How to Prevent the Common Cold

Avoid / Cure A Cold Fast

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Avoid Cure A Cold Fast Summary

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Respiratory Illness

Current studies have found little evidence of marijuana-induced increases in respiratory illnesses. A review of a large sample of hospital records revealed that 36 of daily marijuana smokers saw a physician for colds, flu, or bronchitis in a six-year period. Only slightly fewer (33 ) of the nonsmokers sought treatment for these same problems (Polen, 1993). These data suggest that cannabis consumption does not create meaningful increases in the rates of respiratory illnesses. Nevertheless, other work reveals

Cold Remedies

Capsules and tablets for relieving symptoms of colds account for a large percentage of OTC drug sales. Like the cough syrups, they are a mixed bag of different formulas and strengths. Common ingredients are antihistamines, aspirin and other pain relievers, nightshade drugs to dry up excess secretion in the nose and throat, and caffeine and phenylpropanolamine to offset the sedative effects of the other ingredients. Usually these mixtures are packaged in multicolored tablets and flashy capsules to make them look exotic and powerful. Whether they affect the course of a cold or significantly reduce the symptoms is questionable. (Even when they do suppress symptoms, they may actually prolong colds by making people less aware of their illness and less likely to take good care of themselves.) What is more certain is that OTC cold remedies can affect mood, usually in undesirable ways. Alternate methods of treating colds to avoid these problems include taking hot baths, forcing fluids, eating...

General Information

Well-controlled studies on aminocaproic acid in a limited number of patients showed no serious adverse effects. Minor unwanted effects have been reported in 10-20 of patients and include headache, nasal congestion, conjunctival suffusion, nausea, vomiting, diarrhea, and transient hypotension (32). Skin rashes have also been associated with aminoca-proic acid, including maculopapular and morbilliform eruptions. Rarer dermatological reactions reported include purpuric rashes (33), bullous eruptions (34), and contact dermatitis with positive patch tests (35-37). Treatment with a high dose (the maximum daily dose is 36 g day) can result in an osmotic diuresis (38).

Comparative studies

There have been three double-blind, randomized, parallel-group comparisons of the effects of azelastine nasal spray (1.1 mg day) with combined treatment with oral loratadine (10 mg day) and budesonide nasal spray (336 mg day) in 1070 patients with allergic rhinitis unresponsive to monotherapy (2). The primary outcome measure was the percentage of patients who needed additional therapy for rhinitis after 7 days of treatment, and this was 32-46 across the three studies, with no significant difference between the two treatment groups. The most common adverse event with azelastine was a transient after-taste (8 compared with 1 in the combined group) and the most common adverse event for combined treatment was headache (6 compared with 5 in the azelastine group). Rhinitis and somnolence were the other commonly reported adverse events, in 3 and 2 with azelastine, and 1 and 1 in the combined group. The authors concluded that monotherapy with azelastine is as effective and as well tolerated...

Critical perspectives on antidoping and sport

Anti-doping changed the face of modern sport because it cast the shadow of suspicion over all athletes. Of course, the opposite might be argued, that testing was the best system of preventing wide-scale doping. But it was the very premise of anti-doping - that any drug taking was wrong - that set up an impossible situation. Even slight discrepancies, such as the ephedrine in a common cold treatment, could lead to lengthy bans. Drugs could not be used for short- or long-term recovery, pain management or building strength after an injury. This was an all or nothing strategy.

Adverse Reactions

Sedation and dry mouth are the most common adverse reactions seen with the use of TCAs. Tolerance to these effects develops with continued use. Orthostatic hypotension can occur with the administration of the TCAs. Orthostatic hypotension is a drop in blood pressure of 20 to 30 points when a person changes position, such as going from a lying position to a standing position. Mental confusion, lethargy, disorientation, rash, nausea, vomiting, constipation, urinary retention, visual disturbances, photosensitivity, and nasal congestion also may be seen. Sexual dysfunction may occur with administration of clomipramine.

Adrenergic Sympathomimetic Drugs

As such they increase cardiac output, dilate bronchioles, and usually produce constriction of blood vessels. In medicine, they are commonly prescribed in cardiac emergencies including shock and anaphylaxis, in some cases for weight loss, and in cold remedies, where they shrink swollen membranes in the upper respiratory tract.

Systemic availability of inhaled glucocorticoids

Since many patients with allergic asthma also have rhinitis, they may be taking both inhaled glucocorticoids for their asthma and intranasal formulations for their hay fever. The total systemic availability of glucocorti-coids has been studied after the addition of intranasal therapy in patients already taking inhaled glucocorti-coids (11) in 12 moderately severe asthmatic subjects (mean FEV1 84 predicted), who were randomized in a placebo-controlled, two-way, crossover comparison of inhaled fluticasone (880 micrograms bd) plus intranasal fluticasone (200 micrograms od), inhaled triamcinolone (800 micrograms bd) plus intranasal triamcinolone (220 micrograms od), and respective placebos. Both the inhaled glucocorticoids caused significant suppression of adrenocorticoid activity, although the addition of intranasal formulations did not produce further significant suppression. There were more individual subjects with abnormally low cortisol values when intranasal flutica-sone was added....

Organs and Systems Cardiovascular

In a large, multicenter, double-blind, placebo-controlled, parallel-group study of the efficacy and tolerability of desloratadine in 346 patients with seasonal allergic rhinitis, the symptoms improved significantly and there was no significant effect on the QTc interval (7).

Pharmaceutical interest

Uses The seeds of Brassica juncea (L.) Cosson are pungent and are used in America, Japan, China and other countries to make mustard and oil (canola oil). Canola oil abounds in omega-3 fatty acids and has the potency to lower the risk of stroke. In China, the seeds are used to treat colds, rheumatism, lumbago, abscesses and stomach disorders. The leaves are used to soothe inflammation of the bladder and to stop hemorrhages. In Malaysia, the oil expressed from the seeds is used to treat skin eruptions and to heal ulcers.

Pregnancy Category None

Medical Letter on Drugs and Therapeutics 15 (1973) 86-88. Brady, W.J., Jr., et al. Freon Inhalational Abuse Presenting with Ventricular Fibrillation. American Journal of Emergency Medicine 12 (1994) 533-36. Goldsmith, R.J. Death by Freon. Journal of Clinical Psychiatry 50 (1989) 36-37. Lee, T., et al. Oral Frostbite Secondary to Freon Propellant Abuse. Journal ofToxicol-

Drug administration route

A nasal spray (isotonic aqueous ipratropium pump) has been used in allergic and non-allergic rhinitis as well as the common cold. The spray caused no systemic adverse effects and only minor infrequent episodes of nasal dry-ness and epistaxis, which did not interfere with treatment (15,16).

B is for Bioweapon C is for Chemical attack

The traditional responders to terror - fireman, police, HAZMAT specialists etc. - who are responding to a known event, the first responders to bioterror are those charged with recognizing that something has even happened. This means that the first line of defense is doctors, nurses and other health professionals within our public health infrastructure recognizing unusual symptoms or an odd number of people with similar symptoms coming in to see them. The anthrax letters had a note pointing out that the powder was dangerous, but an attack aimed at mass casualties would not likely have such a warning. The initial symptoms for most agents that would be used in a bioterror attack are not very different from the symptoms of common diseases - in many cases the common cold that health professionals see every day. So they would need to notice a trend or significant spike in people coming in with specific symptoms. Not only that, it relies on communication between hospitals to see if there is...

