UNOFFICIAL GUIDE TO BEATING UPPER RESPIRATORY INFECTIONS
Updated: Jan 16
The cold/flu season is here. Do you know when to see a doctor? What over-the-counter medications to buy? What not to do? Don’t make things too complicated! Read this short article and avoid antibiotics!
In our view, treating an upper respiratory tract infection (such as the common cold or flu) boils down to controlling these symptoms:
- Pain: body aches, muscle ache, headache, etc.
- Nasal symptoms: runny nose and/or post-nasal drip), nasal congestion, sinus pain
- Sore throat
Let’s tackle one at a time.
Fever. These are infections (mostly viral, sometimes bacterial) causing inflammation of the upper respiratory tract. Inflammation leads to fever - more so in case of the flu. The best treatment for fever/inflammation is ... ibuprofen. Adults can safely take 200 mg of the OTC ibuprofen every 4 hours. Just make sure not to take it on an empty stomach or use it longer than a couple of days. As good as it is, it does have very serious side effects.
Pain. With inflammation comes pain. Depending on the type of organism causing the infection, “pain” may manifest as body aches, headaches, sore throat, sinus pain, or whatever. Regardless of the type of pain ... again … ibuprofen works. Yes, your pharmacy may sell various topical “potions” labeled to treat a specific type of pain. Heck, they are still offering homeopathic “snake oil.” These have not been proven to be terribly effective. Stick to ibuprofen. If needed, add some OTC Tylenol (acetaminophen). Rest.
Nasal symptoms. For nasal congestion, the best medication is OTC oxymetazoline (Afrin). It’s not recommended to be used for longer than 5 days to prevent rebound symptoms. Behind-the-counter pseudoephedrine (PSE) is fine too … but it tends to raise the blood pressure and may keep you up at night if taken too late in the day. Plus … because of the current “war on drugs,” some pharmacies have stopped carrying this medication. Instead, they offer a deceptively similar-sounding phenylephrine (PE), which is … junk, in our opinion. Most pseudoephedrine still sold today comes in combination with an antihistamine (see more below). It’s fine, but do make sure you understand WHAT you are taking so as not to overdo the antihistamine part.
For the “runny” symptoms (nasal drainage, postnasal drip), the goal is to “dry” things up. Afrin helps a bit. Additionally, ask your doctor to prescribe a nasal spray called Atrovent Nasal Spray (ipratropium bromide). It works well with few side effects in most healthy adults … but must be used frequently throughout the day. Finally (and most importantly), don’t forget about over-the-counter antihistamines. Old ones (first generation), such as diphenhydramine, brompheniramine, and chlorpheniramine, are quite powerful but tend to be sedating (making you sleepy). For the best effect, take the smallest dose BUT frequently - every 6-8 hours. Newer antihistamines - loratadine, cetirizine, and fexofenadine - tend to be less sedating. “Official wisdom” holds that these meds are good only for allergies (not colds) and should not be taken more than once a day. But … our patients report taking them for colds up to four times a day with good results and no side effects … not that we recommend it :)
Sore throat. Again, ibuprofen works just fine. So does warm tea. Avoid OTC “sprays” sold by pharmacies - they don’t last and taste like !@#$. Most sore throats are actually caused by nasal secretions (“post-nasal drip”). Therefore, dry the nose (see above), fix the throat.
Earache. Usually, what you feel is the “referred” pain from the throat: you swallow - your ears (and/or teeth) hurt. Additionally, the passages (eustachian tubes) connecting the nose and middle ear swell up, trapping fluid in the middle ear. You can try pseudoephedrine (see above) or simply take … ibuprofen. Ultimately, it’s a matter of time (usually a couple of days) vs. any "branded" intervention. If you must, try garlic ear drops. Many moms swear by them.
Cough. Now … this is a big one: it needs to be treated aggressively from the get-go. Otherwise, you will find yourself coughing for weeks to come. Acute cough is mostly caused by post-nasal drip, best treated (as we suggested above) with both topical (Afrin, Atrovent) and oral medications (antihistamines). For the actual cough, try some OTC dextromethorphan liquid gels. We also saw good results with a Mexican herbal medication called Broncolin. For even better results, have your provider prescribe Tessalon perles. (If you are in Vegas, you can see a telemedicine provider, such as Careborne, and have your prescription sent to the pharmacy of your choice.)
Insomnia. You get sick, you can’t sleep. You stay up, you feel worse! Old days, your doctor would’ve recommended something like THIS. Today, the PC police would not even allow us to joke about these things … Then again, generally healthy adults can (and should) be able to put together a sleep “medication” of their liking. Or … you could take melatonin!
And that’s about it! It’s really that simple!
Now, what if, a couple of weeks later, you are still not better? That’s when an antibiotic prescription MAY help. Contact Careborne or check with your regular doctor.