Cold, Flu, Allergy Treatments

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Facts about cold, flu, and allergy treatments

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  • The three classes of analgesics/antipyretics that are available over the counter (OTC) are aspirin, acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDs). These are used to treat pain and fever.
  • Antibiotics have no effect on viruses, which are the cause of colds. However, bacterial infections that can follow viral infections, for example, infections of the ears and sinuses, may be treated with antibiotics.
  • Nasal decongestants are chemicals (for example, pseudoephedrine, oxymetazoline, etc.) that narrow the blood vessels in the nose, thereby preventing fluid from leaking and the lining from swelling. These can be used for short-term relief in older children and adults.
  • Analgesic/antipyretic medications are often sold in combination with other ingredient(s) to treat cold/flu/allergy symptoms.
  • Antihistamines are commonly used to block the histamine effect that causes the symptoms of an allergic reaction. "First generation" antihistamines such as diphenhydramine (Benadryl) have been in use longer, are less expensive, and are more sedating (prone to cause drowsiness) than the newer, "second generation" antihistamines (fexofenidine [Allegra], loratidine [Claritin], etc.), which have minimal sedative effects.
  • OTC antihistamines frequently are combined with a nasal decongestant and sometimes also with a cough suppressant or an analgesic. Generally, antihistamine preparations are not effective for cold symptoms.
  • Codeine and hydrocodone are narcotic oral cough suppressants that require a doctor's prescription. Dextromethorphan (Tussin P) is an oral cough suppressant that is available OTC.
  • Guaifenesin (Robitussin, Mucinex) is an oral expectorant that is believed to increase the leaking of fluid out of the lung tissue and into the airways.
  • There is no conclusive evidence that mega-doses of vitamin C prevent colds or decrease the severity and duration of cold symptoms.
  • Aspirin-containing medicines should never be used for children and teenagers with influenza, chickenpox, or other viral illnesses.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 11/3/2011


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Find out which OTC medication will relieve your cold, flu, or allergy symptoms.

Making Sense of OTC Cold and Cough Medications

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara K. Hecht, PhD

Unsure about the hundreds of cold and flu preparations on the drugstore shelves? You're not alone. Deciding among the OTC (over-the-counter) remedies for cold, flu, or allergy symptoms can be intimidating, and a basic understanding of the types of drugs included in these medications can help you make an informed choice.

Decongestants

Decongestants are the drugs of choice for a stuffy, congested nose. Decongestants act by narrowing the blood vessels in the nose, leading to decreased blood flow in the nasal tissues and reduced leakage of fluid from the nose. Decongestants can either be taken orally or applied locally (topically) in the form of nasal sprays or drops.

Pseudoephedrine and phenylephrine are decongestants that can be taken orally. Phenylephrine and oxymetolazone are examples of topical decongestants. While topical decongestants are effective after a few minutes, oral preparations (tablets) can take about 30 minutes to work. Decongestants act as stimulants that can increase heart rate, raise the blood pressure, exacerbate palpitations, and lead to feelings of nervousness or feeling "hyper."

It's important to note that decongestants do not relieve a runny or itchy nose.

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