Organs and Systems Respiratory

Churg-Strauss syndrome is a rare form of allergic granu-lomatous vasculitis, first described in 1951, characterized by the histological findings of eosinophilic tissue infiltration, extravascular eosinophil granulomas, and necrotiz-ing vasculitis. It develops in patients with a history of upper airway disease (especially allergic rhinitis and sinusitis) and asthma. There are different definitions of the syndrome, and it is important to know which definition is being used when the results of different incidence studies are being compared. Clinically the syndrome has been defined (3) as a combination of asthma, peripheral eosi-nophilia (over 1.5 x 109 l), and a systemic vasculitis involving two or more extrapulmonary organs. Recognized clinical risk factors include moderate to severe asthma, chronic sinusitis, and a recent reduction in systemic corti-costeroid therapy (4). An important feature is the phasic developmental pattern of the disease, and corticosteroid therapy suppresses some...

Central Nekvous System

There is some evidence, both real and anecdotal, to suggest lhat cannabis use may have a slight, temporary effect on the body's immune system, Tfcere is nothing to show that this possible effect is more significant than lhat suffered with the similar effects of moderate alcohol or caffeine use. Much o( the evidence may originate from contagious diseases (especially the common cold) hitching a ride on joints passed between friends.


A decongestant is a drug that reduces swelling of the nasal passages, which, in turn, opens clogged nasal passages and enhances drainage of the sinuses. These drugs are used for the temporary relief of nasal congestion caused by the common cold, hay fever, sinusitis, and other respiratory allergies.

See also Monoclonal antibodies General Information

In a placebo-controlled study of subcutaneous omalizu-mab (50,150, and 300 mg before the ragweed season and every 3 or 4 weeks during the pollen season) in 536 patients with seasonal allergic rhinitis, injection site reactions were mild and infrequent, there were no clinically significant alterations in laboratory values, and anti-idiotypic antibodies to omalizumab were not detected there was no evidence of immune complex-related adverse events (5-7).

Placebocontrolled studies

In a double-blind, placebo-controlled study in 288 patients with previously treated erosive or ulcerative gastro-esophageal reflux disease rabeprazole 10 or 20 mg day was significantly more effective than placebo in preventing relapse of erosive or ulcerative gastro-esophageal reflux disease and was well tolerated (10). Commonly reported adverse events were abdominal pain, nausea, diarrhea, rhinitis, pharyngitis, a flu-like syndrome, and back pain. Rabeprazole had no clinically significant effects on laboratory values, thyroid function tests, the electrocardiogram, vital signs, or body weight.

General adverse effects

The adverse effects of the thiazolidinediones are comparable and include weight gain, upper respiratory tract infections, headache, and hypoglycemia (mostly in combination with other hypoglycemic drugs). Fluid retention sometimes occurs (19,21) and can lead to or exacerbate heart failure and pulmonary and general edema, which was reported in 1.5-12 of patients taking pioglitazone. Small clinically unimportant falls in hematocrit and hemoglobin occur because of hemodilution. Changes in liver enzymes and bilirubin have not been reported with rosiglitazone, and although there have been some reports of hepatic-related adverse effects, they have not been definitive (SEDA-25, 515). However, troglitazone causes liver complications, sometimes fatal, and this has led to its withdrawal from the market. There are no drug interactions with other hypoglycemic agents.

Evaluating Alternative Remedies

A drug is any chemical compound you take to alter your physical or mental state. Penicillin, codeine, and fluoxetine are drugs. So are caffeine, alcohol, and nicotine. The vitamin C many people take to ward off colds is a drug. Herbs are drugs. Multivitamins, stress pills, and minerals like zinc supplements are drugs, too. All of these are drugs, with the possible benefit of changing your physical or mental state, and the potential for bad reactions. It's important to know that a remedy can be therapeutic at one dose but cause problems if the dose is too high. Just because it's natural doesn't mean that you can't take too much. For example, in small doses, vitamin A is essential for proper metabolic function, especially aiding vision, but large doses can cause yellowing of the skin. Large doses of vitamin B6 can cause clumsy hands and feet and numbness around the mouth. The high doses of vitamin C used by some people in the mistaken belief that it wards...

Pregnancy Category C

Phan can relieve abstinence symptoms experienced by heroin addicts. Such results do not demonstrate whether dextromethorphan has cross-tolerance with all the drugs just named, allowing it to be substituted for any of them their withdrawal syndromes all include elements mimicking the common cold and flu, and dextromethorphan may simply be able to relieve flulike symptoms regardless of cause.

Phenolics and Polyphenols

Hypericin (Fig. 15.7), an antidepressant anthraquinone from Hypericum perforatum (St. John's wort), is reported to have antiviral activity 59 , while chrysosplenol C is a potent and specific inhibitor of picornaviruses and rhinoviruses, the common cold viruses 60 . Chrysophenol C isolated from the Australian plant Dianella longifolia and chrysophanic acid from Pterocaulon sphacelatum inhibits the replication of poliovirus 2 and 3 due to hydrophobic C-6, and the methyl group at C-3 of chrysophanate molecule 61 . It is evident that the introduction of an aryl group at the piperazine moiety of fluoroquinolone is responsible for its antiviral activity, with a specific action on HIV by inhibiting transcription and tat functions 62 . Substitution of the fluorine at position 6 with an amine group yielded aryl-piperaz-inyl-6-amino-quinolone, which is a selective and potent inhibitor of HIV-1 replication by interfering with tat-TAR interactions 62 , and can be useful for rational drug design...

Xanthium strumarium L

Uses In China, the fruits of Xanthium strumarium L. are used to invigorate health, soothe inflammation, promote urination, combat fever, stop spasms, treat sinusitis, headache and to counteract putrefaction. In Korea, the fruits are used to treat rheumatism and to soothe inflamed parts. In Malaysia, Xanthium strumarium L. is used to counteract postnatal infection. In Vietnam, a decoction of 6 g-12 g of fruits of Xanthium strumarium L. is used to treat furonculosis, impetigo, rhinitis, urticaria, goiter, rheumatism, mycosis, heal ulcers, assuage cramp, toothache and headache, soothe sore throat, and to treat dysentery. In India, the entire herb is used to cool, to calm, to sweat, and to promote urination and the secretion of saliva. The leaves are used to treat malaria and the fruits are used to treat smallpox. The roots are used to treat cancer.

Abu Ali alHusayn ibn Abdallah ibn Sina See Avicenna

Acetabarb Phenobarbital. Acetaldehyde CH3CHO, also called acetic aldehyde ethanol and ethylaldehyde, is an organic compound belonging to the aldehyde group. A colourless flammable liquid with a pungent, fruity odour, it is important as an intermediate in the manufacture of many chemicals, pharmaceuticals, and plastics, including acetic acid, butyl alcohol, chloral, and pyri-dine and is used in the manufacture of perfumes and flavours. Acetaldehyde is widely used as a starting material for the synthesis of many organic compounds. Acetaldehyde may cause irritation of mucous membranes, lacrimation, photophobia, conjunctivitis, corneal injury, rhinitis, anosmia, bronchitis, pneumonia, pleurisy, headache, and unconsciousness.

Phenobarbital sodium Natrium5thyl5phenylbarbiturat

NBA Non-beverage alcohol alcohol other than that made for consumption methanol, isoamyl alcohol, or isopropyl alcohol, appearing as aftershave lotions, antifreeze solutions, astringents, canned heat, cooking sherry (salty), cough syrup (with or without codeine), denatured alcohol, disinfactants, hair tonic, liquid cold remedies, mouthwash, rubbing alcohol, shoe polish, solvents (gasoline, paint thinner, shellac, turpentine), terpin hydrate -drunk for cheapness. Nbj.t Arundo donax.

Antiedema sympathomimetics

Naphazoline is used in severe rhinitis associated with colds, allergic reactions, and severe and chronic inflammatory conditions, in particular for inflammation of the antrum of Highmore as well as for stopping nosebleeds. Synonyms of naphazoline are nafazair, sanorin, rinazin, and privine. Oxymetazoline is used for the same indications as naphazoline, primarily for rhinitis. Synonyms of this drug are afrin and duramist.

