The Common Cold & Viral Upper Respiratory Illness (Viral URI)

Get plenty of rest and drink plenty of fluids. Also take one or more of the following medications:

For fever and pain, Acetaminophen (Tylenol®) is generally preferred. Ibuprofen (Advil®) and/or naproxen (Naprosyn®) appear to carry less risk for Reye's syndrome than aspirin. For other symptoms, over-the-counter cold (OTC) preparations (Nyquil®, Tylenol Cold® & Sinus®, others) can provide significant relief. Be sure to read product labels to find the best cold preparation to match your symptoms and to determine if that medicine is safe for you.

To dry out the nose and relieve nasal obstruction, try a traditional antihistamine (diphenhydramine [Benadryl®], others). All antihistamines are best used for allergy, but they can be helpful for suppressing some viral URI symptoms. Because these products can make you sleepy, avoid driving and other complex tasks when taking these medications. Newly available OTC loratadine (Claritin®) is non-sedating but may not be as effective for suppressing viral URI symptoms.

To relieve a "stuffy," clogged nose, try an oral decongestant (pseudoephedrine [Sudafed®], others). Note that these products can be associated with insomnia, nervousness, and irritability in some patients. Often decongestants are combined with other drugs (especially antihistamines) in OTC medications. A "-D" at the end of a medication's name suggests that the medication includes an oral decongestant.
To make blowing your nose easier, take guaifenesin (Robitussin®, Mucofen®, Humibid LA®, Mucinex®, Humibid-e®). These products thin mucous and can help thin thick discolored drainage.

To suppress coughing, take dextromethorphan can be helpful as a cough suppressant.

Prescription anti-flu medications (amantadine, rimantadine, zanamivir, oseltamivir) can be used to treat and prevent flu. Typically they must be started within 48 hours of the start of symptoms. These products shorten the severity and duration of the infection, but they can have significant side effects.

Viral infections can be associated with bacterial overgrowth and occasionally lead to a bacterial infection (acute bacterial rhinosinusitis), which typically requires antibiotic therapy. Viral URIs also may worsen asthma symptoms (wheezing) in patients with asthma; such symptoms also require further evaluation and treatment.

Seek medical advice or treatment if:
• Symptoms are getting worse after 7 days
• Symptoms are unchanged or getting worse after 10 days
• You experience shortness of breath or have any respiratory difficulty
• You experience a high fever (> 102^o F)
• You develop eye pain/ swelling and/or vision changes
• You develop severe head or facial pain/swelling

Wash your hands frequently.

Cold and flu viruses are spread by touching infected persons or objects that have come in contact with the virus and then touching one's nose or mouth. Frequent handwashing is important to prevent this process. (Inhalation of infected particles in the air also can spread colds/respiratory viral infections.)

• Persons age >50 years
• Residents of nursing homes and other long term care facilities
• Adults and children (> 6 months of age) who have chronic heart or lung conditions, including asthma
• Adults and children (> 6 months of age) who need regular medical care or require hospitalization because of metabolic diseases (diabetes), chronic kidney disease, or weakened immune system.
• Children and teenagers (age 6 months to 18 years) who are on long-term aspirin therapy
• Women who will be more than 3 months pregnant during the flu season
• Persons who can give the flu to people who are at high risk for complications (healthcare workers, caregivers
• Household members of patients at risk, employees in health care, nursing homes, or long care facilities)
• Anyone (>6 mos of age) who wants to lower their risk of getting the flu.

Two medicines are approved for prevention of influenza viral infection. Amantadine and rimantadine are approved for prevention of Influenza A and oseltamivir is approved for preventing Influenza A and B in children (age >13 years). Both zanamivir and oseltamivir are indicated for the early treatment of influenza.

• More than 200 different viruses can cause the common cold (viral URI).
• Viruses do not respond to antibiotic treatment.
• Symptoms due to viral URI typically last 2–14 days, but some symptoms can linger for several weeks (most people recover in about 7–10 days).
• Productive cough or discolored nasal discharge does not necessarily require antibiotic therapy.
• Influenza (flu) is a viral infection caused by the influenza virus.