Knowledge about common cold medication issues

Author: Chen Gengsen, Chief Pharmacist, Qilin Town Health Center, Puning City

Cold medicine is a medicine that helps us treat the enemy, the cold. It is almost always available in our family medicine cabinets. It is the most frequently used common medicine and is considered the "most familiar companion". However, if used improperly, the "most familiar companion" can also hurt you, possibly damaging your liver or causing you to be "heartbroken". Therefore, it is very important to use and choose the "most familiar companion" reasonably to avoid damage to our bodies. Let me talk about how to use and choose cold medicine reasonably. There are many issues that need attention.

1. Overview What kind of enemy are we and our "most familiar companion" fighting against? How does the enemy attack us? What kind of discomfort can it cause to the human body?

Cold has many aliases, such as "common cold", "cold", "cold", "cold", "mild typhoid fever", "severe cold", "acute upper respiratory tract infection", "influenza", etc. Cold is a common acute upper respiratory tract viral infectious disease, most of which are caused by viral infection, mostly sporadic, more common in winter and spring, and more common when the seasons change.

According to the scope of the disease, we can divide it into common cold and influenza.

The main cause of colds is that the cold virus enters the body through the mouth, eyes or nose. When a patient coughs, sneezes or talks, the virus spreads through droplets in the air. The virus can also be spread through close contact with cold patients and sharing contaminated items such as utensils, towels, toys or telephones.

Common clinical manifestations of colds include nasal congestion, sneezing, runny nose, fever, cough, headache, etc. The symptoms can be mild or severe. Some patients have no symptoms and do not feel the infection, while some patients react violently, which can lead to serious conditions such as myocarditis and sudden death.

Fortunately, most colds are self-limiting, which means that if nothing unexpected happens, our body will produce antibodies in about 7 days to eliminate the cold virus enemy, and the symptoms will gradually ease or even disappear completely.

Colds can also cause complications or aggravate existing diseases, in addition to the myocarditis and sudden death mentioned above; common complications include acute ear infections, asthma, acute sinusitis and other secondary infections, including streptococcal pharyngitis, pneumonia or bronchiolitis. It is worth noting that as the cold progresses, the secretions from the nose may become thicker and yellow or green, but this is not a sign of bacterial infection, and the color of the secretions is not an indicator for the use of antibiotics. It is recommended that the indicators for the use of antibiotics be the white blood cell count in the blood routine test.

2. When do we need the “most familiar partner”?

If there are no obvious symptoms such as fever or cough, drug treatment is not recommended. If the body temperature exceeds 38.5℃, or there is a severe cough or other discomfort, some drugs may be needed to relieve the symptoms. If the fever is greater than 38.5℃, the fever lasts for more than 3 days or longer, the fever recurs, there is shortness of breath, wheezing, severe sore throat, and headache, special attention should be paid, as these may also be dangerous symptoms.

In addition, for people with poor physical conditions, not controlling the cold may also increase the risk of complications. At this time, we can consider using the "most familiar partner" to help.

3. “The most familiar partner”, how to choose the most suitable one?

First of all, we need to judge by ourselves whether the symptoms meet the medication indications mentioned above. If not, there is no need for medication, but some measures to relieve symptoms: ① We can drink plenty of fluids, such as water, juice, broth or warm lemon water are good choices, but avoid caffeine and alcohol because they can cause dehydration. ② Drinking chicken soup and other warm liquids can relieve fatigue and relieve congestion. ③ Rest is conducive to recovery from illness and reduces the chance of infecting others. ④ Adjust the temperature and humidity of the room. If the air is dry, a cold mist humidifier or vaporizer can moisten the air and help relieve congestion and cough. ⑤ Salt water gargle can temporarily relieve sore throat or itching. ⑥ Nasal drops with normal saline can relieve nasal congestion.

If the indication for medication is met, we still need to choose the medicine according to the situation. There is no cure for colds. Antibiotics have no effect on cold viruses. Unless there is a bacterial infection, antibiotics should not be used. Therefore, most cold medicines are only temporary solutions and can only relieve symptoms. The main types of medicines that can be used are as follows:

1. Painkillers. For fever, sore throat and headache, you can use acetaminophen, ibuprofen or other antipyretic analgesics. But do not give aspirin to children or adolescents, especially those with chickenpox or flu-like symptoms, as it can cause serious side effects of Reye's syndrome.

2. Decongestant nasal drops or sprays, such as ephedrine and oxymetazoline. Adults can use decongestant drops or sprays for up to five days. Long-term use can cause rebound symptoms. Children under 6 years old should not use such drops or sprays.

3. Cough Syrup The U.S. Food and Drug Administration and the American Academy of Pediatrics strongly recommend not giving OTC cough and cold medicines to children under 4 years old because they can be harmful. It is also generally not recommended to give cough or cold medicines to older children. If you take them, follow the instructions on the package insert. Do not give your child two medicines with the same active ingredient, such as chlorpheniramine, ephedrine, or acetaminophen.

It is important to note that when choosing your "most familiar partner", you should carefully read the instructions or ask your doctor for guidance on how to use it to avoid repeated use of the drug that may lead to serious side effects.

First, we need to understand the ingredients of each "most familiar partner". The name of "most familiar partner" can help us quickly understand what ingredients the cold medicine contains.

