Transcription:
Common Cold Treatments

Melanie Cole: The common cold is one of the lead reasons for physician visits and you know if you’ve had one recently how crappy they can make you feel. However, the dizzying array of over the counter medications to help with symptoms can be absolutely confusing at best. My guest today to clear some of that up today is Dr. Jovino Hernandez. He is a pharmacy clinical coordinator and residency program director with BayCare Health. Welcome to the show. Let's just start with how do you know what it is that you have? How do you know if it’s a cold versus allergies versus the flu?

Jovino O Hernandez PharmD, BCPS: That's a good question. Sometimes it's hard to tell them apart, but both are caused by viruses, and even though you're more likely to feel a stuffy nose or a sore throat with a cold, the flu symptoms are usually going to be a lot worse. Unlike a cold, the flu is going to come on very quickly and it's going to cause some high fevers and chills, you're going to get a headache, have muscle aches and you're going to feel many more symptoms than you would with your common cold. If you suspect you have the flu, the best thing to do is go to your doctor's office and get a test early on that can help determine if you have the flu. The good news about the flu is even though it is a much more severe disease compared to a cold, if you do get a yearly vaccination, you can help prevent getting the flu.

Melanie: How do you really catch a cold? It seems like the germs are everywhere. Are we supposed to walk around with masks on or use sanitizer on everything? What are we looking for? What are some of the things that we should be aware of?

Dr. Hernandez: Your mother probably told you when you were growing up to cover yourself up or you might catch a cold in the cold air and cold air is not going to directly cause a cold, but the winter time in the fall is a perfect time for the cold to spread. The cold is a virus and when a person sneezes, there are droplets that come out of the nose or through their cough and the virus spreads through tiny droplets that are in the air. When a person touches a droplet that can be on a chair, on a phone, a microwave or a counter, they can touch their mouth, their nose or even their eyes and they can help spread it. Cold air actually makes it a little easier for the virus to remain in the air longer, so yes, the cold air can help cause a cold. Also, in the fall, in the winter, our kids are back in school and spreading germs around. As you mentioned earlier about using wipes, that’s a perfect lead on to what we can do to help prevent these colds from spreading. We can wipe down different items in our house or at work, things like doorknobs are commonly touched, refrigerator doors, microwave handles, even armrests and the phone can help prevent the spread of the cold.

Melanie: It seems inevitable that we will get a cold at some point. Let's talk about treatments. You go to the cold and flu section in the pharmacy and it’s dizzying as I said in the intro. Tell us about some of those different medications for headaches, body aches, fever, sore throat and nasal congestion. What is all that stuff supposed to do? Does it help cure it or is it just symptom management?

Dr. Hernandez: Unfortunately, there is no such thing as a cure for the common cold. The best thing that we have are treatments that can help with our symptoms. In reality, the best treatment of all is getting some rest and getting fluids into your system. We can help with the symptoms. For runny noses, we can have saline lavages, nasal sprays and there's some over the counter decongestants that we can use containing phenylephrine. For sore throats, we all know about throat sprays that could help. Ice chips, lozenges that we can get, the old standby of saltwater gurgle is also very effective. For coughs, we have lozenges that we can use, we want to avoid those in young children as they can choke, humidifiers, steam can help. For the pain that we’re getting, particularly for a sore throat, for example, we can use things like ibuprofen or acetaminophen that can help with the pain or fever, but we'd be careful with these. As you mentioned earlier, there are all kinds of different medications out there, but a lot of these medications are mixed together. If we grab something that says Tylenol for example, often times it’s going to have acetaminophen in it, but it’s also going to have decongestants, it may have something that helps you fall asleep, it can help have something for a cough and we have to be careful before we may take that when we leave the pharmacy and jump in our car, taking something back and cause us to become drowsy as we’ll driving. It’s always important to read your labels, and if you don’t know, if you're confused, don’t be scared to ask the pharmacist who’s there. That’s their job to help you figure out these medications because it is tough.