Cromoglycate nedocromil and lodoxamide

Sodium cromoglycate is widely used in the prophylactic treatment of allergic diseases, especially bronchial asthma and allergic rhinitis. It inhibits histamine release from mast cells by a stabilizing effect on the cell membrane. It is usually given by inhalation or intranasally. The bioavailability following inhalation is low (

Amfetamines Introduction One of a

AMFETAMINES - History Amfetamine was synthesized in 1887 but its central stimulating effects were not discovered until 1927. It was patented 1932. The interest was first focused on its respiratory stimulating effect but soon even its CNS stimulating andrenaline-like effects was noted. Amfetamine became very soon the drug of fashion in the 1930s and 1940s with striking similarities to the enthusiasm when cocaine was introduced in the 1880s. It was promoted as being an effective cure for a wide range of ills but its addictive effects was ignored. In the beginning it was prescribed as a medicine against common colds and nose problems because of its vessel constricting effects and also to counteract sedative poisoning. The pharmaceutical industry then enthusiastically promoted it as a cure for a wide spectra of symptoms e g hangovers, depressions, nausea, vomiting in pregnancy, weight reduction. Derivates of amfetamine such as metamfeta-mine was developed in both oral and intravenous...

The Birth Of Methamphetamine

Ephedra With Meth

Although methamphetamine is synthetic, it traces its roots to a small leafless bush called Ephedra that grows in China and North America. For more than 5,000 years, Chinese healers have dried and boiled the stems of this plant to make a tea called mahuang that opens air passages and makes breathing easier, helping those suffering from asthma and other respiratory illnesses. The tea also increases energy and general well being. In 1847, when Mormons settled in Utah, they discovered that the native peoples of the western United States enjoyed an exciting drink made from Ephedra. Since Figure 1.1 The ephedra sinica bush is used to make mahuang and ephedrine, stimulants used to fight colds and asthma, but it is also one of the ingredients in amphetamines and methamphet-amines. Dagmar Ehling Photo Researchers, Inc. Figure 1.1 The ephedra sinica bush is used to make mahuang and ephedrine, stimulants used to fight colds and asthma, but it is also one of the ingredients in amphetamines and...

Levosalbutamol levalbuterol

Salmeterol 42 hg bd has been compared with inhaled ipratropium bromide 36 hg day and inhaled placebo in a randomized, doubleblind study for 12 weeks in 405 patients with chronic obstructive pulmonary disease (52C). Both salmeterol and ipratropium bromide significantly increased the peak expiratory flow rate compared with placebo. Non-specific ear, nose, and throat symptoms (e.g. sore throat and upper respiratory tract infections) were more common with salmeterol and ipratropium than placebo. There were no significant differences between the groups in the total number of ventricular and supraventricular extra beats. There was no tolerance to the bronchodilating effects of salmeterol.

Therapeutic studies

Loratadine than with montelukast alone (14 versus 9.7 ). The most common adverse events during the trial were headache and upper respiratory tract infection (each in about 10 of subjects). There were no significant differences in the frequencies of adverse experiences between montelu-kast plus loratadine and montelukast alone. Ten patients withdrew because of an adverse event six had exacerbation of asthma requiring steroid administration (three in each of the two arms of the study). One patient taking montelukast plus loratadine and four taking montelukast alone had transient self-limiting laboratory abnormalities.

Special hazards of smoked cannabis

Since tobacco smoking is known to be the most important cause of chronic obstructive lung disease and lung cancer, it is reasonable to be concerned about the adverse effects of cannabis smoke on the lungs. There have been several attempts to address this question by exposing laboratory animals to cannabis smoke. After such exposure on a daily basis for periods of up to 30 months, extensive damage has been observed in the lungs of rats (120E), dogs (121E), and monkeys (122E), but it is very difficult to extrapolate these findings to man, as it is difficult or impossible to imitate human exposure to cannabis smoke in any animal model. The various studies that have been undertaken in human cannabis smokers seem to be far more relevant, although here the problem is confounded by the fact that many cannabis smokers take the drug with tobacco, making it difficult to disentangle the effects of the two agents. In 144 volunteers who were heavy smokers of cannabis only, 135 who smoked tobacco...

Topical administration to the nose

The local application of glucocorticoids for seasonal or perennial rhinitis often results in systemic adverse effects. The use of nasal sprays containing a glucocorticoid that has specific topical activity (such as beclomethasone dipropionate or flunisolide) seems to reduce the systemic adverse effects, but they can nevertheless occur, even to the extent of suppression of basal adrenal function in children (371). Local adverse effects include Candida infection, nasal stinging, epistaxis, throat irritation (372), and, exceptionally, anosmia (373). The use of intranasal glucocorticoids in the treatment of allergic and vasomotor rhinitis in Sweden has doubled over a period of 5 years, and the number of reported cases of nasal septum perforation increased over the same time (376). The most common risk factor in 32 patients with nasal septum perforation (21 women, 11 men) was glucocorticoid treatment. Information from the Swedish Drug Agency showed that 38 cases of gluco-corticoid-induced...

Enuresil Amfetamine sulfate Enuretine Phenobarbital Environmental Tobacco Smoke

Ephcodral Phenobarbital. Ephed-organidin Phenobarbital. Ephedhal Phenobarbital. Ephedra-phen Phenobarbital. Ephedral Phenobarbital. Ephedrine Mild, slow-acting drug used to treat moderate attacks of bronchial asthma and to relieve nasal congestion from hay fever or infection of the upper respiratory tract. Non-addictive, ephedrine may cause insomnia and restlessness. Ephedrine is obtainable from plants of the genus Ephedra, particularly the Chinese species Ephedra sinica, and it has been used in China for more than 5,000 years to treat asthma and hay fever. It is effective

The cardiotoxic effects of antihistamines

In a large multicenter, double-blind, placebo-controlled, parallel-group study of the efficacy and tolerability of desloratadine in 346 patients with seasonal allergic rhinitis, the symptoms improved significantly and there was no significant effect on the QTc interval (9C). Fexofenadine Fexofenadine is the active metabolite of terfenadine and is effective in seasonal allergic rhinitis and chronic idiopathic urticaria (19r). The effect of co-administration of azithromycin on plasma concentrations of fexofenadine 60 mg bd has been examined in a randomized third-party-blind, placebo-controlled, parallel-group study in 98 healthy volunteers (11C). An initial loading dose of azithromycin (500 mg) was given on day 3, followed by 250 mg od for 4 days. Concomitant azithromycin caused substantial increases in the Cmax and AUC of fexofenadine (69 and 67 respectively). However, there were no statistically significant increases in the PR, QT, QTc interval, QRS complex duration, or ventricular...

Drug Drug Interactions General

Symptoms to expect when an interaction occurs, such as unexpected drowsiness (after alcohol or other drugs) or a sudden severe headache (within 2 hours of a meal or medication). Because of the many variables involved, foods or medications that are taken with impunity on one occasion can interact dangerously on another. The director of a British counselling service has reported that of 119 patients taking MAO inhibitors who experienced problems, 35 reported hypertensive crises, 4 fatal (48). Despite warnings, these patients had eaten amine-containing foodstuffs or taken over-the-counter cold remedies. MAO inhibitors should not be prescribed unless the patient is able to understand such instructions and repeat them after explanation compliance can be confirmed at subsequent inquiry. Those who take multiple medications, who have difficulty with comprehension or compliance (such as the elderly), or who are frightened by such explanations should not be given these drugs.

