frequency waves to vibrate metal diaphragm that breaks water to micro-fine cool mist

secondary mode of transmission

aerosol transmission

warm mist humidifiers steam humidifiers (vaporizers)

heating elements that boils water into pure steam

flu season

late November through early April HA more aches and pain up to 2-3 weeks more chill and sweating sometimes sneezing and stuffiness

Zinc

lozenges/lollipops/gum (COld-Eaze, Zicam) -Controversial efficacy; mechanism unclear but thought to inhibit viral binding to epithelial cells in the upper respiratory tract - Formulation important - addition of citric or tartaric acid in some preparations may chelate the zinc ion, reducing efficacy - Dose - one lozenge every 2 hours while awake and continue for the duration of the illness - Adverse effects - unpleasant taste, mouth irritation nausea - Drug interactions - avoid citrus products 1 hour around dose

Sore throat OTC tt

not to be used in less than the age of 2 no useful antiseptics if persistent more than 2 days along with fever, rash etc.. doctor

sinusitis vs common cold

rhinorrhea with pus filled mucuc, HA, sinus pain impaired taste and smell, localized pain and tenderness

Allergic rhinitis vs common cold

rhinorrhea, nasal congestion, sneezing, nasal pruritis same- runny nose and sneezing no itchiness in throat or malaise if you have allergies

primary mode of transmission

self inoculation

Cool mist humidifier impeller humidifier

uses high speed rotating disk submerged in water spins water towards diffuser to release fine mist no replacement filters needed

warm versus cool

warm can add medicated inhalants can cause burns cool water is not boiled higher chance of spreading bacteria, mold, minerals into air airborne particles can irritate lungs no risk of accidental burns safer if young children are present

Systemic analgesics

• Aspirin • Ibuprofen • Naproxen Systemic Analgesics • Acetaminophen • Used to treat the following symptoms of colds/flu - Fever - Aches (body aches and headaches) - Sore throat

Sore throat products

• Benzocaine - blocks initiation and conduction of nerve impulses via Na ions • Menthol/phenols - produces cooling sensation for comfort in sore throats • Dyclonine - blocks impulses at peripheral nerve endings in skin and mucous membranes • Precautions/education-- Pregnancy category C • Avoid eating/drinking 1 hour following treatment (anesthetics) • Provide temporary relief • May be used every 2-4 hours

Classes of medication that treat cold/flu/cough

• Decongestants • Antihistamines • Expectorants • Antitussives • Analgesics and Antipyretics • Anesthetics

Nasal symptoms

• Edema, clear and watery rhinorrhea • Inflammation of mucous membranes and thickening of the turbinates causes narrowing of the airways • Patient can only treat nasal congestion caused by the common cold, allergic rhinitis, or associated with sinusitis

topical sore throat products

• Lozenges - hard molded candies whose local anesthetics are released as they dissolve in the mouth • Liquids - spraying, swishing, or gargling for 1 minute (or 15 seconds for phenol/phenolate sodium) then expectorate; repeat QID; (not as effective since contact is limited to the oral cavity)

exclusions to self tt cold/flu

• Persistent sore throat or cough > 7 days • Cough with thick yellow sputum or green phlegm • Fever ≥ 101 oF (38.6 oC) • Difficulty breathing, wheezing, SOB • S/sxs of bacterial infections

non rx tt

• Rest and maintain adequate fluid intake • Maintain nutritious diet • Humidification • Upright positioning • Saline gargle or nasal irrigation • Bulb syringe for infants and toddlers • Quit smoking

Sore throat etiologies

• Streptococcal pharyngitis "strep throat" - sore throat caused by streptococcal infection • Usually caused by beta hemolytic strep group A • Symptoms - extremely red and painful, sudden onset, accompanied by fever, headache, enlarged tender lymph nodes, and tonsilar exudate • NO concurrent cough or rhinorrhea as in common cold Post-nasal Drip