Colds 7.6

Question 1

How to decide what to use

Answer 1

• Aim for most bothersome symptoms
  
  • Nasal congestion and cough usually

Question 2

What can the patient expect when they start taking cold medicine

Answer 2

• With analgesics and decongestants will feel better the rest unsure

Question 3

How long will they take medicine

Answer 3

• 3-4 days up to 7 for decongestants
  
  • Coughs can last for longer

Question 4

Benefit of extra strength products

Answer 4

• Some of the ingredients may be subtherapeutic

Question 5

What is the difference between daytime/ nighttime configurations

Answer 5

• Daytime is the same as nighttime but night time has a first gen antihistamine for sedation effect

Question 6

What to do with cough and cold medication (Saline/suction, honey, topical decongestants, dosing off label

Answer 6

1. Increase use of saline/ suction
   
   • Decrease expectations (not that good as they will still have congestion
     2. Use of honey for coughs
   • Not increasing therapeutic control and just a marketing thing
     
     • Low expectations but okay to use
       3. Increase use in topical decongestants
   • Not near a kids dose only 12 and up, not an increase use (100-1 oral to topical)
     
     • Don’t giving a kid an adult topical now but with experience there is much less adverse effects

Question 7

Pregnancy and cough medicine

Answer 7

• Avoid produce use in 1st trimester
  
  • If used
    Product selection same process
    Decongestants (topical safer then oral)
    Analgesics appear safe (check with physician)
  • DM use over codeine
  • Antihistamines are safe but not needed for common cold
  • Guaifenesin appears safe
  • Pregnancy rhinitis can occur

Question 8

Diabetics (sick day management, caloric intake, blood glucose)

Answer 8

i) Sick day management is key for type 1 diabetics
- More worried about T1 as they don’t make insulin, on a sick day glucose is being produced and blood sugar levels increase, throwing on a drug is like adding a stick on. More worried about the cold itself
ii) Caloric and alcohol content of cough/ cold medicines get lots of attention but not big concerns
iii) Impact on blood glucose
- The cold itself is the biggest influence
- Oral decongestants have a small impact
- Topical decongestants/ antihistamines/ antitussives/ expectorants not an impact on bg

Question 9

Hypertensives and cough/cold medicine

Answer 9

1. Oral decongestants
   
   • Can affect bp: Blood vessels get tighter so bp goes up a tiny bit, but legal aspects
   • A key question to ask is have you used one before
     2. Legal aspects
   • How to word a recommendation (if giving a product)
   • Id rather not recommend one but if you want to I will help you pick one if you have used a decongestant before