CNS effects of secondgeneration antihistamines

Desloratadine Desloratadine appears to be minimally sedative, given that several studies (so far published only as abstracts) have shown no impairment in terms of wakefulness or psychomotor performance (31c-33c). Moreover, in a study in which desloratadine was effective and well tolerated in patients with seasonal allergic rhinitis there were no clinically significant sedative effects (34C). Similarly, in a multicenter, randomized, doubleblind, placebo-controlled study desloratadine was effective in the treatment of moderate to severe chronic idiopathic urticaria, and there were no significant adverse effects (10C). Sensory systems There have been several reports of a bitter taste associated with azelastine nasal spray for the treatment of allergic and non-allergic rhinitis compared with placebo in Acute generalized urticaria occurred in a 42-year-old woman taking cetirizine for seasonal allergic rhinitis and conjunctivitis, which had previously been treated with loratadine (45A). 9....

Therapeutic Mechanisms On The Transpersonal Level

Tanya, a 34-year-old teacher and divorced mother of two children, was undergoing LSD psychotherapy for depressions, anxiety states, and a prone-ness to fatigue. One of her LSD sessions brought an unexpected solution to a severe physical problem which had been considered purely organic in nature. For the previous twelve years she had been suffering from chronic sinusitis with occasional acute flare-ups because of colds or allergies. The sinus troubles had started shortly after her wedding and represented a severe inconvenience in her life. The major manifestations were headaches and strong pains in the cheeks and teeth, low-grade fevers, heavy nasal discharge, and bouts of sneezing and wheezing. On many occasions she was awakened by a coughing attack some mornings these symptoms lasted three to four hours. Tanya had numerous tests for allergies and was treated by many specialists with antihistamines, antibiotics, and flushing of the sinuses with disinfectant solutions. When all this...

Nonselective 3adrenergic agonists

Non-selective -adrenergic agonists are not recommended for asthma treatment. Some of these drugs are used in oral OTC drugs for the common cold. These combinations do not follow good therapeutic practiccs, and arc not recommended during pregnancy. Ephedrine, pseudoephedrine, phenylephrine, and related coin-pounds are u-adrenergic receptor agonists, which cause bloodvessel constriction. It has been demonstrated that ( -adrenergic receptor agonists slow uterine blood flow, but their effects have not been sufficiently studied in relation to most reproductive outcomes in animals or humans. Ephedrine is one of the first drugs that was used for the treatment of asthma. It causes an increased release of catecholamines, and has both a- and -adrenergic properties. It has a short duration of action. Ephedrine is no longer in use for the treatment of asthma because of the unwanted side effects, especially on the cardiovascular system. Pseudoephedrine, phenylephrine, and phenylpropanolamine are...

Promoting an Optimal Response to Therapy

Decongestants are used only occasionally in the clinical setting. Because some of these products are available without a prescription, their use may be discovered during a patient history for other medical disorders. Nonprescription nasal decongestants should not be used by those with hypertension or heart disease unless such use is approved by the primary health care provider. After administering a topical nasal decongestant, some patients may experience a mild, transient stinging sensation. This usually disappears with continued use. To minimize the occurrence of rebound nasal congestion, the drug therapy should be discontinued gradually by initially discontinuing the medication in one nostril, followed by withdrawal from the other nostril.

Herbal Alert Goldenseal

Goldenseal, also called Hydrastis canadensis, is an herb found growing in the certain areas of the northeastern United States, particularly the Ohio River Valley. Goldenseal has long been used alone or in combination with echinacea for colds and influenza. However, there is no scientific evidence to support the use of goldenseal for cold and influenza or as a stimulant as there is for the use of echinacea (see Chap. 54). Similarly, goldenseal is touted as an herbal antibiotic, although there is no scientific evidence to support this use either. Another myth surrounding goldenseal's use is that taking the herb masks the presence of illicit drugs in the urine.

Adicto a drogas narcoticas Addicted to narcotics

The purified, active compounds are used clinically and are obtained from the adrenal glands of domesticated animals or prepared synthetically. The administration of adrenaline results in an increase in blood pressure by increasing the rate and force of contraction of the heart and by constricting the peripheral blood vessels. It also dilates the bronchioles and in this way is an aid to respiration. Adrenaline exerts a metabolic effect manifested by a rise in blood glucose. Noradrenaline elicits similar responses but its metabolic effects and actions on the heart are much less than those of adrenaline. The rise in blood pressure after the administration of noradrenaline is due to its powerful vasoconstrictor action. Adrenaline is used in combination with local anaesthetics because its vasco-constriction properties delay the absorption of the local anaesthetics, and in this way prolongs their activity and reduces their toxicity. It is useful in acute allergic disorders, such as drug...

The Three Components of a Diagnosis

These three aspects are most easily seen in the understanding and description of a physical illness. For example, the etiology of the common cold is a rhinovirus. The common cold is relatively well understood because our technology is good enough to identify the etiology (viruses can actually be seen under an electron microscope, and their chemical composition can be determined through genetic testing), people have studied and understood the process of infection and inflammation for many decades and understand a great deal of underlying biochemistry and physiology, and throats can be looked at over and over again to follow the whole process.

Herbs Commonly Used during Pregnancy

Chamomile is traditionally used as a mild sedative and against digestive problems, but excessive use in pregnancy should be avoided 31 . Echinacea is often used prophylactically against the common cold for its antiviral and antibacterial properties 34 . The majority of the available studies report positive results, but there is not enough evidence to recommend its use during pregnancy 35 . Cranberry is used to prevent and treat urinary tract infections, even if there is no conclusive evidence to recommend its use 36 . In addition, specific herbs are traditionally used to prevent miscarriage or to prepare for childbirth at the end of pregnancy due to their potential uterine-stimulating properties. Wild yam and lobelia are reputed to prevent miscarriage 28 . Blue cohosh is thought to increase efficiency of contractions in labour 18 attributable to caulosaponin. Raspberry leaf is frequently ingested by women in the third trimester as it is thought to tone the uterus in preparation for...

Nonprescription Drugs

Nonprescription drugs are drugs that are designated by the FDA to be safe (if taken as directed) and obtained without a prescription. These drugs are also referred to as over-the-counter (OTC) drugs and may be purchased in a variety of settings, such as a pharmacy, drugstore, or in the local supermarket. OTC drugs include those given for symptoms of the common cold, headaches, constipation, diarrhea, and upset stomach.

See also Disinfectants and antiseptics General Information

Benzalkonium chloride is composed of a mixture of alkyldimethylbenzylammonium chlorides. The hydro-phobic alkyl residues are paraffinic chains with 8-18 carbon atoms. Benzalkonium chloride is used as a preservative in suspensions and solutions for nasal sprays and in eye-drops. Depending on the concentration of the solution, local irritant effects can occur. In nasal sprays it can exacerbate rhinitis (1) and in eye-drops it can cause irritation or keratitis (2).

See also Antihistamines General Information

Seasonal allergic rhinitis affects about 10 of schoolage children, and there is evidence of a significant impact of the disease on health-related quality of life. The effect on health-related quality of life of once-daily of cetirizine syrup 10 mg day for 4 weeks has been studied in 544 children with seasonal allergic rhinitis in a multicenter, open, non-comparative study (2). In addition to improvements in symptom scores the authors also reported significant improvements in health-related quality of life, with good tolerability of the drug. Treatment-related adverse effects were reported in 22 subjects, of which somnolence was the most frequent problem, reported by six of the subjects. Only 12 of subjects discontinued treatment owing to an adverse effect. Health-related quality of life and clinical outcomes in 865 adult patients with seasonal allergic rhinitis treated with cetirizine or placebo for 2 weeks have been evaluated in a double-blind, randomized, parallel-group study (3)....

Second Generation Effects Teratogenicity

A critical review of drug therapy for allergic rhinitis during pregnancy has been published (12). Mast cell stabilizers are not teratogenic and can be considered as excellent first-line choices to treat allergic conjunctivitis and rhinitis. However, any recommendation should be accompanied by informed consent.

