Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
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.
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.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Herpes simplex virus (HSV) can cause infections that affect the mouth, the face, the genitals, the skin, the buttocks, and the anal area. This article will concentrate on non-genital herpes. Many people acquire the virus and have no symptoms. For others, painful blisters appear near the area where the virus entered the body. Typically, the blisters heal completely but reappear at some point in the future when least expected (or desired). In between attacks, the virus resides deep in the roots of the nerves that supply the involved area. When herpes simplex lesions appear in their most common location, around the mouth and lips, people often refer to them as "cold sores" and "fever blisters."
What causes cold sores?
There are two types of HSV, type I and type II. In general, type I, also known as herpes labialis, causes infections above the waist, most commonly as oral "cold sores." Type II infectio...
Unsure about the hundreds of cold and
flu preparations on the drugstore
shelves? You're not alone. Deciding among the OTC (
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