Heart-to-heart conversation on the Common Cold and Upper Respiratory Infections- Best Treatment
We have terrific treatments for
heart failure and cancer with all sorts of diagnostic capabilities including
gene mapping but curative treatment of the common cold largely alludes us.
Many people have upper respiratory infections especially in the spring and fall. Some people also can have allergies that can be confused with a cold and would be treated differently (using antihistamines) than a cold.
Many people have upper respiratory infections especially in the spring and fall. Some people also can have allergies that can be confused with a cold and would be treated differently (using antihistamines) than a cold.
The optimal treatment of a cold is
oftentimes to rest, drink fluids, eat healthy foods and, most importantly,
avoid giving the problem to others. The latter is particularly important and
handwashing, sneezing precautions and simply staying away from others is a
really key issue to being kind to others.
Antibiotics may be needed when someone is immunosuppressed (such
as someone on steroids or someone whose had a kidney transplant) or someone who
has severe underlying heart or lung disease or has a significant pneumonia.
However, antibiotics are vastly over used for colds and upper respiratory
symptoms. Antibiotics can also have
significant side effects including a potentially severe diarrhea called Clostridium
difficile ("C Diff") diarrhea.
Antibiotics can make bacteria resistant to antibiotics when we really need the
antibiotics for serious infection.
Oakland Cardiology
Signs that antibiotics and further workup such as a chest x-ray might be needed include a high fever of over 102-103 degrees and profuse green sputum with cough as the only symptom (that is, no nasal congestion or other symptoms) suggesting this may be pneumonia.
If there are flu-like symptoms with severe muscle aches (feeling like you've been run over by a truck) as well as fever and cough or gastrointestinal symptom, antiviral medicine such as Tamiflu maybe helpful if given within the first 48 hours of symptom onset. On the other hand, if more than 48 hours and passed Tamiflu will not help and over the counter symptom specific medications should be used.
Many people say that they "can't afford to be sick" or "need to get back to work" or that their "cough is been going on for weeks" and that they "need antibiotics". Many doctors or places such as urgent care centers feel like they need to supply antibiotics under these circumstances but if the symptoms are really those of a cold or simple upper respiratory infection then the treatment should be aimed at the symptoms. Symptomatic treatment with over the counter drugs can be helpful. Over the counter decongestants such as pseudoephedrine for runny noses work well during the day but should be avoided if very high blood pressure or fast abnormal heart rate issues and at bedtime because they can interfere with sleep. Acetaminophen may be used for discomfort but at a total dose less than 2000 mg/day.
Combined multi-symptom treatments with over-the-counter drug such as DayQuil or NyQuil may be helpful but often times the patient is best to look on the shelf or consult with the pharmacist to see which of the symptoms is best treated with the over-the-counter medication.
Probably the most common scenario that I see is someone who has a persistent cough that has lasted for 3 to 4 weeks. That is best treated by cough suppressant starting out with dextromethorphan or possibly guaifenesin to help loosen up the cough or mobilize phlegm. If things become extreme, further treatment with prescription drugs such as codeine or nonsedating medicines such as Tessalon Perles may help.
Oakland Cardiology
Signs that antibiotics and further workup such as a chest x-ray might be needed include a high fever of over 102-103 degrees and profuse green sputum with cough as the only symptom (that is, no nasal congestion or other symptoms) suggesting this may be pneumonia.
If there are flu-like symptoms with severe muscle aches (feeling like you've been run over by a truck) as well as fever and cough or gastrointestinal symptom, antiviral medicine such as Tamiflu maybe helpful if given within the first 48 hours of symptom onset. On the other hand, if more than 48 hours and passed Tamiflu will not help and over the counter symptom specific medications should be used.
Many people say that they "can't afford to be sick" or "need to get back to work" or that their "cough is been going on for weeks" and that they "need antibiotics". Many doctors or places such as urgent care centers feel like they need to supply antibiotics under these circumstances but if the symptoms are really those of a cold or simple upper respiratory infection then the treatment should be aimed at the symptoms. Symptomatic treatment with over the counter drugs can be helpful. Over the counter decongestants such as pseudoephedrine for runny noses work well during the day but should be avoided if very high blood pressure or fast abnormal heart rate issues and at bedtime because they can interfere with sleep. Acetaminophen may be used for discomfort but at a total dose less than 2000 mg/day.
Combined multi-symptom treatments with over-the-counter drug such as DayQuil or NyQuil may be helpful but often times the patient is best to look on the shelf or consult with the pharmacist to see which of the symptoms is best treated with the over-the-counter medication.
Probably the most common scenario that I see is someone who has a persistent cough that has lasted for 3 to 4 weeks. That is best treated by cough suppressant starting out with dextromethorphan or possibly guaifenesin to help loosen up the cough or mobilize phlegm. If things become extreme, further treatment with prescription drugs such as codeine or nonsedating medicines such as Tessalon Perles may help.
Doctors and patients need to help
with avoiding excess antibiotic use so that bacteria do not become resistant to
antibiotics when we really need them. Patients can help by not setting the
expectation for antibiotics when they have a cold. And chicken soup, staying
home with good hand washing and avoiding spreading the infection to others, and
symptom oriented over the counter medication is clearly the way to go in most
cases.
MI Heart Dr.
MI Heart Dr.
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