Illegal Recreational Drugs

In the United States, the origins of modern drug criminalization stretch back over a century and a half, to a point when many currently banned substances were legal and widely available. Opium, one of the first popular narcotics, was commonly used in eighteenth-century America for a variety of medicinal purposes, from dysentery and rheumatism to cholera and lockjaw. The drug was liberally recommended by doctors, who described opium as God's Own Medicine, something that the Creator himself seems to prescribe. 4 Morphine, first derived from opium in 1803 and named after Morpheus, the Greek god of dreams, also was freely used as a stronger palliative with fewer direct side effects. Another opium derivative, first synthesized in 1874, was dubbed heroin because it heightened the sense of self-worth and gave the user a sense of heroism, a euphoric feeling. Heroin was used in relieving any number of illnesses, particularly those related to the upper respiratory system coughs, congestion,...

Different Drug at Different Amounts

Dextromethorphan, as found in cough and cold medicines, is generally a safe and beneficial drug it is only dangerous if used beyond the suggested dosage listed on the product package. In fact, cough medicines are generally extremely safe with very few side effects. Because of their safety record, they are sold directly to consumers who have determined that they need the medicine. It is an accepted practice for people with colds, allergies, and headaches to treat themselves with OTC drugs there is no need for a doctor to write a prescription. DXM is an antitussive, a medicine that combats coughing. In small amounts, it treats coughing, itchy throats, runny noses, and congestion from colds, allergies, and the flu. It begins to work after approximately fifteen to thirty minutes, and acts to alleviate coughing for three to six hours.

Factors Affecting Nasal Absorption

Drug absorption can be affected by the condition of nasal mucosa. Disease states such as allergic rhinitis, sinusitis, the common cold or nasal infection can result in increased nasal secretions. Such conditions may also result in increased or decreased viscosity of the mucus layer, and the resultant outcome for any of the above occurrences will be reduced absorption, either due to rapid clearance from the nasal cavity or the increased physical barrier between drug and mucosa. Physical abnormalities such as a deviated septum or nasal polyps may also affect the dynamics of mucociliary clearance and therefore drug absorption.

Selective adrenergic agonists

Intranasal corticosteroids are effective in the treatment of allergic rhinitis. They are safe, and there is no evidence of systemic effects. Bioavailability is higher than after inhalation, but the recommended dose for allergic rhinitis is lower than the dose given by inhalation. For this indication, beclomethasone has also been shown to be safe during pregnancy (Gilbert 2005). Data on pregnancy outcome after maternal exposure to intranasal budesonide are limited, but as pharmacological studies did show a much lower systcmic exposure after intranasal administration, their safety is comparable to orally inhaled budesonide (Gluck 2005). Recommendation. Inhaled corticosteroids are the first drugs of choice for the treatment of asthma in pregnant women. The use of beclomethasone or budesonide is preferred, because these have been widely used in pregnancy and have a good safety record. Systemic use of the corticosteroids, prednisone, and its metabolite, prednisolone, is indicated in case...

We are discussing the peripheral nervous system at this point Many of the NTs mentioned now will appear in the section

Pertussis or whooping cough is an acute, transmittable disease caused by a toxin produced by the gram-negative bacterium bordetella pertussis. The protein toxin derivatizes one of the subunits of the G-protein in a manner similar to the cholera toxin. Since this material is airborne the effects are seen in the lungs which secrete excessive amounts of fluid resulting in a characteristic cough and the symptoms of the common cold as well as vomiting from the ingestion of mucous.

Anticholinergic Drugs

Isaksson M, Bruze M, Hornblad Y, Svenonius E, Wihl JA. Contact allergy to corticosteroids in asthma rhinitis patients. Contact Dermatitis 1999 40 327-8. 30. Bennett ML, Fountain JM, McCarty MA, Sher-ertz EF. Contact allergy to corticosteroids in patients using inhaled or intranasal corticosteroids for allergic rhinitis or asthma. Am J Contact Dermatitis 2001 12 193-6.

Humulus scandens Lour Merr

Uses In China, the aerial parts are used to treat malaria, typhoid, gonorrhea, syphilis, cough, colds, lithiasis, spermatorrhea and malignant sores, promote urination, invigorate the genito-urinary system, stop dysentery and to resolve inflammation. The fruit is used to treat fever, promote appetite and urination, stop dysentery and to counteract poisoning from snake bites and scorpion stings. In Vietnam, the leaves are used to treat fever and stop dysentery.

Secondgeneration antihistamines

Second-generation antihistamines have proved to be important therapeutic tools in the treatment of atopic disease, including both seasonal and perennial allergic rhinitis, urticaria, and atopic dermatitis (20). Several studies have shown that the use of second-generation anti-histamines as adjunctive therapy can benefit patients whose allergic asthma co-exists with allergic rhinitis (21).

Common Use Drugs Alcohol Tobacco and Caffeine

The coffee bean was harvested around 600 ad in Ethiopia.14 Although coffee was banned in Egypt in the sixteenth century, for instance, the major issues involving caffeinated substances did not involve prohibition but instead international trade and taxation, best illustrated in American history by the colonists' outrage at new taxation schemes imposed by the British Crown and the resulting Boston Tea Party. Today, caffeine is available in coffee, tea, soft drinks and energy drinks, chocolate, cough and cold remedies, stay-awake tablets, and other products, subject in the United States only to minimal restrictions related to purity and labeling.

General Properties of Echinacea Species

Echinacea species have been described as the most important plants used by the Native Americans for treatment of many diseases. In many American and European countries Echinacea is widely used as a medicinal herb or food supplement for stimulating immune function. Echinacea species have been used for treatment of many diseases, including colds, tonsillitis, bowel pain, toothaches, snake bites, seizures, cancer, septic conditions, and wound infections. At the beginning of the twentieth century, Echinacea was the best-selling American medical plant in the United States, although its use decreased after the introduction of antibiotic drugs 24, 27, 28 . Fluid extracts of Echinacea purpurea are widely used for the prevention and treatment of colds and respiratory infections, although the clinical efficacy of this agent has not been proven. It has been used in high doses for short period of time for treatment of the common cold, coughs, flu or acute cold, bronchitis, upper respiratory...

Case 10 Drug Crime Can the Government Punish Addiction

The defendant, Larry Robinson, had been convicted under this statute based on testimony that he had needle track marks, discoloration, and scar tissue on his arms, coupled with the defendant's own admission of using narcotics in the past. The Court's opinion began by noting that government clearly had the power to regulate drug traffic within its borders, including imposing criminal sanctions for the manufacture, sale, or possession of drugs. But in this case, California was prosecuting Robinson for the status of narcotic addiction, which it described as an illness or disease. The Supreme Court opined, It is unlikely that any State at this moment would attempt to make it a criminal offense for a person to be mentally ill, or a leper, or to be afflicted with a venereal disease. 31 With addiction thus characterized an illness, the Court struck down the California law as violating the constitutional limits on criminal penalties, famously noting that even one day in prison would be a...

Cyamopsis tetragonoloba

Guar gum can cause occupational rhinitis and asthma. Of 162 employees at a carpet-manufacturing plant, in which guar gum is used to adhere the dye to the fiber, 37 (23 ) had a history suggestive of occupational asthma and 59 (36 ) of occupational rhinitis (24). Eight (5 ) had immediate skin reactivity to guar gum. Eleven (8.3 ) had serum IgE antibodies to guar gum.

Antihistamines H1 receptor antagonists

Histamine release from mast cells and basophils makes a major contribution to the allergic response, and antihistamines are widely used in the treatment of certain symptoms of allergic disease. However, histamine also functions as a neurotransmitter in the central nervous system, being particularly important in maintaining a state of arousal or awareness (1R). First-generation H1 receptor antagonists easily cross the blood-brain barrier, and their consequent well-documented sedative and an-ticholinergic effects, together with short half-lives, greatly limit their use in the treatment of allergic symptoms. However, despite these deficiencies it must be remembered that firstgeneration drugs are still widely used, mainly as over-the-counter products, often in combination with other drugs. Second-generation H1 receptor antagonists have major advantages over the earlier drugs most notably they lack significant CNS and anticholinergic adverse effects. They have proved to be important...

