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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