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The Common Cold

Much confusion exists about the common cold. Colds are caused by several hundred different viruses. Common cold symptoms include runny nose, stuffy nose, cough, body aches, fever, sore throat, sneezing, and fatigue. Colds are spread by breathing respiratory droplets (airborne particles spread by coughing or sneezing) or by spreading droplets to the eyes, nose or mouth (usually with the hands). Colds generally last about 10 days.



Unfortunately there is no effective treatment to shorten the course of a cold. Neither antibiotics nor vitamin C have been shown to have any impact on colds. However, your body's own immune system will very effectively rid your body of the cold virus in about 10 days. So what can you do in the meantime? Fortunately we have very effective medications that relieve the symptoms of a cold:
  • DECONGESTANTS (Sudafed): relieve stuffy nose and sinus pressure and pain
  • ANTIHISTAMINES (Chlortrimeton, Benadryl, Claritin, Zyrtec): dry up runny nose and post-nasal drainage
  • ANALGESICS/ANTIPYRETICS (Aspirin, Tylenol, Advil, Ibuprofen): relieve pain and fever
  • ANTITUSSIVES (Dextromethorphan "DM" products): quiet coughs
  • EXPECTORANTS (Robitussin, Mucinex): thin secretions so they can be cleared more easily

Most medications are combinations of two or more of the above ingredients. So how do you pick from the hundreds of cough and cold medications available in the pharmacy? One option is to pick a product with the ingredients to relieve your particular symptoms (the products are usually labelled with one or more of the above ingredient classes). Unfortunately, cold symptoms usually vary from day to day, and a combination medication that fits one day's symptoms will not be appropriate for another day. A better option is to buy single ingredient medications so you can take only the medication or medications necessary to relieve your current symptoms. Single ingredient cold medications can be taken together as long as you don't mix two products that belong in the same category. For instance, you should not take two decongestants at the same time. Using single ingredient products also allows you to avoid some side effects. Common side effects of these ingredients are:

  • DECONGESTANTS: insomnia (sleep disruption), nervousness, heart palpitations, and slowed urination
  • ANTIHISTAMINES: drowsiness, dry mouth or nose, constipation, slowed urination, and occasionally nervousness
  • ANALGESICS/ANTIPYRETICS: nausea and heartburn (aspirin and ibuprofen only)
  • ANTITUSSIVES: nausea

None of these are serious side effects except for the heartburn caused by aspirin or ibuprofen. You can sometimes minimize the side effects by planning the dosing times. For instance, take decongestants during daytime hours (to minimize insomnia), and take antihistamines at bedtime (to minimize drowsiness). Circumstances in which certain ingredients must be avoided are as follows:

  • DECONGESTANTS: poorly controlled high blood pressure, serious heart rhythm problems, overactive thyroid, narrow angle glaucoma (an uncommon form of glaucoma), and patients taking the antidepressants Nardil or Parnate
  • ANTIHISTAMINES: narrow angle glaucoma (an uncommon form of glaucoma)
  • ANALGESICS/ANTIPYRETICS: aspirin and ibuprofen in patients with a history of stomach or duodenal ulcer, aspirin in children with flu or chicken pox
  • ANTITUSSIVES: dextromethorphan ("DM" ingredients) in patients taking the antidepressants Nardil or Parnate

When to See the Doctor

Most colds can be treated at home as discussed above. However, other illnesses that do require medical attention share many of the common cold symptoms. Any of the following suggest a visit to the doctor is necessary:
  • Sore throat with fever
  • Severe sore throat
  • Cough with fever
  • Shortness of breath
  • Productive cough longer than 1 week
  • Any cold that doesn't improve in 10 days
  • Any cold in a patient with moderate to severe asthma or emphysema, or a patient taking chemotherapy or chronic steroids