Monoamine Oxidase Inhibitors

As with the dietary proscriptions, any medication that increases tyramine can precipitate a hypertensive crisis such medications include numerous over-the-counter preparations for coughs, colds, and allergies. The same rule applies to sympathomimetic drugs (such as epinephrine and amphetamines or cocaine) and dopaminergic drugs such as anti-parkinsonian medications.

Nineteenth Century Medicines

Prior to the Food, Drug and Cosmetic Act of 1938, the United States had few laws governing medicines, drug development, and drug distribution. In the late 1800s, patent medicines reigned supreme. Medicine show professors traveled around North America, hawking their miraculous, exotic cures from soapboxes or platforms in carnival tents. These medicine men brought North America everything from Foley's Honey and Tar (for coughs and colds) to Hot Springs Liver Buttons (which promised to keep your liver all right and your bowels regular ). The audience listened and purchased these cures because the products promised health in a bottle during a time of limited access to good medical care.

Organs and Systems Nervous system

Five cases of severe headache refractory to oral analgesics have been reported in patients treated with 10-38 MU of botulinum toxin for glabella frown lines (n 4) and in a patient treated with 120 MU for palmar hyperhidrosis (10). The headache lasted for 8 days to 4 weeks, did not respond to oral prednisolone, and in some patients was accompanied by photophobia, ear tenderness, or nasal congestion. Two patients had had a similar headache after a previous treatment with botulinum toxin and in another patient a similar headache occurred after the next treatment. None of the patients had a history of severe headaches.

Organs and Systems Immunologic

Total serum IgE has been measured in 36 patients with allergic rhinitis and 11 healthy subjects given a submaximal dose of oxitropium bromide 600 micrograms by inhalation (2). FEV1 was greater than 80 of predicted in all subjects. Baseline FEV1 correlated negatively with serum IgE concentration. Oxitropium bromide inhalation produced an increase in FEV1 (mean 155 ml) that was significantly greater in allergic patients with high serum IgE than in healthy subjects (64 ml) or in those with allergic rhinitis and low serum IgE (82 ml). The effect of an inhaled beta2-adrenoceptor agonist (orciprenaline) was similar in all three groups. These findings may explain some of the variation in response to inhaled antimuscarinic drugs in patients with asthma. The data also suggested that IgE may itself modify airway tone by an increase in cholinergic responsiveness.

Pueraria thunbergiana P lobata

And for treatment of the common cold. Puerarin (Fig. 16.1), daidzin, and daidzein are three of the major isoflavonoid compounds isolated from the extract of P. lobata. P. lobata flavonoids increase the cerebral blood flow of anesthetized mice 74 and reduce the infarct volume in MCAo by increasing the activities of SOD 75 . Their isoflavonoids have potent inhibitory effects on PGE2 production 76 , and the an-tioxidant effect, partly dependent on free-radical scavenging, antilipid peroxidation, and enhancement of SOD activity 77 .

Family Burseraceae Kunth 1824 nom conserv the Frankincense Family

Pharmaceutical interest A number of plants classified within the family Burseraceae are of economic values. Commiphora abyssinica (Berg) Engl. and Boswellia carteri Birdw. (Biblical incense, olibanum) provide myrrh and frankincense, respectively. Myrrh has been used to heal wounds, relieve nasal congestion, and oral pains. Opopanax (bissabol, scented bdellium) is produced by Boswellia erythraea Engl. var. glabrescens Engl., and like frankincense, is used as a fixative and perfume. Other examples are Bursera simaruba (L.) Sarg. (gumbo limbo, naked Indian), a common tropical American tree, and Aucoumea klaineana Pierre, of tropical Africa, which furnishes the Gaboon mahogany used to make precious furniture. Elemi (British Pharmaceutical Codex, 1934) or Manila elemi, is a gum-resin exuded through the bark of Canarium luzonicum (Miq.) A. Gray or Canarium commune, which has once been used to make paints, varnishes, soap and elemi oil (by distillation), and in the form of an ointment (20 ),...

Clinical Use Of Agents

Remains to be seen whether selective prostanoid receptor antagonists might provide better medicines for the treatment of pain and other therapeutic indications. A summary of the available agents and their indications is presented in Table 6.13. The therapeutic areas in which these agents are used are diverse and are a consequence of the widespread physiological actions of the natural prostaglandins. Prostaglandins used in the termination of pregnancy, cervical ripening, and labor induction include dinoprost (PGF2a) and carbaprost (15-methyl-PGF,,), dinoprostone (PGE2), sul-prostone,gemeprost, and misoprostol. Alpros-tadil (PGEi) is used to treat erectile dysfunction. Prostaglandins used in cardiovascular conditions include alprostadil and the PGE, analog, limaprost, as well as epoprostenol (prostacyclin) and its analog, iloprost. Miso-prostol is used clinically, with some success, as an inhibitor of gastric acid secretion. Prosta-glandins, particularly of the F series, are widely used...

Ascorbic Acid Vitamin C

Deficiencies of this vitamin have been associated with the early sailors who lacked fresh fruit and vegetables. However, it was a problem on land and was seen in the Irish potato famine, the California gold miners, and territorial prisons. There long has been a mystique surrounding this vitamin, with interest sharply increasing when Linus Pauling published his book Vitamin C and the Common Cold, forcing the medical, nutritional, and biochemical professions to reexamine carefully the role of this essential nutrient in human health. A significant problem with studying this vitamin is the fact that ascorbic acid is not a vitamin in most animals. It was not until the discovery that guinea pigs also require ascor-bate that animal experiments could be conducted.

Organs and Systems Skin

Years with moderate to severe allergic asthma requiring inhaled glucocorticoids in a randomized, placebo-controlled, double-blind trial (11). There were no serious treatment-related adverse events, and the frequencies of most adverse events were similar with omalizumab and placebo. However, urticaria was more frequent with omalizumab (4 versus 0.9 ). It usually resolved spontaneously or with antihistamine therapy and did not recur with subsequent treatment. Urticaria was also reported in a small number of adults (0.5 ) given omalizumab for allergic rhinitis (12).


Effects An adaptogen that may provide energy and stamina, boost the immune system, detoxify various drugs and metals, have antiviral properties, improve peripheral circulation, balance the bodily systems, counteract stress, and improve mental functioning. It is said to be a potent anticancer agent and may be useful in fighting off the flu and other respiratory infections. Evidence suggests it might be useful in the treatment of colds, flu, high cholesterol, chronic lung weakness, HIV, cancer, and tumors.

Echinacea species

Echinacea species (coneflower, black Sampson hedgehog, Indian head, snakeroot, red sunflower, scurvy root) have become increasingly popular, particularly for the prophylaxis and treatment and prevention of cold and flu symptoms. However, the claimed efficacy of Echinacea in the common cold has not been confirmed in a randomized, double-blind, placebo-controlled trial (20) or a systematic review (21). Echinacea is claimed to have antiseptic and antiviral properties and is under investigation for its immunostimulant action. The active ingredients are gly-cosides (echinacoside), polysaccharides, alkamides, and flavonoids. Between July 1996 and November 1998, the Australian Adverse Drug Reactions Advisory Committee received 37 reports of suspected adverse drug reactions in association with Echinacea (22). Over half of these (n 21) described allergic-like effects, including bronchospasm (n 9), dyspnea (n 8), urticaria (n 5), chest pain (n 4), and angioedema (n 3). The 21 patients were aged...

