‘Tis the Season for Sneezin’ By: Marge McCoy, R.Ph.

Probably some of the most commonly asked questions we receive during the winter deal with cold treatments. Here’s a brief “clip and save” primer on cold medications to help you through this winter cold season. You may not need everything in those “magic bullet” tablets that contain everything but the kitchen sink, so why take unnecessary drugs? Sometimes you may have only a single symptom that is causing you problems. We’ll try to help you navigate the twisty drug road map that winds through the cough and cold section. Not all over-the-counter medications should be mixed with other OTC medications or prescription medications. Remember, if you have any questions or concerns, ask you pharmacist or health care provider.

Decongestants – help when your head feels “stuffy”. They can also help relieve a sensation of plugged ears due to head congestion.

Side effects can include wakefulness (so don’t take near bedtime) and the oral medications may not be appropriate for those with high blood pressure, diabetes, prostate problems and certain other conditions. (Examples: Sudafed®, pseudoephedrine) Due out in January 2005 is Sudafed PE® which contains phenylephrine. This decongestant is offered as an alternative to those pseudoephedrine products that can be used to produce illegal methamphetamine.

The decongestant nasal sprays work quite well, but cannot be used for longer than three days or they can give you rebound congestion. (Examples: Afrin® or oxymetazoline, Neo-Synephrine® or phenylephrin)

Anti-histamines – help when your symptoms include sneezing, itchy or watery eyes, runny nose or sinus drainage down the back of your throat. Side effects can include drowsiness, dry mouth or dry eyes. (Examples: Benadryl® or diphenhydramine, Chlor-Trimeton® or clorpheniramine, Claritin® or loratadine which is non-drowsy).

Cough Suppressants – help stop coughing. It is OK to suppress a cough that is dry and hacking, or one that is keeping you up all night, but if it is “productive” (a cough that helps clear that junk out of your lungs) – it is best not to stop the cough from doing its job. Side effects can rarely include drowsiness. (Examples: Robitussin DM® or Tussin DM®, Delsym®, Dex-Alone®, all contain dextromethorphan)

Mucous thinners – help thin mucous (a fancy term for snot) so that it is easier for your body to clear. Not everyone agrees on the effectiveness of this drug, but we have found it to be quite effective in certain cases. The more water you drink when taking this medication, the more effective it can be. Here’s a comment from personal experience – the liquids in this category are less expensive, but don’t taste very good. We usually recommend generics for cost savings, but here’s one place we opt for the more expensive tablets for convenience and taste. (Examples: liquids - Robitussin® or Tussin®, guiafenesin; tablets - Mucinex®, Humibid®)

Pain and Fever Reducers – do exactly what they claim, but not all are appropriate for all cold sufferers. For example those on blood thinners should not take aspirin or ibuprofen. (Examples: Tylenol® or acetaminophen, Bayer® or aspirin, Motrin IB® or ibuprofen)

Combination Products – you can find various combinations of these products on your drug store shelves. Pick just what drugs you need. Read labels and ask questions. (Examples: Thera-Flu®, Nyquil®, Dayquil®, Tylenol Multi-Symptom®)

Miscellaneous – some products contain alternative cold treatments, such as herbals. Echinacea has long been popular for warding off colds. Recent studies downplay its importance, but it is one option and has not been shown to be harmful. Goldenseal falls in the same category as Echinacea, but Goldenseal has been shown to cause liver problems with continued use.

Zinc containing lozenges (Cold-Eeze®) and nasal sprays (Zicam®) have been demonstrated to help shorten the duration and severity of colds if they are begun soon enough (within 48 hours of the start of the cold). The lozenges can leave a metallic taste in your mouth and there is some recent concern that the zinc nasal sprays can permanently alter taste in a small number of users. We think a better option is Airborne®. It is a combination of vitamins, minerals and herbals that we have found to be quite effective in many cases. We also take Airborne® before we get on any crowded public transportation (like airplanes). We always keep Airborne® on hand because the sooner you start it after the cold virus invades your body, the better it works.

Sanitizers – Not all colds are picked up by being next to a runny-nosed, sneezing toddler in the grocery store. In fact we pick up a huge quantity of germs through touching things (door handles, money, etc.). Not a problem, you say – my skin protects me from the germs. Yes, that’s absolutely true, but we unwittingly transmit the germs on our hands into our bodies by touching our eyes, rubbing our noses, etc. That puts those germs in a place where they can quickly be happy and multiply. One way to combat this is frequent hand-washing. Another option when you are out and about is to wipe out the bad bugs on your hands with a small portable bottle of hand sanitizer. (Example: Purell Hand Sanitizer®)

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Marge and Rick McCoy are the pharmacists who own and operate Lopez Island Pharmacy. They feel it is important for patients to have knowledge about their medications to get the most from their health care dollars. Between the two of them they have over 60 years of pharmacy experience.