1999. Nidus Information Services, Inc. Well-Connected Report: Colds, FlusCold and Cough Remedies
I.
Common Cold Remedies
A.
Nasal Wash
1.
For common colds and mild allergic rhinitis, a nasal wash can be
helpful for removing mucus from the nose.
2.
A saline solution can be purchased at a drug store or made by mixing
one teaspoon of salt and one pinch of baking soda in a pint of warm water.
3.
One study reported that neither a simple saline nor a commercial
hypertonic saline nasal wash had any effect on cold symptoms.
4.
Some physicians argue, however, that a traditional nasal wash, used
for centuries, is effective and uses no baking soda and more fluid for each dose
and less salt than the saline washes in the study.
5.
The patient leans over the sink head down, pours some solution into
the palm of the hand, and inhales it through the nose one nostril at a time. The
patient spits the remaining solution out and blows the nose gently.
6.
The solution may also be inserted into the nose using a large rubber
ear syringe, available at a pharmacy.
B.
Home Remedies
1.
Plenty of fluids and rest when needed are still the best bits of
advice.
2.
Chicken soup does indeed help colds, but it appears to be the hot
steam that offers the benefit; tea or any hot beverage may have the same
effects. Gargling warm salt water, cough drops, or throat sprays may help
relieve sore throat and reduce coughing.
C.
Mild Pain Relievers
1.
Mild pain relievers, such as aspirin, ibuprofen (Advil), or
acetaminophen (Tylenol) may help mild sore throat and other symptoms.
2.
Although many people take such medications for colds, one study
suggested that these drugs may actually neutralize the body's immune response
against the rhinovirus and even increase nasal symptoms, but the study was very
small.
3.
Acetaminophen or ibuprofen (usually Tylenol, Advil, or Motrin) is the
pain reliever of choice in children.
4.
Aspirin and aspirin-containing products are not recommended for
children or adolescents.
5.
Reye's Syndrome, a very serious condition, has been associated with
aspirin use in children who have chicken pox or flu.
6.
Nasal Strips. Nasal strips (Breathe Right) are placed across the
lower part of the nose and pull the nostrils open. These strips may open the
nasal passages and ease congestion due to a cold or hayfever, although there is
no scientific evidence yet that they offer such benefits.
II.
Cough Remedies
A.
Patients should not suppress coughs that produce mucus and phlegm; it is
important to expel this substance.
B.
To loosen phlegm, patients should drink plenty of fluids, use a
humidifier or steamer. For thick phlegm, patients may try cough medications that
contain guaifenesin (Robitussin, Scot-Tussin Expectorant), which loosens mucus.
C.
For patients with a dry cough, a suppressant may be useful, such as one
that contains dextromethorphan (Drixoral Cough, Robitussin Maximum Strength
Cough Suppressant.)
D.
Medications that contain both a cough suppressant and an expectorant are
not useful and should be avoided. Medicated cough drops that contain
dextromethorphan are not very useful.
E.
A patient is just as likely to find relief from hard candy or lozenges.
F.
Those that contain menthol and mild anesthetics, such as benzocaine,
hexylrescorincol, phenol, and dyclonine (the most potent), may soothe mild sore
throat.
G.
Decongestants and Antihistamines
1.
Many of the same remedies that contain decongestants and
antihistamines for allergy symptoms are also sold for relief of cold symptoms.
2.
Infants and small children should not be given antihistamines or
decongestants, in any case, either as single drugs or in combination, without
the advice of a physician.
3.
Except in special circumstances, combination cold remedies should
generally be avoided.
4.
Some ingredients may produce side effects without even helping a
cold.
5.
In some cases, the ingredients conflict (such as a cough expectorant
and a cough suppressant).
6.
A patient can't increase a particular ingredient in a combination
formula that they might to control one symptom without increasing other
ingredients that do not do any good and may even be harmful at higher doses.
H.
Nasal Decongestants.
1.
Decongestants may help dry nasal congestion, but they should not be
taken for more than one or two days.
2.
They work by shrinking vessels in the nose; by reducing blockage,
they decrease the risk of developing sinusitis caused by viruses or bacteria.
3.
Many over-the-counter decongestants are available, either in tablet
form or as nasal decongestants that are applied directly into the nasal passage
as sprays, drops, or vapors.
4.
Nasal forms work faster than oral decongestants but often require
frequent administration.
5.
Oral decongestants may cause other vessels in the body to constrict,
temporarily raising blood pressure in people with hypertension.
6.
Other side effects of oral decongestants include insomnia, agitation,
abnormal heart rhythms (particularly in people with existing cardiac problems),
and urinary retention in men with enlarged prostates.