Melanie: I’d like to jump back to a cough for a second because now some of these cough medications, we have to get over the pharmacy. We can't buy them on the shelf anymore and things like honey have been touted down to help especially with children and we’re not even supposed to be giving children. Do we want to suppress a cough? What's the deal with that?

Dr. Hernandez: A lot of times, a cough is your body’s natural response of trying to get your mucus up. A lot of times, if a cough is tolerable, it’s a good idea just to let the person cough because you're coughing up, you're clearing out your lungs of the gunk that collects within our system. Realistically, if we can get away without giving a cough suppressant, it’s best to do that. Unfortunately, most of the over the counter medications for coughs are not very effective, but prescription medications that you can get now for coughs are very effective, but those also have side effects associated with them also. It’s best if we can avoid having to take cough suppressants that we get at the doctor’s office. It’s best to avoid those if possible.

Melanie: Before we get onto some of the complimentary things like vitamin C and zinc and all those things, what about antibiotics? A lot of people run to their doctors and say I've got a cough, a runny nose, maybe there's some green stuff coming out so please give me an antibiotic. Now we’re talking about stewardship and the guidelines are changing.

Dr. Hernandez: Colds are caused by viruses as I mentioned earlier and there's not an antibiotic in this world that’s going to cure a cold virus. In fact, if we take an antibiotic for a cold, we are probably doing more harm than good because next time we do need antibiotics, the bacteria in our system is less likely to be affected by the antibiotic, so they learn how to fight back when we take antibiotics. It’s best for us to avoid antibiotics and not to even ask for an antibiotic if we go in for the common cold. As a patient, a lot of times, you want to go into your doctor’s office and you're expecting them to cure you. We put pressure on our physicians to give antibiotics, but in the long run, we’re doing more harm than good.

Melanie: Now there are all these things. We hear about airborne and vitamin C and take a ton of vitamin C and zinc and you mentioned nasal lavage and probiotics and vapor rubs. What about all of these things? How many of them do we try to see if they help us be more comfortable or hopefully prevent one?

Dr. Hernandez: It’s controversial that the vitamin C, the data out there, is there's nothing that’s really concrete that really helps prevent a common cold. With zinc lozenges, if we catch it early enough, it can shorten the time that we have the symptoms of a cold, but that has to start immediately when we start feeling the symptoms of a cold. Things like vapor rub, those could be very effective and can be very soothing. They can help open up your nasal passages and make it easier to breathe. If you're breathing easier, you feel better, so those are actually quite harmless and they can be effective.

Melanie: People suffer from all of these symptoms. When is it that you would advise it’s time to go see your physician and get it checked out?

Dr. Hernandez: If you have a high fever of 101.4 or higher that's persistent, that's a good time to go. If your symptoms don't start to get better or relieve within 10 days, that could be a sign of a more serious infection. A persistent cough can be a sign of pneumonia, something more serious, or congested with a headache could be a sinus infection. Painful swallowing, for example, can be a sign of strep throat. These are all things that need to be followed up with a physician.

Melanie: Now give us your best advice. As a clinical pharmacy coordinator, you're a pharmacist, people get confused. Share your expertise with us on colds and flu or possibly preventing them in the first place and what you want us to know what questions that you would like people to ask you when they're looking at all these medications.

Dr. Hernandez: I guess the most important thing is looking at the medications and figure out what symptoms that you're trying to treat and just treating that one symptom or two. I think we tend to grab the medication that’s going to take care of the fever, take care of a runny nose, take care of a cough, and it’s going to put us to sleep while we’re at it. Often times, we don’t need all that. As I mentioned earlier, often times, the best treatment is plenty of rest and fluids, but try to take the medication that’s going to affect your particular symptom. A lot of it also is prevention. As I mentioned earlier, if we can take the steps to wash our hands, to clean down in our house the commonly grabbed areas like microwave handles or refrigerator or at work and phones, we can help prevent the spread of the common cold.

Melanie: Thank you so much. That’s great information, something we all need to hear. Thank you for joining us today. You're listening to BayCare Health Chat. For more information, please visit baycare.org. That’s baycare.org. This is Melanie Cole. Thanks so much for tuning in.