BHealthy Blog

Help, My Nose is Running and I Don’t Know What to Do!

By Megan Sessums, Pharmacist Resident, BHMC-Little Rock The weather has turned cooler and the leaves have fallen, time to cue the waterworks… I mean runny noses. This time of year many people may be wondering, do I have allergies, a cold, or the flu?

Since each share common symptoms and many over-the-counter medications are marketed for both cold and flu, it’s easy to become confused. It is important to distinguish between these conditions to help determine whether antibiotics may be needed.

Often just over-the-counter medications can be used to treat symptoms, and in order to prevent highly resistant strains of bacteria, you want to avoid taking antibiotics when not absolutely necessary.

When Are Antibiotics Needed?

Antibiotics are not effective against viruses and should only be used when there is clear evidence of a bacterial infection.

If antibiotics are used too often for things they can’t treat such as the common cold or flu, they become less effective against the bacteria they are intended to treat.

Not taking antibiotics exactly as prescribed can also lead to antibiotic resistance. For example, if you take an antibiotic for only a few days instead of the full course, the antibiotic may not completely wipe out all of the bacteria. The surviving bacteria become even more resistant and can be spread to other people.

So now that you know when antibiotics are needed, let’s discuss the differences between the common cold, the flu, and seasonal allergies.

The Common Cold

The common cold is a contagious infection of your upper respiratory tract, which includes the nose and throat. It is caused by a number of different types of viruses. Symptoms may include cough, sore throat, nasal congestion, and runny nose.

Generally with the common cold, you won’t have a high fever and will likely recover in about a week or two. Although more than 200 different types of viruses can cause a common cold, the rhinovirus is the most common culprit (30 to 35 percent of all adult colds), and it is highly contagious.

Unfortunately there is no cure for the common cold. While antibiotics are ineffective against viruses, there are many over-the-counter medications to help minimize cold symptoms.

Pain relievers such as acetaminophen (Tylenol) and ibuprofen (Motrin) can be used to reduce symptoms such as fever, sore throat, and headache. Pseudoephedrine (Sudafed), phenylephrine (Sudafed PE), and oxymetazoline nasal spray are decongestants used to alleviate sinus pressure. Individuals shouldn’t use decongestants for more than a few days due to the risk of chronic rebound congestion.

The expectorant guaifenesin (Mucinex) is used to help thin mucus and is indicated for a productive cough. A productive cough helps clear mucus from the airways and results in expelled mucus. On the other hand, a dry cough feels itchy and dry on your throat and does not expel mucus. Suppressants such as dextromethorphan (Delsym) are used to subdue a dry cough.

Pharmacists are great resources to help select the best over-the-counter products for your common cold.

The Flu

So how is the common cold different from the flu? The flu is also caused by a virus, specifically the influenza virus. However, the flu can be a much more serious illness.

The flu begins abruptly with a fever ranging from 102 to 106 degrees, body aches, and lack of energy. It is uncommon for adults to have a fever with the common cold.

There is also no cure for the flu, but your physician may prescribe antiviral drugs such as oseltamivir (Tamiflu) or zanamivir (Relenza) to lessen symptoms and shorten the time you are sick. In order to be most effective, it is important to start taking these medications within 48 hours of symptoms onset.

Bacterial Respiratory Illnesses (strep, pneumonia)

There are many bacterial infections that can cause similar symptoms such as fever, chills, cough, and sinus complications. Bacterial respiratory tract infections are less common than viral infections and most commonly affect the upper respiratory system, including the sinuses and throat.

Pneumonia is the most common bacterial infection of the lower respiratory system. Once a bacterial infection is suspected or confirmed, your physician may prescribe antibiotics. Over-the-counter medications can also be used to decrease the effects of the symptoms.

Seasonal Allergies

This time of year a runny nose can also be associated with seasonal allergies. More than 36 million Americans suffer from seasonal allergy symptoms such as runny nose, sneezing, and itchy or watering eyes.

Over-the-counter antihistamines such as fexofenadine (Allegra), loratadine (Claritin), or cetirizine (Zyrtec) can be used to decrease seasonal allergy symptoms.

How to Prevent Getting Sick?

The best way to prevent the spread of germs is by washing your hands often with soap and water, scrubbing for at least 20 seconds (that is about the length of the song “Twinkle, Twinkle Little Star”). Always avoid touching your eyes, nose, and mouth with unwashed hands.

The easiest way to prevent the flu is by receiving the yearly influenza vaccine. The Centers for Disease Control and Prevention recommends an annual flu vaccine for everyone 6 months and older.

Unfortunately, no vaccine has been developed for the common cold.

Although differentiating between the common cold, flu, and seasonal allergies can be difficult, your physician or health-care professional will diagnose you based on the description of the symptoms and the findings during the physical exam. Laboratory tests can also be performed to confirm diagnosis.