NHP for treatment of URI Flashcards
echinacea for treatment of URI
- uesd to reliece symptoms and shorten duration of URTI
- also used for prevention
- dose varies based on formualtion (caps vs tinctured)
- often taken TID
*possibly effective, to maybe recommend for prev or use at onset or UTRI if they want a NHP but cousel on lack of efficacy data
what are cautions for Echinacea use
- good safety profile
- GI side effects are most common
- allergic rxns can occur - caution in individuals sensitive to Asteraceae/Compositaw family (ragweed, chrysanthemum)
- theoretical exacerbation of auto-immune disorders (lupus, rheumatoid arthritis)
- rash common in children
efficacy of echinacea
-most individual studies so not support prophylacic use
*tend towards benefit in several studies but not statistically significant
- conflicint results when used as onset of cold-> possibly due to diff products between studies
- no ipmact on duration when used for treatment at onset od cold
- any benefit is modest at best, most consistent evidence for prevention (ish)
use of american Ginseng for treatment of cough and cold
aka panax quinquedolius
- used for many things: diabetes, immune treamtnet, enhanced athletic performance, adaptogen etc
- uses specific extract containing 80% polysaccharides and oligosaccharides and 10% protein) to prevent URTI -> Cold-FX
most effects caused by ginsenosides but immune enhancement seems to be due to polysaccharides and oligosacchaides
*maybe reccomend for prophylactic use (but all studies for this funded by manufacturer), accept for use at cold onset
overall posible effective
cautions for use of american Ginseng
GI, nervous and cardiovascular system adverse effects -> rates similar to placebo
- interaction with warfarin -> dec effectiveness of warfarin therapy
= other ginseng species (Panax ginseng) can cause insomnia, mastaldia, vaginal bleeding, amenorrhea, changes in BP, changes in blood clotting
^ not with cold Fx with other varieties
evidence for use of american Ginseng
- 3 RCT for Cold FX overall found no evidence for efficacy when used as onset (despite use of extra strength marketed for that)
- only partially efficacious for prevention
if patient wants to take Cold Fx how should they take it
1 tab (200mg) BID
take daily during winter months
use of vitamin C for the common cold
- used for treatment and prevention
- acts to maintain normal immune function and has antioxidant activity
- accept, maybe recommend
- possible effective
*benefits may not outweight risks for high doses of vitamin C
cautions for vit C treatment
doses above 2g/day - diarrhea, Gi upset, precipitation of urate, oxalate, or cysteine stones or drugs in urinary tract, hyperoxaluria, hyperuricosuria, hematuria and crystalluria
efficacy of vitamin C for cold treatment
- uf used at cold onset, conflicting evedence, most evidence is negative
- may cause slight reduction in cold duratoin
- evidence doesnot support prophylactic use with exemption fo times of exteme physical stress (marathon)
- treat colds with 1-3 g daily or prevention during physical stress with 600-1000mg daily
zing for cold treatment
- used at onset to derease sevarity
- amy also e used as prophylaxis
- mainly exist as lozenges
*mechanism of action for cold treatment unknwon
*accept maybe recommend, possible effective
cautions for Zinv use
unpleasat taste, taste distortion
- abdominal cramping
nausea is common
- so not sue intranasal zinc- hundreds of cases of anosmia
evidence of efficacy of zinc for cold treatment
- several studies showed decrease in duration of common cold in adults (issues with blinding in stuides bc of distinctive zinc taste)
- not all studies showed benefit, possible due to diff in formulation
*citria acid, minnitol and sorbition used to mask taste may chelate and decrease ionization
- antoher study found that zinc reduced duration of cold by about a day
things to counsel on for patients taking zinc
- take lozenge Q2H while awake, start within 24-48 hours of symptom onset
- lozenge shoudl be dissolved in mouth
- do not take at same time as tetracyclines, quinolones, etc (can cause chelation leading to reduced drug absorption)
- do not take at same time as foods containing citric aci, minnitor or sorbition (chelation, reduced ionization)
