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Eko Setiawan
Farmasi komunitas 1
2016
Learning objectives
Know what is common cold along with its pathophysiology,
clinical presentation, and causes.
Know the basic knowledge of common cold medications
Explained further in Praktikum session
Common cold
Common cold
A common cold is a viral infection of the upper
respiratory tract
The majority of colds are caused by rhinoviruses
COMMON
COLD
VIRAL
Clinical presentation
Scolaro KL. In Berardi et.at; Blenkinsopp et.al
Sore throat
Rhinorrhea (runny nose)
Clear, thin, watery nasal secrets at the beginning of infection
progress to thicker, yellow secrets returning to clear,
thin, watery nasal secrets when the cold resolves
Colds or flu
Colds
Symptoms:
runny nose beginning
with clear mucus that
develops into thicker,
green mucus as the cold
progresses
blocked nose
sore throat
sneezing
cough
Flu
usually comes on much
more quickly than a cold
Symptoms:
sudden fever of 38-40C
(100-104F)
muscle aches and pains
sweating
feeling exhausted and
needing to lie down
a dry, chesty cough
http://www.nhs.uk/Livewell/coldsandflu/Pages/Isitacoldorflu.aspx
Complication
Sinusitis
Middle ear infections
Bronchitis
Bacterial pneumoniae
Exacerbation of asthma and COPD
Information gathering
Patient identity
Signs and symptoms
chief complaints; CC look at warning signs and
symptoms
Action taken
Medications used (current and past medications)
Medical history (Past MEDICAL history) give
examples
Other appropriate information
Social history
Family history
Allergy and adverse drug reaction history
Tietze KJ. Clinical skills for pharmacists
Information-gathering
Important information to be gathered when handling patients
with cold (adopted from Blenkinsopp et.al)
Patient identity
Age (approximate)
Child, adult
Flu symptoms
Medical conditions
Allergic rhinitis
Bronchitis
Heart disease
Asthma
Medication used
Other information
Allergy
Family history
Social history
Next slide
Blenkinsopp et.al
ANTIHISTAMINES
First generation might be
preferred due to its
anticholinergic effect
Indication: relief of rhinorrhea and
sneezing; limited value in ARTI (no
benefit if used alone, may have some
benefits when used together with
other agents)
Contraindications:
Hypersensitivity and lactation
Cautious Use*: In patients with
glaucoma, prostatic hypertrophy,
breathing problems, chronic
bronchitis, and young or advanced
age
Drug Interactions: CNS
depressants, MAOIs, phenytoin,
ketoconazole, erythromycin, and
cimetidine
Adverse Effects: Drowsiness, dry
mouth, nervousness, and dizziness
*Do not exceed recommended dose or dosing frequency of any
nonprescription medication.
HTN = hypertension; CAD = coronary artery disease; MAOI =
monoamine oxidase inhibitor; TCA = tricyclic antidepressant;
ARTI = acute upper respiratory tract infection; CNS = central
nervous system.
Antitussive /Expectorant
Systemic analgesic
E.g., paracetamol, ibuprofen,
Vitamin C
Inconsistent results
May have some benefits for
people undergoing high
physical stress
Echinacea
Might be effective in the
early treatment common
cold in adults.
has been reported to cause
allergic reactions and rash.
Zinc
Cochrane review 2011:
beneficial in reducing the
duration and severity of the
common cold in healthy
people, when taken 24 hours
of onset of symptoms.
However, the authors are
reluctant to give
recommendation for the use
of zinc for common cold due
to high variability of dose,
formulation, and duration of
the zinc used in the trials
Saline spray
Insufficient evidence
Reference
Blenkinsopp A, Paxton P, Blenkinsopp J. Symptoms in the Pharmacy: A
Guide to the Management of Common Illness. 6th ed. West sussex:
Wiley-Blackwell; 2009.
Brian C. Upper respiratory tract infections and other infections of the head and
neck. Available from
http://www.microbiologybook.org/Infectious%20Disease/Upper%20respirator
y%20tract.htm. Accessed Sept 20, 2016
Covington et.al. Treating the common cold: an expert panel consensus
recommendations for primary care physician. The American Journal of Nurse
Practitioner. 2004; 8(11): 77-88
NHS. Colds or flu. Available from
http://www.nhs.uk/Livewell/coldsandflu/Pages/Isitacoldorflu.aspx. Accessed
Sept 13, 2016
Rutter P. Community pharmacy: symptoms, diagnosis, and treatment. 3rd ed.
Elsevier, Churchill livingstone; 2013
Scolaro KL. Disorders related to colds and allergics. In Berardi RR, Ferreri SP,
Hume AL, et al. Handbook of nonprescription drugs: An interactive approach to
self care. 16th ed. Washington DC: American Pharmacists Association; 2009:
177-201
Tietze KJ. Clinical skills for pharmacists: A patinet-focused approach. 3rd ed.
Missouri: Elsevier Mosby; 2012.