John’s Cold Case: Assessment and Analysis

Would you treat this patient for his cold? Why or why not?

Common colds are one of the primary reasons for physician visitation. Due to the acute viral nature of the infection, it can be severely disruptive to daily activity and symptoms may extend for as long as three weeks. Most medical professionals do not recommend seeing a physician unless there are serious complications since there is nothing a doctor can do other than to provide recommendations on self-treatment at home. It is not recommended to prescribe antibiotics or prescription medication unless there are complications due to their potential side-effects (Allan & Arroll, 2014). In the case-study, John is not exhibiting any pathological anomalies. The most significant concern during a cold is the transition to the more severe upper respiratory tract or ear infections. However, his lungs and tympanic membranes are clear, and examination shows mainly inflammation of sinuses typical in the cold. Although above normal, his temperature is below the threshold of what is considered a fever. A doctor should give recommendations on the type of over-the-counter medicines the patient can take to relieve his symptoms.

If you were to treat this patient, what would you use? How many days would be appropriate?

An antihistamine therapy combined with decongestants is shown to have a moderate effect. It reduces nasal obstruction and shown improvement in global symptoms. Also, intranasal ipratropium has significant improvement for rhinorrhea, which is particularly relevant for this patient experiencing mucous production and nasal discharge. These treatments, particularly nasal sprays, should not be used for more than three days as there should be significant relief of pressure during this time. Acetaminophen (paracetamol) is shown to be effective in lowering a slight fever that was measured during the physical examination. Besides, it serves as a mild analgesic that can address the intermittent headaches experienced by the patient due to nasal congestion. Standard adult dosage should not be taken for longer than ten days without consulting a physician.

There is frequent usage of traditional and nonpharmacological medicine for the treatment of common colds. Although these methods are not directly targeted at cold treatment and are not clinically proven, they maintain a certain level of health benefits which may mediate symptoms. Intake of honey can help with cough management. Zinc and vitamin C has shown evidence of reducing the duration and severity of cold symptoms. Also, it is possible to use nasal irrigation, herbal medicine, and echinacea for improvement (Allan & Arroll, 2014).

How would this treatment vary if the patient was a child?

Many conventional cold over-the-counter medications cannot be effectively given to children or cause possible harm. These medications are one of the leading causes of substance deaths for children under the age of five, strongly recommended to be avoided by the U.S. Food and Drug Administration. Therefore, any over-the-counter cold medicines marketed for young children have potentially adverse effects. Acetylcysteine can be used for any underage children to help with mucus breakup and supports the body’s antioxidant system. Dosage may vary, but the duration of treatment may range up to 28 days. High-dose inhaled corticosteroids or nasal irrigation, dependent on age, can be used for decongestant purposes. Minimal use of vapor or echinacea rub has shown to be effective. Some other methods that minimize symptoms include buckwheat honey, zinc sulfate, and Pelargonium sidoides (geranium) extract (Fashner, Ericson, & Werner, 2012). Children often experience colds more often than adults, which may create the illusion of worrying that a series of minor infections is a prolonged and chronic illness. Therefore, the medication should be used sparingly to maintain effectiveness and efforts should be aimed at supporting the child’s immune system.

References

Allan,G. M., &Arroll, B. (2014). Prevention and treatment of the common cold: Making sense of the evidence. Canadian Medical Association Journal, 45(7), 190-199. Web.

Fashner, J., Ericson, K., & Werner, S. (2012). Treatment of the common cold in children and adults. American Family Physician, 86(2), 153-159.

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