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RESPIRATORY DISORDERS: URI The Common Cold & Similar Respiratory Ailments Nursing 870 THE COMMON COLD Most frequent cause of acute illness in US & industrialized world Caused by members of several families of viruses Causes varying degrees of : rhinorrhea, sneezing, sore throat, cough, low-grade fever, headache and malaise Separate entity from close differentials: influenza, bacterial pharyngitis, acute bronchitis, acute bacterial sinusitis, allergic rhinitis and pertussis THE COMMON COLD Preschool children: 5-7 episodes per year Adults: 2-3 per year Rhinoviruses (>100 subtypes) more common spring & fall Others: adenoviruses, coronaviruses, and human metapneumoviruses THE SNEEZE WHAT DO OUR PATIENT’S WANT? No antibiotics! ABX will cause more harm than good. Symptomatic care is the rule Consider CDC flyers for the exam room Patient satisfaction surveys http://www.fda.gov/downloads/ Drugs/ResourcesForYou/UCM23 3746.pdf Nonprescription Remedies for the Common Cold Action Drug Side Effects Acetaminophen Minimal Aspirin Stomach irritation Risk of Reye syndrome in children Ibuprofen, Naproxen Stomach irritation Naphazoline Oxymetazoline Phenylephrine Xylometazoline Drowsiness, dry mouth, and, in older people, blurred vision, difficulty urinating, constipation, light-headedness when they stand, and confusion Benzonatate Confusion and stomach upset Codeine Constipation, drowsiness, difficulty urinating, and stomach upset Dextromethorphan Minimal, but at high doses, confusion, nervousness, and irritability Naphazoline Oxymetazoline Phenylephrine Xylometazoline Rebound congestion (worse congestion when the drug wears off) if the drug is used for more than a few days Pseudoephedrine Palpitations, high blood pressure, nervousness, and insomnia Phenylephrine Fast heart rate, dizziness, nervousness, and insomnia Guaifenesin Minimal, but at high doses, headache and stomach upset Analgesics/antipyretics Relieve aches and pains and reduce fever Antihistamines* Open nasal passages and help relieve sneezing Cough suppressants May help reduce cough Decongestants, nasal sprays Open clogged nasal passages Decongestants, oral Dries runny nose Expectorant May help loosen mucus Retrieved from: http://www.merckmanuals.com/home/infections/viral_infections/common_cold.html WHAT TO EXPECT Set appropriate expectations for recover Virus will run its course over 10-14 days (residual cough may last longer) Have patients return to the office if: • Symptoms take a marked turn for the worse after about a week • Return of or increased fever • Significantly worse cough/sputum production