THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Saturday, December 30, 1995 TAG: 9512290081
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: By DEBRA GORDON, STAFF WRITER
LENGTH: Long : 129 lines
CHECKED OUT THE cold and flu aisle in your local drugstore lately?
It's enough to make you sicker.
There are cold and cough remedies. Cold, cough and allergy remedies. Syrups that make you sleepy; pills that don't. Special elixirs for children - for daytime, nighttime, for infants and older kids. Seven different preparations containing Sudafed - 12-hour decongestant, regular decongestant, nasal decongestant (non-drowsiness), sinus Sudafed, non-drying sinus Sudafed, severe cold formula and cold and cough formula. There's even a cough syrup for diabetics.
And then there are the generic versions of almost everything.
How do you choose?
``I get asked this question a lot this time of year,'' says Dave Halla, pharmacist at Gray's Pharmacy in Norfolk.
His response: What are your specific symptoms?
For instance, do you cough more when you're lying down? Then you have some sort of post-nasal drainage and need an antihistimine. But not just any antihistimine. You wouldn't take Benadryl, for instance, because that's for allergies. What you want is something with chlorpheniramine, or brompheniramine, found in drugs like Chlor-Trimeton or Contac, Dristan or Comtrex, which help dry up your secretions.
But some antihistimines have side effects of drowsiness. That's why many over-the-counter drugs also contain decongestants, which have their own side effects of jitteriness. Together, they cancel each other out.
Decongestants, like pseudoephedrine, found in Sudafed, help with mucous drainage and sinus pressure. They work by shrinking the mucous membranes to open the sinuses.
Then there are the chemicals to suppress your cough. Dextromethorphan, or DM, a non-narcotic cough suppressant, is a popular one. In the doses recommended in over-the-counter preparations, however, some pharmacists question its effectiveness.
You say you have a tickle-type cough? Then try a lozenge that has an anaesthetic in it, like Sucrets. Other lozenges also contain cough suppressants along with the pain suppressant.
Then there's guaifenesin, an expectorant found in many cough syrups. It causes the mucous membranes, both the sinuses and the bronchial membranes in the lungs, to sweat internally, Halla explains. This ``sweat'' helps thin mucous secretions so you can bring up the thick mucous that is making you cough. When it remains thick, he says, it sticks to the lining of the upper respiratory tract and you can't cough it up.
When dealing with young children, use more caution in what non-prescription drugs you use. Never give aspirin to a child who has a fever, since it has been associated with the potentially fatal Reye's syndrome.
Alternatives for children include clearing the nose with a bulb syringe, putting saltwater drops in the nose and increasing fluid intake.
Halla also asks his customers what kind of heat they have in their house. Forced air is very drying, which makes the inflamed nasal membranes even more inflamed, he says.
He recommends using cool- or hot-mist humidifiers to add moisture to the air. He prefers the cool-mist machines because it's easier to control the temperature in the room.
And what about generic vs. name brands?
Generally the generic is just fine, he says. Unless you're buying a time-release product. Then he recommends sticking with the name brand because they tend to work better.
Stay away from nasal sprays, he says, unless you're flying in an airplane and will be subject to air pressure changes. Otherwise, he says, you run the risk of bacterial infections in the sinuses or becoming resistant to the spray's effects.
And his personal favorite?
Comtrex.
``It's got a little bit of antihistimine, decongestant, acetaminophin and cough suppressant,'' he says. He also suggests that instead of taking the full dose recommended, you take a lower dose and work your way up.
Antihistimines: relieve runny nose and sneezing. Useful in the flu, when your body releases histamines, which cause itching, sneezing and a runny nose and watery eyes. Antihistamines temporarily block the action of histamine on the nasal passes to clear up congestion in your nasal passages. With colds, they're used for their drying side effect, and are frequently combined with decongestants, which may help to reduce drowsiness.
Decongestants: relieve a stuffy nose. They contract the blood vessels in the nose, which helps reduce the pressure in ear canals and nasal passages, so the patient breathes easier.
Cough suppressants: stop coughing. They work by inhibiting nerve transmissions from the cough center of the brain to the throat.
- Source: Current Health, January 1995
So you or your kid is sick. What have you got? What can you do?
Colds and flu are caused by viruses. And there's little to nothing doctors can do to treat viruses. One message they'd like to get out - antibiotics don't work against viruses.
So begging your pediatrician for a penicillin prescription for little Susie won't work.
``If we do give them an antibiotic, it may set them up for antibiotic resistance when they get sick with secondary germs,'' said Chesapeake pediatrician Sue Lee.
Another message: It's not too late to get your flu vaccine. In an average year, 20,000 Americans will die from influenza, primarily the elderly and those with immune problems. Vaccines are available at all local health departments and physician offices.
So when do you take your child to the doctor?
In young children, Lee recommends calling if infants under 3 months run a fever, if there is vomiting with the cough, if they're not eating, are so fussy they don't want to be held, or so lethargic they don't wake up. Other danger signs to watch for: very fast breathing, when children have to use their abdomen to breathe and wheezing when they breathe.
In older children, if they're not audibly wheezing and don't have a very high fever, Lee recommends waiting two or three days before calling the doctor to see if the fever and aches and pains improve. ``But if it's been six or seven days and they still have a fever and green nasal discharge and the cough is worse and they're miserable, then they need to be seen.
``These things are nearly always viruses, and usually the symptoms will peak and then they'll get better in three to four days.''
There are drugs that can help treat the flu - if they're administered early. Amantadine and rimantadine work by stopping the replication of the virus, but must be given within 48 hours of symptoms. And it's not always effective in younger children, said Dr. Bobby Garrison, a Norfolk pediatrician.
He advises parents to call or come in if their children are so sick that the parent is feeling uncomfortable. But, he warns, don't expect miracles.
``Colds will last a week whether we look at the child or not. And the flu will last five or six days. We don't affect that one way or the other.'' MEMO: [For a related story, see: VIRUS AMONG US, also on page E1 of THE DAILY
BREAK for this date.]
KEYWORDS: COLDS FLU VIRUS by CNB