Colds and Flu

Sore throat, runny nose, nose bunged up and a nagging irritant cough. These are the symptoms of a cold, and when accompanied by a general feeling of aches and pains lasting some days, even flu. One feels miserable, other members of the family and children are often affected.

Colds start slowly. The symptoms tend to be confined to the nose, throat and chest. There is often slight headache and tiredness. Temperature and appetite may be normal. The patient is not usually bed ridden.

Flu has a rapid onset. Symptoms involve the whole body with generalised muscular aches and pain often labeled as "fibrositis". Headache and fatigue may be severe. The patient often has a raised temperature, and lack of appetite. The patient is often bed ridden.

These types of conditions are caused by viruses and are described as "self limiting" and get better in time alone. They are not cured by antibiotics. There is a large range of over the counter medicines available without prescription from local pharmacists and he/she is often able to give good advice on treatment. Medicines help the patient to feel better....medicines have no effect on the condition itself.

The author is often asked "What is the best medicine, Doctor?" There is no one answer. My advice is to keep it simple, keep to patient symptoms. Use simple drugs. Avoid combination medicines as when complications arise it is unclear what is doing what.

For headache and pain, use paracetamol.

The soluble type tends to work quicker and is tolerated better in a nauseated patient. Look at the bottle and note that the many proprietary preparations that are available at extra cost have no advantage over the standard drug. This applies to children's preparations also.

Exceeding dosage has no effect on the disease, and is highly dangerous. Paracetamol over-dosage of even small amounts can cause liver and kidney damage and can be life endangering.

Aspirin and ibuprofen are of use here but in my experience best avoided as they can cause gastric upset. Codeine containing mixtures likewise are useful, but can cause constipation.

Aspirin now should never be given to children under the age of 16 years.

Paracetamol is not recommended, except on a doctors' advice to babies under 3 months:
Paracetamol Dose:

• Babies 3 months to 1yr - 60mgs to 120mgs, four times per day
• Children 1yr to 6yrs - 120mgs to 250mgs, four times per day
• Children 6yrs to 12yrs - 250mgs to 500mgs, four times per day
• Adults - 2 x 500mgs, four times per day

That is, maximum doses - liquid, capsules, tablets or any other formulation.
For congestion and nasal stuffiness

Numerous proprietary combinations are available. These tend to be either so called "decongestants", or are called "antihistamines" all of which can be taken both by mouth, or by using nasal sprays or nasal drops. They are the same drugs often used to treat allergies. Look at the bottle to find out what is contained.

The author advises simple "decongestants" containing ephedrine or pseudoephedrine. These should be avoided in certain medical conditions such as diabetes, heart disease and hypertension, and hypothyroidism.

"Antihistamines" similarly are very effective and are longer acting but can cause drowsiness or sedation, which may or may not be required. Loratidine (Clarityn) is a non-sedating antihistamine. Promethazine (Phenergan) has more sedative effect. Patients should be aware of such sedation effect when performing skilled tasks such as driving. Excessive alcohol consumption should also be avoided.


Written by Medpages Editorial Team
Last Editorial Review: 15/1/2010