Opiate Antagonists

In an open, single-blind randomized study naltrexone (50 mg day) and acamprosate (16651998 mg day) were used for 1 year by 157 recently detoxified alcohol-dependent men with moderate dependence (128C). The time to first relapse was 63 days (naltrexone) and 42 days (acamprosate) after 1 year 41 of those given naltrexone and 17 of those given acamprosate had not relapsed. Adverse effects were more common with naltrexone and were worse during the first 2 weeks of treatment. They included nausea (25 vs. 4 ), abdominal pain (23 vs. 4 ), drowsiness (35 vs. 2 ), headache (13 vs. 6 ), and nasal congestion (23 vs. 7 ).

Contact allergy

Tixocortol pivalate is a marker for glucocorticoid contact allergy, as a positive patch test suggests established contact allergy to hydrocortisone, prednisolone, and their derivatives (68). A literature search via Medline from 1966 to May 2000 revealed only one patient hypersensitive to tixocortol pivalate and budesonide in a pilot study in 34 patients (10 with asthma, 13 with rhinitis, 11 with both) (69). From case reports, the prevalence of glucocorticoid-induced contact allergy has been estimated at 2.9-5 . A 46-year-old woman, who had used inhaled budeso-nide (dosage not stated) for 8 years for vasomotor rhinitis, developed a recurrent perioral rash, which responded to treatment with oral erythromycin 1 g day for 6 weeks. One year later, she had a recurrence, which resolved with oral erythromycin. She continued to use inhaled budesonide.

Causes of Insomnia

Medical Conditions Medical conditions that may cause insomnia include hy-perthyroidism, heart problems, breathing difficulties, and even colds. If you think a medical problem may be causing your insomnia, it is essential to seek out a full medical evaluation, including a physical examination. Medications Many medications used for the relief of asthma and colds contain stimulants like albuterol (Proventyl, Ventolin), metaproterenol (Alupent), terbu-taline (Brethine), and pseudoephedrine (Sudafed), which can produce insomnia.


SIDE EFFECTS Common (10-50 ) Mild sedation, impaired muscular coordination, an unsteady gait, and nausea are common when you first start, but tend to go away within the first week. Others include headaches, nasal congestion, blurry or double vision. Those requiring attention from your physician You should consult your physician immediately if you notice the first sign of a rash you should also consult your physician immediately if you notice yellow eyes or skin, signs of liver failure any physical or emotional changes not listed.


The use of rabeprazole in acid-related disorders has been reviewed (40R). Rabeprazole has proven efficacy in healing, symptom relief, and prevention of relapse of peptic ulcer and gastro-esophageal reflux disease and can form part of effective Helicobacter pylori eradication regimens. It was generally well tolerated in both short-term and long-term studies of up to 2 years. Headache was the most important reported adverse effect. Other commonly reported adverse effects were diarrhea, rhinitis, nausea, pharyngitis, abdominal pain, and flatulence. The changes in serum gastrin concentrations were consistent with proton pump inhibitor pharmacology, and no study has reported mean values at end-point that were outside the reference range. In controlled trials, the frequency of abnormalities of hepatic amino-transferases was similar to that of placebo. Scoring of enterochromaffin-like cells in gastric biopsies taken prospectively from patients in studies of up to 2 years have shown some...


In a placebo-controlled study of subcutaneous omalizumab (50, 150, and 300 mg before the ragweed season and every 3 or 4 weeks during the pollen season) in 536 patients with seasonal allergic rhinitis, injection site reactions Skin The safety of subcutaneous omalizumab has been assessed in 334 boys and premenar-chal girls aged 6-12 years with moderate to severe allergic asthma requiring inhaled corti-costeroids in a randomized, placebo-controlled, double-blind trial (96C). There were no serious treatment-related adverse events, and the frequencies of most adverse events were similar with omalizumab and placebo. However, urticaria was more frequent with omalizumab (4 vs. 0.9 ). It usually resolved spontaneously or with antihistamine therapy and did not recur with subsequent treatment. Urticaria was also reported in a small number of adults (0.5 ) given omalizumab for allergic rhinitis (97R).

Marijuana and Health

Sidney (15) and Polen et al. (24) at Kaiser Permanente HMO reviewed the medical charts of approx 65,000 patients and showed that, after adjusting for gender, age, race, education, marital status, and alcohol use, frequent marijuana smokers (duration of marijuana use between 5 and 15 years) had an increased risk of making outpatient visits for respiratory illness, injuries, and other illnesses compared with nonsmokers. In addition, the relative risk of cervical cancer among women who used marijuana but never smoked tobacco was 1.42 compared with those who used marijuana. However, there was no increased risk for other cancers in association with marijuana use. There was an increased risk of mortality associated with ever using marijuana among men, AIDS (probably reflective of lifestyles), injury poisoning, and other causes of death, whereas among marijuana using women, there was a decreased risk for mortality.


Clinical and pharmaceutical aspects of rosigli-tazone have recently been reviewed (88M). Frequently reported adverse effects in many studies include weight gain, upper respiratory tract infection, injury, and headache for which no cause can be found. Fluid retention can lead to or exacerbate heart failure and pulmonary and general edema (see under Fluid balance). Hematocrit and hemoglobin are reduced. Changes in liver enzymes and bilirubin have not been reported, and although there have been some reports of hepatic-related adverse effect they have not been definitive (see also SEDA-25, 515). There are no drug interactions with other hypoglycemic agents.


Bacitracin zinc has been used for giardiasis (12), in which it appears effective. In the doses used, adverse effects have been limited to nausea, abdominal discomfort, and diarrhea in a small number of patients. Similar effects have been noted when zinc gluconate lozenges were administered for the common cold (13).


Many nonprescription remedies for common colds include pseudoephedrine (CAS RN 345-78-8), which is related to ephedrine and has similar effects, both desired and undesired. Depending on actions being measured, pseudoephedrine may have from 25 to 50 of ephedrine's strength. Pseudoephedrine can be used to make methamphetamine and meth-cathinone.


Menthol is a cyclic alcohol, obtained from the volatile oils of various species of Mentha. It is largely used as a flavoring or olfactory agent in a variety of products, including cigarettes, liqueurs, cough drops, mouthwashes, toothpastes, and shampoos. Menthol has been used in different medications to relieve symptoms of asthma and rhinitis. It can cause perioral dermatitis, urticaria, and stomatitis (28A).

Specific propellants

The therapeutic effects of salbutamol and salmeterol were unaffected by hydrofluoroalkane 134a, and there were no clinically significant differences in safety parameters (13,14). The safety of the hydrofluoroalkane 134a salbutamol sulfate inhaler, Airomir, has been evaluated in a postmarketing surveillance study (15). A non-randomized study has been performed in 6614 patients with obstructive airways disease taking metered doses of salbutamol delivered by inhalers using either hydrofluoroalkane or chlorofluorocarbon as the propellant. There were no significant differences between the groups in the rate of hospital admissions for the condition for which salbutamol was prescribed, in visits to accident and emergency departments, or in unscheduled home visits. There were adverse events in 25 of patients in both groups. The most common adverse events were infection, bronchospasm, and upper respiratory tract infection. Adverse events attributed to the medication occurred in 3.1 of the...

A natural conspiracy

Echinacea is one of the worst culprits. This stuff has been touted as a cure for the common cold, or at the very least has been claimed to be effective in reducing the intensity and duration of a cold. Study after study has shown that it is ineffective against colds and often contains less ingredient than is advertised on the bottle. Nonetheless, literature in the store directed people take it every two hours at the first signs of a cold to reduce the severity of the illness. The woman in the store pointed me right to it when I asked what to take for a cold and told me 'this stuff works great.'

