It is said that the average person has more than 200 colds in his or her lifetime, so it can be said that colds are the most common illness in hospitals! However, in addition to the “drink plenty of water”, which is a universal remedy. “Do I need to take medicine for a cold? is also on the list of topics, and there are many different opinions, which shows the degree of concern. So, the question is, can you answer the following questions correctly for the most common clinical disease?
Question 1: Is there any difference between the treatment of common cold and influenza?
Common cold: Most of them are caused by viruses, usually without fever and systemic symptoms, and can be cured spontaneously after 5~7 days, mainly by symptomatic treatment.
Influenza: caused by the influenza virus, mostly presents with acute respiratory symptoms such as fever, cough and sore throat. Sudden outbreak and rapid spread. Serious complications such as pneumonia, encephalitis or myocarditis may occur.
In terms of treatment, patients with a laboratory pathogenic diagnosis or high suspicion of influenza and with risk factors for complications should be treated with antiviral drugs within 48 h of onset, regardless of underlying disease.
Patients with influenza requiring hospitalization should also be treated with antiviral drugs if the specimen tests positive for influenza virus after 48 hours of onset.
Question 2: What is the most common cause of the common cold?
Most of them are caused by viruses: rhinovirus is the most common pathogen causing the common cold, others are coronavirus, parainfluenza virus, respiratory syncytial virus, etc.
Question 3: What types of people are most likely to have complications from colds?
Elderly people and children are prone to complications of cold and flu. Patients with underlying diseases have more severe clinical symptoms, which can be prolonged and prone to complications: such as bacterial bronchitis, bacterial pneumonia, and even complications of other organs heart, kidney and brain, some of which induce asthma. And for pregnant women, high fever caused by cold may cause risks of teratogenicity, miscarriage, fetal central nervous development insufficiency and congenital cardiovascular disease.
Question 4: Should it be treated symptomatically, antiviral or antibacterial?
According to the 2012 Expert Consensus on the Standardized Treatment of the Common Cold: For individuals with no other co-morbidities and normal immune function, the benefit of antiviral drugs is limited. The antiviral drugs have the majority of adverse reactions and are also difficult to combat with precision. Therefore, the common cold is also based on symptomatic treatment and relief of cold symptoms. And antibacterial drugs are ineffective in treating the common cold. Application of antibacterial drugs is considered only when combined with bacterial infections, such as sinusitis, otitis media, pneumonia, etc.
However, according to the report, more than half of the patients still choose to apply antibacterial drugs, mostly without doctor’s guidance, and this abuse of antibacterial drugs does more harm than good to induce bacterial resistance.
Symptomatic drugs include the following.
Antipyretics and analgesics: relieve muscle aches, fever and other symptoms.
Decongestants: constrict sinus vasoconstriction and reduce nasal congestion and runny nose.
Antihistamines: Anti-allergic, alleviate runny nose, sneezing and other allergy symptoms.
Cough suppressants: cough suppressant effect.
Expectorants: sputum becomes thinner and easier to cough up.
Question 5: Should antibacterial drugs be used for patients with fever?
Although more than 90% of colds are caused by various types of respiratory viruses, bacterial infections may also occur as the illness progresses. Some people say, “Isn’t it the role of antibacterial drugs to reduce fever when you use antibacterial drugs for fever? The reason for this is that fever occurs when the virus invades the bloodstream and stimulates the body’s immune system. And generally the fever process is only three or four days, and fever reduction is not the role of antibacterial drugs. Therefore, antibacterial drugs should not be abused for viral colds alone, as it will lead to dysbiosis and bacterial resistance.
Question 6: Can I mix several kinds of compound cold medicines?
Most of the cold medicines on the market today are compounded, i.e. a medicine containing multiple active ingredients. The common cold medicines on the market are summarized as follows: As you can see from this table, different compounded cold medicines may contain the same active ingredients, although they have different names. For example, acetaminophen and pseudoephedrine, which are contained in most drugs, can easily cause duplication and overdose of the same active ingredient if administered at the same time.
In 2007, the FDA ordered the withdrawal of all compounded cold medications on the market for children under the age of two because of the problem of duplicate medication causing deaths in children, which means that children under the age of two are prohibited from taking compounded cold medications. So it seems that unless one is particularly aware of the ingredients of a compound, it is better to take only one kind of cold medicine.
Question 7: What are the precautions for children, pregnant women and the elderly?
According to the 2015 Expert Consensus on the Standardized Use of Common Cold Drugs for Special Populations: Children: Children under 2 years of age need to be especially cautious with their medications. The most suitable antipyretic and analgesic drugs for children are currently considered to be acetaminophen and ibuprofen. Aspirin and other salicylates should be used with caution in children with fever, as they may induce Reye’s syndrome and lead to death.
Pregnant and lactating women: Cold and flu medications should be used with special caution. Pregnant women should refrain from using aspirin, diclofenac sodium, diphenhydramine, ibuprofen, dextromethorphan and other drugs to avoid affecting fetal development or causing prolonged pregnancy. Drugs such as Benadryl and Amantadine are prohibited for breastfeeding women as they can affect young children through breast milk.
The elderly: Generally speaking, there are no special contraindications for cold and flu medications in the elderly. However, because the elderly tend to have more underlying diseases, they need to pay attention to related diseases and drug interactions.
Question 8: What cold medicines should not be used if there are underlying diseases?
Acetaminophen is recommended for patients with combined cardiovascular and cerebrovascular diseases, while NSAIDs are not recommended. It is also not recommended for patients with a history of gastric, duodenal, or gastrointestinal bleeding. It is important to note that aspirin may also cause drug allergy and should be used with caution in patients with a history of related allergies or cross-sensitivity. Because pseudoephedrine has a similar structure to adrenaline drugs and has an agonistic effect on the heart, it is not recommended for patients with combined cardiovascular and cerebrovascular diseases.
In addition, pseudoephedrine should also be used with caution in patients with thyroid disease, diabetes mellitus, and prostate hypertrophy.