Common Cold

(upper respiratory tract infection)

The respiratory tract is divided into upper and lower parts:

Upper respiratory tract: consists of the sinuses, middle ear, pharynx, epiglottis and larynx
Lower respiratory tract: consists of the structures below the larynx, the bronchi, bronchioles
and alveoli
 “Common Cold”: Introduction
 Also known as Acute Rhinitis
 Viral infection of upper respiratory tract
 Most common acute illness
 Seasonal variance with highest number of cases in
winter months
 Incidence in adults is 2-4 infections per year
“Common Cold”: Causitive Organism
 More than 200 viruses can cause the cold
1. Rhinoviruses ( over 100 serotypes) : 30-50% of all cases
2. Coronaviruses : 10-15% of all cases
3. Influenza viruses : 5-15% of all cases
4. Parainfluenza viruses : 5% of all cases
5. Respiratory synctial virus : 5% of all cases
6. Other viruses :
• Adenovirus
• Enteroviruses
• Metapneumoviruses
“Common Cold” : Transmission
Transmission
 Person-to-person
Droplet/secretions from infected
 Airborne and close contact
 Aerosol
large and small droplets
 Hand contact
 Fomites
some viruses can live on surface for 2-4 hours
 “Common Cold”: Clinical Features
Incubation period :1-5 Days

 Nasal congestion
 Rhinorrhea
Bilateral , clear sputum ( may be sligtly mucopurulent)
 Sneezing
 Cough
 Lymphadenopathy
 Other sign & sypmtoms:
• Pharyngitis (sore throat)
• Conjuntivitis
• May have low grade fever, headache,myalgias, fatigue
Symptoms are self-limited, often lasting up to 10 days. In children, the median duration is eight days
in those who receive medical care, and 90% of cases resolve within 23 days.
“Common Cold”: Complications
• Usually caused by secondary bacterial infections
 Acute Otitis Media
 Sinusitis
 Bronchitis
 Pneumonia
 Exacerbation of Asthma or COPD
“Common Cold”: Diagnosis
 “Common Cold”: Treatment
 The primary goals of treatment are reduction of symptom duration and
severity.
 Antibacterial drugs have no activity against viral infections, although in
the past they were widely prescribed, sometimes with spurious rationale
such as prophylaxis against bacterial superinfection, sometimes simply
because patients demanded them.
 Informing patients about the natural course of the common cold can help
manage expectations, limit antibiotic use and avoid unnecessary over-the
counter purchase
 Treatment for Adults
 EFFECTIVE SYMPTOMATIC TREATMENTS:
 Effective treatments for symptoms of the common cold in adults are limited to
 Intranasal ipratropium (Atrovent)
 Over-the-counter analgesics
 Decongestants with or without antihistamines
 Zinc
 Analgesics
 Ibuprofen
o Reduce headache, ear pain, muscle pain, joint pain, and sneezing
o Do not improve cough, cold duration, or total symptom score.
o Ibuprofen is more effective than acetaminophen for reducing fever-related discomfort.
 Acetaminophen
o Acetaminophen may provide short-term relief of rhinorhea and nasal obstruction but has no effect on sore throat, myalgias,
sneezing, or cough
 Treatment for Adults
 Decongestants:
o Nasal decongestants (oral and intranasal) may relieve nasal congestion, but there is no evidence
that they reduce cough.
o Topical oxymetazoline reduces the duration and severity of nasal congestion after multiple doses.
 Antihistamines in Combination Medications:
o Antihistamines combined with oral decongestants and/or analgesics may provide some relief of
cold symptoms, although the effect on cough is limited.
o This benefit is most pronounced in the first two day
o When started on the first day of symptoms, medications containing ibuprofen and pseudoephedrine
may reduce the severity of cold symptoms .
 Ipratropium
o Intranasal ipratropium is the only medication that improves persistent cough related to URI in
adults.
 Treatment for Adults
 Complementary and Alternative Treatments:
o Taking at least 75 mg of zinc acetate or gluconate lozenges per day relieves cough and
nasal discharge more quickly when treatment is started within 24 hours of symptom onset.
 Probiotics:
o Three months of daily use of a fermented dairy product containing Lactobacillus casei
reduced the duration of URI symptoms by 1.5 days in older adults.
 Treatments for Children:
 Safe and effective treatment options for symptoms of the common cold in children vary somewhat
from those for adults.
 Nasal saline irrigation, analgesics, and time are the mainstays of treatment for URIs in children.
 Acetylcysteine:
o The mucolytic acetylcysteine may safely decrease cough after six to seven days in children two
years and older.
 Ipratropium:
o Intranasal ipratropium may decrease rhinorrhea but not congestion related to URIs in children five
years and older.
 Nasal Saline Irrigation:
o Children who use saline nasal washes six times per day have faster resolution of nasal secretions
and nasal obstruction and reduced use of antipyretics, decongestants, and antibiotics.
 Treatments for Children:
 Complementary and Alternative Treatments:
o Application of ointment containing camphor, menthol, and eucalyptus oils on the chest and
neck of children at bedtime can relieve nasal congestion and reduce night time cough
frequency and severity, improving sleep for both the child and parents.
 Menthol:
o The use of menthol alone may also improve perceived nasal patency but may not help with
cough
o Menthol is safe for use in children two years and older
 Honey:
o The use of honey before bedtime may also reduce the frequency and severity of cough.
o Honey should not be given to children younger than 12 months because of the risk of
exposure to botulinum spores
 Inefective Treaments:
 There are more ineffective treatments for the common cold than effective treatments, and
some may even be harmful
 Treatments that are not recommended include
 Antibiotics
 Antivirals
 Most cough medications
 Antihistamine monotherapy
 Intranasal corticosteroids
 Steam
 Vitamins D and E
 “Common Cold”: Prevention
 Good hand hygiene is the most effective and practical way to prevent URIs in children and adults.
 The use of hand sanitizer is more protective than hand washing and is associated with shorter
duration of symptoms and fewer school absences.
 Washing hands several times per day for at least 15 to 30 seconds can help prevent illness.
 Regular soap is as effective as antibacterial soap.
 Stress relief
 Stay active
 Proper sleep
References:
 https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=treatment+of+common+Col
d+by+Katharine+&btnG=#d=gs_qabs&t=1710850312752&u=%
23p%3D-LIa6cK4eTYJ
 Clinical Pharmacy and Therapeutics Fifth edition Chapter no:35 page no: 545
 “
Thank you

”
Presented by:
Saqlain Ali Abid
Supervised by:
Sir Jamshaid Akbar Sheikh