Specific allergens

The incidence of adverse systemic reactions during immunotherapy for perennial allergic rhinitis using standardized extracts of Dermatophagoides farinae has been estimated in 386 patients who received 22 722 injections. The incidence of systemic reactions was 6.22 per patient and 0.12 per injection. Systemic reactions began 3-30 minutes after an injection (average 11 minutes). Asthma, atopic dermatitis, and a high concentration of IgE (but not specific IgE) in serum were identified as important risk factors for severe systemic reactions. Systemic reactions occurred in 12 of 18 patients who had an IgE concentration over 100 U ml and asthma and or atopic dermatitis. In patients who had none of these risk factors the incidence of systemic reaction was 1.64 per patient. The authors estimated that the rate of systemic reactions could be reduced by 75 if patients with identified risk factors were strictly excluded from immunotherapy for allergic rhinitis (11).

Safety Data

Most herbal products have not been subjected to rigorous clinical trials, and there remains a dearth of knowledge concerning how children are affected by these substances. Paediatric subjects are physiologically more vulnerable to certain adverse effects of herbs than adults. For example, some herbs such as senna and aloe are known cathartics and some herbal teas contain powerful diuretic compounds these actions may cause dehydration and electrolyte disturbances quickly in an infant or young child. Moreover, some subpopulations are more susceptible to certain adverse effects of herbs than other children. Subjects with allergies may be at increased risk, since the allergic potential of some plants commonly used in children that could cause contact dermatitis, rhinitis, conjunctivitis and wheezing is well known. For example, chamomile can cause anaphylaxis and other herbs such as angelica and rue are capable of photosensitization 95 . Thus paediatricians must be cautious regarding the...

Herbal Alert Ephedra

When a patient is to have nose drops instilled for nasal congestion, the nurse examines the nasal passages and describes the type of secretions present in the nose. The nurse also should obtain the blood pressure because nose drops that contain adrenergic drugs are not given to those with high blood pressure.

The Birth of the FDA

The medication was called sulfanilamide. Sulfanilamide, in pill form, tasted terrible and was difficult to swallow, so the manufacturer decided to produce the same medication in liquid form. In 1937, Massengill developed a liquid sulfanilamide solution, added some pink food coloring and cherry flavoring, and began selling the product to the public. Because of its bright color and appealing taste, the new medicine, now called Elixir Sulfanilamide, was especially useful for children. Parents bought the tasty solution for sons and daughters who had earaches, chest colds, sore throats, high fevers anything caused by a bacterial infection. The pill form worked well surely the liquid form of the same medication would work well, too.

Bromo Quinine

The correct name for a cold is coryza, or acute rhinitis. It is an acute inflammation of the nasal cavities. This condition does not occur over night or by getting your feet wet or sitting in a draft. These shocks only bring it to a head. The beginning of it has been many weeks or months before, by allowing the system to run down and poisons to accumulate in the system.


A double-blind, placebo-controlled evaluation of per-flenapent emulsion as a contrast agent for the liver, kidneys, and vasculature has been reported in 151 patients of whom 12 had adverse effects compared with nine who received placebo (12). Injection site pain, vasodilatation, rash, and rhinitis occurred more often with perflenapent than placebo.

Physical Effects

It is important to note that while hallucinogens share very similar physical effects, the degree to which each physical effect is experienced varies greatly from one psychedelic to another. This is because the duration of each hallucinogenic high varies. Users of LSD often report extreme fatigue the day after tripping and require long periods of rest and sleep. Researchers believe this feeling of exhausion is the result of the 12-hour trip that LSD users experience. Because of its shorter duration of psychedelic action (four to six hours), MDMA does not produce the same day-after fatigue. However, long-time MDMA users report an increased sensitivity to day-after fatigue as they get older, along with an increased susceptibility to colds and infections.


Crude opium has been used since antiquity as an analgesic, sleep-inducer (narcotic), and for the treatment of coughs. It has been formulated in a number of simple preparations for general use, though these are now uncommon. Laudanum, or opium tincture, was once a standard analgesic and narcotic mixture. Paregoric, or camphorated opium tincture, was used in the treatment of severe diarrhoea and dysentery, but is still an ingredient in the cough and cold preparation Gee's linctus. In Dover's powder, powdered opium was combined with powdered ipecacuanha (see page 344) to give a popular sedative and diaphoretic (promotes perspiration) to take at the onset of colds and influenza. Opium has traditionally been smoked for pleasure, but habitual use develops a craving for the drug followed by addiction. An unpleasant abstinence syndrome is experienced if the drug is withdrawn.

Safety first

Not just to bioterrorism, but to all forms of terrorism and public health emergencies. Unfortunately, throwing money at the issue will only partially fix the problem. We are in serious need of leadership and public education that leads to organization and efficiency in our health care system. More people died of infections acquired in hospitals, the common cold, obesity-induced heart disease or cigarette smoking last year than ever died from bioterrorism, but we don't panic about these problems. The massive amount of money spent on terrorism preparedness has left us scarcely prepared to deal with an attack. As a nation, we have to take our collective heads out of our asses.


Precautions It may create symptoms of toxicity when taken alone these may be alleviated when taken in combination with Aldosterone. It is recommended that those with cardiovascular problems (particularly hypertension and angina pectoris) should not use vasopressin, as it narrows the blood vessels. Some say that angina patients will experience heart pain Pearson and Shaw discourage use in such cases. It should also be avoided by those with kidney disease and epilepsy. For others, it occasionally results in nasal congestion, runny nose, itching or irritation of nasal passages, nasal ulcerations, abdominal cramps, heartburn, nausea, headaches, and more frequent bowel movements. Vasopressin should be snorted into the upper nasal cavities, as inhaling it deep into the lungs may trigger spasms of the larynx and shortness of breath.


Effects Sarsaparilla is said to increase energy, regulate hormonal activity and protect against radiation. Herbalists have used it for catarrhal problems, colds, fever, flatulence, frigidity, gout, hives, impotence, infertility, nervous system disorders, PMS, rheumatism, and certain blood disorders.

Synthetic drugs

Amphetamine, another widely used synthetic drug, was first synthesized in Germany in 1887. However, it was not used until the late 1920s, when it was investigated as a cure for a variety of illnesses, including epilepsy, schizophrenia, alcoholism, opiate addiction, migraine, head injuries, and radiation sickness. In 1932, amphetamine was marketed as an over-the-counter inhaler to treat nasal congestion. Five years later it was found to have a positive effect on some children with attention deficit hyperactivity disorder (ADHD). In 1919, scientists in Japan discovered methamphetamine, which was more potent and easier to make than amphetamine.

Cynara scolymus

Two vegetable warehouse workers developed occupational rhinitis and bronchial asthma by sensitization to C. scolymus (17). Skin prick tests to artichoke were positive and IgE specific for artichoke was found. Nasal challenge with artichoke extract triggered a reduction in peak nasal inspiratory flow of 81 and 85 . One patient had a reduction in peak expiratory flow rate of up to 36 after exposure to artichoke in the workplace.


In a meta-analysis of randomized controlled trials of 3-5 days of azithromycin or other antibiotics that are typically given in longer courses for upper respiratory tract infections, there were no significant differences in bacteriological outcomes (161M). Azithromycin was withdrawn because of adverse events in only 37 (0.8 ) of 4870 patients.

The Mucus Layer

The nose is an important site of particle deposition although the efficacy of the nasal filter depends on the diameter of the inhaled particles. Almost all particles larger than 10 m (e.g. pollen grains) are retained in the nose during breathing at rest, while most particles smaller than 2 m (e.g. mould spores) pass through the nose (27,28). The rate of mucocilliary clearance varies between individuals and can be altered by factors such as cigarette smoking, medicinal products and disease states such as allergic rhinitis, nasal polyps, cystic fibrosis or the common cold (9,12). The mucus layer and any foreign particles are swept towards the back of the nasal cavity where they can be swallowed and subsequently destroyed in the gastro-intestinal tract. This forms part of the body's defence system, preventing substances such as bacteria or allergens from reaching the lungs (12). It is therefore important that any nasal drug formulations do not have an irreversible effect on this process....