7.
Patients should always check the active ingredients in any
nonprescription drug.
8.
Active ingredients in nasal decongestants include oxymetazoline (Sinex
Long-Lasting, Afrin, Sinarest, Dristan 12-Hour, Neo-Synephrine 12-Hour,
Nostrilla, NTZ, Vicks), xylometazoline (Otrivan), phenylephrine (Neo-Synephrine,
Nostril Nasal Decongestant, Sinex), naphazoline (Naphcon Forte, Privine), and
tetrahydrozoline (Tyzine).
a.
Oxymetazoline and xylometazoline are long-acting decongestants; they are
effective in a few minutes and have a significant effect for six to eight hours;
oxymetazoline remains somewhat effective even longer.
b.
Oxymetazoline seems to have little or no adverse effect on blood
pressure, does not overstimulate the nervous system, and is less likely than
other ingredients to cause urinary retention.
c.
Xylometazoline is a similar agent and studies to date indicate that it is
has similar effects.
d.
The short-acting drugs naphazoline and tetrahydrozoline can stimulate the
central nervous system and cause changes in blood pressure. In general, products
with these ingredients should be avoided unless nothing else works.
e.
Phenylephrine is also short-acting but does not stimulate the nervous
system.
I.
Oral decongestants
1.
also come in many brands and contain pseudoephedrine, phenylephrine,
or phenylpropanolamine.
2.
Sudafed, which contains pseudoephedrine, is the only over-the-counter
single ingredient oral decongestant.
3.
Pseudoephedrine has fewer stimulating effects than others.
4.
Phenylephrine is one of the most popular decongestants; it works very
rapidly, lasts from 30 minutes to four hours, and rarely stimulates the nervous
system.
5.
Phenylpropanolamine is a stimulant and may cause changes in blood
pressure.
J.
Antihistamines
1.
Histamine is the chemical released when antibodies overreact to
allergens and is the cause of many symptoms of allergic rhinitis.
2.
The antihistamines relieve itching, sneezing, and nasal discharge.
3.
Many prescription and non-prescription antihistamines are available
and include short-acting and long-acting forms.
4.
They are available in tablet, nasal-inhaler, eye drop, and syrup
form.
5.
Antihistamines are generally categorized as first- and
second-generation. One study indicated that so-called first-generation
antihistamines may reduce cold symptoms; experts postulate that their benefits
for the cold are likely to be due to the drowsiness they cause. The newer
antihistamines do not have these effects and also appear to have no benefits
against colds.
a.
First-generation antihistamines are available over the counter and
include diphenhydramine (Benadryl), carbinoxamine (Clistin), clemastine (Tavist),
chlorpheniramine (Chlor-Trimeton), and brompheniramine (Dimetane). Most
first-generation antihistamines have anticholinergic activity, which tends to
produce a number of side effects -- most seriously, drowsiness and impaired
thinking, which can increase the risk for auto and other accidents.
b.
The second-generation drugs include fexofenadine (Allegra), loratidine
(Claritin), and cetirizine (Zyrtec). Azelastine (Astelin) is the first
antihistamine to be available in a nasal spray preparation, and it can reduce
nasal congestion. Its downsides are a bitter taste, drowsiness, and expense.
Levocabastine (Livostin) is the first antihistamine to be used for relief of
both nasal symptoms and itching and red eyes. (Allegra has also been found to
relieve nasal congestion.) They do not have anticholinergic properties and so
sedation is less severe (although all antihistamines cause some drowsiness).
K.
Supplements and Herbal Remedies
1.
Zinc.
a.
Some, but not all, studies have reported that zinc carbonate lozenges
(Cold-Eeze) reduce the duration of many cold symptoms.
b.
Vitamins. Taking vitamin C and E in standard doses is probably harmless.
Although there is no hard evidence that they prevent colds, one analysis of
studies found that large doses of vitamin C reduced the duration of the cold by
21%.
c.
Echinacea. The herbal remedy echinacea is now commonly taken to
prevent cold and flu symptoms. There are three species: Echinacea (E.) purpurea,
E. pallida, and E. augustifolio. In a recent study, people who took extracts of
either E. purpurea or E. augustifolio experienced no protection against colds. A
few other studies have found benefits with various Echinacea forms, but at this
time there are no standards or quality controls available for echinacea
(including what part of the plant to use) or any other herbal remedies.
References
Cold
Cough Remedy. http://coldcoughremedy.health-selfcare.com/defaults.
© 1996-2001. WebMD
Corporation.
1999. Nidus Information Services, Inc. Well-Connected Report: Colds, Flus