Non sedating decongestants

04-Mar-2020 23:52 by 10 Comments

Non sedating decongestants - disk utility updating boot support partitions volume required

For complementary and nonpharmacologic treatments, the literature addresses more global outcomes.

There are no studies of hydrocodone use in patients with the common cold, although the drug's effectiveness has been demonstrated in patients with other conditions.2829Several mechanisms can cause cold-related nasal congestion and rhinorrhea.12 Although these mechanisms differ from those that cause allergy-related symptoms, antihistamines remain a popular therapy for the common cold.Topical ipratropium, a prescription anticholinergic, relieves nasal symptoms in older children and adults.Antibiotics have not been shown to improve symptoms or shorten illness duration.Adults have an average of two to four episodes annually, and young children may have as many as six to eight episodes.A common cold is characterized by sore throat, malaise, and low-grade fever at onset.Complementary and alternative therapies (i.e., Echinacea, vitamin C, and zinc) are not recommended for treating common cold symptoms; however, humidified air and fluid intake may be useful without adverse side effects.

Vitamin C prophylaxis may modestly reduce the duration and severity of the common cold in the general population and may reduce the incidence of the illness in persons exposed to physical and environmental stresses.

Systematic reviews have shown that antibiotics have no role in the treatment of the common cold.1415 This is because antibiotics are ineffective at reducing symptom duration or severity and because of the risk of adverse gastrointestinal effects, cost of treatment, and increased resistance of bacteria to antibiotics.1415A Cochrane review showed that there is a lack of good evidence to determine the effectiveness of any over-the-counter product at reducing the frequency or severity of cough in children or adults.5 Some authors explicitly recommend against the use of these medications.1617 The American College of Chest Physicians guideline does not recommend centrally acting cough suppressants (e.g., codeine [Robitussin AC], dextromethorphan [Delsym]) for cough secondary to upper respiratory tract infection.18Despite these conclusions, two of the three studies included in the Cochrane review suggest that dextromethorphan provides a modest clinical benefit.519 One of these studies (a meta-analysis) showed a reduction in the frequency and severity of cough for persons 18 years or older without significant adverse effects.19 The average treatment difference was 12 to 17 percent in favor of dextromethorphan for cough bouts, cough components, and cough effort.19One study included in the Cochrane review showed that combination antihistamine/decongestant medications have a modest benefit but with significantly increased adverse effects.

In contrast, newer-generation, nonsedating antihistamines do not effectively reduce cough.18 Because of the conflicting evidence, physicians must weigh the risks and benefits of dextromethorphan or combination antihistamine/decongestant medications 10 Although clinical trials have reported a low incidence of minor adverse effects, anecdotal reports of serious adverse effects and dosing errors have prompted the American Academy of Pediatrics and other experts to caution against the use of these preparations in children.2124There also is little evidence to support the use of codeine and its derivative hydrocodone (Hycodan) to relieve cough caused by the common cold in adults and children.5 One small study of codeine use in children25 and two small studies in adults2627 failed to show a benefit.

Antihistamines and combination antihistamine/decongestant therapies can modestly improve symptoms in adults; however, the benefits must be weighed against potential side effects.

Newer nonsedating antihistamines are ineffective against cough.

For information about the SORT evidence rating system, see page 453 or https://org/The literature on the common cold is extensive, but it is inconsistent in its rigor.

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