Download The Most Common Cause of cold

Respiratory Disorders
Presented by
Muhammad H. Shamim
Doctor of Pharmacy Candidate
2005
Anatomy of the respiratory tract
Nerve supply of the nose
Cough
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Most common symptom for which
patients seek medical care
Is an important defensive reflex
Can be infectious or non-infectious
Can be acute or chronic
Can be productive or non-productive
Treatment of cough
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Drugs of choice
What products should be avoided
Exclusion to self-care
Counseling patients for cough
Drug
Adults
Children 6-<12
years
Children 2-<6
years
Codeine
10-20 Q4-6
(120mg)
5-10 Q4-6
(60mg)
1mg/kg/d in 4
equal doses or
by ABW
DM
10-20 Q4
30mgQ6-8
5-10 Q4
15 Q6-8
2.5-5mgQ4
7.5 Q6-8
Diphenhydramine HCl
25mg Q4
(150 mg)
12.5 Q4
(75 mg)
6.25 Q4
(37.5 mg)
Guaifenesin
200-400 Q4
100-200
Q4
50-100 Q4
Difference between cold & flu
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Both colds and flu are caused by
viruses, and the real difference between
them is simply the type of virus that
causes the illness
Symptoms
Cold
Flu
Fever
Common in children, Common in children
usual in adults
Muscle ache
Mild, infrequent
Very Common, often
severe
Fatigue
Mild, brief
Can be severe, can
last several weeks
N/V &
Diarrhea
Congestion,
runny nose,
sore throat
Uncommon
Common, especially
in children
Common, especially
in early stages
Common, but in the
late stages
Statistics on cold
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Americans suffer from 1 billion colds annually
Children have about 6-10 colds a year
Adolescents and adults average 2-4
colds/year
Adults greater than age 60 have fewer than
one cold per year
The Most Common Cause of cold
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The most common agent is rhinovirus which
is spread by contact, sneeze, or cough
propelled airborne transmission
Rhinovirus has >100 different serotypes
Peaks in April-May and September
During the peak autumn season, this virus
can cause up to 80% of all upper respiratory
infections
Other Viruses Causing cold
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Coronaviruses
Parainfluenza viruses
RSV
Adenoviruses
enteroviruses
Myths about common cold
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“catching cold from wet feet or becoming chilled”
“Susceptibility to colds requires a weakened immune
system”
“Central heating dries the mucus membranes of the nose
and makes a person more susceptible to catching a cold”
“Having cold symptoms is good for you because they help
you get over a cold, therefore you should not treat a cold”
“Drinking milk causes increased nasal mucus during a
cold”
“You should feed a cold and starve a fever”
Why is cold more common in
children??
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Newborn children acquire temporary immunity to cold
viruses from their mother. By six months this immunity
has waned, and children are susceptible to >100 cold
viruses
Children are particularly at risk for virus infections
which affect the lower airway such as pneumonia and
bronchiolitis and to middle ear infection (otitis media).
Sinus development is incomplete in young children, but
they also develop viral and bacterial sinusitis.
Sinus, ear drainage passages, and bronchial tubes are
small in children and are easily obstructed by mucus and
mucosal swelling
What Happens after
exposure?
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Virus and the host’s inflammatory
response
Colonization of respiratory epithelial
cells
Triggering of histamine, leukotrienes,
TNF, and other cytokines
Well-known symptoms begin
What are the symptoms?
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Sore throat
Sneezes
Nasal congestion
Rhinorrhea
cough
Treating the Symptoms of common
cold
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Oral and intranasal decongestants
Antihistamines
Analgesics and antipyretics
Antitussives and mucolytics
Natural products for Cold Treatments
What are Allergies?
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Allergies typically feature a clear nasal discharge with sneezing.
There may be itchy, watery eyes and/or a dry cough.
Often parents notice a "rabbit nose" -- a child crinkling her nose
to relieve the itchy sensation inside.
The "allergic salute" -- rubbing the nose with the hand,
sometimes leaving a horizontal crease on the nose -- is another
common sign.
"Allergic shiners" -- dark circles under the eyes -- have long
been associated with allergies, but are less predictive than the
other symptoms
From allergen to allergic reaction
Location of Sinus Cavities
Sinusitis
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Is the infection of the sinuses
Can be acute or chronic
The goals of treatment
Sinusitis in children
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A sinus infection in a child often begins
like a cold but lasts for greater than 10
to 14 days with no period of
improvement.
Sometimes a sinus infection begins with
a high fever (>103 F), facial swelling, or
facial pain.
Delsym dosing
(DM 30 mg/5ml)
< 12 months
Not recommended
12-23 months
1.25 mL (?tsp)
2-5 years
2.5 mL
6-12 years
5 mL
>12 years(>95 lbs)
10 mL
Lets apply the knowledge
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Case No:1: 28 years old woman comes to
your pharmacy and asks for some OTC meds
for cough. She says she is pregnant and is
currently taking amoxacillin. What would you
recommend to her to help her relieve her
cough?
Case No:2
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Allen is a 35 years old pharmacy
student who is looking for something to
help his congestion. He just measured
his BP in the pharmacy and it was
155/98. Recently he has been taking a
lot of ibuprofen to help him with his
knee pain. He also takes elavil for nerve
pain. Any recommendations????
Case No:3
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Amy is a 31 years old lawyer who
comes to your pharmacy asking for a
decongestant. You graciously point her
to where oral decongestants are in your
pharmacy. Before she leaves her
husband walks in with their 2 month old
baby. You thought the baby was so
cute. What is wrong with the picture??
Case No:4
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Carl uses tylenol frequently for his arthritis
pain. He comes to your pharmacy and is
looking for some meds to relieve his
symptoms of cold. You as an intern point to
the section where cold OTC products are. you
ring him up later for tylenol for cold and
sinuses, a bottle of benadryl, Nyquil, and
sudafed. What did you just do that could
have been avoided??
Case No:5
My prescription medications include the
following:
Atenelol 25 mg once daily
Zestril 20mg once daily
HCTZ 25 mg daily
Help me find OTC products which are safer for
my cold, congestion in my chest, and a
terrible cough which is productive
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Questions
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