Each or two characters in the name of cold medicines represent a certain ingredient. For example, "Shuangpu pseudoephedrine tablets",

"Aminophene pseudoephedrine tablets II" and "Aminophene pseudoephedrine tablets", etc., the "pu" in the drug names,

"Aminophen", "ammonia", "pseudo-ephedrine", "ephedrine", "Meifen", "Mei" and "Min", etc., all represent one of the ingredients.

Then, the specific ingredients represented by the names are explained as follows: "Pu" refers to chlorpheniramine (chlorpheniramine maleate) or paracetamol (acetaminophen). "Shuangpu" refers to chlorpheniramine (chlorpheniramine maleate) and paracetamol (acetaminophen). "Aminophenol" and "amino" refer to acetaminophen (i.e. paracetamol). "Pseudoephedrine" and "Ma" refer to pseudoephedrine. "Meifen" and "Mei" refer to dextromethorphan hydrobromide. "Pseudoephedrine" and "Ma" refer to pseudoephedrine. "Meifen" and "Mei" refer to dextromethorphan hydrobromide. "Min" refers to chlorpheniramine maleate (i.e. chlorpheniramine).

Second, we need to understand what precautions should be taken when using these "most familiar partners"?

(1) Antipyretic and analgesic drugs have certain gastrointestinal irritation. Short-term use is tolerable for most people, but patients with gastrointestinal ulcers should use them with caution and take appropriate stomach protective drugs when necessary.

(2) If children and adolescents use aspirin to reduce fever when they have a cold, they may develop a rare but potentially fatal adverse drug reaction called Reye's syndrome, which manifests as severe

Liver damage and encephalopathy. Therefore, when choosing antipyretic drugs for children, aspirin should be avoided and acetaminophen, etc. can be chosen.

(3) You should also avoid drinking alcohol when taking antipyretic and analgesic drugs, otherwise it may cause liver damage.

(4) Patients with colds should not use it for a long time. If there is no improvement after a few days, they should seek medical attention immediately.

You should not continue to take medication on your own for a long time.

(5) Some cold medicines can cause drowsiness. How can we avoid this? When you have a cold, your body will produce more of a substance called histamine that can cause allergic reactions. It causes allergic symptoms such as itchy nose, runny nose, sneezing, etc. Therefore, anti-histamine drugs are often added to cold medicines to relieve these symptoms. Commonly used anti-allergic ingredients in cold medicines, such as chlorpheniramine (chlorpheniramine) and diphenhydramine, have the side effect of causing drowsiness. Therefore, when driving or performing dangerous operations such as high-altitude work or operating machinery, you should avoid using drugs containing the above anti-allergic ingredients to avoid danger. Commonly seen cold medicines are divided into day and night tablets. The day tablet will not cause drowsiness. The main reason is that the day tablet does not contain the above anti-allergic ingredients. This kind of cold medicine can be used safely while driving.

Third, when should antiviral drugs be taken?

A common antiviral drug in cold medicine is amantadine, which is effective for colds and influenza.

Antiviral drugs have certain adverse drug reactions. For the common cold, simple symptomatic treatment can achieve better results, and there is no need to take antiviral drugs. However, for some special patients, antiviral drugs need to be used in a standardized manner under the guidance of a physician.

Fourth, what are the principles for selecting cold medicines?

The principle of drug selection is to choose drugs with corresponding ingredients according to the symptoms.

There is no need to choose the corresponding medicine. When taking cold medicine, the most important thing to pay attention to is to prevent repeated use. There are many overlapping ingredients in cold medicines of different brands, and some even have only different names, but the ingredients are exactly the same. This means that if you take several cold medicines at the same time, it is easy to cause the dosage of some ingredients to exceed the safety limit. Once the medicine is taken in excess, the safety is no longer guaranteed. For example, acetaminophen can cause liver damage when the daily dose is greater than 4g. Therefore, when using cold medicine, generally do not use two or more at the same time. Even if you use several medicines at the same time, you must make sure that there are no repeated or the same type of ingredients to avoid adverse consequences. In addition, when children use medicines, you should try to use medicines specifically for children, or read the instructions for children's use carefully. Children are not simply smaller versions of adults, and there are obvious physiological differences between them and adults. Therefore, you cannot simply reduce the dose and use adult medicines. It is not recommended to use adult medicines directly for children without understanding the usage and dosage of children.

4. The enemy is so powerful and cunning, and cold medicine has certain toxic side effects. How can we guard against the enemy?

Currently, there is no vaccine that has been proven to completely prevent colds.

First, we can strengthen our protective shield, the immune system. Eating well, getting enough exercise and sleep, and managing stress may help boost immunity and prevent

Prevent colds.

Secondly, reduce the risk factors. For example, during the cold epidemic, avoid going to places with many people around, such as schools or airplanes, unless necessary. If you have to go, it is recommended to wear a mask and take personal protective measures. Conventional measures can be taken to slow the spread of cold viruses: clean your hands thoroughly with soap and water frequently, and teach children the importance of washing hands. If soap and water are not available, use alcohol-based hand sanitizer and use disinfectants to clean the kitchen, etc.

In short, prevention is better than cure. Once we have to take cold medicine as a last resort, we need to master the indications, precautions for use of various drugs, toxic and side effects, and other medication knowledge to ensure safe use.