Pediatric Cough and Cold Preparations

Discuss how respiratory viruses that cause the common cold are transmitted and spread. 2. List the major categories of medicines found in most cough and cold preparations. 3. Describe the primary effect of antihistamines in treating the common cold. 4. Explain how decongestants decrease nasal congestion. 5. Explain why topical nasal decongestants may be especially dangerous in infants. Definitions There have been many definitions for the “common cold. ” Studies conducted on out-comes of cold remedies often are not consistent in their definition of this illness, but it can be defined rather succinctly by a certain set of signs and symptoms (Table 1). Upper respiratory tract infection is another term used interchangeably in the literature, but this broad term can include both viral and bacterial causes as well as illnesses other than the common cold. The term “common cold ” is understood to mean that the cause is viral. Cough and cold medicines contain pharmacologically active ingredients that alone or in combination are intended to relieve some or all of a patient’s symptoms. For both the parent and the practitioner, deciding which of the multitude of available products to use can be confusing and overwhelming. The intent of this article is to simplify this process by describing what these medicines are intended to do, discussing their efficacy as determined by available evidence, discussing safety issues, and relating these to the epidemiology and pathophysiology of the common cold. Epidemiology Colds are extremely common in infants and children and are becoming more prevalent as larger numbers of children participate in child care. The average number of colds per year generally is quoted as being 3 to 10. If each cold lasts the usual 10 to 14 days, this translates to up to 140 days of cold symptoms per year. The common cold is a self-limited viral illness that can be caused by more than 100 different viruses. The rhinoviruses are the most frequent culprits. At least 100 serotypes of rhinoviruses have been identified. Table 2 lists the viruses known to cause the common cold. There are also nonviral causes of illnesses that have coldlike symptoms. In general, colds are more prevalent during the winter months, despite differences in wintertime temperatures in various locations.